Opinions of healthcare professionals on the definition of severe mental illness. A qualitative study

Background. Over the years, a number of definitions of severe mental illness (SMI) have been proposed and substantial controversy about the definition still remains. The aim of this study was to evaluate the views of a group of mental health professionals on the appropriate criteria for defining SMI. Methodology. This was a qualitative study, based on five focus groups with mental health professionals (psychiatrists, psychologists, nurses, general practitioners, monitors and social workers) from Carlos Haya Hospital in Malaga, Spain. A content analysis was performed on the transcriptions by three independent researchers. Results. The professionals agreed that a certain degree of dysfunctionality must be present for a definition of SMI. There was some disagreement between the different categories of professionals regarding the inclusion of dimensions such as diagnosis, family and social support, use of healthcare resources and duration of the illness as necessary and sufficient criteria for the definition of SMI. From the professionals' discourse, some personal patient variables such as age of onset of illness, lack of insight and level of education emerged as relevant for the definition of SMI. Conclusions. Apart from the dimensions considered in the literature, the interviewed mental health professionals discussed other criteria that could be taken into account in the definition of SMI. Perceptions differ between categories of professional and work settings in which they operate.