Mainstream and IMPACT-West clients must meet the following criteria established by the State of South Dakota Department of Human Services, Division of Mental Health.

Severe Mental Disability
The individual's severe and persistent emotional, behavioral, or psychological disorder has resulted in at least one of the following:

• psychiatric treatment more intensive than outpatient care more than once in a lifetime (e.g., emergency services, alternative residential living, or inpatient hospitalization);
• a single episode of psychiatric hospitalization with an Axis I and/or Axis II diagnosis;
• maintained with psychotropic medication for at least one year;
• frequent crisis contacts with a mental health center for more than six months as a result of a persistent psychiatric illness.

Impaired Role Functioning
The individuals severe and persistent emotional, behavioral or psychological disorder has resulted in at least three of the following:

• unemployed or has markedly limited job skills and/or a poor work history;
• employed in a sheltered setting;
• unable to perform basic living skills without assistance;
• exhibits inappropriate social behavior, which results in concern by the community and/or requests for mental health services by the judicial/legal information;
• inability to procure appropriate public support services without assistance;
• requires public financial assistance for out of hospital maintenance;
• lack of social support systems in natural environment (e.g., no close friends, lives alone, isolated).