This study examined history of arrest and victimization in an urban community sample of severely mentally ill adults. Adults (n = 308) were consented and interviewed in one of four short-term residential treatment facilities in San Francisco. Nearly three quarters (71.4%) had been arrested at some time in their lives, 28.2% of whom had been arrested in the past 6 months. Substance use and homelessness were associated with history of arrest, while gender and ethnicity were not, although African Americans were more likely to have spent longer time in jail or prison. One quarter (25.6%) reported victimization. Being female (OR 2.02, 95% CI 1.2-3.5, p = 0.032) and homeless (OR 2.1, 95% CI 1.2-3.8, p = 0.013) were associated with reporting victimization. Severe mental illness, in particular in combination with substance abuse and homelessness, is associated with higher prevalence of both arrest and victimization history. Healthcare providers should solicit histories to include these events in order to understand and provide optimal care and case management services.

Determinants of physical functioning in this sample included well-known demographic predictors of health outcomes. The more striking finding was a deviation from normative data that began for study participants at the age of 25 years, indicating an early onset of limitations. The consistent trend of poorer functioning with each successive age group raises questions about the pace of physical decline among adults with mental illness that may be addressed in longitudinal studies.

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This randomized controlled trial examined benefits of adding active health promotion to basic primary care (BPC) services for SMI adults. It compared BPC with BPC plus wellness training (WT), a 12 months intervention promoting individual skills in self-management. Three hundred nine participants enrolled during short-term residential treatment completed baseline assessments and were assigned to treatment groups, before discharge. Outcomes of perceived health status (SF-36), global assessment of function, and ratings of self-efficacy were assessed at follow-up interviews at 6, 12, and 18 months. The intent-to-treat analysis employed multilevel regression to examine differences by group on outcomes across time, controlling for health related covariates. The WT group showed significantly better outcomes on the SF-36 physical functioning and general health scales. Findings affirm ability of SMI adults to benefit from active health promotion.