Author: Amresh Shrivastava
Publisher: Springer Nature
ISBN: 3030198472
Category : Psychology
Languages : en
Pages : 351
Book Description
This book analyzes schizophrenia management in the context of recent clinical therapeutic advances that have transformed the measurements and outcomes landscape. Unlike any other resource, this volume carefully develops the social and clinical guidelines that affect the life of the patient and defines its role in schizophrenia treatment outcomes. The text begins by determining the concepts, development, neuroscience, and guidelines for positive outcomes before analyzing the gaps in the literature. The text addresses medical concerns in relation to outcomes in schizophrenic patients, including substance use, impact from antipsychotic medications, and medical comorbidities. The text also covers external determinants that may inhibit positive outcomes, including cultural factors, stigma, and environmental issues. Written by experts in schizophrenia care, this book compiles sound research, current clinical trends, and modern measurement markers into a well-organized compendium that delivers this data into a practical guide for measuring treatment outcomes in patients suffering from the disease. Schizophrenia Treatment Outcomes is the ultimate guide for psychiatrists, psychologists, nurses, social workers, and all medical practitioners interested in improving outcomes for schizophrenia patients.
Schizophrenia Treatment Outcomes
Schizophrenia Research Trends
Author: Konstance V. Almann
Publisher: Nova Publishers
ISBN: 9781600217463
Category : Medical
Languages : en
Pages : 284
Book Description
Schizophrenia is a chronic, severe, and disabling psychosis, which is an impairment of thinking in which the interpretation of reality is abnormal. Psychosis is a symptom of a disordered brain. Approximately One percent of the population worldwide develops schizophrenia during their lifetime. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. The current evidence concerning the causes of schizophrenia are many. It is quite clear that multiple factors are involved. These include changes in the chemistry of the brain, changes in the structure of the brain, and genetic factors. Viral infections and head injuries may also play a role. New molecular tools and modern statistical analyses allow focusing in on particular genes that might make people more susceptible to schizophrenia by affecting, for example, brain development or neurotransmitter systems governing brain functioning. State-of-the-art imaging techniques are being used to study the living brain. They have recently revealed specific, subtle abnormalities in the structure and function of the brains of patients with schizophrenia. In other imaging studies, early biochemical changes that may precede the onset of disease symptoms have been noted, prompting examination of the neural circuits that are most likely to be involved in producing those symptoms. This book presents new and important research in the field.
Publisher: Nova Publishers
ISBN: 9781600217463
Category : Medical
Languages : en
Pages : 284
Book Description
Schizophrenia is a chronic, severe, and disabling psychosis, which is an impairment of thinking in which the interpretation of reality is abnormal. Psychosis is a symptom of a disordered brain. Approximately One percent of the population worldwide develops schizophrenia during their lifetime. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. The current evidence concerning the causes of schizophrenia are many. It is quite clear that multiple factors are involved. These include changes in the chemistry of the brain, changes in the structure of the brain, and genetic factors. Viral infections and head injuries may also play a role. New molecular tools and modern statistical analyses allow focusing in on particular genes that might make people more susceptible to schizophrenia by affecting, for example, brain development or neurotransmitter systems governing brain functioning. State-of-the-art imaging techniques are being used to study the living brain. They have recently revealed specific, subtle abnormalities in the structure and function of the brains of patients with schizophrenia. In other imaging studies, early biochemical changes that may precede the onset of disease symptoms have been noted, prompting examination of the neural circuits that are most likely to be involved in producing those symptoms. This book presents new and important research in the field.
Neurodevelopment and Schizophrenia
Author: Matcheri S. Keshavan
Publisher: Cambridge University Press
ISBN: 9780521823319
Category : Medical
Languages : en
Pages : 576
Book Description
This book was originally published in 2004 and concerns developmental neurobiology. In the decade preceding publication, developmental neurobiology made important strides towards elucidating the pathophysiology of psychiatric disorders. Nowhere has this link between basic science and clinical insights become clearer than in the field of schizophrenia research. Each contributor to this volume provides a fresh overview of the relevant research, including directions for further investigation. The book begins with a section on advances in developmental neurobiology. This is followed by sections on etiological and pathophysiological developments, and models that integrate this knowledge. The final section addresses the clinical insights that emerge from the developmental models. This book will be valuable to researchers in psychiatry and neurobiology, students in psychology, and all mental health practitioners.
