What is the definition of a Severe and Persistent Mental Illness (SPMI)?

To determine if an individual meets criteria for a having a diagnosed or diagnosable severe and persistent mental illness, the individual must be 18 years of age in addition to meeting the following criteria:



  • A diagnosis of a mental disorder according to DSM-5: a major affective, non-organic psychotic disorder or a disorder that may lead to a chronic disability such as a personality disorder

  • If the individual is diagnosed with only one of the following, they do not meet eligibility criteria for service:

    • Feeding and Eating Disorders

    • Elimination Disorders

    • Sleep-Wake Disorders

    • Sexual Dysfunctions

    • Paraphilic Disorders



  • Meets at least 3 of the 5 categories of functional disability as below:

    • Requires support with instrumental activities of daily living such as managing finances, managing transportation, shopping and meal preparation, house cleaning and home maintenance, managing communication and managing medications.

    • Is unemployed, is employed in a sheltered setting or supportive work situation, or has markedly limited skills and a poor work history

    • Safety concerns related to self or others, or exhibits inappropriate social behavior which results in intervention by the mental and/or judicial system

    • Has difficulty in establishing or maintaining a personal social support system/ limitations or moderate impairment in social functioning

    • Requires public financial assistance from out-of-hospital maintenance and may be unable to procure such assistance without help

  • Disability must be the result of mental illness and not primarily relating to an acquired brain injury or developmental disability, etc.



  • Duration of at least two years