11 SPMI Mental Health Signs You Should Watch In 2024

All mental health disorders are a cause for concern. 

But, in most cases, it is possible to recover from mental illness and return to a normal life.

However, long-term mental health issues can have negative consequences for the individual and those around them.

This article will explain what severe and persistent mental illness (SPMI) is and what warning signs to look for if you believe you or a loved one may be suffering from one.

Serious And Persistent Mental Illness (SPMI)

While many people suffer from mental health disorders at some point in their lives, most are able to recover through a combination of treatments, including psychotherapy and medication.

Even people who experience repeated bouts of mental illness can recover and enjoy periods of good mental health.

However, some mental health disorders are so severe that they have long-term negative consequences for the sufferer and their families.

In effect, their mental illness becomes a disability that impairs them from living a normal life.

What Is SPMI in Mental Health?

Serious and persistent mental illness — SPMI — is a term used to cover a wide range of mental health disorders. 

The term refers to a patient population rather than a specific condition and is characterized by long, ongoing mental suffering in the patient, which also burdens their caregivers.

SPMI usually starts in early adulthood and affects the patient’s family and relationships, educational achievement, career, and ability to function in society throughout their lifetime.

There are three dimensions used to classify SPMI — diagnosis, disability, and duration.

However, there is no agreed-upon definition or specific group of mental illnesses that fall under this category. 

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What Is Considered SPMI?

SPMI affects roughly 2.8 percent of the population in the US, representing about 5 million people.

While there is no set definition, SPMI includes severe conditions such as:

  • Schizophrenia
  • Schizoaffective disorder
  • Bipolar disorder
  • Major depression
  • Autism
  • Obsessive-compulsive disorder
  • Delusional disorder (also known as psychosis — the inability to tell what’s real and what isn’t)


Post-traumatic stress disorder — PTSD— is a psychiatric disorder that occurs following a traumatic event. 

This could be a war, natural disaster, surviving rape or torture, or even having exposure to traumatic events, such as learning of the violent death of a loved one.

It is characterized by obsessive and fearful thoughts about the event and may include flashbacks.

Research shows that PTSD is a common co-occurring condition in SPMI patients, with between 70 and 98 percent of SPMI-presenting adults also having a history of trauma.

Sufferers of SPMI who also have a history of trauma and PTSD are more likely to relapse, suffer from substance abuse disorders, and rely more intensively on health care services — which may include hospitalizations.

Research also indicates that SPMI sufferers are more likely to experience traumatic events and become debilitated by them.

What Is the Hardest Mental Illness to Live With?

Any serious and persistent mental illness is difficult to live with due to the features that characterize them (diagnosis, disability, and duration).

Serious mental illness, such as major depression, bipolar disorder, or schizophrenia, becomes debilitating due to its long-term effects on the sufferer’s functional ability to carry out their normal daily activities.

It impacts the individual’s quality of life, but it also affects those around them. SPMI is a problem that involves the entire family due to the care and assistance the patient requires.

It can also affect the relationships between the patient and their friends and family, which can make them feel more isolated. 

11 SPMI Mental Health Signs to Watch

Fifty percent of mental health disorders begin before age 14, and 75 percent by age 24. 

There are tell-tale signs that something is not right before the mental disorder appears. 

Often family, friends, teachers, or the individual themselves start to notice changes in behavior that can lead to diagnosis. 

If you think that you or someone you love may be suffering from SPMI, look out for these 11 signs of serious mental illness.

#1: Difficulty Functioning in Daily Living

SPMI can affect an individual’s motivation, interests, and ability to perform daily tasks.

Dropping out of sports or other activities, poor performance at school or work, and neglecting personal hygiene may all be signs of an underlying problem.

#2: Changes in Behavioral Health

Mental health disorders often affect the way our bodies function. 

Two of the strongest indicators of a problem are dramatic changes in sleep patterns (such as insomnia) and appetite.

#3: Erratic Mood Swings and Behavior

If you or a loved one are experiencing dramatic changes in mood or feelings of depression, fear, worry, or anxiety, it may be a sign of a mental health issue.

Overreacting, lashing out for no reason, and even aggressive or violent behavior can also indicate that something’s not right.

#4: Poor Memory, Reasoning, and Judgment

Losing the ability to think rationally, short-term memory impairment, illogical reasoning, and difficulty concentrating can all be potential signs of an underlying mental health issue.

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#5: Paranoia

If you or someone you know are experiencing strong feelings of suspicion, extreme fear, or anxiety over perceived (but not real) dangers, it could be an indication of SPMI.

#6: Hallucinations and Delusions

When someone starts seeing things that aren’t there, they are hallucinating.

Delusions occur when a person believes something has happened that hasn’t. 

These may be paranoid delusions, such as believing someone is trying to kill them, but could also include “magical” thinking and believing in impossible things, as would a child.

These may be the signs of the start of a severe mental disorder, such as schizophrenia, and require professional attention.

#7: Erratic or Unusual Behavior

If someone starts behaving impulsively or in a way that is out of character for them, it may be a sign of serious mental illness.

#8: Feelings of Worthlessness

A pervasive feeling of worthlessness can leave the individual with a sense of desperation and hopelessness, believing that they have nothing of value to offer the world.

They may feel unworthy of love, success, or money, and they may even feel unworthy of the help and assistance of their family or loved ones.

#9: Suicidal Thoughts or Behaviors

If feelings of worthlessness persist, it can lead to suicidal ideation (thoughts) and even risky behaviors that could potentially cause the death of the individual, including substance abuse.

#10: Disconnection and Withdrawal

A person may feel disconnected from the world and people around them when suffering from a serious and persistent mental illness, which can cause them to withdraw and become increasingly isolated. 

#11: Heightened Sensitivity

If you or your loved one experiences increased sensitivity to sensory inputs, such as bright lights, loud noises, strong smells, or crowded places, it could be a sign of a serious mental illness, especially when it presents with the other signs listed above.

What Should You Do If You Suspect SPMI?

If you think that you or a loved one is suffering from SPMI, such as major depression, bipolar, or schizophrenia, it’s essential to seek professional help as soon as possible. 

Speak to your health care provider to determine the best course of treatment for the patient, and speak to a qualified psychotherapist about individual and family therapy.

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The good news is that once diagnosed, SPMI can be managed through individual and family therapy, medication, and lifestyle adjustments. 

Looking out for the 11 SPMI mental health signs can help you catch it early on and find solutions to help you or your loved one live a fulfilling and joyful life — even with SPMI.

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About The Author

Bijan Kholghi is a certified life coach with the Milton Erickson Institute Heidelberg (Germany). He helps clients and couples reach breakthroughs in their lives by changing subconscious patterns. His solution-oriented approach is based on Systemic- and Hypnotherapy.