From the Department of Community, Mental Health and Systems, Rush College of Nursing, Chicago, IL. Corresponding Author: Kathleen R. Delaney, PhD, PMH-NP, Professor, Department of Community, Mental Health and Systems, Rush College of Nursing, 600 S Paulina Street, Chicago, IL. E–mail addresses: alice_geis@rush.edu (A. Geis), kathleen_r_delaney@rush.edu (K.R. Delaney). © 2010 Elsevier Inc. All rights reserved. 0883-9417/1801-0005$34.00/0 doi:10.1016/j.apnu.2010.08.002 “WHOWASABLE to get their hemoglobin A1C results?” The room was silent. The advanced practice psychiatric nurse (APN) is gathered with eight clients in a psychoeducational group named Managing Diabetes. All of the participants are recovering from a major mental illness and coping with Type 2 diabetes. Several clients have other comorbid medical illnesses. The issue on the floor (a follow-up of last week's topic) was controlling blood sugar level. The clients had been asked to obtain their latest AIC results. The question hung in the air unanswered. One client, who had been called by his primary care provider's office with his results, volunteered an answer, “7.6.” The remaining seven people in the group had little to say because they had not gotten in touch with their providers to obtain the information. Exploring the issue, it became clear that the clients either did not know how to access their medical information or were not comfortable doing so. The group leader (the first author of this column) realized that to move the group toward self-management of diabetes, the approach needed tweaking. The group uses a set of tools based on the American Diabetic Association's guidelines and modified as needed for use with persons with serious psychiatric disorders. What became clear in this instance was that, sometimes, tool kits do not have all the tools that one needs to put integrated care in motion. These clients needed help with selfadvocacy, particularly with their health care providers. Without that, the clients lacked the information they needed to begin the self-management process. Luckily, about the same time, a nursing student at the agency became interested in this idea of building clients' self-advocacy skills. She worked with the APN to devise a set of group