These high rate of PTSD impact the physical as well as mental health of patients with SMI. In a multisite study of 782 patients with SMI , Muser et al .(2004) found that 34.8% of patients had PTSD, which was associated with more alcohol disorders, increased recent psychiatric hospitalization, health problems leading to subsequent doctor visit, and hospitalization for these medical problems. Cusack, Freueh and Brady (2004) also found PTSD in patients with SMI to be positively associated with poorer physical and mental health