Operational Definition of Serious Mental Illness: Heterogeneity in a Review of the Research on Quality-of-Life Interventions

Abstract

BACKGROUND: An operational definition of serious mental illness (SMI) with well-defined inclusion criteria allows the identification of the most vulnerable individuals and secures resources to meet their needs and develop social programs for their treatment, rehabilitation, and recovery. In addition, the contents of a clinical construct such as SMI have an impact on both the development and the clinical application of the research results. However, currently, different ways of operationalizing the definition of SMI coexist. AIMS: The aim of this review was to explore whether unanimity exists in the operationalization of SMI definitions in quality-of-life interventions research. METHODS: A review of the literature based on searches of the MEDLINE and PsycINFO databases was conducted. Intervention studies were selected in which quality of life was the outcome variable and adults with SMI were the subject population. RESULTS: A wide range of definition of SMI is used in the scientific literature. CONCLUSIONS: There is a lack of unanimity in the variables considered necessary to identify SMI. The scientific literature uses different approaches to operationalize SMI, and these approaches vary considerably among studies. Caution is required when interpreting quality-of-life research that includes individuals labeled with SMI. It is necessary to reach a consensus on the criteria for applying the SMI label to ensure its content validity.

Testing Kumpfer’s Resilience Model Among Adults With Serious Mental Illness

“…Thus, the generalizability of our findings to people with SMI who differ from our sample may be limited. Future research should consider using objective measurements to determine psychiatric diagnosis (e.g., the Structured Clinical Interview for DSM -5®), functional disability (e.g., the Global Assessment of Functioning), and duration (e.g., number/duration of psychiatric hospitalizations) to confirm individuals meet the researchers’ definition of SMI (Martínez-Martínez et al, 2020), and recruiting a more representative sample of people with SMI to increase the generalizability of findings. Next, as mentioned earlier, some of our insignificant results may be related to statistical power.…”

Digital Community Inclusion of Individuals With Serious Mental Illness: A National Survey to Map Digital Technology Use and Community Participation Patterns in the Digital Era

“…The survey was distributed in Israel between February 2018 and May 2019 among adult individuals (over the age of 18 years) who identified as having SMI (the study group) and those without SMI (a comparison group), based on a screening question. SMI was defined on the basis of the Substance Abuse and Mental Health Services Administration criteria [ 42 ], which are acceptable for distribution of block grants to state governments, and the Israel National Insurance Institute criteria in Israel for disability support [ 43 , 44 ]. Accordingly, individuals with chronic conditions, such as schizophrenia, major depression, or another mental health disorder that results in serious disability are considered under the umbrella of SMI [ 45 , 46 ].…”

Psychometric properties of post-traumatic stress disorder (PTSD) checklist for DSM-5 in persons with serious mental illness

“…Prior research, however, has not evaluated the factor structure of the PCL-5 among individuals with serious mental illness (SMI), which is commonly defined as ‘having (within the past year) a diagnosable mental, behavior, or emotional disorder that causes serious functional impairment that substantially interferes with or limits one or more major life activities.’ (Substance Abuse and Mental Health Services Administration (SAMHSA), 2017 ). Although clear consensus is lacking in its definition (Martínez-Martínez, Richart-Martínez, & Ramos-Pichardo, 2020 ), SMI has traditionally been linked with schizophrenia, bipolar disorder, and treatment refractory major depression (Parabiaghi, Bonetto, Ruggeri, Lasalvia, & Leese, 2006 ; Ruggeri, Leese, Thornicroft, Bisoffi, & Tansella, 2000 ; Ellison, Russinova, Lyass, & Rogers, 2008 ; Russinova, Bloch, Wewiorski, Shappell, & Rogers, 2018 , Grubaugh, Brown, Wojtalik, Myers, & Eack, 2021 ) and most states in the U.S. define SMI as any major psychiatric disorder that is accompanied by persistent impairment in functioning.…”