Op-ed: Case management is critical for homeless, mentally ill in CT

Kate LeBlanc

Controlling for total population, Connecticut has one of the top five highest number of mentally ill individuals who are homeless in the country.

Just over a year ago, the Obama administration granted $32 million to Connecticut to renew support for housing and service projects. This funding goes toward a variety of programs aimed at finding transitional housing, as well as permanent housing, for unsheltered individuals. The money also pays for vocational training, mental health counseling and substance abuse treatment.  All of these interventions are likely to be beneficial and effective for decreasing homelessness in Connecticut, but those individuals with severe mental illness may need an intensive approach to help them get off the streets, and maintain stable housing.

After traditional mental institutions closed their doors several decades ago, causing many impaired people to become homeless, case management became essential to those with severe mentally illness. This type of care allows clinicians to keep a close eye on patients to make sure they stay on track. Traditional case management, however, is often not sufficient for a person with a severe mental illness, and a more intense approach may be necessary.

Assertive Community Treatment, or ACT, is a form of case management geared toward those individuals who need the most comprehensive care. As opposed to conventional case management, ACT teams have a low client to staff ratio, and a strong focus on outreach. Of note, clinicians visit clients in their homes – after a home is secured by the team – and perform essential interventions outside of the office. This prevents clients from becoming homeless again, as they are followed closely by a team with their best interest in mind. ACT teams work with patients on a time-unlimited basis, and the personalized care has proven effective.

There are not nearly enough organizations with ACT teams in place in Connecticut. If a portion of the grant given by the Obama Administration last year were to be allocated toward putting more ACT teams into action, the rates of homelessness — especially among the severely mentally ill population — would likely decrease.

The service projects in place at this time are not intensive enough to meet the special needs of these individuals, however, as they often do not know how to access these resources and maintain long-term stability.  This is why ACT teams who do outreach and provide time-unlimited care are critical to meet the needs of these patients as soon as possible.

Bristol resident Kate LeBlanc received her bachelor’s of science degree in nursing from the University of St. Joseph in West Hartford, and will graduate in August as an advanced practice registered nurse (APRN). The winner of the university’s Florence Nightingale Award, LeBlanc’s clinical work has focused on working with homeless mentally ill individuals.