Care Managers Must Know the Signs of Mental Illness to Best Serve ClientsMost people believe mental illness is rare, but the numbers tell a different story. For case managers, it is especially important to know whether a client with chronic disease or complex needs may be struggling with mental illness.
Mental illness is a disease causing disturbances in thought and/or behavior, resulting in patients who are unable to cope with some of the ordinary demands and routines in life. There are more than 200 classified forms of mental health conditions; some may be caused by a biochemical imbalance, while others can be triggered by stress associated with chronic disease.
Mental Health by the Numbers
The incidence of adults and children in America who suffer from mental health challenges is staggering. Case managers who work exclusively with this population can typically offer a wide range of support, including coordinating community services and effective treatment, and assisting clients and families in achieving independence.
It is important for all case managers to understand mental illness and learn how to identify the signs and symptoms. Research shows that:
- Approximately 20% of adults in the U.S., or 40 3.8 million people, experience a mental illness each year according to the National Alliance on Mental Illness
- Nearly one out of every five youths from age 13 to 18 will experience a severe mental disorder during their lifetime
- Each year, serious mental illness costs $193.2 billion in lost earnings
- Those who live with a serious mental illness also face an increased risk of chronic health conditions
- Over one-third of students with a mental health condition dropout of high school
- More than 90% of those who die by suicide have symptoms of a mental health condition.
- 1% of adults live with schizophrenia
- 6% with bipolar disorder
- 9% have experienced at least one major depressive episode
How to Identify Clients with Mental Health Conditions
Trying to tell the difference between expected behavior and signs of mental illness is not always easy, especially in people who are under stress. Although there is no easy test and each disorder has its own symptoms, there are some common signs of mental illness to help you identify those who may benefit from mental health support.
- Anxiety and depression
We all feel stressed or sad from time to time. However, anxiety and depression can be a sign of mental health issues when it is constant and interferes with other activities. If you have noticed your client has lost interest, seems sad or irritable all the time, and lacks motivation and energy, they may be suffering from more than sadness. Symptoms of anxiety may include shortness of breath, headaches, diarrhea or a racing mind. Your client may not share these symptoms with you, but by watching their behavior and their ability to stay on track during a conversation, the symptoms may become evident.
- Extreme mood changes
We all experience times when moods change, but sudden and dramatic changes in mood, such as uncontrollable “highs,” feelings of euphoria, prolonged or strong feelings of anger or irritability may be symptoms of mental illness.
- Changes in sleeping habits or feeling constantly fatigued
To maintain optimal health, we need 8 hours of sleep each night. When an individual experiences persistent changes in sleeping patterns, this might indicate a mental illness. Insomnia can be a sign of anxiety, depression or substance abuse. In some cases, your client may be sleeping 8 or more hours and still feel fatigued on a consistent basis. This is another indication they may be struggling with a mental health condition.
- Weight or appetite changes
Some people eat more when they are under stress or feeling bad, and others eat less. This effects weight gain or loss and is also a warning sign of a mental health condition or eating disorder.
- Inability to deal with daily activities
This may include avoiding friends and social activities, changes in sex drive, or recent withdrawal and loss of Interest in activities your client previously enjoyed. Students may demonstrate an unusual drop in function at school, such as quitting sports or failing grades. Adults may demonstrate a similar drop in function at work, such as not meeting deadlines and poor performance.
- Heightened sensitivity
Demonstrating a heightened sensitivity to sights, sounds, smells or touch, such as avoiding over-stimulating situations or jumping dramatically at loud noises, may also indicate mental health conditions.
- Feeling guilty or worthless
Some experiencing mental health conditions express feelings or thoughts such as “I’m a failure,” “It’s my fault” or “I’m worthless.”
- Difficulty relating to other people
Your client may express confused thinking or constant problems concentrating, difficulty understanding or relating to people and difficulty perceiving reality, including an inability to perceive changes in their own feelings that may appear as a lack of insight
- Substance abuse
If it appears your client is drinking an excessive amount of alcohol, relying on alcohol each day, using other recreational or prescription drugs to cope with life or exhibiting drug-seeking behavior, they may suffer from an addiction problem and an underlying mental health condition for which they are attempting to self-medicate.
- Multiple physical ailments without obvious causes
Vague physical complaints, such as headaches, stomach aches and ongoing aches and pains without a current diagnosis explaining the symptoms, is another sign of a mental health condition. In this case, it is important your client is evaluated for an underlying medical conditions which may not have been diagnosed.
The Importance of Supporting Clients with Mental Illness
Clients with serious mental illness often have difficulty managing other health conditions or engaging in ongoing treatment, resulting in poor clinical outcomes, relapse and re-hospitalizations. There are a number of variables that can affect their level of engagement, including early diagnosis, proper treatment, accessibility of care, trust in the treatment plan, and strong connection to their care manager.
Your care of those with mental illness is complex and multifaceted. By optimizing your relationship and bond with them, you essentially ensure greater delivery of services and lower financial and emotional cost to the client, their family and the community.
For more education on how to identify and assist patients or clients who may be suffering from mental illness, see our online Care Management Training for Hospitals or Care Management Training for Health Plans.
Mental Health By the Numbers. National Alliance on Mental Illness
Know the Warning Signs. (February 2, 2015) National Alliance on Mental Illness
Nine Signs Of Mental Health Issues. (December 2016) Health Direct
Dixon, L.B., Holoshitz, Y., Nossel, I. Treatment Engagement of Individuals Experiencing Mental Illness.(2016) World Psychiatry, 15(1):13-20