One project has been a new 20-bed unit for extended-stay patients considered discharge resistant. The hospital medical director undertook transformation of an existing unit with a traditional, largely custodial orientation. The target group included patients who appeared unwilling to leave the hospital and some patients whose transfers had been rejected by outside agencies. This unit opened in July 2003, under newly recruited medical leadership. The affiliation's strategies included mentoring, training, and modeling recovery-oriented skills and attitudes; identifying individual discharge barriers; developing directed staff interventions; and assessing patient and staff attitudes and behaviors over time. The methodology incorporated established protocols such as Eli Lilly and Company's Team Solutions, the social and independent living skills modules developed by Robert Liberman, M.D., and illness management-and-recovery (IMR) groups, as well as novel strategies adapted for the perceived needs of the setting. Facilitation of successful discharge addressed the unique barriers for each patient. Skills for development encompassed identification and pursuit of individual life goals, improving frustration tolerance, interviewing skills, social and independent living skills, awareness of hopes and desires, personal responsibility, problem solving and independence, and reduction of cognitive symptoms.