Articles

Managing Co-Occurring Substance Use in SMI Services: Integrated Operational Approaches That Reduce Harm
Substance use is common in SMI populations and significantly increases clinical, safeguarding, and system risk. This article explains how SMI services operationalize integrated, harm-aware substance use responses that reduce crisis and meet commissioner expectations. Read more...
Medication Adherence and Relapse Prevention in SMI Services: Operational Systems That Work in Practice
Medication nonadherence is one of the most predictable drivers of relapse, crisis, and re-hospitalization in SMI populations. This article sets out operational medication support systems that balance autonomy, safety, and accountability while meeting Medicaid and county oversight expectations. Read more...
Housing Instability and Tenancy Sustainment in SMI Services: Operational Models That Reduce Crisis
Housing instability is one of the strongest predictors of crisis and inpatient use in high-acuity SMI populations. This article explains practical tenancy sustainment workflows, cross-system coordination, and governance controls that help SMI providers reduce displacement, safeguarding risk, and avoidable emergency escalation. Read more...
Managing Missed Contacts and Engagement Volatility in High-Acuity SMI Services
In SMI services, missed contacts are rarely “noncompliance” and more often a predictable signal of risk, instability, or system friction. This article sets out operational workflows for outreach, escalation, and documentation that reduce crisis events while meeting Medicaid and county expectations for continuity and safety. Read more...
Clinical Oversight and Decision-Making in High-Risk SMI Services
High-acuity SMI services depend on strong clinical oversight to manage risk, support frontline staff, and produce defensible decisions. This article sets out how supervision, escalation authority, and governance structures operate in real services under Medicaid and county scrutiny. Read more...
Managing Co-Occurring Substance Use in SMI Services: Operational Integration, Risk, and Accountability
Co-occurring substance use is the rule, not the exception, for people with serious mental illness and complex needs. This article explains how SMI services can integrate substance use management into daily delivery, reduce crisis escalation, and meet Medicaid and county expectations without fragmenting care. Read more...
SMI, Housing Instability, and Complex Needs: Designing a Community Stabilization Pathway
For high-acuity SMI populations, housing instability is not a “social issue” separate from clinical risk—it is a driver of relapse, crisis use, and safeguarding concerns. This article explains how to build a stabilization pathway that integrates outreach, tenancy-facing workflows, and clinically-led risk management while staying funder-ready. Read more...
Building a High-Acuity SMI Service Model: Triage, Engagement, and Clinical Continuity
High-acuity SMI services fail most often at the handoffs: referral intake, outreach, medication continuity, and escalation. This guide breaks down a practical service model that stabilizes people with serious mental illness and complex needs across community settings, with clear workflows, accountability, and funder-ready evidence. Read more...