The leading cause of disability in the United States is serious mental illness, which poses political, economic, and social challenges. About 26% of American adults have a mental illness, and 6% have a serious mental illness. This population is the disability group least likely to be employed, with recent unemployment estimates ranging from 35% to 62%.

This Practice Guideline provides an overview of the occupational therapy process for adults with serious mental illness, defining the domain and interventions that occur within acceptable practice. It provides evidence for intervention with schizophrenia, bipolar disorder, and major depression, as well as those related to education and supported education, work and supported employment, community living, health and wellness, and cognition.