This program provides psychiatric assessment and rehabilitation for adults with severe and persistent mental illness who may also be experiencing concurrent disorders to substance use and who have exceeded the capabilities of district level resources; typically who have been treatment refractory and are struggling in their home environment. The program offers recovery-orientated service, integrating individuals' wishes and goals through a wellness framework. Patients are supported in developing the skills and supports necessary to live successfully and satisfactorily in the community. In order to accomplish these goals, patients are offered in-depth interdisciplinary psychosocial assessment to identify needs with relevant interventions. Outreach is offered subsequent to discharge with time limited follow-up and consultative services.