A Good Case Manager Is Hard to Find

The quest to find good professionals to work with your loved one with mental illness may … frankly … drive you crazy.  We’ve paid good money to:

  • A therapist who thought my son had a bad case of “failure to launch” and completely missed the fact that my son was developing schizophrenia. (My hand to God … it’s true.) Even better, when my son had to be taken to the emergency room and the psych ward, we were unable to reach him because his office phone had been cut off for nonpayment.  Thanks, Cigna.
  • A therapist who talked my son with schizophrenia into not taking his medicine.  (Surprise! His ideas about the illness being the remnants of drug use were wrong.)
  • A psychiatrist whose wife/office assistant got me mixed up with another patient’s caregiver, yelled at me, realized her mistake and said, “Please don’t tell my husband.” 

I now realize that we were incredibly blessed with my daughter’s psychiatrist, who spent several hours with her every month for a 11-year period from 1989 to 2000. Today psychiatrists dispense medicine, period. You see them for 15-minute appointments once a quarter, and you work hard to convince your loved one to at least tell them the truth about their symptoms.  It’s relatively easy to lie to someone who hardly ever sees you.

Nonetheless, it’s important to partner with your loved one’s social worker, case manager, therapist and/or psychiatrist. I’ve found there’s a natural period where they assume that you are part of the problem, but it can change over time. And, even if the therapist is unable to tell you things, you have every right to call the therapist with important information.

We worked for 3-1/2 years to get my son moved to a good counseling center where he soon will have a case manager who I personally knew from many months in a support group where he was the facilitator.  He heard me bitch so much about the other social workers and therapists that he was a little worried about working with me.  I got that from this direct quote: “You’re going to be mad at me now.”

Probably not.  The issue with schizophernia is that the illness begins at about age 20, when the young person is trying to get away from Mom.  That makes trying to get the person to do what you know they need to do all the more trying.  Until he left his job, he was a strong thoughtful social worker who did a great job in the role of my son’s advocate.

The biggest issue is keeping a good relationship with a case manager or therapist in place.  Lots of people change jobs, and, when that person is your loved one’s link to sanity, it can have a serious impact.  Things also get better when you are lucky enough to have your loved one entered a permanant supportive housing situation. The case manager for all residents is in an office on-site, and that has been so wonderful.