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Speakers: Interviewer, Amanda Biel

INTERVIEWER: Welcome to this week's podcast. This week, we're discussing ethics, clientele, and the case management process.

Can you describe the characteristics of a client in the community setting?

AMANDA: Sure, a client within the community setting usually has several problems; from anything pertaining to health and mental health to substance abuse. So there are really a lot of issues to address with a client, and that's usually why a case manager is also present.

INTERVIEWER: As a case manager, what are some ethical challenges you might face?

AMANDA: I think a case manager faces the most ethical challenges because of the HIPPA laws and regulations. It's illegal for a case manager to disclose a lot of information, so if you have a client who has a communicable disease, unfortunately, you cannot disclose that information.

For instance, you may have families that are concerned for the well-being of that particular client, but due to confidentiality and ethics, you're unable to disclose that information. Although the family is well-intentioned, and you really want to work with the family because you're really focused on the client's well-being, it's difficult to provide too much information because of the ethical implications.

INTERVIEWER: So how would these challenges be different in, say, a correctional setting?

AMANDA: Within a correctional setting, you're limited to the services you can provide. For example, if you have a client within the prison system who needs mental health services, you're limited to only those services provided within the prison system within that facility.

If you have a client who is out in the community, you can go to various private, local, and state-based resources that provide services to that client for mental health or substance abuse. In the prison system, you're solely limited to whatever can be provided within the walls of that prison system.

In some cases, individuals are referred to outside services, but that's usually reserved for serious medical concerns. In most cases, however, everything is handled within the correctional atmosphere.

INTERVIEWER: Could you talk a little more about the special populations that would be in a correctional setting and would need special attention?

AMANDA: Special populations include substance abusers, mentally ill inmates, females, and elderly inmates. For example, the substance abuser is using drugs, or illicit, controlled substances for a reason. The case manager must focus therapy on finding the underlying problem, not only on the substance abuse itself.

They're considered a special population because it's not necessarily that a substance abuser is just addicted to drugs; it's that there's an underlying problem that they may be trying to escape from, which turns them to using drugs or alcohol as a solution.

There's also a lot of concern and issues regarding the mental health population. They require a lot of special attention. Somebody who has a mental illness, such as schizophrenia, paranoid schizophrenia, or bipolar disorder, is typically on a psychotropic medication that is required to maintain stability.

When you have a client with a mental illness who is not taking their medication properly, they become unstable. This instability can manifest as violence or depression, and they may try to hurt themselves or somebody else. So they really need to be helped within the correctional setting as well.

A lot of female clients, for example, have been victims of sexual assault, sexual abuse or even physical abuse. So when you deal with a female client, you don't want to place her with a male case manager, especially if she's been a victim of domestic violence. If she's been victimized by a male, she's probably not going to respond so freely with a male as compared with a female.

Elderly clients require more physical attention because they need regular health care. As we get older, we tend to have more ailments. When an elderly client or inmate starts deteriorating, they don't have access to regular care in the prison system. You need to be able to advocate for the services that will help them the get the medication or the medical treatment they require.

INTERVIEWER: Consider these concepts as you read your materials, complete your assignments, and participate in class discussion. Follow up with your instructor if you have any questions.

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