Mindy Downs has been doing social work for 25 years. She can’t imagine doing anything else.
For those who do what Downs does, being a case manager is more than a job; it’s a calling.
“This is what I feel like I’m supposed to be doing,” said Downs, who has been a case manager at the Bert Nash Community Mental Health Center for 13 years. “It’s a meant-to-be thing.”
According to the Case Management Society of America, “Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote patient safety, quality of care, and cost effective outcomes.”
Case managers work one-on-one with clients, many of whom have severe and persistent mental illness. Downs defines what she does simply as helping people who need support. Caring for others is at the very heart of being a case manager, she said.
“I really wouldn’t be doing what I do if I didn’t love helping people,” Downs said.
She finds the work extremely gratifying.
“When people experience success or do something they never really thought they could do, that’s the most rewarding thing for me,” Downs said. “In some cases, just being alive is an accomplishment.”
Any case manager would say the work can be challenging.
“It’s not easy work,” Downs said. “None of these are easy stories. You are dealing with people’s lives and all of their stories and issues are different and have made them who they are today.”
Mary Neal, who has been a case manager at the Bert Nash Center for 12 years, enjoys the variety of the work.
“No two days are the same; no two clients are the same,” she said. “Sometimes we go out in the community and access resources. Sometimes we take a drive and talk about symptoms and coping skills. Sometimes we work on improving physical health. Every day is different.”
Case management is very collaborative work. Case managers work very closely on behalf of their clients with other social service agencies throughout the community.
“It’s important to have that collaboration and communication between providers,” Neal said.
Earning the client’s trust is critical to developing a good working relationship.
“It takes time to build a relationship with a client,” Neal said. “They have to see that they can trust you.”
Downs agreed wholeheartedly.
“You really can’t get anything accomplished if you don’t have a relationship and trust,” she said. “For some of my clients, I’m the longest relationship they have ever had. So, independence can be pretty scary.”
As one client of hers said, “I’m straddling being independent and clinging on to her for dear life. I don’t know how she does it; she always has time for me. And she’s tenacious. She’s like a little pit bull in Birkenstocks.”
That’s a goal of case management, to help clients develop skills that will allow them to function more independently.
“It may be some little thing that makes a difference,” Neal said. “But I like doing this work because it’s rewarding seeing results and just helping people.”
Emotional check-ins are part of every contact with a client.
“I ask how they are feeling, if they are anxious or depressed,” Neal said. “We talk about triggers. We talk about problem-solving and coping skills.”
“She talks to me about my problems and tries to get me to understand things better,” said a client of Neal’s. “She calms me down and teaches me how to deal with my problems. I appreciate her being there for me. I appreciate everything she does for me.”
Sometimes clients can be resistant to change or need a little nudge to help them do something they didn’t think they could do.
“Sometimes you have to push people a little bit harder than they think they want to be pushed, so that they can see what they can do,” Downs said.
Brad Cook supervises case managers at the Bert Nash Center, but for more than a dozen years he was on the front lines doing case management work himself.
“It seemed like an honorable way to live your life; to care for other people, to give back to the community,” he said.
His experience as a case manager was focused on working with the homeless population.
“Because to me they were the population that was the most vulnerable and needed the most help,” he said.
When Bert Nash case managers talk to Cook about challenges they may be facing with clients, he can be understanding and helpful. Because, he’s been there.
“The job can be difficult,” Cook said. “You have to have a lot of resiliency. Even if it’s one step forward, two steps back, it’s worthwhile. Even if it ends up that nothing changes, it’s not a waste of time, because the client is still working toward something. It’s about the journey.”
It’s a journey that is made easier along the way, thanks to the helping hand of a case manager.
“Sometimes I feel like I could use a case manager, too,” Neal said, smiling. “We probably all could.”