Severe and Persistent Mental Illness

Mental disorders are the leading cause of disability in the U.S. and Canada for people ages 15 to 44, according to the National Institute of Mental Health. Fortunately, only about six percent – or 1 in 17 – suffer from a severe and persistent mental illness.


Severe and persistent mental illness, or SPMI, is the term mental health professionals use to describe mental illnesses with complex symptoms that require ongoing treatment and management, most often varying types and dosages of medication and therapy.
A Cyclical Illness

Severe mental illness typically does not level off and remain at a steady state. Rather, symptoms come and go in relation to stress. As a result, people with SPMI may be able to function independently for periods of time but may need intensive support with housing, school, work, social functioning, and other everyday life concerns when they experience a stressful event.

A Misunderstood Illness

There are many misconceptions about severe mental illness. For example, many people think schizophrenia means “split personality” or they believe psychotic refers to someone who is very angry. Others think that these disorders are identical to mood disorders. In reality, every severe and persistent mental illness is a biological phenomenon caused by physical changes in the brain, causing marked changes in a person’s ability to make choices based on consequences, to socialize, to access community supports, to identify what is real, and to organize thoughts.

Common SPMI Illnesses
  • Schizophrenia
  • Schizoaffective disorder
  • Delusional disorder, psychosis not-otherwise-specified, and other psychotic disorders
  • Bipolar disorder, also known as manic-depression
  • Severe depression that resists treatment and impacts ability to function
  • Personality disorders that are severe enough to prevent functioning

Our Program and Services

At initial visit, all persons receive a detailed psychiatric and medical history and assessment of their current functioning. Persons then receive a recommendation for services, which may medications and individual or group psychotherapy. An individualized treatment plan is co-created with a primary clinical therapist. The primary clinical therapist will coordinate care with input from the person and family.

Admission Criteria

This program is for persons age 18 and older who live within a 45 minute drive from one of our clinical locations. Those persons who live beyond a 45 minute drive may receive consultation services via in person or through our internet telemedicine (audio-video) interface.

Our Staff and Services

Clinical staff include psychiatrists, nurse practitioners, clinical social workers, psychologists, and professional counselors. Using research-based, best-practice clinical skills, we assist persons with their recovery. We provide illness education and medication management, and help persons come up with personal coping and relapse prevention strategies.

Clinical services offered include:

  • Medication management
  • Supportive therapy with focus on recovery management interventions
  • Individual: cognitive behavior therapy, insight oriented therapy, and behavior therapy
  • Group therapy and social skills training
  • Psycho-education and medication adherence
  • Family psycho-education
  • Cognitive enhancement therapy
  • Psychological and neuropsychological testing
  • Linking and coordinating to community based services
  • Telemedicine services: providing psychiatric and psychological services via internet based audiovisual application

If you’d like to find out more about the program and the services we offer, or want to make an appointment, contact Sarina Grewe, LMSW at 586-263-1234.