A Case Manager’s Perspective
My name is Luis Esquivez, QMHA-1, and I work as a clinical case manager at New Narrative Spring Creek Center. Over time, I’ve learned that case management is about so much more than connecting people to services. It’s about helping people find their footing in systems that often feel overwhelming and unforgiving. Day to day, my role looks like a mix of problem–solver, advocate, listener, and resource navigator. No two days are exactly the same, and honestly, that’s one of the reasons I love what I do.
Meeting People Where They Are
Every participant I meet has a story, and before I can help them, I need to understand it. My work usually starts with a thorough assessment, talking through their history, their current situation, and what they need to move forward. It’s not just about ticking boxes. It’s about listening to what’s really being said and often what’s not. I look at their strengths as much as their struggles. Whether it’s housing insecurity, unemployment, transportation barriers, or mental health challenges, I try to paint a clear picture of where they’re starting from and where they want to go.
Spring Creek Clinic at New Narrative
Unlike clinicians who may focus more on processing emotions, my case management role is often about getting people’s basic needs met first. If someone doesn’t know where they’ll sleep tonight or how they’ll get to their next appointment, counseling alone won’t be enough. That’s where case management steps in, helping build the stability that allows everything else to follow.
Creating a Plan That Works
Once I understand someone’s needs, we build a plan together. This is never one size fits all. I coordinate with clinicians, doctors, housing programs, and community agencies to create a network of support around the person. That might mean setting up a psychiatry appointment, applying for benefits, connecting them to a food pantry, or advocating for them with a housing provider. A big part of my job is breaking down complicated systems and making them more accessible for the people I serve.
But the truth is, case management is getting harder. Resources continue to shrink as funding is cut or redirected. The need keeps growing, but the safety net we’re working with is stretched thinner each year. Sometimes that means longer waitlists, fewer available beds, or services that simply no longer exist. It can be frustrating to look a client in the eye and know the support they need isn’t there anymore. And yet, we keep showing up, doing everything we can to bridge those gaps.
I like to think of myself as a bridge between my clients and the services that can help them thrive. Even when resources are limited, my job is to make sure people don’t face those systems alone.
A Team Effort: Molly Minson’s Impact
One of the best parts of this work is knowing I’m not doing it alone. Case management thrives when different strengths come together, and my coworker Molly Minson is a great example of that. Molly focuses on housing and benefits, areas that are crucial for many of our participants. She maintains updated resource lists across Washington and Multnomah County, acts as a bridge between participants and the housing team at New Narrative, and checks in regularly to make sure their needs are met.
As a certified Strengths, Opportunities, Aspirations, Results (SOAR) consultant, she helps participants apply for SSDI and SSI, organizes medical records, explains paperwork, and works directly with SSA offices to make confusing processes more manageable.
For many participants, trauma, diagnoses, or past negative experiences make interacting with government systems daunting. Molly steps in to read, summarize, and plan next steps, walking beside them through the process. Having another set of eyes on the situation relieves a lot of stress and anxiety for those we serve.
Molly’s work shows how collaboration strengthens what we do. Her ability to walk beside participants during some of their most stressful moments reflects the heart of case management: partnership and trust.
Advocacy That Empowers
One of the most meaningful parts of this work is advocacy. Sometimes that means going with a client to an appointment, so they don’t have to face it alone. Other times it’s pushing back against a system that isn’t working in their favor. Over time, I try to help clients build their own confidence and skills to advocate for themselves. My goal isn’t for them to rely on me forever. It’s for them to feel empowered enough to stand on their own.
Cultural responsiveness also plays a big role in my work. Every person comes with their own background, values, and lived experiences, and these need to be respected and centered. Real advocacy happens when you see and honor the full person in front of you.
Why Case Management Skills Translate Everywhere
What’s great about case management is how transferable the skills are. Whether you work in mental health, schools, healthcare, or community programs, the foundation is the same: assess, plan, coordinate, advocate, document, repeat. At the heart of it, case managers help people navigate complex systems and move toward greater independence.
For me, that’s the most rewarding part. Watching someone go from feeling stuck and unseen to finding their own power is something that never gets old. It’s hard work, yes, but it’s real work. And it matters.
That’s what being a clinical case manager is all about.
When you support New Narrative, you’re providing resources for our frontline staff as they work with participants to impact their future and goals. Please consider making a donation today.
