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Serious Mental Illness (SMI)

Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. www.nimh.nih.gov/health/statistics/mental-illness.shtml

Serious mental illnesses (SMIs) are a small subset of the 300 mental illnesses that are in DSM. ... By all accounts, serious mental illnesses include “schizophrenia-spectrum disorders,” “severe bipolar disorder,” and “severe major depression” as specifically and narrowly defined in DSM.  ​People with those disorders comprise the bulk of those with serious mental illness. However, when other mental illnesses cause significant functional impairment and substantially limit major life activities they also count as a serious mental illness. According to the National Institute of Mental Health, serious mental illness is relatively rare, affecting only 5% of the population over 18. Serious mental illness includes schizophrenia; the subset of major depression called “severe, major depression”; the subset of bipolar disorder classified as “severe” and a few other disorders.mentalillnesspolicy.org/serious-mental-illness-not/

Members of the media regularly call the Treatment Advocacy Center to ask, "Why is your estimated total of people with 'serious mental illness' so different from -" before naming another group or agency or similar resource.
The answer inevitably lies in how SMI is defined.
At the Treatment Advocacy Center, where the mission is to remove barriers to treatment for the most disabling serious mental illnesses (SMI), we define SMI as severe psychiatric diseases with symptoms that put individuals who experience them at the greatest risk for criminal justice involvement, homelessness, hospitalization and/or involuntary treatment. Typically, these are disorders with psychotic features, although mania also can elevate risk. www.treatmentadvocacycenter.org/fixing-the-system/features-and-news/3771-research-weekly-what-is-qserious-mental-illnessq
From the Treatment Advocacy Center: A Bed Instead Campaign
One of the most useful resources that has been created as a result of the #ABedInstead campaign is an infographic that illustrates what happens when serious mental illness isn’t treated. There are 8.1 million people who suffer from mental illness and 3.9 million of these people have untreated mental illness.Multiple studies have shown that individuals with serious mental illness are especially vulnerable to being victimized, and that is even more likely if they are non-adherent to medications according to our Victimization and Serious Mental Illness backgrounder.
There are 169,000 homeless adults who have untreated mental illness, and 44 states and D.C. hold more people with serious mental illness in jails and prisons than the largest remaining psychiatric hospital. Individuals with bipolar disorder have a suicide risk 15 times higher than the general population, and suicide is the most common cause of death in schizophrenia.
All of this data is included in our infographic, in an easy-to-read way that can be shared however is easiest for you. It’s even available as a printable PDF. Feel free to share this infographic throughout your social media channels and your own websites.
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​Managing the Physical Health Risks That Come With Severe Mental Disorders
nursing.usc.edu/blog/mental-illness-physical-health-risks/

Research has found that people with severe mental disorders (SMD) have an average life expectancy that is 10 to 20 years lower than the general population. External link  This may seem unsurprising when considering the heightened risk of suicide among people with conditions such as major depressive disorder, schizophrenia and bipolar disorder. However, research has found that physical health risks are a major factor in the shortened life span of people with SMD. More importantly, many of these risks, such as diabetes and cardiovascular disease, are preventable, prompting the medical community to take action and push for more interdisciplinary care.

Continued below...Read more in the above link.
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​According to “Guidelines for the Management of Physical Health Conditions in Adults With Severe Mental Disorders,” External link  released by the World Health Organization (WHO), individuals living with SMD are at a much higher risk for developing a number of physical health complications. These health risks include both non-communicable and communicable diseases.
  • People with SMD have an approximately one to three times higher risk of cardiovascular morbidity and mortality compared to the general population.
  • People with schizophrenia and bipolar disorder have double the risk for diabetes compared to the general population while people with depression have 1.5 times the risk.
  • Infectious diseases, including tuberculosis and hepatitis, appear to contribute to an increased risk of death in people with SMD, with a risk that is four to eight times greater than that of the general population.
  • Among people with SMD, the median prevalence of HIV in the United States is 1.8 percent with a higher rate of 3.8 percent among inpatient populations. The overall United States adult population estimated prevalence of HIV is 0.5 percent.​
  • One of the most prominent links between mental and physical health is a person with SMD’s increased exposure to behavior-based risk factors. This can include smoking, substance abuse, lack of physical activity, unhealthy diets and engaging in risky behavior.
management_of_physical_health_conditions_in_adults_with_severe_mental_disorders_who_guidelines.pdf

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