Publisher: Cambridge University Press
ISBN: 9780521823319
Category : Medical
Languages : en
Pages : 576
Book Description
This book was originally published in 2004 and concerns developmental neurobiology. In the decade preceding publication, developmental neurobiology made important strides towards elucidating the pathophysiology of psychiatric disorders. Nowhere has this link between basic science and clinical insights become clearer than in the field of schizophrenia research. Each contributor to this volume provides a fresh overview of the relevant research, including directions for further investigation. The book begins with a section on advances in developmental neurobiology. This is followed by sections on etiological and pathophysiological developments, and models that integrate this knowledge. The final section addresses the clinical insights that emerge from the developmental models. This book will be valuable to researchers in psychiatry and neurobiology, students in psychology, and all mental health practitioners.
Trauma, Psychosis, and Posttraumatic Stress Disorder
Author: Kate V. Hardy
Publisher: Frontiers Media SA
ISBN: 288945360X
Category :
Languages : en
Pages : 219
Book Description
There is abundant evidence showing a strong association between trauma exposure, psychotic symptoms, and posttraumatic stress disorder (PTSD). Early trauma exposure contributes to the formation of psychotic symptoms and the development of psychotic disorders or severe mental illnesses such as schizophrenia, bipolar disorder, and treatment-refractory major depression. Furthermore, among persons with psychotic disorders, multiple traumatization over the lifetime is common, due to factors such as social stigma, the criminalization of severe mental illness, and increased vulnerability to interpersonal victimization. In addition to these factors is the traumatic nature of experiencing psychotic symptoms and coercive treatments such as involuntary hospitalization and being placed in seclusion or restraints. Not surprisingly, these high rates of trauma lead to high rates of PTSD in people with psychotic disorders, which are associated with more severe symptoms, worse functioning, and greater use of acute care services. In addition to the impact of trauma on the development of psychotic disorders and comorbid PTSD, traumatic experiences such as childhood sexual and physical abuse can shape the nature of prominent psychotic symptoms such as the content of auditory hallucinations and delusional beliefs. Additionally, traumatic experiences have been implicated in the role of ‘stress responsivity’ and increased risk for transition to psychosis in those identified as being at clinical high risk of developing psychosis. Finally, although the diagnostic criteria for PTSD primarily emphasize the effects of trauma on anxiety, avoidance, physiological over-arousal, and negative thoughts, it is well established that PTSD is frequently accompanied by psychotic symptoms such as hallucinations and delusions that cannot be attributed to another DSM-V Axis I disorder such as psychotic depression or schizophrenia. Understanding the contribution of traumatic experiences to the etiology of psychosis and other symptoms can inform the provision of cognitive behavioral therapy for psychosis, including the development of a shared formulation of the events leading up to the onset of the disorder, as well as other trauma-informed treatments that address distressing and disabling symptoms associated with trauma and psychosis. Until recently the trauma treatment needs of this population have been neglected, despite the high rates of trauma and PTSD in persons with psychotic disorders, and in spite of substantial gains made in the treatment of PTSD in the general population. Fortunately, progress in recent years has provided encouraging evidence that PTSD can be effectively treated in people with psychotic disorders using interventions adapted from PTSD treatments developed for the general population. In contrast to clinician fears about the untoward effects of trauma-focused treatments on persons with a psychotic disorder, research indicates that post-traumatic disorders can be safely treated, and that participants frequently experience symptom relief and improved functioning. There is a need to develop a better understanding of the interface between trauma, psychosis, and post-traumatic disorder. This Frontiers Research Topic is devoted to research addressing this interface.
