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Case management or do it on your own?

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Dont know if there is a better forum for this or not but ill try it out here snd it might be rambly, sorry

My therapist and psychiatrist suggested I do case management and community treatment or something like that to hrlp me keep my life in check and living independently. If it weren't for my co dependent boyfriend I wouldn't be able to do anything for myself but there is only so much a 25 year old can help me with, snd if someone doesnt force me to I dont show up to myappointments or eat and I haven't had success going back to school or finding work or even finding a general practitioner fot myself. Case management was supposed to help me get back on my feet and stay out of a hospital and stuff. That was early in medication, now I have ben on meds for some time I am 40% improved and I am not sure if cast management is stil something I should do?

Off meds I see needing it but now I am confused what to do, if it will help our if I should just push through it. I am not sure if having a case manager would be a sign of weakness our defeat our something our if I actually need it.

My group leaders in iop are always talking about how people need to do things for themselves and asking why I "chose" not to work our be homeless in the past and why I am stil chosing not to progress in my life. I'm a but conflicted now, they say I am very competent becausr I get dressed everyday and show up to group and that I should just get over myself, talk on the phone and get a job cleaning houses our something. I dont know why I dont, I'm very afraid and forgetful and have trouble following myself to do things, but I am suspecting now since iop that I am lazy our something. I lost my therapist becausr I kept forgetting my appointments andi have ben to afraid to make another appointment with my psychiatrist, they tell me I am able to use the phone but I haven't used it yet.

If I am lazy then I would just be lazier if I got a case manager, maybe. But I really dop have trouble keeping upwith my life, I just dont know anymore if this is something I need help with or if I am just a lazy person and need to grit my teeth and work harder on my own. I am on medication so I should be able to do everything, right? It made sense why I fell behind before but becausr I am in a better placer now I don't se ea reason for not functioning like I should.

I'm vert confused, just wondering if anyone has had case management before, if it helped, our how they "keep up" on their own, what do you do for yourself? I find myself just hiding indoors all day doing nothing and not really caring so I wonder if its a character defect in myself in which case it would be morally wrong to expect case managers to help me with a character defect? I would like help to do things, but im an adult so why shouldn't I be able to go to the doctor or Start school our keep a job or brush my teeth or go fot a walk? I only remember being competent inn residential becausr there was a lot of structure but maybe that its part of three problem, that I never really toughed out being an adult.

I can't tel if case management is helpful or detrimental?

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If I were you, if both my therapist and shrink suggested that I have a case management then I would take that

suggestion to heart.  They are both looking out after your best interests. 


Your group leader sounds like a trite ass.  HIs suggestions are very cliché. 

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i have case management


people who give that bootstrap bullshit just because THEY don't require more support and think everyone should be like them should shut the fuck up.


it's great that your boyfriend helps you


my partner/husband does help me as well


but i don't know that i would still have support outside of mental health services if i had to rely on them for so much


and the fact is, just because someone else doesn't need case management, even someone with the same diagnosis...it's a travesty that people in our culture have this notion that they understand ANYONE ELSE'S life or symptoms just because they have experienced THEMSELVES and THEIR symptoms.


i realize it's hard not to be down on yourself, especially when others who are themselves in the mental health system cannibalise to make themselves feel better, but if you are doing what you can and you need the support...sometimes asking for help and accepting it IS doing everything you can for yourself and being as stable as possible is reason enough


best to you x

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I don't think case management would be a bad thing for you. If you are legitimately having trouble managing your life due to your illness (all your issues are well known problems for people with psychotic disorders), then I say, why not? It could only be beneficial at this time. Maybe one day you won't need case management anymore, but maybe you need that help to get there, you know? 


I personally don't have case management, I do it on my own. But, I also don't suffer from symptoms constantly like some others do. I am very lucky that my medications have pretty much treated all of my symptoms for the time being. 


Don't listen to the people telling you that you should be able to do it all on your own. They aren't you and they never will be. They will never know what it's like to live your life. It is not a character defect that you need help. We all need help from time to time, and that's okay. And just because you are on medication, that doesn't mean you should magically be able to do everything yourself. These supports (such as case management) exist for a reason, because we know that medication does not miraculously cure mental illness. 


I'm having trouble expressing myself today. But in short, from what I know of your story and your symptoms, I think case management is a great idea for you. You are not lazy, you are not defective in any way. You simply need help right now, and that's okay. 

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Thank all of you so much, it really held to put some things together in my head. Im going to bring it up again and ask my doctors how to start the process, I'm only doing the iop once a week now snd I notice I'm sloping a little bit, I'm really trying, I know peoplr on the outside dont get it and probably think less of me because I am a capable person and can be again but for some reason right now I'm too many steps behind. It s frustrating. I know my dad used to think I just didn't care, he lost a lot of respect for me.

