Relevant training for case managers in severe mental illness

The UK700 Group (2000) case management trial demonstrated that there were “no clear beneficial effects on costs, clinical outcome or cost effectiveness” by reducing the case-loads of case managers working with patients with psychotic disorders. However, they went on to advise that the policy of intensive case management for patients with severe psychosis is not justified. The findings of this study do not support such a conclusion. The key issue studied (i.e. intensive case management) was determined purely by numbers of patients on the manager's case-load. No attempt is made to describe the level of training of the case managers in techniques and skills needed for effective working with patients who have a severe mental illness. The need for relevant training for case managers in severe mental illness has been addressed in the Clinical Standards Advisory Group report on schizophrenia (Gournay & Beadsmore, 1995). An alternative explanation for the findings of this study may be that without specific training in severe mental illness, purely reducing case manager's case-loads is not effective. It is most disappointing and surprising that this issue has neither been addressed in a study of this magnitude nor referred to in the discussion.