Serious Mental Illness Service

In addition to our general mental health services, we have clinicians who offer therapy with a specific focus on Serious Mental Illnesses like Psychotic and Bipolar Disorders.

What Are Serious Mental Illnesses (SMI)?

Serious / Severe Mental Illnesses (SMI) are mental health conditions that can result in significant impairments and distress for those living with them. Specific mental disorders often considered to be SMI include Psychotic Disorders, like Schizophrenia and Schizoaffective Disorder, and Bipolar Disorders. Severe episodes of Major Depression can also be considered SMI.

What Is Psychosis?

Psychosis isn’t a diagnosis itself, but rather describes a state in which someone experiences reality in a way that most people don’t. The person may be experiencing:

  • Sensory experiences that aren’t triggered by external stimuli, like hearing voices or music that others can’t hear.

  • Fixed, false beliefs, like believing that the government is spying on them (without clear evidence or reasons to believe this would be likely)

  • Trouble thinking, speaking, or acting in their typical, coherent manner

Psychosis can arise for a number of reasons, some of which include:

  • Like Schizophrenia or Schizoaffective Disorder

  • Like Major Depressive Disorder and Bipolar Disorder

  • Being triggered by the use or withdrawal from substances like cannabis, alcohol, or cocaine

  • Connected with neurodegenerative disorders and other neurological conditions

What Are Bipolar Disorders

Formerly called manic-depressive disorder, Bipolar Disorders are a class of difficulties related to episodic and significant changes in moods and functioning. These mood episodes can range from lows (depressive) to predominantly elevated or irritable episodes (manic or hypomanic)

Symptoms of manic or hypomanic episodes can include:

  • Inflated self-esteem or grandiosity

  • Decreased need for sleep (i.e., limited sleep yet still feeling rested)

  • Being more talkative than usual or ‘pressured’ speech

  • Racing thoughts

  • Increased goal-directed / productive activities

  • Excessive involvement in activities that can have notable harmful consequences

Symptoms of depressive episodes can include:

  • Feeling persistently sad or low

  • Decreased pleasure in activities that usually bring joy

  • Notable changes in sleep and eating patterns

  • Concentration difficulties

  • Inappropriate guilt, worthlessness, or hopelessness

  • Fatigue and loss of energy

  • Thoughts related to death or suicide

How Do We Treat Serious Mental Illness?

The treatment strategies that we use for SMI will vary depending on what the specific presenting issues are, but in general, we use a combination of the following strategies:

  1. Encourage a thorough medical consultation with relevant medical doctors to rule out organic causes and discuss medication options. Medications can be particularly important and helpful when navigating SMI.

  2. Provide psychoeducation about SMI and any relevant diagnoses.

  3. Encourage mood tracking to get a better sense of mood and activity patterns throughout the week.

  4. Develop relapse prevention plans by identifying triggers and early warning signs for episodes to avoid or interrupt the recurrence of future episodes.

  5. Practice mindfulness strategies to increase contact with the present moment and help improve acceptance of distressing experiences, like hallucinations or unhelpful moods or urges.

  6. Develop a routine to help manage lifestyle and biological factors, like regulating sleep, maintaining balanced eating and exercise, and potentially helping with medication adherence, if this has been identified as a focal goal.

  7. Reframe unhelpful thinking patterns that may be leading to significant distress, negative judgments, and/or impulsive and potentially harmful behaviours.

  8. Increase engagement with meaningful activities to improve life satisfaction.

  9. Develop and maintain a meaningful and supportive social network, as well as learn strategies to improve communication and reduce interpersonal conflict.

  10. Learn coping and relaxation strategies to help manage acute distress.

Our SMI Team