Focus on Progress Engages Behavioral Health Clients Telephonically

Saturday, March 10th, 2012
This post was written by Patricia Donovan

Emphasizing that the call is to monitor how well the individual is doing is one way telephonic case managers can engage behavioral health clients in the process, says Jay Hale, director of quality improvement and clinical operations for Carolina Behavioral Health Alliance (CBHA). CBHA uses telephonic case management to impact a wide geographical area from a central location.

Hale shared this strategy and other aspects of CBHA’s telephonic case management program during a March 7 webinar on Telephonic Case Management: Protocols for Behavioral Healthcare Patients.

The use of computer-based surveys by CBHA telephonic case managers has dramatically reduced paperwork, allowing the case managers to make the most of the typical 20-minute phone interaction with a client. The surveys were developed in-house and target vulnerable individuals in three distinct populations — adults with mental illness, adults in substance abuse recovery and children or adolescents with mental illness.

Rating scales in the surveys use words, not numbers, explains Hale, a tactic he says works better over the phone. For example, when asked to rate the presence of symptoms, clients must choose from None, Mild, Moderate or Severe, rather than assigning a numeric rating.

Case managers follow the scripts while engaging patients telephonically, clicking through responses on the screen.

But even with the help of standardized scripts, case managers must employ a conversational style, Hale adds. And it’s not necessarily the length of the phone call, but the frequency of calls, that cements the relationship with the client, as well as the ability of the telephonic case managers to stay on task.

“We’re not here to counsel, but to problem-solve, case-manage, find resources and support the client’s relationship with provider,” says Hale.

CBHA utilizes one case manager for every 40,000 health plan members, and estimates that one of six eligible members engages with a case manager (i.e. completes a survey). CBHA case managers must interact with all three populations, but often admit to relating best to a single group, like adolescents or individuals in recovery from substance abuse.

Although unable to directly tie results to its telephonic case management program, CBHA has seen improvement in 7-day and 30-day follow-up after inpatient stays.

Telephonic case management is crucial at discharge; outreach can include calls to the client, hospital and provider to ensure follow-up appointments are kept.

Listen to an interview with Jay Hale.

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