The recommendations put forth in the 1984 American Psychiatric Association Task Force Report The Homeless Mentally Ill provoked widespread discussion in the media, in government, and among mental health professionals. Why, then, do the homeless mentally ill still wander our streets in ever-increasing numbers? That is the subject of this follow-up report, which makes recommendations for the 1990s based on new knowledge about this national problem. The report begins with an analytical review of the available literature since 1984Aa backward glance at what weAve learned and how far weAve yet to go in documenting and responding to the needs of the homeless mentally ill. A discussion of deinstitutionalization in the 1990s underscores the importance of providing community asylum and sanctuary. The second section of this volume addresses treatment and rehabilitation, summarizing current clinical work with the homeless mentally ill. Contributors use case studies to illustrate how mobile outreach teams, residential care facilities, day treatment programs, and clinical case management can serve as effective interventions. They propose special techniques for dealing with medically ill, substance-abusing, and other dually diagnosed homeless mentally ill individuals. And finally, they suggest approaches for reintroducing these individuals back into the community through effective rehabilitation strategies.