Millions of people in this world are living with acute mental health conditions. Some are more severe than the others. However, some individuals continue to face persistent mental health challenges. Severe and persistent mental illness, or SPMI, is a term for mental health conditions that make it hard to manage daily life for a long time.
What Is Severe and Persistent Mental Illness (SPMI)?
Severe and persistent mental illness means living with a mental health condition that remains for a long time. This state lasts a long time and makes daily life much harder. These conditions can make everyday activities, such as work, maintaining relationships, or self-care, difficult. Unlike short-term struggle, SPMI usually needs ongoing support and care.
Experts agree that SPMI is not merely about a specific diagnosis. Rather, it is defined by how serious the symptoms are, how long they last, and how much they affect your ability to work, connect with others, or take care of yourself.
How Common Is SPMI?
In 2024, about 5.6% (1 in 20) of adults in the USA experienced a serious mental illness. That’s around 14.6 million or 1 in 20 adults. More than 7 million adults in the USA live with conditions like schizophrenia, schizoaffective disorder, or bipolar disorder. These mental illnesses are some of the main causes of disability around the world.
In 2022, 15.4 million adults with serious mental illness were reported, and about 10.2 million (66.7%) received some kind of mental health treatment. That means one in every 3 people with serious mental illness didn’t get any treatment at all.
This gap is even wider worldwide. Most people with these conditions are not getting the care they need, and 59.44% and 90% with bipolar disorder and two-thirds of psychotic illnesses aren’t receiving recommended treatment.
Mental Health Disorders That Fall Under SPMI
Some mental health conditions are considered severe and persistent mental health conditions when they cause ongoing problems with daily life and functioning. 
Schizophrenia
This is a long-term mental disorder that changes how someone thinks, feels, and acts. It can involve seeing or hearing things that are not real, like hallucination, holding beliefs that are not based on reality (delusions), and having trouble organizing thoughts or telling what’s real.
Schizoaffective Disorder
This condition includes symptoms of schizophrenia, along with mood changes like depression or episodes of high energy (mania).
Bipolar Disorder
This condition causes severe mood swings, along with changes in energy and activity levels. People can have times when they feel very happy or full of energy (mania or hypomania), and other times when they feel very sad or tired (depression), which can make daily life hard.
Major Depressive Disorder
Depression can be counted in SPMI when it is persistent and lasts for a long time, making it harder to get through daily life. This is more than just feeling sad for a while. It entails feeling hopeless, losing interest in activities you once enjoyed, and struggling with everyday tasks.
Obsessive-Compulsive Disorder (OCD)
When OCD is severe, it can mean having unwanted thoughts and needing to do certain actions or routines over and over. These can take up a lot of time and make it hard to manage daily life.
Borderline Personality Disorder (BPD)
This condition can cause strong mood swings, trouble with relationships, acting without thinking, and feeling unsure about who you are.
Autism:
Autism spectrum disorder may be considered SPMI if it makes daily life very challenging for adults, especially when individuals have other mental health conditions as well.
Symptoms of Severe and Persistent Mental Illness
SPMI is a long-lasting condition, which means symptoms often stay and need regular care. It’s a lot like managing diabetes or heart disease. There may be periods during which symptoms appear more stable, but they can recur or worsen.
Psychiatric Crises
People with SPMI often go through times of serious crisis that may need a lot of help. These people may need to go to the hospital often when their symptoms get too hard to handle outside of the hospital. Crisis times can include very bad episodes of losing touch with reality, thoughts of suicide or actions, or very strong mood swings that can be dangerous for themselves or others.
Cognitive and Behavioral Challenges
One of the main challenges with SPMI is that it can affect how you think and remember things. You might notice it’s harder to focus, make decisions, or remember important details. During difficult periods, it’s also common to see changes in your behavior, like forgetting to take care of yourself or doing things that don’t feel like you.
Impact on Daily Functioning
SPMI can make daily life feel a lot more difficult. You might find it hard to keep up with work or school, and your relationships with family and friends may feel more stressful. Even things like finding a house, managing your money, or getting along with others can start to feel overwhelming.
What Causes SPMI?
There isn’t one single cause of SPMI. Instead, it usually happens because of a mix of things like genes, the body, life experiences, and social factors that all work together to cause mental disorders.
Genetic Factors
Mental illness can be passed down in families, so having a family member with a mental illness can make someone more likely to have SPMI. Scientists have identified additional genes involved, but having a genetic risk does not guarantee that someone will develop SPMI.
Biological Factors
Other biological factors might include infections, brain injuries, problems during pregnancy, drug or alcohol use, not getting enough healthy food, or coming into contact with harmful chemicals. Changes in brain function, brain structure, or hormone levels can also affect the onset and evolution of SPMI over time.
Environmental and Psychosocial Factors
How we act and where we live can also matter. Things like going through something hard, constant stress, feeling alone, or not having people to help can cause symptoms to start or get worse, especially for people who are already at risk.
Treatment Approaches for SPMI
At Brainpower Wellness Institute, we treat serious and persistent mental illness (SPMI) by looking at all parts of your life, and not just one side. Your SPMI diagnosis list will be personalized to your needs using evidence-based methods.
Medication Management
Medication is often an important part of treating serious mental illness, but it’s just one part of the solution. At Brainpower Wellness Institute, medication is used along with therapy, counseling, and changes to your daily habits to help your mental health. For example, certain medications can help with symptoms such as seeing or hearing things that are not there and may reduce the risk of symptoms recurring. The exact medication you take will depend on your own SPMI diagnosis and needs.
- Medicines for schizophrenia and schizoaffective disorder (including newer pills like risperidone, quetiapine, aripiprazole, ziprasidone, and paliperidone)
- Medicines that help balance mood and treat symptoms for bipolar disorder
- Antidepressants for major depression
- Various medications for OCD and other conditions
People with serious mental health conditions often have a hard time taking their medicine the way the doctor tells them to. This can happen because of side effects, forgetting to take it, not liking how it makes them feel, not really understanding their illness, cost, or feeling judged by others. Getting help with taking medicine and having regular check-ins can make things easier. The team at Brainpower Wellness Institute can explain how your medicine works, what side effects to watch for, and why it is important to follow your treatment plan.
Comprehensive Therapeutic Support
At Brainpower Wellness Institute, you’ll find a team of mental health professionals, doctors, and licensed therapists who work together to support you. They use proven therapy methods and focus on what works best for your needs.
There are several types of therapy and support you can try, including:
- Cognitive behavioral therapy (CBT) helps you spot patterns in your thoughts and habits and work on changing the ones that are not helpful
- Psychoeducation, so you can learn more about what you are experiencing and how to manage it
- Family therapy, where your loved ones join in, so you can all work together to improve communication and build a more supportive home
- Trauma-focused care, which is designed to help if you have gone through stressful or traumatic experiences
- Marriage and family therapy, which can help you strengthen your relationships and improve how your family works together.
Holistic, Personalized Care
At Brainpower Wellness Institute, treatment is guided by three core values: compassion, commitment, and care. The practice takes pride in creating treatment plans that fit your needs and preferences. Their approach looks at more than just symptoms and focuses on your overall mental, emotional, and physical health. The team keeps up with the latest in mental health care, offering new solutions and proven methods to help you get better and improve your life.
