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Introduction |
Mental Health Intensive Case Management (MHICM) is an intensive outpatient VA program with similarities to the Assertive Community Treatment (ACT) model. The first program began in 1987 under the name Intensive Psychiatric Community Care Program (IPCC). By the early 90’s these programs spread throughout the country. Randy Stacey, director of Helping Hands Clinic, wrote the proposal for the Gainesville MHICM program and was the programs first coordinator. The first patients were enrolled in 1995 with Richard Christensen (UFCOM psychiatrist) serving as medical director. From the beginning the focus has been to enroll patients with severe mental illness who have high rates of psychiatric and medical inpatient use. Eligibility includes evidence of severe psychosocial dysfunction and residence within a 50-mile radius of the main office. Exclusion criteria include serious dementia and primary substance abuse. The goals of MHICM are to help veterans with severe mental illness meet basic needs, access VA and community resources and improve quality of life in the community. The team includes a psychiatrist, case managers and support staff. Each case manager has about ten to fifteen patients. The majority of the patients have a diagnosis of schizophrenia, schizoaffective disorder or bipolar. Patients in the program are in close contact with their case manager and psychiatrist. The staff frequently make house calls to check up on the patients and administer medications. During the week patients can attend a variety of groups that range in topics from spirituality to medication management. There are also leisure activities incorporated into the weekly schedule where veterans and staff can get together. These activities help patients learn socialization skills in a non-threatening environment. The program also assists veterans in finding appropriate housing, which may be a private apartment or a group home depending on the individual’s needs. The intensive nature of this program has resulted in a reduction in bed days of care and better quality of life for the patients. Throughout the country, intensive case management teams are operating at minimal staffing and some are facing further staff reductions. For more information on MHICM contact Kate Hulbert, Program Coordinator Kathleen.Hulbert@med.va.gov or Mike Bengtson, MD, Medical Director Mike.Bengtson@med.va.gov |
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