Ciddi Ruhsal Hastalığı Olan Bireylerde Olgu Yöneticiliği: 24 Aylık Uygulama Sonuçları

2019; 30(4): 245-252
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Case Management for Individuals with Severe Mental Illness: Outcomes of a 24-Month Practice

Objective: The aim of this study is to conduct a case management
model on a group of individuals with severe mental illness (SMI) and to
evaluate the outcomes during a 24-month follow up.
Method: A total of 34 patients diagnosed with schizophrenia or
schizoaffective disorder with at least one exacerbation over the last year,
poor treatment compliance, who were unemployed and unable to live
independently and who gave consent to participate were included to
the study. Case management was conducted by a medical professional
in the house, schizophrenia association, hospital, and workplace of
the patients by interviewing the patients, family members, and the
employers of the patients, at intervals arranged according to the need of
each patient. Patients were assessed at baseline stage, the sixth, 12th and
the 24th month regarding functionality, clinical condition, treatment
compliance and family burden.
Results: The study was completed in 24 months with 30 patients with
a mean age was 36, mean education level of 11 years, and a mean illness
duration of 13 years. The majority consisted of unmarried males living
with their parents. During the follow up, every patient participated in the
recommended rehabilitation programs with, improvement in treatment
adherence and functionality. A significant decrement was detected in
the number of hospitalizations when compared to the history before the
start of the study. Family burden decreased. Ten patients got employed
and 3 patients left work.
Conclusion: It can be concluded that case management hypothesized
to be beneficial for people with SMI with positive outcomes on clinical
recovery, improved social and vocational functionality and reduced
incidences of hospital stay should be included as a routine psychosocial
rehabilitation service.
Key Words: Severe mental illness, case management, functioning, hospitalization