Nurse Case Manager

Service Description

This service is offered by Nurse Case Managers and includes management and/or review of the medical services needed by active clients affected by a severe and persistent psychiatric illness.

This service allows clients to benefit from regular follow-up and offers a link to a variety of health professionals to ensure maintenance of their health, and to prevent the deterioration of psychiatric and physical health. If a nurse/case manager is unavailable, Supportive Independent Living counsellors will provide the same service.

Services Offered

  • Verify that clients have access to the medical services to which they are entitled
  • Offer a home-based medication management and administration service for individuals affected by a severe psychiatric illness, or an office-based service for those who are not able to manage their own medication (ex. suicidal, psychotic, delusional or manic)
  • A follow-up and physical health care service for clients affected by long-term psychiatric illness (ex: foot care, follow-up with diabetic clients)
  • Ensure that medical files are kept up to date for all clients, such as medication, regular blood work, medical examinations, eye exams, etc.
  • Provide accompaniment and client transportation to the pharmacist, physician, hospital, etc.

Eligibility Criteria

  • Active client of the agency, affected by a severe and persistent psychiatric illness
  • Difficulty managing medication
  • Client unable to obtain home-based services from a pharmacy, practicing physician and/or nurse practitioner
  • Client and circumstances do not pose a physical threat to the nurse/case manager

Referral Procedures

Referrals to the service may come directly from the client, family members, internal psychiatric consultants or counsellors, physicians, pharmacists or any other community agency.