Regardless of the treatment setting, rehabilitation program, or population, an interdisciplinary (multidisciplinary) team approach is most useful in dealing with the multifac-eted problems of clients with mental illness. Different members of the team have expertise in specific areas. By collaborating, they can meet clients’ needs more effectively. Members of the interdisciplinary team include the phar-macist, psychiatrist, psychologist, psychiatric nurse, psy-chiatric social worker, occupational therapist, recreation therapist, and vocational rehabilitation specialist. Not all settings have a full-time member from each discipline on their team; the programs and services that the team offers deter-mine its composition in any setting.
Functioning as an effective team member requires the development and practice of several core skill areas:
· Interpersonal skills, such as tolerance, patience, and understanding
· Humanity, such as warmth, acceptance, empathy, genu-ineness, and nonjudgmental attitude
· Knowledge base about mental disorders, symptoms, and behavior
· Communication skills
· Personal qualities, such as consistency, assertiveness, and problem-solving abilities
· Teamwork skills, such as collaborating, sharing, and integrating
· Risk assessment and risk management skills
The role of the case manager has become increasingly important with the proliferation of managed care and the variety of services that clients need. No standard formal educational program to become a case manager exists, however, and people from many different backgrounds may fill this role. In some settings, a social worker or psy-chiatric nurse may be the case manager. In other settings, people who work in psychosocial rehabilitation settings may take on the role of case manager with a baccalaureate degree in a related field, such as psychology, or by virtue of their experience and demonstrated skills. Effective case managers need to have clinical skills, relationship skills, and liaison and advocacy skills to be most successful with their clients. Clinical skills include treatment planning, symptom and functional assessment, and skills training. Relationship skills include the ability to establish and maintain collaborative, respectful, and therapeutic alli-ances with a wide variety of clients. Liaison and advocacy skills are necessary to develop and maintain effective inter-agency contacts for housing, financial entitlements, and vocational rehabilitation.
As clients’ needs become more varied and complex, the psychiatric nurse is in an ideal position to fulfill the role of case manager. In 1994, the American Nurses Association stated that the psychiatric nurse can assess, monitor, and refer clients for general medical problems as well as psy-chiatric problems; administer drugs; monitor for drug side effects; provide drug and client and family health educa-tion; and monitor for general medical disorders that have psychological and physiological components. Registered nurses bring unique nursing knowledge and skills to the multidisciplinary team.