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Administrative data are mainstay tools in managing and monitoring individuals served by health care systems. Although psychiatric illness impacts population health, there is a near absence of ordinal, psychiatric severity measures based on administrative data. In the present study, we describe the construct, concurrent, and predictive validity of a novel, brief administrative measure of psychiatric severity, the Manifestations of Psychiatric Severity Index (MoPSI). We also examine clinical characteristics of groups defined by different MoPSI score ranges and report a scoring algorithm to facilitate out-of-sample extension. Results are based on a panel of 912 US Veterans who served during Operations Enduring Freedom, Iraqi Freedom, and New Dawn, had pending Department of Veterans Affairs disability claims for posttraumatic stress disorder (PTSD), and had at least one Veterans Health Administration health care encounter in the prior 180 days. After adding 17.51 to participants’ scores, the median MoPSI score was 0.04 with interquartile range 0.30 and total range 0 to 23.18. Scores did not differ statistically significantly by age, gender, or race. Construct and concurrent validity were supported by finding statistically significantly higher MoPSI scores among those who were unmarried, reported low income, or had a chart diagnosis of serious mental illness or PTSD. Predictive validity was supported by finding higher prior MoPSI scores among those who subsequently reported smoking cigarettes or using “street drugs.” Kendall’s rank correlation coefficient between prior MoPSI scores and self-reported PTSD and depression and anxiety symptoms 6 …