The following is an update compiled by Vice Chair for San Francisco General Hospital and Trauma Center James Dilley, MD.
Citywide Case Management celebrates 30 years
The national trend in reducing institutional care in the treatment of the chronically and seriously mentally ill in the 1960s and ’70s resulted in a critical need for mental health services to be provided in the community. San Francisco is a community with a large number of such individuals and as a result, San Francisco General Hospital’s Department of Psychiatry launched a new program of Assertive Community Treatment (ACT), designed to meet the needs of these clients and especially those who were high utilizers of inpatient care. Thirty years ago this year, on March 1, 1985, the department launched Citywide Case Management on the premise that assisting clients with housing, entitlements, food, and clothing, provided the opportunity to develop a more long lasting therapeutic alliance and the opportunity to address medication, individual and family psychotherapy, psycho-education, and other treatment needs.
Since that time, Citywide Case Management’s success linking with clients and reducing hospitalizations has meant growing from one program to a division of five related programs. Helping create the San Francisco Behavioral Health Court, reducing homelessness through on-site treatment in supported housing, engaging clients in supported employment, hosting innovative research, and developing culturally/linguistically focused case management teams are some of Citywide’s strategies for helping clients recover from severe mental illness and live richer, fuller lives. Citywide has also been a site for several research projects with department researchers, including Sophia Vinogradov and Christina Mangurian.
Located today at 982 Mission Street, in the South of Market area, Citywide’s intensive case management teams provide care to over 1,000 of the city’s most seriously ill clients while providing support to 240 additional clients in supported housing programs at the Richardson and Rene Casanave Apartments, and an additional team cares for residents of 24 single room occupancy hotels. Finally, Citywide also developed and manages vocational rehabilitation and employment programs at SFGH and at 982 Mission, and helps 280 clients each year learn job skills and improve self-esteem by providing them an opportunity to perform meaningful work and to be paid for providing a range of services, including light construction work, catering and administrative tasks.