Publisher: Frontiers Media SA
ISBN: 288945360X
Category :
Languages : en
Pages : 219
Book Description
There is abundant evidence showing a strong association between trauma exposure, psychotic symptoms, and posttraumatic stress disorder (PTSD). Early trauma exposure contributes to the formation of psychotic symptoms and the development of psychotic disorders or severe mental illnesses such as schizophrenia, bipolar disorder, and treatment-refractory major depression. Furthermore, among persons with psychotic disorders, multiple traumatization over the lifetime is common, due to factors such as social stigma, the criminalization of severe mental illness, and increased vulnerability to interpersonal victimization. In addition to these factors is the traumatic nature of experiencing psychotic symptoms and coercive treatments such as involuntary hospitalization and being placed in seclusion or restraints. Not surprisingly, these high rates of trauma lead to high rates of PTSD in people with psychotic disorders, which are associated with more severe symptoms, worse functioning, and greater use of acute care services. In addition to the impact of trauma on the development of psychotic disorders and comorbid PTSD, traumatic experiences such as childhood sexual and physical abuse can shape the nature of prominent psychotic symptoms such as the content of auditory hallucinations and delusional beliefs. Additionally, traumatic experiences have been implicated in the role of ‘stress responsivity’ and increased risk for transition to psychosis in those identified as being at clinical high risk of developing psychosis. Finally, although the diagnostic criteria for PTSD primarily emphasize the effects of trauma on anxiety, avoidance, physiological over-arousal, and negative thoughts, it is well established that PTSD is frequently accompanied by psychotic symptoms such as hallucinations and delusions that cannot be attributed to another DSM-V Axis I disorder such as psychotic depression or schizophrenia. Understanding the contribution of traumatic experiences to the etiology of psychosis and other symptoms can inform the provision of cognitive behavioral therapy for psychosis, including the development of a shared formulation of the events leading up to the onset of the disorder, as well as other trauma-informed treatments that address distressing and disabling symptoms associated with trauma and psychosis. Until recently the trauma treatment needs of this population have been neglected, despite the high rates of trauma and PTSD in persons with psychotic disorders, and in spite of substantial gains made in the treatment of PTSD in the general population. Fortunately, progress in recent years has provided encouraging evidence that PTSD can be effectively treated in people with psychotic disorders using interventions adapted from PTSD treatments developed for the general population. In contrast to clinician fears about the untoward effects of trauma-focused treatments on persons with a psychotic disorder, research indicates that post-traumatic disorders can be safely treated, and that participants frequently experience symptom relief and improved functioning. There is a need to develop a better understanding of the interface between trauma, psychosis, and post-traumatic disorder. This Frontiers Research Topic is devoted to research addressing this interface.
Advances in Psychiatry
Author: Afzal Javed
Publisher: Springer
ISBN: 3319705547
Category : Medical
Languages : en
Pages : 729
Book Description
This book is the newest edition on the series ‘advances in psychiatry’. The previous 3 volumes can be found online at http://www.wpanet.org/detail.php?section_id=10&content_id=660 . They were highly successful in covering a broad area of psychiatry from different perspectives and angles and by reflecting both specialized but also international and global approaches. This series have guaranteed quality therefore can be used by different scientific groups for teaching and learning and also as a means for fast dissemination of advanced research and transformation of research findings into the everyday clinical practice.
Publisher: Springer
ISBN: 3319705547
Category : Medical
Languages : en
Pages : 729
Book Description
This book is the newest edition on the series ‘advances in psychiatry’. The previous 3 volumes can be found online at http://www.wpanet.org/detail.php?section_id=10&content_id=660 . They were highly successful in covering a broad area of psychiatry from different perspectives and angles and by reflecting both specialized but also international and global approaches. This series have guaranteed quality therefore can be used by different scientific groups for teaching and learning and also as a means for fast dissemination of advanced research and transformation of research findings into the everyday clinical practice.
