Psychiatric clinical nurse specialists as intensive case managers for the seriously mentally ill.

The government estimates the number of seriously mentally ill as high as three million, with annual cost for the care of this population approaching billions of dollars. This article describes a program for the seriously mentally ill in the community using psychiatric clinical nurse specialists as intensive case managers. Interventions regarding disease relapse symptomology and early recognition of medication side effects assist clients to seek earlier intervention. Desired outcomes include earlier hospitalizations at less serious stages, reduced length of stay, higher functioning, improved self-care skills, and improvement in obtaining and receiving medical service. With clinical nurse specialists in case management roles, clients receive treatment at more appropriate and less costly service levels.