The MHTS compared the clinical and vocational outcomes of two randomly assigned conditions. Evaluators compared usual care with free access (no cost sharing and no care management other than clinical case management) to evidence-based clinical care in combination with individual placement and support. The intervention was implemented with a reasonable degree of fidelity and minimal patient dropout. The study produced the following key results. First, only 14% of SSDI beneficiaries contacted about joining the study agreed to enroll. Compared with those who did not participate, those who did were younger, had been on SSDI for less time (8 years compared with 12 years), and were more likely to have attempted to get work in recent periods. Thus, the MHTS was conducted with a relatively highly motivated segment of those with severe mental illness on the SSDI rolls; in many respects this represents a best-case scenario. Second, the intervention group was significantly more likely than control participants to engage in both paid and competitive employment (60.5% compared with 40.3%). Third, the level and duration of employment was also significantly greater for the intervention group. The intervention group experienced 6.2 months of employment in various jobs over the 2 study years, compared with 3.7 months for the control group. Weekly hours of work for those employed were about 12 hours for the intervention group and 7.6 hours for the control group. Fourth, the intervention group incurred significantly fewer overnight hospital days and mental health-related emergency department visits.