“…Extensive research have documented the adverse impact of substance abuse on the course of mental illness among persons with SMI, including symptom exacerbation and more frequent hospitalizations, poor adherence to prescribed treatments, and homelessness (Carey, Carey, & Meisler, 1991;Dickey & Azeni, 1996;Drake, Osher, & Wallach, 1991;Haywood et al, 1995;Leal, Galanter, Dermatis, & Westreich, 1999). Integrated treatment approaches, in which both mental health and substance abuse services are delivered within the same program, have demonstrated promising outcomes Donald, Dower, & Kavanagh, 2005;Drake, Mueser, Brunette, & McHugo, 2004).…”