The purpose of this study is to determine whether Recovery Guide support services are effective in promoting recovery and social integration among psychiatrically disabled individuals who experience high rates of inpatient hospitalizations.

The paradigm shift in mental health treatment from a deficit-and institution- based framework to a recovery and community integration frame necessitates new models of "case management" practices. The Recovery Guide model is just such a model. Beyond theoretical frameworks, the effectiveness of Recovery Guides has not been well studied. It is the intent of this study to conduct a randomized trial examining the effects of Recovery Guides on community tenure and integration. Furthermore, it is the intent of this study to to establish fidelity criteria.

Comparison(s): Recovery Guide services in addition to treatment as usual, compared to treatment as usual.

Inclusion Criteria:

• 18 years of age or older
• Currently admitted in the Yale-New Haven Psychiatric Hospital (YNHPH)
• A history of two or more prior admissions within the past 18 months
• Proficient in the use of the English language
• A DSM-IV diagnosis of Schizophrenia, Schizoaffective Disorder, Psychotic Disorder NOS, or Major Depressive Disorder with Psychotic Features

Exclusion Criteria:

• Inability to give signed, written consent
• Primary DSM-IV diagnosis of substance abuse/dependence