Case Management Guidebook

Comprehensive guidance and support to professionals working in homeless and drug services

Key Goals

  1. Identify any mental health support needs.
  2. Ensure appropriate referrals are made and supports are accessed.
  3. Explore if there is a risk of self harm or suicide and to establish a plan for dealing with this issue, should it arise.


Under international human rights law, a person has a right to mental health services. Mental illness can be defined as the experience of severe and distressing psychological symptoms to the extent that normal functioning is seriously impaired. Support may take the form of counselling, psychotherapy, drug treatment or treatment in an in-patient setting. In all instances, referral to appropriate services is important for the well-being of the service user.

Substance misuse is an increasingly recognised problem amongst people with mental health problems. Many individuals suffer from both mental health and substance misuse problems, and while there is some difficulty in identifying which condition occurs first, in cases where individuals suffer from both, experts suggest that each condition may play a role in the development of the other. Substance misuse often worsens the social and psychological problems of people with mental health problems. The negative effects of substance misuse among those with mental health problems may include:

  • Increased risk of homelessness
  • Increase in psychiatric symptoms such as halluci-nations
  • Increased social problems
  • Decreased use of prescription medications and compliance

There also appears to be an increased risk of suicide among substance misusers. For example, the suicide risk among intravenous (injecting) drug users is thirty times that of the general population15.

This section of the guidebook describes access points to various mental health services.

Research shows that one in four people will experience at least one episode of mental illness in their lifetime16; this highlights the prevalence of mental health issues and the need for case managers to be able to discuss these issues in a comfortable and open manner. Mental heath can still be subject of stigma, which can make it hard for people to be honest about their experience.