Improving the physical health-mental health interface for the chronically mentally ill: could nurse case managers make a difference?

Although the increased incidence and prevalence of medical illnesses among the chronically mentally ill has been well documented, access and use of general health care services by this population remains problematic despite the implementation of case management. This article describes the problems experienced in meeting physical health care needs through the five core case-management components of client identification and outreach, assessment, service planning, monitoring of service delivery, and advocacy. A model of case management is proposed that uses psychiatric nurse clinical specialists in supervisory and consultative rôles, and nurse practitioners to deliver primary care.