Community-Based Intensive Treatment (CBIT): Meeting the Complex Needs of Rural Adults With Serious Mental Illness

The purpose for this research project is to successfully achieve the primary systems intervention outcome, maintaining fidelity to the intervention model and time to rehospitalization. In the proposed research, the plan is to build the research infrastructure to ultimately test the effectiveness of CBIT on time to rehospitalization in a sample of rural Americans with SMI and determine the effective implementation strategies to bring the program to scale to address the significant unmet needs of this population. The proposed research will improve scientific knowledge and clinical and community practice by identifying the CBIT intervention's key components associated with enhancements in overall wellness and the mechanisms through which these improvements are attained. This may also better inform the practical and logistical design of future research for CBIT.

Inclusion Criteria: * The target population is adults diagnosed with a serious mental illness living in rural areas and at risk of rehospitalization after being discharged from a psychiatric hospital. * Currently referred or receiving services from the standing CBIT program offered, age 18 years of age or older, and able to provide consent. * Eligibility criteria for the CBIT program are aged 18 or older, who have a serious mental illness (e.g., diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder), and who need an intensive level of care. * In addition, CBIT program participants must meet at least two of the following criteria: 1) At least two psychiatric hospitalizations in the past 12 months or lengths of stay equal to 30 days or more within a 12-month time frame, 2) unmanageable or persistent severe major symptoms (e.g., psychotic symptoms, suicidality) 3) are unhoused, living in unsafe housing, or at risk of becoming unhoused, 4) currently receiving treatment from an inpatient or supervised residential setting, but able to live independently with adequate provision of community-based intensive services. Participants must also live or receive services within the selected rural counties. Exclusion Criteria: * Adults not diagnosed with a serious mental illness, not at risk of rehospitalization * Not having be hospitalized * Not currently receiving or referred for CBIT services * Not able to provide informed consent * Not being 18 years of age or older