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hospitals & health care serious mental illness community-based services case management assertive community treatment mental health recovery independence skills goal achievement team approach support services crisis support substance abuse rehabilitation coping strategies triggers awareness interpersonal skills budgeting skills safe housing employment resources educational resources medication education community resources continuity of care psychosocial rehabilitation hospital discharge transition client engagement personal success mental health education referrals for service insurance verification team leader coordination employment opportunities accurate assessments individualized treatment plans social skills development community integration healthcare coordination psychiatry services emergency support mental health barriers life skills training supportive housing client-centered approach mental health support holistic care collaborative care model client assistance mental health treatment transitional support client advocacy care provider collaboration hospital & health care