Severe and persistent mental illness (SPMI)

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In this world of labels, we accumulate labels as we travel through our lives, some good, some bad, and some we just aren’t too sure about. Lately, I have accumulated labels with regular frequency as I go to my daily group therapy and weekly meetings with my therapist. Psychotic is a fairly new label for me, although the symptoms of psychosis have been with me for as long as I can remember. While meeting with my therapist yesterday, a new label was thrown out and it hit with a thud. This new label made me take a step back, really evaluate my current situation, and my recovery…

Just what is this new label?

Severe and persistent mental illness or SPMI for short. Okay, I’m not going to deny my mental illness hasn’t been persistent throughout my life, but severe? I’ve never thought of my mental illness as severe or all that bad since I am used to it (as best one can get used to mental illness or perhaps I didn’t see myself as mentally ill to begin with). So I get the persistent aspect of this new label but severe?

As usually when presented with something new I have no understanding of, I did some research to find out more about this SPMI label. One of the first things I found is SPMI can also mean severe or persistent mental illness, so it can also mean one or the other, or both. Most confusing. Another thing I discovered while doing my research is there is some debate about just what qualifies someone as having SPMI; it even varies from state to state for disability reasons too. My research helped me some to understanding this new label, but left me still asking, does this apply to me? Then I found a list of common disorders that quality for a SPMI label:

  • Bipolar disorder,
  • Delusional disorder, psychosis not-otherwise-specified, and other psychotic disorders,
  • Major depressive disorder that resists treatment and impacts ability to function,
  • Obsessive-compulsive disorder,
  • Panic disorder,
  • Personality disorders that are severe enough to prevent functioning,
  • Schizoaffective disorder,
  • Schizophrenia

Now I’m getting somewhere and it’s somewhere I’m not sure I like, but at the same time I can see how this new label fits. I am psychotic, have major depression which doesn’t respond to medications well, if at all, I have obsessive-compulsive disorder (OCD), and I have borderline personality disorder (BPD), considered one of the worst personality disorders one can have. This last round of depression has also been hanging on since the end of 2010, so I can see the persistent aspect of this new label as well.

So, a new label has been added to my list of labels, one that seems to be appropriate, but one I’m still not sure how I feel about it.

1 Comment

  1. While my diagnoses are different to yours I too meet the criteria for SPMI. I also don’t know exactly how I feel about that label. I’m not sure if it’s helpful or not. While I understand the need for some labeling in mental illness it seems to me there needs to be some sort of balance in how we address those labels. For example an SPMI label isn’t inherently bad, and it some ways it’s merely descriptive of reality. However, I’ve found that being labeled in such a way needs to be managed correctly, because in my experience it can cause setbacks in personal and clinical recovery, and can cause discrimination in some cases. My attitude to labels is a bit confused, but I’m of the opinion that it’s not so much the labels that are confusing but what they mean for each individual and how they’re addressed by mental health professionals. I think we need to work on the stigma of such labeling and helping the individual work through the labels, for example.

    Sorry, for rambling, but this is a really interesting topic.

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