Although some specialized clinical services aimed at specifically reducing violence may be needed, intense and effective case management is essential for mentally ill persons in the community. Intensive case management for potentially violent clients requires case managers with special skills and low caseloads. Case managers must be "boundary spanners" who understand and are able to negotiate the medical care, social service, housing assistance, criminal justice, and mental health systems. Intensive case management will fail if appropriate treatment and human services are not available in the community. The authors describe elements of intensive case management for potentially violent clients, including the use of individual case managers responsible for small caseloads and 24-hour case manager availability, as well as strong linkages to agencies providing mental health services, substance abuse treatment, and social services and to criminal justice agencies. They summarize the results of recent studies of intensive case management programs that suggest such programs are effective in reducing dangerousness. The authors also discuss cultural and human resource issues that affect planning of intensive case management services. 15 references