The document discusses the term "serious mental illness" (SMI) and what it encompasses. It notes that the federal definition of SMI is very broad, including disorders like schizophrenia, bipolar disorder, major depressive disorder, and others that result in impaired functioning. However, the term SMI is often used more narrowly in public discourse to refer primarily to disorders with potential for violence like schizophrenia and bipolar disorder. The document argues that all mental illnesses deserve research focus given their potential to impair, and that basic science research, though not always focused on specific disorders, is also critical to progress in diagnosing and treating SMI into the future.
The document discusses the term "serious mental illness" (SMI) and what it encompasses. It notes that the federal definition of SMI is very broad, including disorders like schizophrenia, bipolar disorder, major depressive disorder, and others that result in impaired functioning. However, the term SMI is often used more narrowly in public discourse to refer primarily to disorders with potential for violence like schizophrenia and bipolar disorder. The document argues that all mental illnesses deserve research focus given their potential to impair, and that basic science research, though not always focused on specific disorders, is also critical to progress in diagnosing and treating SMI into the future.
The document discusses the term "serious mental illness" (SMI) and what it encompasses. It notes that the federal definition of SMI is very broad, including disorders like schizophrenia, bipolar disorder, major depressive disorder, and others that result in impaired functioning. However, the term SMI is often used more narrowly in public discourse to refer primarily to disorders with potential for violence like schizophrenia and bipolar disorder. The document argues that all mental illnesses deserve research focus given their potential to impair, and that basic science research, though not always focused on specific disorders, is also critical to progress in diagnosing and treating SMI into the future.
The document discusses the term "serious mental illness" (SMI) and what it encompasses. It notes that the federal definition of SMI is very broad, including disorders like schizophrenia, bipolar disorder, major depressive disorder, and others that result in impaired functioning. However, the term SMI is often used more narrowly in public discourse to refer primarily to disorders with potential for violence like schizophrenia and bipolar disorder. The document argues that all mental illnesses deserve research focus given their potential to impair, and that basic science research, though not always focused on specific disorders, is also critical to progress in diagnosing and treating SMI into the future.
we at NIMH have been increasingly focusing our research on serious mental illness (SMI). You come from? In the 1992 ADAMHA Reorganization Act (P.L. 102-321), Congress directed the Secretary of features; however, they vary in terms of severity and disabling effects.” Federal Register Volume 58 No. 96 published Thursday May 20, extreme (and rare) negative outcome of disorders like these, warranting particular emphasis, but it is not the only negative outcome to can see the term SMI in Health and Human Services 1993, pages 29422-29425. consider. For example, recent blogs as well as in to develop a federal anorexia nervosa can be publications from NIMH. But definition of SMI to aid in the While the federal definition fatal—yet eating disorders what does “SMI” really estimation of SMI incidence of SMI is specific to adults, have understandably been mean? If we call some and prevalence rates in states there is an analogous excluded from discussions illnesses “serious,” does that that were applying for grant definition of “serious about SMI following the mean that others are not? funds to support mental emotional disturbance” events in Newtown, And if some mental illnesses health services. (SED) for children. Both SMI Connecticut. are not classified as serious, and SED definitions focus on does that mean they aren’t “Adults with a serious mental the DSM diagnosis, plus In fact, all mental illnesses significant? Does everyone illness are persons: (1) age 18 degree of impairment. have the potential to be with a diagnosis of and over, (2) who currently impairing and meet the schizophrenia or bipolar or at any time during the past As you can see, the “official” meaning of “serious” in the disorder have SMI? What year, (3) have a diagnosable definition of SMI is very sense of the federal about anorexia nervosa or mental, behavioral, or inclusive—though I imagine definition. NIMH supports an borderline personality or emotional disorder of that when people talk about extensive portfolio on all PTSD – do these qualify as sufficient duration to meet SMI these days—they don’t aspects of mental illness— SMI? Should we focus our diagnostic criteria specified have the Federal Register from basic research to efforts on the best science within the Diagnostic and definition in mind. Recently, clinical investigations, from that will reduce the Statistical Manual of Mental SMI has been a subject of rare to common disorders, in tremendous morbidity and Disorders (DSM)-III-R, (4) conversation in the wake of men and women, affecting mortality associated with all that has resulted in functional recent shooting tragedies. adults and children, in a mental illnesses or should we impairment which Discussions about SMI and diversity of populations. To limit ourselves to those substantially interferes with violence—directed towards better understand how NIMH causing the most disability? or limits one or more major self or others— are usually research addresses SMI, let To answer these questions, a life activities…All of these focused on schizophrenia and me provide a quick break- little history might help. disorders have episodic, bipolar disorder, and down of our overall portfolio recurrent, or persistent sometimes major depressive using figures from 2012. Last disorder. Violence is an year, nearly 13% of our total identifying the major circuits run, is the most direct path to budget was mandated for important for behavior, and “paving the way for research on HIV/AIDS. And deciphering the language of prevention, recovery, and about 5% went to the brain are critical cure.” administrative costs: support investments for NIMH in for the Institute, funding our order for us to make progress hospital and clinics, and on diagnostics and general overhead. Research therapeutics for SMI. on disorders that can be Similarly, basic behavioral disabling (including autism) science can give us the tools covered 51% of our non- to detect the earliest signs of AIDS portfolio. But if one schizophrenia or autism. We looks at the broad range of do not count these among our research that could shed light SMI portfolio, yet investing on new diagnostics or new in basic science may be our treatments, then one could most important investments consider that 81.3% of our for people with serious non-AIDS portfolio was mental illness. dedicated to SMI research. So when we say that NIMH Our investment in basic is increasing our focus on science—usually unrelated to SMI, what we really mean is a specific diagnostic that we are investing in the category—accounts for the best science that can reduce 30% interval between our the most disability and SMI portfolio defined mortality. Some of these narrowly (51%) vs. broadly investments are focused on (81.3%). We continually talk biomarkers or new treatments about serious mental for schizophrenia, bipolar disorders as brain disorders. disorder, and major What we don’t say is that our depressive disorder. But we knowledge of how the brain also are committed to works remains far behind our supporting science that will understanding of other organ give us a much deeper systems. Developing tools for understanding of brain and understanding the brain, behavior. That, in the long