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Intensive case management and the multi-problem client : an evaluation of the inter-ministerial project Bradley, Gerald


The purpose of this study is to assess if the Inter-Ministerial Project (I.M.P.), an intensive case management project jointly sponsored by the Greater Vancouver Mental Health Services Society, the Forensic Psychiatric Services, 2and Vancouver Adult Probation, is associated with a reduction in the number of institutional bed day use of a non-random selection of 25 of its clients. The institutional venues considered were all British Columbia provincial correctional institutions, the Forensic Psychiatric Institution, and the psychiatric wings of any general hospital or any provincial psychiatric hospital.By using a pre-test, post-test one group design, with comparisons being made at the one year before and during point, and the two year before and during point, the results indicate a significant reduction in institutional bed day use at both time periods. By examining the dependent variable in each of its component parts—corrections, forensic, and mental health—results indicate that although overall institutional change at the one year and two year follow-up points obtains statistical significance, it is obtained only through the great change in corrections bed day use and no change in either forensic or mental health bed day use. There is also some indication that some of the savings in bed days incurred by corrections might have been owing to bed days expended by the mental health system. Despite design limitations which resulted in an inability to infer causation, the study shows that intensive case management is associated positively with a reduction in corrections system use by multi-problem clients. There is also a suggestion that there might be a transferring of bed day use out of the corrections system and into the mental health system. Given these findings the author concludes that intensive case management might be seen as an effective community intervention, both at reducing institutional use, and for directing use towards institutions more properly suited to the needs of multi-problem clients.

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