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What is Serious Mental Illness (SMI)?

Updated: Oct 20


Did you know that nearly one in five U.S. adults lives with a mental illness? Mental illnesses include many different conditions that vary in level of severity, ranging from mild to moderate to severe. There are two categories that can be used to describe these conditions: Any Mental Illness (AMI) and Serious Mental Illness (SMI). Any Mental Illness includes all recognized mental illnesses. Serious Mental Illness (SMI) on the other hand, is defined more specifically as a diagnosable mental, behavior, or emotional disorder, found in patients 18 and older, that causes serious functional impairment that substantially interferes with one or more major life activities. Having an SMI can directly impact your work life, concentration in school, healthy relationships, socializing, maintaining hygiene, and more. The four diagnoses most commonly associated with SMI are:


  • Bipolar disorder- a mental health condition associated with extreme changes in mood, thought, energy, and behavior. Formally known as Manic Depression, bipolar disorder can change a person’s mood from high to low. These changes in mood can last for hours, days, weeks or months. To learn more about bipolar disorder, visit Depression Bipolar Support Alliance or National Alliance on Mental Illness (NAMI).

  • Major depressive disorder (MDD)- one of the most common mental disorders. People with MDD have experienced at least one major depressive episode (five or more symptoms for at least a two-week period). Symptoms vary from person to person, but may include sadness, hopelessness, anxiety, pessimism, irritability, worthlessness, and fatigue. To learn more about MDD or the different types of depression visit Depression Bipolar Support Alliance.

  • Schizophrenia- a type of serious neuro-psychiatric brain disease in which people interpret reality abnormally. People may experience hallucinations, delusions, extremely disordered thinking and a reduced ability to function in their daily life. For more information about Schizophrenia or to get help visit the Schizophrenia & Psychosis Action Alliance.

  • Schizoaffective disorder- a chronic mental health condition with similar symptoms to Schizophrenia, such as hallucinations or delusions, with additional symptoms of a mood disorder, like depression. To evaluate treatment options or view a full list of symptoms visit National Alliance on Mental Illness (NAMI).


Treating SMI

Although there are a variety of treatment options for people with SMI, they vary by person. Even people with the same diagnosis have different experiences, needs, goals and objectives for treatment. It’s important to find a doctor you are comfortable with and work together to determine the treatment plan that is best for you. A helpful resource, which can be used to explore treatment options and has an abundance of information about SMI is smiadviser.org.

The Early Serious Mental Illness Treatment Locator, another great resource, is a confidential and anonymous source of information for persons and their family members who are seeking treatment facilities in the United States or U.S. Territories for a recent onset of serious mental illnesses such as psychosis, schizophrenia, bipolar disorder and other conditions.


With early and consistent treatment, these conditions can be manageable, allowing individuals to live meaningful and productive lives. Today, there are new tools, evidence-based treatments, and social support systems that help people with SMIs feel better and pursue their goals.


Some Tips for Living with a Serious Mental Illness from SAMHSA are:

  • Find and stick to a treatment plan, with direction from your doctor. Even if you feel better, don’t stop going to therapy or taking medication without a doctor’s guidance. Work with a doctor to safely adjust doses or medication if needed to continue a treatment plan.

  • Keep your primary care physician updated. Primary care physicians are an important part of the long-term management of an SMI, even if you also see a psychiatrist.

  • Do your own research about the disorder. Being educated can help you stick to your treatment plan. Education can also help your loved ones be more supportive and compassionate.

  • Practice self-care. Control stress; eat healthy and exercise; and get enough sleep.

  • Reach out to family and friends. Maintaining relationships with others is important. In times of crisis or rough spells, reach out to them for support and help.

Support from family and friends can play a huge role in a loved one's active recovery. It’s helpful if family members are open to attending support groups or family counseling. Family members often notice when their loved ones are experiencing changes in mood or behavior. By offering support and helping their loved one connect with the appropriate treatment providers and services, individuals are more likely to stay on their recovery journey.


To find a full list of local support services visit our website and download our resource guides . You will find various options in lower Fairfield county, Connecticut. You can also use the SAMHSA treatment locator.


If you're in crisis, contact one of the organizations below.

  • National Suicide Prevention Lifeline, 1-800-273-TALK(8255) or suicidepreventionlifeline.org

  • Crisis Text Line, Text HELLO to 741741

  • Magellan Health Crisis Hotline, 1-800-327-7451

  • Action Line, 1-800-HOPE-135 or 211

  • Kids in Crisis: 203-661-1911

  • The Trevor Project for LGBTQ Lives: 866-488-7386

If you are in need of immediate help, call 911.


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