Severe & Persistent Mental Illness

Mental disorders are the leading cause of disability in the US and Canada for people ages 15-44, according to the National Institute of Mental Health. About six percent, or one in 17, suffer from a severe and persistent mental illness (SPMI). This is the term mental health professionals use to describe mental illnesses with complex systems that require ongoing treatment and management, including medication and therapy. Common SPMI illnesses include:

  • Schizophrenia
  • Schizoaffective disorder
  • Delusional/psychotic disorders
  • Bipolar disorder (manic depression)
  • Severe depression that resists treatment and impacts ability to function
  • Personality disorders that are severe enough to prevent functioning

Symptoms of these illnesses generally come and go in a cyclical fashion in relation to stress. As a result, people with SPMI may be able to function independently for prolonged periods of time, but may need intensive support when it comes to housing, school work, social situations, and other everyday life concerns whenever they experience a stressful event.


There are many misconceptions about SPMIs. For example, some people may think schizophrenia means “split personality,” that psychotic refers to someone who is very angry, or that SPMIs are identical to mood disorders. In reality, every SPMI is a biological phenomenon caused by physical changes in the brain, inhibiting one’s ability to organize thoughts, socialize, identify what is real, make choices based on consequences, and access community support.

What can be done for a person with a severe mental illness?

Between 60-90 percent of individuals with serious mental illness experience a significant reduction of symptoms and improved quality of life with a combination of medication and psychosocial supports. Early identification and treatment of mental illness is of vital importance. By giving people the treatment they need early, recovery is accelerated and the brain is protected from further harm related to the course of illness. Alison has extensive experience working with those affected by SPMIs as well as their friends and family.

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