In my experience managing a heavy caseload, I’ve found that setting clear priorities and organizing my time are essential to maintaining quality care. I focus on assessing each client’s needs to address the most urgent cases first while staying mindful of long-term clients who need ongoing support. Utilizing brief check-ins, collaborating with team members, and implementing self-care strategies also help me stay grounded and present with each client. It’s a balancing act, but with structure and support, quality care remains achievable.

One thing I’ve found helpful is to remember you’re only one person and you can’t do it all. I used to work at a behavioral health clinic whereas a general mental health case manager I had 350 clients, as a SMI case manager my caseload was 150, and as a therapist I had 55 clients. How does one handle all the issues? You can’t. With these caseloads all you can do is burn out fires by answering calls and calling back people who had emergencies and emergencies meant life or death situations. We can’t control systems and the expectations, all we can do is do our best and feel good knowing we did the best we could. Sometimes even asking for help doesn’t work because everyone else is just as busy. Just do your best!

I think it’s essential to develop an institutional analysis skill. To understand the space you’re in, in terms of the behaviors, culture, and discourses that are understood as important in that space. And then you need to plan your time well when executing actions, as well as maintaining your health and emotional balance outside of the workplace. With this, it is possible to have emotional stability during work as well as establish good relationships and be healthy to perform actions with high performance.