Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.

The understanding of how to reduce risk factors for mental disorders has expanded remarkably as a result of recent scientific advances. This study, mandated by Congress, reviews those advances in the context of current research and provides a targeted definition of prevention and a conceptual framework that emphasizes risk reduction. Highlighting opportunities for and barriers to interventions, the book draws on successful models for the prevention of cardiovascular disease, injuries, and smoking. In addition, it reviews the risk factors associated with Alzheimer's disease, schizophrenia, alcohol abuse and dependence, depressive disorders, and conduct disorders and evaluates current illustrative prevention programs. The models and examination provide a framework for the design, application, and evaluation of interventions intended to prevent mental disorders and the transfer of knowledge about prevention from research to clinical practice. The book presents a focused research agenda, with recommendations on how to develop effective intervention programs, create a cadre of prevention researchers, and improve coordination among federal agencies.

Psychotic Disorders: Comprehensive Conceptualization and Treatments emphasizes a dimensional approach to psychosis--one of the most fascinating manifestations of altered brain behavior--that cuts across a broad array of psychiatric diagnoses from schizophrenia to affective psychosis and organic disorders like epilepsy and dementias. Written by an international roster of over seventy leading experts in the field, this volume comprehensively reviews, critiques, and integrates available knowledge on the etiology, mechanisms, and treatments of psychotic disorders, and outlines ways forward in both research and clinical practice towards more objective, mechanistically-based definitions of psychotic disorders. Chapters address topics such as psychosis phenomenology, biomarkers and treatments, the overlaps and interfaces between psychiatric disorders within the psychosis dimension, and novel disease definitions. Furthermore, the volume incorporates findings on potential mechanisms, bridges between various system levels (i.e., genetic, epigenetic, molecular and cellular, brain circuit and function, psychological, social, environmental and cultural) and their interactions, as well as the potential role in causation and/or mediation in psychotic disorders. Finally, the volume outlines a broad array of treatment approaches, from the readily available (e.g., psychopharmacology, various modalities of psychotherapy) to the experimental (e.g., cognitive interventions, neuromodulation). With a concluding section of forward perspectives conjecturing future directions and related challenges, this book aspires to stimulate new knowledge, generate novel frameworks, and carry new directions forward on psychotic disorders.

A bold, expert, and actionable map for the re-invention of America’s broken mental health care system. “Healing is truly one of the best books ever written about mental illness, and I think I’ve read them all." —Pete Earley, author of Crazy As director of the National Institute of Mental Health, Dr. Thomas Insel was giving a presentation when the father of a boy with schizophrenia yelled from the back of the room, “Our house is on fire and you’re telling me about the chemistry of the paint! What are you doing to put out the fire?” Dr. Insel knew in his heart that the answer was not nearly enough. The gargantuan American mental health industry was not healing millions who were desperately in need. He left his position atop the mental health research world to investigate all that was broken—and what a better path to mental health might look like. In the United States, we have treatments that work, but our system fails at every stage to deliver care well. Even before COVID, mental illness was claiming a life every eleven minutes by suicide. Quality of care varies widely, and much of the field lacks accountability. We focus on drug therapies for symptom reduction rather than on plans for long-term recovery. Care is often unaffordable and unavailable, particularly for those who need it most and are homeless or incarcerated. Where was the justice for the millions of Americans suffering from mental illness? Who was helping their families? But Dr. Insel also found that we do have approaches that work, both in the U.S. and globally. Mental illnesses are medical problems, but he discovers that the cures for the crisis are not just medical, but social. This path to healing, built upon what he calls the three Ps (people, place, and purpose), is more straightforward than we might imagine. Dr. Insel offers a comprehensive plan for our failing system and for families trying to discern the way forward. The fruit of a lifetime of expertise and a global quest for answers, Healing is a hopeful, actionable account and achievable vision for us all in this time of mental health crisis.

The National Institute for Health and Clinical Excellence (NICE) has been regarded as a role model for the implementation of cost-effectiveness analysis (CEA), and is being closely watched by health care policy makers across the globe. This book examines Britain’s highly acclaimed approach to CEA and its international potential. It dissects the robustness of the agency’s technology appraisal processes as NICE evaluates innovative methods for diagnosis and intervention. Coverage provides a step-by-step explanation of the NICE appraisal process and examines its successes and limitations.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.