A day in the life of a Hospitals to Home case manager

May 24, 2024

CMHA Toronto’s Hospitals to Homes (H2H) program is an innovative approach to bridging the gap between hospital and community-based care for those with longer-term or chronic mental health conditions.  

A team of three H2H case managers provides rapid access to resources and service navigation from Scarborough Health Network’s Centenary or Birchmount hospitals, in most cases before people are discharged, thanks to the unique case management model and the on-site presence of the case manager. 

We spoke with Ezhil Souparamnian (ES), Jeev Param (JP) and Varun Midha (VM) to hear more about their unique roles and experiences.

Their comments have been edited for length and clarity. 

What’s a typical day like for you?

ES: I receive referrals, meet with clients, schedule intakes and assessments, conduct goal setting and planning sessions, make referrals to appropriate services, and follow up.  

Sometimes I’ll handle interpretations for Tamil-speaking clients. I also run groups with partner agencies. There is quite a bit of teamwork, case discussions, participating in discharge planning, advocacy, and working as a liaison between the client, the referral source, and the team. 

VM: A typical day in the psychiatry department at SHN involves conducting assessments and evaluations of patients, collaborating with interdisciplinary teams to develop treatment plans, providing counselling, advocating for patients' needs, and coordinating aftercare services. I may also participate in case conferences, attend trainings or workshops, and engage in administrative tasks to ensure seamless patient care. 

What led you to choose this type of career?

ES: Compassion. 

JP: This work aligns with my passion. 

VM: I've always been passionate about helping others, and I believe mental health is a crucial aspect of overall well-being. Becoming a social worker specializing in mental health allows me to make a meaningful difference in people's lives and support them through challenging times. 

What would you say to young people who seek to work in a similar capacity as you? What would be your two or three main pieces of advice to them? 

ES: Be curious to learn new things. Be open-minded and non-judgmental. Spend time with nature. 

JP: If you have a strong sense of compassion towards clients with mental health challenges and are committed to working hard, then working in the mental health field can be a fulfilling and rewarding career choice. There are many opportunities available in this field, from counselling and therapy to service navigation and advocacy. With dedication and a willingness to learn, you can make a positive impact on the lives of those struggling with mental health issues. 

VM: Prioritize self-care: Working in mental health can be emotionally demanding, so it's crucial to prioritize your own well-being. Make time for activities that recharge you and seek support when needed.   

Embrace continuous learning: The field of mental health is constantly evolving, so stay curious and open to new knowledge and perspectives. Pursue ongoing education and training to enhance your skills and stay updated on best practices.  

Cultivate empathy and resilience: Developing empathy for your clients' experiences and resilience in the face of challenges will serve you well in this field. Remember to approach each person with compassion and understanding, while also maintaining boundaries to protect your own emotional health.

What are your greatest satisfactions and your biggest challenges in your job? 

ES: When I see smile on a client’s face and gratitude in their eyes – these are my greatest satisfactions. The biggest challenges currently are: 1) helping clients secure housing; 2) sometimes its hard to satisfy family members expectations. 

JP: Witnessing the improvement in the clients' overall well-being is my greatest satisfaction. Some of the challenges are the limited resources available to clients for housing and employment support. 

VM: One of the greatest satisfactions in my job is seeing the positive impact I can have on individuals' lives, witnessing their progress and growth throughout the therapeutic process. It's incredibly rewarding to know that I've played a part in helping someone overcome challenges and improve their well-being.  

Like any profession, there are also challenges. One of the biggest for us is navigating the complexity of mental health issues and working with individuals who may be resistant to treatment or facing multiple barriers to recovery. Additionally, the emotional toll of working with clients who are in distress requires a strong sense of self-care and resilience to maintain our own well-being while providing support to others. 

Tell us about a client left a big impression on you. 

ES: This story reflects my ability to act authentically as a human being from the emotional side while also being a professional taking a rational approach. 

I met a long-time client just before the COVID lockdown at a McDonald’s (he loved McDonald’s coffee). He said, “Ezhil, I don’t have family here, my only daughter lives in San Francisco. If I died could you fulfill my last wishes, I request you as my brother.” 

Unfortunately, he did die during the pandemic. His daughter couldn’t travel here due to the travel restrictions, and the rest of his family was in Tunis and also couldn’t travel.  

Working with a local funeral director here, we came up with a few options. The client's daughter agreed to burial here in Scarborough, but the family overseas wanted us to send his body to Tunis. It was very difficult, not only because of COVID but because of the amount of paperwork required between Canada, the U.S. and Tunis. Luckily, our diseased client’s brother was a retired Tunisian ambassador, and with his influence, the Tunisian embassy got involved. His body was transported to Tunis, buried next to his mom in a cemetery there.  

His daughter was very appreciative, and I was happy to have been able to fulfill my client’s last wishes and help his family.

JP: I had a client who was a refugee claimant and was admitted to the hospital with the diagnosis of schizophrenia just before he to return to his home country. He was connected to the H2H program in 2022 and received our service. He’s now doing well in Canada. He calls me sometimes and expresses his appreciation for the support he received. 

VM: One client who left a big impression on me was a young woman who struggled with severe depression and anxiety. She had experienced significant trauma in her past and was struggling to cope with overwhelming emotions and negative thoughts.  

What made her memorable was her incredible resilience and determination to heal despite facing immense challenges. Despite her struggles, she showed remarkable courage in opening up about her experiences and actively engaging in therapy to work through her issues.  

Witnessing her gradual progress and seeing her regain a sense of hope and purpose was truly inspiring. She taught me the importance of empathy, patience, and the transformative power of therapy in helping individuals heal from even the most difficult circumstances. Her journey serves as a reminder of the resilience of the human spirit and the profound impact that compassionate support can have on someone's life. 

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