Georgia DBHDD’s new definition of SPMI

Current Status: Active PolicyStat ID: 2339257
Creation: 4/13/2016
Last Reviewed: 4/13/2016
Last Revision: 4/13/2016
Next Review: 4/13/2018
Owner: Monica Johnson, MA, LPC:
Director, Division of Behavioral
Health
Chapter: BH Community Services
Section:
Georgia Department of Behavioral Health and
Developmental Disabilities’ Definition of Severe
and Persistent Mental Illness, 01-121
APPLICABILITY
POLICY STATEMENT
1. Designated Mental Illness
The individual is 18 years of age or older and currently meets the criteria for a DSM-V
psychiatric diagnosis, including within developmental or cultural contexts, but excluding a)
substance-related disorders, b) organic brain syndromes, c) intellectual/developmental
Behavioral Health Comprehensive Community Providers (CCPs/Tiers 1, 2, and 3)
DBHDD State Hospitals
DBHDD Field Offices
Forensic Community Integration Homes (CIH)
The Department of Behavioral Health and Developmental Disabilities (DBHDD) recognizes that
all experiences of severe emotional distress deserve appropriate access to individualized
services, support, and treatment as necessary. However, Severe and Persistent Mental Illness
(SPMI) is a specific term used to describe individuals diagnosed with a mental illness requiring
frequent and/or long-term psychiatric treatment, rehabilitation and supports to manage the
condition.
Although symptoms of SPMI may fluctuate over time, with easy access to high quality support
and treatment services, individuals diagnosed with SPMI are able to lead a life of independence
and recovery within the community.
This policy establishes DBHDD’s definition of SPMI.
Criteria
In order to be considered an adult with a Serious and Persistent Mental Illness, criteria in item 1
must be met, as well as criteria in either items 2 or 3 below.
Georgia Department of Behavioral Health and Developmental Disabilities’ Definition of Severe and Persistent Mental Illness, 01-121.
Retrieved 04/13/2016. Official copy at http://gadbhdd.policystat.com/policy/2339257/. Copyright © 2016 Behavioral Health &
Developmental Disabilities
Page 1 of 3
COPY
disabilities or d) V codes, unless co-occurring with a diagnosis of a severe and persistent
mental illness.
And
2. Extended Impairment in Functioning due to Mental Illness
Documentation that the individual has had a duration of mental illness of at least one year,
and within the last 12 months, on a continuous or intermittent basis has had at least (a)
moderate impairment in at least four, (b) severe impairment in two or (c) extreme
impairment in one of the following areas, as determined by a standardized measure (e.g.,
Adult Needs and Strengths Assessment (ANSA) or Level of Care Utilization System for
Psychiatric and Addiction Services (LOCUS):
a. Marked difficulties in self-care (personal hygiene, nutrition, clothing, avoiding injuries,
sleep hygiene, securing health care or complying with medical advice);
b. Marked change in mood or uncontrolled emotion that is clearly disruptive in its effects
on other aspects of the individual’s life, or emotional responses that are inappropriate to
the situation;
c. Marked impairment in activities of daily living (e.g., maintaining a residence, using
transportation, day to day money management, accessing community services).
Inability to obtain or maintain employment and/or conduct daily living chores such as
care of immediate living environment because of symptoms of illness;
d. Marked difficulties in maintaining social functioning (i.e. regard for safety of self or
others, use of leisure time, applying appropriate social skills, lawfulness and adherence
to social norms); or persistent inability to establish or maintain a personal social support
system (i.e. establishing and maintaining social relationships, interpersonal interactions
with primary partner, children or other family members, friends and neighbors);
e. Distorted perceptions of reality, often accompanied by delusions and/or hallucinations.
Frequent deficiencies of concentration, persistence or pace resulting in disruption of
role performance, including inability to complete tasks or structured activities commonly
found in occupational, home or educational settings.
Or
3. Reliance on Psychiatric Treatment, Rehabilitation and Supports
Documented history showing that the individual, at some time prior to the current
presentation, met the criteria described in item 2 (above), but the symptoms and/or
functioning problems are currently lessened by medication or psychiatric rehabilitation and
supports. Medication refers to prescribed psychotropic medications which may help to
reduce some primary manifestations of mental illness (e.g., hallucinations,) but may or may
not affect functional limitations caused by the mental illness. Psychiatric rehabilitation and
supports refer to highly structured and supportive settings (e.g., residential or supportive
housing programs) which may greatly reduce the demands placed on the individual and
thereby, minimize primary symptoms and signs of the underlying mental illness.
Georgia Department of Behavioral Health and Developmental Disabilities’ Definition of Severe and Persistent Mental Illness, 01-121.
Retrieved 04/13/2016. Official copy at http://gadbhdd.policystat.com/policy/2339257/. Copyright © 2016 Behavioral Health &
Developmental Disabilities
Page 2 of 3
COPY
Approver Date
Keisha Blackwell, LMSW, MBA: BH Policy Coordinator 4/7/2016
Anne Akili, Psy.D.: Policy Director 4/7/2016
Terri Timberlake, Ph.D.: Director, Adult Mental Health 4/7/2016
Emile Risby, M.D.: Medical Director 4/7/2016
Monica Johnson, MA, LPC: Director, Division of Behavioral Health 4/13/2016
Anne Akili, Psy.D.: Policy Director 4/13/2016
REFERENCES
RELATED POLICIES
Attachments: No Attachments
The current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual
of Mental Disorders (DSM).
The International Classification of Disease, Tenth Edition (ICD 10).
Provider Manual for Community Behavioral Health Providers, 01-112
Georgia Department of Behavioral Health and Developmental Disabilities’ Definition of Severe and Persistent Mental Illness, 01-121.
Retrieved 04/13/2016. Official copy at http://gadbhdd.policystat.com/policy/2339257/. Copyright © 2016 Behavioral Health &
Developmental Disabilities
Page 3 of 3

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