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March 19, 2014

Dear Colleague:

The Substance Abuse and Mental Health Services Administration (SAMHSA) is embarking on a
review of the definitions for Serious Mental Illness (SMI) and Serious Emotional Disturbance (SED)
that were first introduced by SAMHSA in a Federal Register Notice dated May 20, 1993.

The Statute that created the Community Mental Health Services Block Grant required states to
submit a plan for providing comprehensive community mental health services to adults with SMI
and children with SED, and required the Secretary of the Department of Health and Human Service
to establish and disseminate a definition of these terms. The definition that was published in the
Federal Register is the same definition still in use today and states receiving Block Grant funds are
required to use the definition in their planning and service implementation processes.

The process that is being identified in this e-mail relates specifically to the SED definition, which
states that children with a SED are persons:
From birth up to age 18,
Who currently or at any time during the past year,
Have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to
meet diagnostic criteria specified within DSM-III-R,
That resulted in functional impairment which substantially interferes with or limits the
childs role or functioning in family, school, or community activities.

Over the past twenty years, there have been changes in the way that community based mental
health services are delivered, including the introduction of such critical concepts as recovery and
self-directed care. As a result, SAMHSA is conducting this review to obtain feedback about the
strengths and challenges of the definitions, and to determine if there are recommendations for
revisions. The definitions will be reviewed by focusing on the core components of diagnosis,
duration and functional level; along with a number of additional considerations that need to be
addressed, including language, age range, recovery orientation, risk and protective factors,
implications for data collection, potential shifts in priority populations being serviced and impact
on funding sources.

To begin the review process for the SED definition there will be a Listening Session
webinar on March 31, 2014 from 2:30 3:30pm, EST. At that time we will provide a brief
description about the background and goals for this review, and begin to obtain input and feedback.
During the webinar, we will provide a link that can be used to provide feedback online. This initial
round of feedback will occur between March 31, 2014 and April 18, 2014. The information
obtained during that time will be synthesized and additional opportunities will also be identified.
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To register for the webinar and listening session, please go online to:
https://soundconnect.webex.com/soundconnect/onstage/g.php?d=748129886&t=a

If you are unable to participate in the webinar but would like to receive the link for the
online information exchange, please register to receive the information exchange only by
emailing SOCTANetwork@ssw.umaryland.edu with SED Definition Link in the subject line. In the
e-mail, please indicate whether you would like to be added to the TA Network listserv to receive the
weekly TA Telegram and other important announcements.

I strongly encourage you to participate in SAMHSAs review of the SMI/SED definitions. Please join
us for the SED Definition Listening Session and feel free to share this information with your
colleagues. If you have any questions, please e-mail SOCTANetwork@ssw.umaryland.edu for
assistance.

Thank you for your participation in this important process.




Gary M. Blau, Ph.D. Diane L. Sondheimer
Chief Deputy Chief
Child, Adolescent and Family Branch Child, Adolescent and Family Branch
Center for Mental Health Services Center for Mental Health Services
Substance Abuse and Mental Health Services Substance Abuse and Mental Health Services