Abstract
There is increasing recognition in Europe that targeted services for the severely mentally ill, such as those developed in North America, may have a place within local sectorised services. Three high quality community support services were visited in Madison, Chicago and New Hampshire. All three services showed considerable similarity of organisation and work practices, with an emphasis upon continuity of care and an assertive style of case management. Substantial differences from U.K. practice and staffing patterns were evident. The clinical activities of Case Managers are described and the network of district services in which CSPs are embedded is outlined. Implications for integrating CSP-type programmes into British Mental Health Services are discussed.