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Published Online:https://doi.org/10.1176/ps.35.9.925

Case managers have been assigned a key role in community support systems (CSS) for deinstitutionalized chronic mental patients, yet little research has been published on how case managers actually work with clients. In separate intensive interviews the authors questioned 30 CSS clients and their 15 case managers about how the case managers helped or failed to help clients with their daily functioning. Results are discussed in terms of the case managers' general role and their role in linking clients to activities, providing social support, and preventing rehospitalization. The findings suggest that the case managers, by focusing on management of reality rather than on symptomatology, foster their clients' community adjustment.

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