As the name indicates, a person with SMI has a severe illness that interferes with their life in a substantial way. Only a small proportion of those with mental disorder have an SMI. The symptoms and features of SMI are described below.

Common symptoms of a person with SMI

Delusions: believing things that are untrue, for example that people are in love with them, or that people are trying to poison them
Hallucinations: hearing or seeing things that no one else can hear or see
Agitation and restlessness
Withdrawal and lack of interest
Increased speed of talking
Irritable mood (getting angry easily)
Grand ideas (out of keeping with reality)
Talking in a way that does not seem to make sense
Poor self-care (not related to poverty).

When you find two or more of the symptoms listed above, an SMI is likely. However, you need to retain an open mind because it is also the case that, when these symptoms occur acutely, i.e. they arose all of a sudden and have been present for less than a week, these same symptoms could be due to another serious medical condition such as malaria, meningitis or pneumonia. Alternatively, when these symptoms are exhibited by a person who drinks a lot of alcohol, they could also be due to changes in the brain caused by drinking. Therefore, it is very important that your assessment is thorough and that you do not confuse physical illness and mental illness in identifying the underlying causes of severe symptoms. The failure to detect and treat malaria, meningitis or pneumonia quickly could result in the patient dying within hours or days.