I have had the privilege of working primarily in a psychosocial rehabilitation setting while also having the opportunity to work in crisis stabilization and outpatient therapy. As such, I have worked with clients with varying levels of acuity and needs. A common complaint I have heard from clients is not having enough time to make adequate progress towards recovery in relation to the amount of time they are allowed treatment.

One of my primary critiques of CPST is that it is being designed to be a time-limited treatment modality which will only further complaints from clients about only having access to time-limited services. Recovery is a deeply personalized process and putting a time-constraint before even starting services may not be conducive to treatment. The reality is some clients may need significantly more time in services compared to others and if we are to support the autonomy of the client, we should avoid imposing an expectation that a client must be at certain point in recovery at a specific time. In addition, individuals with SMI (serious mental illness) generally have complex needs (housing, legal, health, nutrition, relational) that can take a significant amount of time to resolve before they might have an opportunity to adequately benefit from treatment.

Anyone who has been involved with Virginia's current behavioral health system (even clients) will note that access to treatment and and staffing seems to be one of the most pressing concerns with our state's behavioral health system. CPST's proposal for the staffing of such a program are especially concerning as it ignores the national behavioral health staffing crisis that we are experiencing. Where will all the staffing for CPST come from if we are already having issues staffing existing programs?

CPST means to do well but I think this treatment modality can fit into enhancing current services offered. CPST notes that housing is one of the needs to be addressed by the program. Why not instead provide enhancement to existing PSH (permanent supportive housing) programs? CPST seems to sound like a blend of ACT (Assertive Community Treatment), PSH, and PSR (Psychosocial Rehabilitation) all put together. Why should we create a new program that could potentially result in redundancies when we can enhance and strengthen existing programs. Not to mention, that there is scientific evidence that these existing programs work. If we are not seeing the results that we are expecting from these programs, perhaps we need to focus on enhancing and reworking some of the programs rather than introducing a new one. I think we could address many of the needs of the community outlined by CPST if we enhanced interdisciplinary collaboration between programs such as PSH, ACT, and PSR.