Women & Psychosis
Author: Marie Brown
Publisher: Rowman & Littlefield
ISBN: 1498591922
Category : Psychology
Languages : en
Pages : 227
Book Description
Interrogating the relationship between women and psychosis from a variety of perspectives, this edited collection explores personal, literary, spiritual, psychological, biological, and psychodynamic approaches. The contributors reflect on medieval mystics and witches, postpartum psychosis, disordered eating, art and literature, feminism, and male/female differences in schizophrenia. Women with experience of psychosis, psychotherapists, and a shaman provide first-person accounts to give the book a personal grounding. Curated with the intent to expand the way we think about women and psychosis, the contributors to this collection recognize that “voices and visions” do not occur in a vacuum, but are experienced within, and are influenced by, particular socio-cultural contexts.
Publisher: Rowman & Littlefield
ISBN: 1498591922
Category : Psychology
Languages : en
Pages : 227
Book Description
Interrogating the relationship between women and psychosis from a variety of perspectives, this edited collection explores personal, literary, spiritual, psychological, biological, and psychodynamic approaches. The contributors reflect on medieval mystics and witches, postpartum psychosis, disordered eating, art and literature, feminism, and male/female differences in schizophrenia. Women with experience of psychosis, psychotherapists, and a shaman provide first-person accounts to give the book a personal grounding. Curated with the intent to expand the way we think about women and psychosis, the contributors to this collection recognize that “voices and visions” do not occur in a vacuum, but are experienced within, and are influenced by, particular socio-cultural contexts.
Schizophrenia
Author: Steven M. Silverstein
Publisher: MIT Press
ISBN: 0262019620
Category : Medical
Languages : en
Pages : 403
Book Description
Leading researchers address conceptual and technical issues in schizophrenia and suggest novel strategies for advancing research and treatment. Despite major advances in methodology and thousands of published studies every year, treatment outcomes in schizophrenia have not improved over the last fifty years. Moreover, we still lack strategies for prevention and we do not yet understand how the interaction of genetic, developmental, and environmental factors contribute to the disorder. In this book, leading researchers consider conceptual and technical obstacles to progress in understanding schizophrenia and suggest novel strategies for advancing research and treatment. The contributors address a wide range of critical issues: the construct of schizophrenia itself; etiology, risk, prediction, and prevention; different methods of modeling the disorder; and treatment development and delivery. They identify crucial gaps in our knowledge and offer creative but feasible suggestions. These strategies include viewing schizophrenia as a heterogeneous group of conditions; adopting specific new approaches to prediction and early intervention; developing better integration of data across genetics, imaging, perception, cognition, phenomenology, and other fields; and moving toward an evidence-based, personalized approach to treatment requiring rational clinical decision-making to reduce functional disability. Contributors Robert Bittner, Robert W. Buchanan, Kristin S. Cadenhead, William T. Carpenter, Jr., Aiden Corvin, Daniel Durstewitz, André A. Fenton, Camilo de la Fuente-Sandoval, Jay A. Gingrich, Joshua A. Gordon, Chloe Gott, Peter B. Jones, René S. Kahn, Richard Keefe, Wolfgang Kelsch, James L. Kennedy, Matcheri S. Keshavan, Angus W. MacDonald III, Anil K. Malhotra, John McGrath, Andreas Meyer-Lindenberg, Kevin J. Mitchell, Bita Moghaddam, Vera A. Morgan, Craig Morgan, Kim T. Mueser, Karoly Nikolich, Patricio O'Donnell, Michael O'Donovan, William A. Phillips, Wulf Rössler, Louis Sass, Akira Sawa, Jeremy K. Seamans, Steven M. Silverstein, William Spaulding, Sharmili Sritharan, Heike Tost, Peter Uhlhaas, Aristotle Voineskos, Michèle Wessa, Leanne M. Williams, Ashley Wilson, Til Wykes
Publisher: MIT Press
ISBN: 0262019620
Category : Medical
Languages : en
Pages : 403
Book Description
