Inclusion Criteria:

• * Serious Mental Illness (diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or chronic depression with moderate impairment in functioning) receiving services at Centerstone(KY and TN)
• * Diagnosis of a chronic medical condition increasing risk of early mortality from cardiovascular or respiratory disease (e.g., diabetes, hyperlipidemia, hypertension, COPD, heart failure, tobacco dependence, obesity), and at least 1 ER visit or hospitalization within the past year or judgment by the treatment team of substantial need for illness self-management training.

Exclusion Criteria:

• * Consumers who do not speak English
• * Consumers with either no, or a well-controlled medical condition will not be included
• * Individuals residing in a nursing home or other institution
• * Evidence of significant cognitive impairment as indicated by a Mini Mental Status Examination score \<24, will be excluded
• Eligibility for the COVID -related substudy is dependent on enrollment and participation in the parent project.