In this chapter, we focus on persons with serious and chronic mental illness. There are a number of disorders that come under this general umbrella (schizophrenia, bipolar disorder, schizoaffective disorder, mood disorders, Asperger’s disorder); what they have in common is the presence of persistent psychiatric symptoms that are severe enough that the person is unable to function in his or her environment. These symptoms often include distortions of reality, such as hallucinations (auditory, visual, or both) or delusions (False beliefs). The often odd behavior of the person with serious mental illness (SMI) may disturb others as well as themselves. These conditions are typically of long duration, sometimes lifelong, and are usually treated with pharmacotherapy as the primary intervention.