Introduction
Intensive case management services (ICMS) have been designed to meet the needs of young people who fit the criteria of 'high-risk youth'; young people who are child protection clients and have multiple and complex behavioural and emotional difficulties requiring long term and substantial support.
ICMS focuses on the provision of intensive support to young people with high needs for whom less 'assertive' case management practice either has not previously worked or is considered unlikely to be effective. This proactive approach to case management is characterised by a high level of contact with the young person, with an intensity of relationship, and strong participation in decision-making by both the young person and, where appropriate, family members and significant others. The services are multidisciplinary and provide intensive youth outreach programs for young people.
The development of intervention strategies should be based on the best interests of the young person, and framed in the case plan with appropriate, mutually agreed goals and tasks in the action table which enable the young person to build on identified strengths and develop new competencies. This needs to be done within the context of a safe, supportive and positive environment.
The intense nature of ICMS requires a high level of agency support for case managers including the provision of training, supervision, debriefing and peer support. Consideration also needs to be given to ensuring worker safety. Caseload varies depending on the intensity of a case. Staff need to be highly skilled and experienced to undertake this work, usually with a social or youth work background, and be able to work with young people in an affirming and non-judgemental manner, no matter what the situation or the type or intensity of the presenting issue.
ICMS aims to reduce high-risk behaviour and increase stability in the life of the young person in the context of harm minimisation, through strategies to develop resilience and protective behaviours, increase involvement in activities which are meaningful for the young person and enhance self esteem and life skills, and in building opportunities for attachment to significant others and developing sustaining relationships. This is usually in conjunction with an intensive one-to-one home-based care.
Major components of ICMS include:
Case management and coordination
ICMS assigns a case manager for each high-risk youth. The case manager is responsible for developing a trusting relationship with the young person, implementing the individual case plan, ensuring effective planning and coordination of services involved, and reviewing the progress of the plan.
Intensive outreach and support
Services are provided on an outreach basis. These services include intensive personal support, assessment and individual service planning, monitoring, crisis intervention and case management.
Extended hours availability
ICMS services are available during extended hours, including evenings, seven days a week and also including public holidays.
After hours crisis support and intervention
After hours consultations with professionals regarding the management of referred high-risk youths are provided with a capacity to respond to crisis situations. In cases where statutory intervention is required, the AHCPES will be consulted to determine the response required.
Consultation and specialist advice for professional and family members
ICMS provides a limited case consultancy service to other bodies dealing with young people and to referring child protection practitioners to enable professionals to assist young people when the program has been unable to accept a referral.
Multi-disciplinary staffing
ICMS services are delivered by professional staff working in a multi-disciplinary team that includes drug and alcohol workers, mental health workers and intensive case managers.
Post-statutory support
ICMS ensures adequate exit planning is undertaken and that accommodation and support services are put in place to meet the particular needs of exiting adolescents. It is imperative that young people are assisted to maintain supportive family relationships and connections with other supportive adults which will endure beyond statutory care.
Service coordination
Case planning remains the responsibility of child protection, including significant decisions that are part of the case plan, such as the permanency objective, placement and so on.
Divisions are responsible for service coordination which is established through regular formal liaison meetings between child protection, placement coordination, mental health, drug and alcohol services, ICMS and representatives from other funded sector programs.
Referral to ICMS
All referrals to the ICMS program are initiated by child protection and should occur; subject to agency capacity, when child protection has assessed an intensive response is required to meet the young person's needs and safety. It is a requirement that ICMS clients are on the divisional high-risk youth register and their status is reviewed fortnightly. The ICMS enters into a formal case management agreement for all young people accepted to the program.