Im going to try seeing the case management as a stepping stone to doing it on my own and not a crutch.

The people in iop really kinda confused me :P I understand where they are coming from it is good to do things for yourself and I want to, but they kept implying that the way my life had been was a choice, they said sometimes being homeless is a choice but for me it was a consequence, maybe I did and do choose to drop out of life buti dont want to, I would rather have a job and friends and self reliance but I haven't gotten there yet.

when I dont live up to to what expectations I lead people to it bothers people, makes me seem rude like I just dont care or am lazy but 90% of the time I forget or I'm afraid for some reason. Even my boyfriend says now if I dont start doing something with my life that we won't work out and that maked me sad, I want to do things but my mind blanks out when I try to think of the steps to do it and then I get overwhrlmed and get scared our just give up.......i do feel lazy but maybe case managers can help me learn to do it on my own. I would really like to start school again, I was on track to start a phd program before all of this, I just ned to catch up

Tgank you all again so much, it really helps

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In my experience, they won't offer you something unless they think it is needed. When they think you no longer need the service, they'll let you know. If it were me, I'd take all the help I could get. 

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I have a case worker or manager.

My experience has been mixed. They meet with me once a week and I have group twice a week.

They set up my dr appointments and make sure I have a ride to get there. They sit in on the appointments with me so they can give their view of how I'm doing.

They set up monitored med delivery for me.

They talk to the dr for me if I have a problem that needs addressing.

Without it I would lapse and fall through the cracks. I'd end up in the state hospital again for indefinitely. I wouldn't be able to keep up with my care alone. And my husband works so he wouldn't be able to help me all the time.

They make sure I take my morning meds. I am to be sure to take my afternoon and bedtime doses on my own. Well who the hell am I kidding my husband has to remind me nearly daily to take my meds when there are times I forget or don't want to.

I'm working on being more independent though. I call when I'm having a problem now instead of waiting for them to notice that I'm not doing so well. I started driving again to a few select places with help at first. I hadn't driven in years. They even helped me learn how to ride the bus and navigate that system before I started driving again.

My week is highly structured and scheduled because of case management. Monday I have group. Tuesday I have an appointment with my case manager. Wednesday I have group. Thursday, Friday, Saturday, Sunday, I spend all day with my husband or parents. I am always doing something to keep busy and I'm rarely alone.

They can help you structure your week like that. They can get you into groups and help you find a job. Or go back to get your phd if that is your goal.

If you have any specific questions you can ask away or PM me and I will try to help out.

I wish you luck in getting the help that you need and deserve.

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i agree with everyone else...if you need it you need it. having a case manager can only help you. i have one but he really isn't the most reliable person in the world but when he comes around he helps me out. i don't think it is a sign of weakness or becoming lazy, it's to help you manage and organize your life. i also have another case manager at my day program who helps me out. she'll talk to my pdoc if necessary and she also checks me out to make sure i'm doing alright.

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Tgank your all again so so much. Does it help you open up more when you have more people to be accountable to? I have trouble telling my doctors things and it stabs me in the back. I live away from family and dont have much for support outside of my boyfriend so maybe case manager wl be even more helpful than I thought. I feel a lot more informed and comfortable with the idea after heating from you all!

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I had a case manager and she was wonderful. She came to my house once a week and helped me with phone calls and business things that I didn't know how to deal with. She helped me clean up the house, and we would always have a cup of tea together and she would ask me lots of questions to see how I was getting along. SHe looked after me for about 6 months until I didn't really need her any more. I can really recommend trying out the case management thing, and if you like it, it can really help.

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  • 2 weeks later...

I kind of have a case manager but that's not exactly what we call it here.  She's a licensed social worker who comes to my house for three hours a week (at the moment, it's been 0 hours during the months I'm depressed and 3 hrs/week is the most I've ever seen her) and we work on things like cleaning, laundry, budgeting, going outside in the daytime and talking to people (my least favorite thing ever), not having massive panic attacks at paperwork and ignoring it forever, reality checks about my relationships, encouragement, being respectful and understanding other people's boundaries.


She 'displays' being a functional adult, if that makes sense.  In my case, I was not really allowed to have emotions as a child, nor was I affirmed that I could mess up and people would still care about me, so my social worker pays special attention to those things. 


If you had asked me what I thought when I first started seeing her, I would've said that I didn't need her.  Now I think she's the biggest help I've had-- I've gotten so much better!

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