5. G. L. Engel, "The Need for a New Medical Model: A Challenge for Biomedicine," Science , Vol. 196 (1977), pp. 129-136.

6. See National Alliance for the Mentally Ill Web page, at www.nami.org.

7. HHS, Mental Health: A Report of the Surgeon General , p. 5.

8. Note that this definition assumes an objective approach to measuring/defining severity of mental disorders (other than schizophrenia). Those with mild cases would be considered to have mental health problems rather than SMI.

9. Children and adolescents struggling with serious mental illness are sometimes classified as "Seriously Emotionally Disturbed" (SED).

10. Note that the DSM-IV defines "moderate" as "between mild and severe"--a fairly pointless distinction.

11. What about people struggling with autism, mental retardation, or dementia (such as Alzheimer's)? These needs are best addressed in the context of long-term-care support services, as opposed to SMI services. What about those struggling with addictions, such as drugs and alcohol? People suffering from addictions demonstrate a high rate of "comorbidity," meaning that it is not unusual for them to also meet criteria for serious mental illness. Thus, addiction is often a secondary issue that must be addressed as one component of mental health treatment, but the primary focus for SMI remains the disorders listed above. The same could be said for other disorders not listed, such as attention deficit disorder, eating disorders, elimination disorders, tic disorders, and impulse disorders. Severe cases have a high rate of comorbidity.

12. I. I. Gottesman, Schizophrenia Genesis--The Origins of Madness (New York: W. H. Freeman, 1991).

13. C. J. Murray, and A. D. Lopez, "Evidence-Based Health Policy--Lessons from the Global Burden of Disease Study," Science , Vol. 274 (1996), pp. 740-743.

14. J. Angst, F. Angst, and H. H. Stassen, "Suicide Risks in Patients with Major Depressive Disorder," Journal of Clinical Psychiatry , Vol. 60, Suppl. 2 (1999), pp. 57-62.

15. "Health Care Reform for Americans with Severe Mental Illnesses: Report of the National Advisory Mental Health Council."

16. Ibid .

17. R. C. Kessler et al., "Posttraumatic Stress Disorder in the National Comorbidity Survey," Archives of General Psychiatry , Vol. 52 (1995), pp. 1048-1060.

18. See Children and Adults with Attention Deficit Disorder Web page, at www.chadd.org.

19. The Mental Health Equitable Treatment Act of 2001 (S.543) sponsored by Senator Pete Domenici (R-NM).

20. See footnote 8.

21. P. Ditton, Mental Health and Treatment of Inmates and Probationers, U.S. Department of Justice, Bureau of Justice Statistics, NCJ-174463, 1999.

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