Intervention Trial to Decrease Cardiovascular Risk in Persons With Serious Mental Illness

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)