“It's Overwhelming . . . Everything Seems To Be Too Much:” A Theory of Crisis for Individuals with Severe Persistent Mental Illness

Crisis in individuals with severe persistent mental illness (SPMI) is a poorly understood phenomenon for which traditional crisis models do not apply. In this study we explored the crisis experience using in-depth interviews conducted with individuals with severe persistent mental illness from two community support programs. A grounded theory of the crisis experience was developed and the results illustrate that underlying vulnerability sets the stage for crisis occurrence which involves feeling overwhelmed and lacking control and manifests as agitation/anger/aggression, being low, feeling anxious, or euphoria. Immediate responses to crises involve getting help or managing alone and numerous factors contribute to crisis resolution and prevention.