The definitions of serious mental illness and serious emotional disability published by the Center for Mental Health Services (CMHS) in the Federal Register are as follows.
Serious Mental Illness (SMI)
"…, adults with a serious mental illness are persons 18 years and older who, at any time during a given year, had a diagnosable mental, behavioral, or emotional disorder that met the criteria of DSM-III-R1 and … that has resulted in functional impairment which substantially interferes with or limits one or more major life activities.…"
The definition states that "adults who would have met functional impairment criteria during the referenced year without the benefit of treatment or other support services are considered to have serious mental illnesses….DSM-III-R ‘V’ codes, substance use disorders, and developmental disorders are excluded from this definition…."
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Estimation Methodology for Adults With Serious Mental Illness (SMI)
AGENCY: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, HHS.
Federal Register: June 24, 1999 (Volume 64, Number 121). Pages 33890-33897
Online via GPO Access [wais.access.gpo.gov][DOCID: fr24jn99-67]
Serious Emotional Disability (SED)
The CMHS definition is that children with “serious emotional disturbance” are persons:
From birth up to age 18
Who currently or at any time during the past year have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within DSM- III-R
That resulted in functional impairment, which substantially interferes with or limits the child's role or functioning in family, school, or community activities (p.29425).
The definition goes on to indicate that “these disorders include any mental disorder (including those of biological etiology) listed in DSM-III-R or their ICD-9-CM equivalent (and subsequent revisions) with the exception of DSM-III-R `V' codes, substance use, and developmental disorders, which are excluded, unless they co-occur with another diagnosable serious emotional disturbance….” (p. 29425).
“Functional impairment is defined as difficulties that substantially interfere with or limit a child or adolescent from achieving or maintaining one or more developmentally-appropriate social, behavioral, cognitive, communicative, or adaptive skills. Functional impairments of episodic, recurrent, and continuous duration are included unless they are temporary and expected responses to stressful events in their environment. Children who would have met functional impairment criteria during the referenced year without the benefit of treatment or other support services are included in this definition….” (p. 29425).
Federal Register: Volume 58, Number 96. Pages 29422-29425.