Massachusetts Department of Mental Health Cuts More Than 100 Case Managers: the Tip of the Iceberg?

By Stephen L. Day, Technical Assistance Collaborative

I had just returned from a business trip and saw a copy of the recent Boston Globe article about the lay-off of 100 case managers. This is just the tip of the iceberg as states all across the country seek to balance budgets in the face of severely restricted revenues. It is likely there will be many more direct care staff layoffs and cuts in other community services and supports affecting thousands of people with disabilities before the economic situation improves.

There’s so much bad news facing so many of us right now that it’s hard not to lose sight of what these layoffs really mean in human terms.

The 100 case managers being laid off are probably serving about 3,000 individuals and families. Every one of these people and families has a case manager because they have a serious mental disability that makes it difficult for them to live successfully in their homes and communities.

Case managers help people get and keep the supports they need to live as independently as possible and to remain integrated in their communities. But more importantly, case managers represent a trusted human relationship with a caring person. For many people with mental disabilities this trusting relationship is essential to their own personal pathways towards recovery and self-sufficiency. This trusted relationship is more than the bureaucratic function of service planning and linking people to services. It is frequently the primary bridge between a person’s isolation and disconnection from society and their potential to find a way back to community living.

All of us depend on trusting relationships with people who support us in various ways. And all of us need human contact and support to make our ways in the world. Without the on-going support and trusting relationship with a case manager, some people with mental illness have no source of this support – no one to give them a hand as they struggle to overcome and learn to live successfully with their disability.

When you see homeless people with mental illness, or when you see people with mental illness being jailed for petty offenses, think about the fact that they might not have had a trusted relationship with some caring person who could help them in their journey away from homelessness or jail and towards self sufficiency in the community. When case managers are laid off, the people with disabilities that they serve are likely to become disconnected from sources of support in their communities. The short term savings attained through the lay-offs are more than likely to result in higher costs shelters, emergency rooms, inpatient acute acre, and jails.

What do you think? How can we ensure that those with disabilities continue to have access to the supports they may need in the face of ongoing cutbacks?


About the Author
Stephen L. Day is co-founder and Executive Director of the Technical Assistance Collaborative, a national non-profit organization that works to achieve positive outcomes on behalf of people with disabilities, people who are homeless, and people with other special needs. Steve has provided consultation and technical assistance to 35 states, over 100 local jurisdictions, and numerous national policy and advocacy organizations.