The nature of the effort required of a holistic practice with severely and chronically mentally ill persons, integrating, on a practical level, a complex field of information and influences, can already be seen in the earliest social work aftercare practice. This practice and the ideas that shaped it occurred decades before deinstitutionalization and case management became policy passwords, and policies and programs are still evolving to adequately recognize and appropriately channel the effort and resources required.In looking back at the early professional collaboration between socialwork and psychiatry, we confront the vision that infused it. We recognize the need for continued shared struggle to conceive and to implement an integrated and collaborative vision of treatment, care, and rehabilitation for persons with serious mental illness: a vision that fundamentally recognizes the moral necessity for treatment that is caring, the therapeutic potential of care that is proper, and the value of comprehensive rehabilitation that is medical, psychological, and social.