The study examined predictors of management problems among residents of a s
upported single room occupancy hotel (SRO) for persons with severe and pers
istent mental illness (SPMI). Case workers completed questionnaires on the
prior six months. We found that medication-compliant residents without drug
abuse were rarely disruptive, while those with co-morbid substance abuse w
ere often disruptive. Residents non-compliant with medication also tended t
o cause management problems whether or not they abused drugs. Supported res
idences should be staffed and organized to minimize medication non-complian
ce and substance abuse which are associated with behavioral disruptiveness.