Leading researchers address conceptual and technical issues in schizophrenia and suggest novel strategies for advancing research and treatment. Despite major advances in methodology and thousands of published studies every year, treatment outcomes in schizophrenia have not improved over the last fifty years. Moreover, we still lack strategies for prevention and we do not yet understand how the interaction of genetic, developmental, and environmental factors contribute to the disorder. In this book, leading researchers consider conceptual and technical obstacles to progress in understanding schizophrenia and suggest novel strategies for advancing research and treatment. The contributors address a wide range of critical issues: the construct of schizophrenia itself; etiology, risk, prediction, and prevention; different methods of modeling the disorder; and treatment development and delivery. They identify crucial gaps in our knowledge and offer creative but feasible suggestions. These strategies include viewing schizophrenia as a heterogeneous group of conditions; adopting specific new approaches to prediction and early intervention; developing better integration of data across genetics, imaging, perception, cognition, phenomenology, and other fields; and moving toward an evidence-based, personalized approach to treatment requiring rational clinical decision-making to reduce functional disability. Contributors Robert Bittner, Robert W. Buchanan, Kristin S. Cadenhead, William T. Carpenter, Jr., Aiden Corvin, Daniel Durstewitz, André A. Fenton, Camilo de la Fuente-Sandoval, Jay A. Gingrich, Joshua A. Gordon, Chloe Gott, Peter B. Jones, René S. Kahn, Richard Keefe, Wolfgang Kelsch, James L. Kennedy, Matcheri S. Keshavan, Angus W. MacDonald III, Anil K. Malhotra, John McGrath, Andreas Meyer-Lindenberg, Kevin J. Mitchell, Bita Moghaddam, Vera A. Morgan, Craig Morgan, Kim T. Mueser, Karoly Nikolich, Patricio O'Donnell, Michael O'Donovan, William A. Phillips, Wulf Rössler, Louis Sass, Akira Sawa, Jeremy K. Seamans, Steven M. Silverstein, William Spaulding, Sharmili Sritharan, Heike Tost, Peter Uhlhaas, Aristotle Voineskos, Michèle Wessa, Leanne M. Williams, Ashley Wilson, Til Wykes
Trends in Schizophrenia Research
Author: Mary V. Lang
Publisher: Nova Publishers
ISBN: 9781594541544
Category : Psychology
Languages : en
Pages : 236
Book Description
Schizophrenia is a chronic, severe, and disabling psychosis, which is an impairment of thinking in which the interpretation of reality is abnormal. Psychosis is a symptom of a disordered brain. Approximately 1 percent of the population worldwide develops schizophrenia during their lifetime. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. The current evidence concerning the causes of schizophrenia is a mosaic. It is quite clear that multiple factors are involved. These include changes in the chemistry of the brain, changes in the structure of the brain, and genetic factors. Viral infections and head injuries may also play a role New molecular tools and modern statistical analyses are allowing focusing in on particular genes that might make people more susceptible to schizophrenia by affecting, for example, brain development or neurotransmitter systems governing brain functioning. State-of-the-art imaging techniques are being used to study the living brain. They have recently revealed specific, subtle abnormalities in the structure and function of the brains of patients with schizophrenia. In other imaging studies, early biochemical changes that may precede the onset of disease symptoms have been noted, prompting examination of the neural circuits that are most likely to be involved in producing those symptoms. This new book presents the newest in-depth research from around the world on schizophrenia.
Publisher: Nova Publishers
ISBN: 9781594541544
Category : Psychology
Languages : en
Pages : 236
Book Description
Schizophrenia is a chronic, severe, and disabling psychosis, which is an impairment of thinking in which the interpretation of reality is abnormal. Psychosis is a symptom of a disordered brain. Approximately 1 percent of the population worldwide develops schizophrenia during their lifetime. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. The current evidence concerning the causes of schizophrenia is a mosaic. It is quite clear that multiple factors are involved. These include changes in the chemistry of the brain, changes in the structure of the brain, and genetic factors. Viral infections and head injuries may also play a role New molecular tools and modern statistical analyses are allowing focusing in on particular genes that might make people more susceptible to schizophrenia by affecting, for example, brain development or neurotransmitter systems governing brain functioning. State-of-the-art imaging techniques are being used to study the living brain. They have recently revealed specific, subtle abnormalities in the structure and function of the brains of patients with schizophrenia. In other imaging studies, early biochemical changes that may precede the onset of disease symptoms have been noted, prompting examination of the neural circuits that are most likely to be involved in producing those symptoms. This new book presents the newest in-depth research from around the world on schizophrenia.
