Current approaches to identifying the severely mentally ill

Area of Science:

• Mental Health Services Research
• Health Economics
• Psychiatry

Background:

• Mental health care provision is resource-intensive, necessitating targeted allocation.
• Prioritization of care is crucial, especially in systems like the UK's National Health Service, which operates on the principle of need.
• Identifying individuals with severe mental illness (SMI) is key to equitable resource distribution.

Purpose of the Study:

• To review existing definitions of SMI used in research and practice.
• To survey current practices in England for identifying individuals eligible for mental health care.
• To propose a framework for defining SMI to guide resource prioritization.

Main Methods:

• Literature review of definitions of severe mental illness in research.
• Survey of 20 agencies in England to collect written documentation on eligibility criteria.
• Consultation with government departments, user groups, and professional bodies.

Main Results:

• A lack of consensus exists regarding definitions of SMI in research.
• Current practices in England utilize criteria related to safety, support, diagnosis, disability, and duration.
• The findings indicate the utility of the SIDDD dimensions (Safety, Informal/Formal support, Diagnosis, Disability, Duration) in defining SMI.

Conclusions:

• The SIDDD dimensions provide a structured approach for defining severe mental illness at a local level.
• This framework can aid in identifying priority groups for mental health care services.
• Standardizing definitions through the SIDDD dimensions can improve the efficiency and equity of mental health resource allocation.