An exploratory study of mandated safety measures for home visiting case managers

The purpose of this qualitative focus group study was to assess staff perceptions of the implementation and effectiveness of safety measures mandated for home visiting case managers. A participatory action research framework was used to conduct 5 focus groups of case managers employed by a state mental health system in the United States. The participants were employed by a program to provide case management for the severely and persistently mentally ill in the community. Safety measures instituted after the homicide of a visiting case manager were found to be effective in some agencies but not in others. There was variability between agencies in the strictness with which safety protocols, accountability procedures, accompanied visits for high-risk situations, and training were implemented. Contextual factors influenced perceptions of safety. Mandatory safety measures for home visiting health workers may be feasible but further research is necessary to explore risks and contextual factors.