Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).

Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.

Opening Doors to Recovery: Opening Doors to Recovery (ODR) was created by a large, collaborative group in southeast Georgia as a recovery-oriented approach that navigates clients into services that may in some cases be fragmented and seemingly inaccessible. The team of three Community Navigation Specialists (CNSs) strives to help clients reduce institutional (e.g., hospital, jail) recidivism and embrace recovery. Their process of community navigation is a broader function than traditional case management as it includes mapping out and connecting clients to all available local resources, which requires being embedded in the community. The work of the CNSs benefits from commitments of diverse collaborative ODR partners, including local treatment providers, law enforcement, employers, and housing programs. Each CNS was expected to meet with the client at home or in community settings at least monthly, with the client having contact with at least one CNS weekly.

Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.

Case Management (CM) services consist of providing essential environmental support and care coordination to assist the individual with improving his/her functioning, gaining access to necessary services, and creating an environment that promotes recovery as identified in his/her Individual Recovery Plan (IRP). The focus of interventions includes assisting the individual with: (1) developing natural supports to promote community integration, (2) identifying service needs, (3) connecting them to services and resources, (4) coordinating services identified on the IRP to maximize service integration and minimize service gaps, and (5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs. Contact must be made with the individual ≥2 times per month, at least one of which must be in-person, in a non-clinic setting.

Intensive Case Management (ICM) is very similar to CM, but 4 in-person visits are required monthly. At least 60% of contacts must be face-to-face, and at least 50% must be delivered in non-clinic settings. ICM teams include 9 professionals: a licensed clinician, 4 masters-level clinicians, 2 bachelors-level clinicians, and 2 paraprofessionals. The team's maximum caseload is 200 in rural settings and 300 in urban settings (22-33 per team member).