* We thank Gary R. Bond, Ph.D., and Kikuko Yamamoto, M.P.H., M.A., for contributing to this page.  Dr. Bond is Chancellor’s Professor of Psychology at Indiana University Purdue University Indianapolis (IUPUI), where he has been on the faculty for 18 years.  Ms. Yamamoto is a doctoral student in Clinical Rehabilitation Psychology at IUPUI.

Individuals with severe mental illness (SMI) such as schizophrenia, schizoaffective disorder, bipolar disorder, and major depression, often experience serious functional impairments. These impairments affect the way persons with SMI attend to aspects of daily living, such as physical health, work, education, financial management, and family and social relationships.

Research has substantially supported the view that persons with SMI can, with the right type of support, pursue successful normal adult roles in the community. Mental health services should aim not just to keep the consumers stable and out of the hospital, but to help them to pursue their own goals, independence, management of their illnesses, and self-fulfillment—which is what rehabilitation is all about. During the last decade, extensive efforts have been made to document the best rehabilitation approaches to help persons with SMI return to high-quality functional lives to the greatest extent possible.

In 1998, a national expert panel identified six areas of interventions having strong research support for their use in the rehabilitation of SMI. The six areas of ”evidence-based practices” are:

� Assertive community treatment;

‚ Dual disorders (SMI with a co-occurring substance abuse problem) treatment;

ƒ Family intervention;

„ Illness self-management training;

… Medication treatment; and

† Supported Employment.

Critical ingredients of each of the 6 areas are listed below, and it is important to note that all the six areas share key principles, such as community integration as the goal, assertive outreach, focus on consumer strengths, emphasis on consumer needs and choices, individualized and flexible services, long-term support, and cultural sensitivity and competence.  Evidence-based practices are often delivered in combination and in a coordinated fashion. 

Identification of effective interventions for SMI is an ongoing effort. One of the most exciting developments in the field of rehabilitation is the commitment by researchers, mental health care professionals, state mental health directors, consumers, and their families, to disseminate and implement the evidence-based practices in routine mental health settings that provide services for persons with SMI. Consumers and their families have a right to have access to interventions that are proven to be effective, and provision of services proven to be ineffective is an unethical practice.  The empowered, proactive consumers and their families may be one of the best hopes for the rehabilitation of people with SMI.