The individual who is severely and persistently mentally ill: directions for research and practice.

Psychiatric mental health nursing has not invested time and resources in the care of those with severe and persistent mental illness. In this article, current nursing research is reviewed and practice/research directions are delineated in the following areas: acute and chronic manifestations of symptoms, behavioral manifestations related to institutionalization, responses to psychiatric disorders over time, the long-term effects of psychotropic medication on behavior, and the impact of physical illnesses on psychiatric disorders. Knowledge is sorely needed in all of these areas to improve the nursing care of those persons with severe and persistent mental illness.