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This paper studies the rates of rehospitalization as well as the average length of stay in a 10 year period of individuals with serious and persistent mental disorders. All individuals in this study received CSP and come from rural Western Minnesota. Findings indicate no lessening of the effectiveness of CSP over the 10 year period as measured by both rate of rehospitalization and length of treatment. The study gives further evidence for the importance of milieu in treatment of people with serious and persistent mental disorders, with the more sparsely populated areas having a lower rate of rehospitalization.