Please select the eligibility criteria that correspond to the clinical trial below.
Title: Life Goals Behavioral Change to Improve Outcomes for Veterans With SMI
Brief Summary: Persons with serious mental illness are at increased risk of cardiovascular disease. The goals of this study are to test a treatment, Life Goals Collaborative Care to help promote health behavior change and to get feedback from patients and providers on what is needed to help better coordinate and physical and mental health care of these patients.


Options:
A: Inclusion Criteria:

* ▪ Age 18 and older

  ▪ Body mass index at least 25 kg/m2 OR one of the following CVD risk factors:
* Hypertension (SBP\>= 140mmHg or DBP\>= 90mmHg or on antihypertensive medications;
* Diabetes mellitus (fasting blood sugar\> 125mg/dl or hemoglobin A1c\>6.5 or on a hypoglycemic medication);
* Dyslipidemia (LDL \>130 mg/dl , HDL\<40 or total cholesterol \>=200 or on a lipid lowering agent);
* Current tobacco smoker

  * Able and willing to give informed consent
  * Completion of baseline data collection
  * Willing to accept randomization
  * Willing to participate in the intervention

Exclusion Criteria:

* ▪ Cardiovascular event (unstable angina, myocardial infarction) within the past 6 months

  * Serious medical condition which either limits life expectancy or requires active management (e.g., certain cancers)
  * Condition which interferes with outcome measurement (e.g., dialysis)
  * Pregnant or planning a pregnancy during study period. Nursing mothers would need approval from physician.
  * Alcohol or substance use disorder if not sober/abstinent for 30 days
  * Planning to leave rehabilitation center or clinic within 6 months or move out of geographic area within 18 months
  * Investigator judgment (e.g., for concerns about participant or staff safety)
B: Inclusion Criteria:

* Patients with the current diagnosis of Bipolar disorder type I or type II according to current DSM-5 criteria and confirmed with a semi structured interview (SCID).
* Hamilton Depression Scale score under or equal to 8 during the last month.
* Young Mania Rating Scale score under or equal to 6 during the last month.
* No history of relapses during the last 3 previous months but at least 1 relapse during the last year.
* Availability of a telephone account with an unlimited data plan during the 12 following months.

Exclusion Criteria:

* Lack of skills to use the offered smart-phone or unwillingness to learn them.
* FAST score above or equal to 20.
* Past or current participation in psychoeducation groups.
* Obsessive-compulsive disorder according to DSM-5 criteria.
* Concomitant severe medical condition.
* Pregnancy.
C: Inclusion Criteria:

* Diagnosis of serious mental illness (schizophrenia, bipolar disorder, other psychosis, major depressive disorder, or other recurrent depression or affective disorder)
* Have at least one of the following risk factors for CVD (cardiovascular disease):

Body mass index (BMI) \>28 or waist circumference of \>35 (women) or \>40 (men) inches OR Self-reported diagnosis of hypertension ("high blood pressure"), dyslipidemia ("high cholesterol") or diabetes or high blood sugar OR Documentation in the medical record of a diagnosis of or treatment for hypertension (defined as documented diagnosis or blood pressure of \>140/90 on 2 occasions or prescription for an antihypertensive medication), dyslipidemia (documented diagnosis or LDL\>160 or prescription for a lipid-lowering medication) or diabetes mellitus (documented diagnosis or HbA1C \>7% or current prescription for oral hypoglycemic therapy)

Exclusion Criteria:

* Have unresolved substance intoxication or withdrawal, such as appearing to be intoxicated (e.g., incoherent, slurred speech), or experiencing withdrawal symptoms from substance abuse at the time of enrollment.
* Are unwilling or unable to provide informed consent or comply with study requirements at the time of enrollment (e.g., unable to complete forms or attend sessions due to substantial functional limitations).
* Active suicidal ideation at time of enrollment (focused interventions are more appropriate for this group)
D: Inclusion Criteria:

* Confirmed SCID DSM-IV clinical diagnosis by trained remote clinical assessor of:

  * schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, psychotic disorder NOS
* Any duration of untreated psychosis
* Any ethnicity
* Ability to participate in research assessments in English
* Ability to provide fully informed consent (assent for those under age 18)

Exclusion Criteria:

* Inability to understand what research participation entails or correctly answer the questions about research participation that are part of the Study Information Review and provide fully informed consent
* More than 4 months of prior cumulative treatment with antipsychotic medications
* Diagnosis of bipolar disorder, psychotic depression or substance-induced psychotic disorder
* Current psychotic disorder due to a general medical condition
* Current neurological disorders that would affect diagnosis or prognosis. These would include, but are not limited to seizure disorders, dementing or degenerative disorders, lesions or substantial congenital abnormalities. In most cases, disorders such as headache disorders would not require protocol exclusion
* Clinically significant head trauma
* Any other serious medical condition that in the opinion of the investigator would seriously impair functioning making the patient unsuitable for the trial

Answer: C