Pathways, Inc. was established in 1981 by Greenwich families responding to the needs of relatives and others who were discharged from psychiatric hospitals following long periods of institutionalization and were often homeless or living in substandard dwellings. Today the agency also targets services to adults who have been cared for at home by family, often aging parents concerned about how to ensure good long-term care for their children.

The original founders of Pathways sought to prevent homelessness and repeated hospitalizations by creating housing and support services that enable adults with mental illness to manage their symptoms and live independently and productively in their home community. Today, Pathways operates four residences, a psychosocial day program, prevocational training, and a case management and outreach program.