Perpetual Change

Behavioral health specialist

Mental health practitioners are trained primarily to diagnose and treat people with mental health difficulties, and thus come to disasters with this perspective. Although crisis intervention, supportive counseling and education has its place in disaster response, these practices are in many cases helpful to only a small
percentage of the population, and lack relevance to a vast number of people who are better served through tangible assistance, advice and information (Salzer & Bickman, 1999).

I realized while doing a training on disaster recovery case management (excerpt above) that I think we need to re-invent the system. We have case managers, because the system is too complicated for the average person, and then we have multiple case managers to navigate non-interconnected systems. I have never liked this term because I think it is the anti-thesis of 'people first' language, reducing our clients to 'cases'.

A possible alternative might be to look to the entertainment/sports fields (Never thought I would say that). Case managers should be like lawyers or agents. I think a system could work where licensed social workers were like entertainment managers for their clients. All communications come through one person, all resources and connections are coordinated by that one person, and the client can fire them if they do not like them. Why not have a system where the client chooses their agent, and the state pays the agents? It would be easy to put in some quality surveys to see which agents were best serving their clients and which should be let go. In many ways, I think the consultants at boys town serve this role, but the change needs to happen at a higher order of magnitude in the system as a whole.

posted by jjs @ 9:05 PM