This report is the culmination of an extensive study conducted by NAMI of vocational rehabilitation services for people with severe mental illnesses throughout the country. Sections include: the federal-state vocational rehabilitation system and people with severe mental illnesses: history, purpose and efficacy; the role of public mental health systems and psychiatric rehabilitation programs in providing vocational rehabilitation services to people with severe mental illnesses; the role of state advocacy programs in assisting people with severe mental illnesses to access appropriate vocational services and supports; recommendations; and appendices.