Understanding the challenges of inclusion that students with severe mental illness experience are essential for developing inclusive environments in universities. Therefore, a study was conducted among students with mental illness participating in Supported Education programs in universities. A structured instrument was implemented with 79 students in Israel and 59 students in Denmark. Inclusion in a university was divided into social inclusion and academic inclusion. The findings indicate that the two subscales ranked the highest in both samples were 'Difficulties With Learning Skills and Management of Academic Tasks' and 'Social Inclusion Difficulties', 'Barriers to Academic Inclusion' and 'Accessibility Barriers' were ranked lower. These findings indicate that there are common functional difficulties in fulfilling the academic requirements which students experience in both countries as a result of their mental illness. However, it also indicates that their difficulties could stem from the social and environmental response in universities to students with mental illness. Therefore, to develop an inclusive academic environment, a bio-psycho-social perspective is necessary which can enable focusing on individual difficulties as well as broadening the focus of service delivery to adapt a broader social and environmental perspective which will enable persons with SMI to advance within inclusive academic environments.