"Not just another client": Benefits provided by care managers to patients with mental health disorders in underserved areas.

Abstract

Objective: To identify contributions made by care managers (CMs) to treatment for rural patients with posttraumatic stress disorder (PTSD) and bipolar disorder (BD), who are medically underserved and experiencing poverty, in a telepsychiatry collaborative care model.

Method: We conducted an inductive qualitative study analyzing 24 semistructured interviews with patients who screened positive for PTSD or BD and participated in telepsychiatry collaborative care at 12 Federally Qualified Health Centers in Arkansas, Michigan, and Washington between November 2016 and June 2020. Interviews took place between March 2018 and June 2020.

Results: Our findings confirmed that patients with PTSD and BD benefitted from the following collaborative care components, similarly to patients with more common depression and anxiety: individualized and practical treatment, playing an active role in treatment, and increased access. Our principal finding is one not yet fully explored in current research: CMs met patients' need to feel cared for, which may contribute to engagement and serve therapeutic ends. Feeling cared for emerged holistically from three components that occurred both within and outside therapeutic encounters: (a) interactional dynamics; (b) care management tasks; and (c) "nurturing connections" established with the CMs.

Conclusions: We addressed an understudied aspect of productive provider-patient relationships-patients' need to feel that providers care for them-and identified a range of actions and strategies that produce this feeling. CMs may be uniquely positioned to provide this type of care. For underserved segments of the population, leveraging these uniquely skilled clinical personnel could improve access, engagement, and outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).