Seventeen definitions of the severely and persistently mentally ill have
appeared in the literature over the past decade. These definitions have
been used by 13 authors to formulate service programs and to estimate the
prevalence of serious mental illness in the population. To test the
applicability of these definitions, the authors operationalized each
definition and applied it to a representative sample of 222 patients
receiving services in one of Philadelphia's inner-city neighborhoods. The
analysis showed estimates of prevalence of serious mental illness ranging
from 4% to 88% of the treated population, depending on the definition
applied. The NIMH (1987) definition was representative of the middle-range
estimates of 45% to 55% arrived at by eight authors.
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