The Psychosis-Risk Syndrome
Author: Thomas McGlashan
Publisher: Oxford University Press
ISBN: 0199733317
Category : Language Arts & Disciplines
Languages : en
Pages : 256
Book Description
Using the authors' over thirteen years of experience at the psychosis-risk clinic at Yale University School of Medicine, The Psychosis-Risk Syndrome presents a concise handbook that details the diagnostic tools and building blocks that comprise the Structural Interview for Psychosis-Risk Syndromes, or SIPS. Clear and to the point, this volume provides an in-depth description of this new clinical high-risk population, along with instructions on how to use the SIPS to evaluate persons for psychosis-risk.The handbook's main section takes the reader step-by-step through the SIPS evaluation, tracking how patients and families find their way to the clinic, the initial interview, the evaluation process, and the summary session consisting of findings and future options. The core diagnostic symptoms of the SIPS and psychosis-risk states are illustrated with dozens of symptom and case examples drawn from real but disguised patients from the Yale clinic. With an emphasis on clinical usefulness, the handbook finishes with "practice cases" for the reader to test his or her new skills at evaluating clinical populations for psychosis-risk.
Publisher: Oxford University Press
ISBN: 0199733317
Category : Language Arts & Disciplines
Languages : en
Pages : 256
Book Description
Using the authors' over thirteen years of experience at the psychosis-risk clinic at Yale University School of Medicine, The Psychosis-Risk Syndrome presents a concise handbook that details the diagnostic tools and building blocks that comprise the Structural Interview for Psychosis-Risk Syndromes, or SIPS. Clear and to the point, this volume provides an in-depth description of this new clinical high-risk population, along with instructions on how to use the SIPS to evaluate persons for psychosis-risk.The handbook's main section takes the reader step-by-step through the SIPS evaluation, tracking how patients and families find their way to the clinic, the initial interview, the evaluation process, and the summary session consisting of findings and future options. The core diagnostic symptoms of the SIPS and psychosis-risk states are illustrated with dozens of symptom and case examples drawn from real but disguised patients from the Yale clinic. With an emphasis on clinical usefulness, the handbook finishes with "practice cases" for the reader to test his or her new skills at evaluating clinical populations for psychosis-risk.
Changing Trends in Mental Health Care and Research in Ghana
Author: Ofori-Atta, Angela
Publisher: Sub-Saharan Publishers
ISBN: 9988860218
Category : Medical
Languages : en
Pages : 286
Book Description
This Reader is about the changing trends in mental health care and research in Ghana. The book includes a brief history of Department of Psychiatry at the University of Ghana Medical School and Mental Health Care in Ghana through the eyes of professionals who have lived this history. There is also a revised situation analysis of mental health services and legislation from 2005. These are followed by three main sections on Conceptualization of Mental Illness (depression, religion and illness, autism, substance use disorders and schizophrenia), Mental Health Practice in a teaching hospital setting (referrals to Korle-Bu, how psychiatric illnesses manifest, how people's lives are affected and what skill sets and resources are available for dealing with them) and finally the Department's focus on research includes the Mental Health Information System, Sickle Cell Disease, Medical Ethics, and Liaison Psychiatry. In the concluding paragraph, read about the way forward in mental health care and research.
Publisher: Sub-Saharan Publishers
ISBN: 9988860218
Category : Medical
Languages : en
Pages : 286
Book Description
This Reader is about the changing trends in mental health care and research in Ghana. The book includes a brief history of Department of Psychiatry at the University of Ghana Medical School and Mental Health Care in Ghana through the eyes of professionals who have lived this history. There is also a revised situation analysis of mental health services and legislation from 2005. These are followed by three main sections on Conceptualization of Mental Illness (depression, religion and illness, autism, substance use disorders and schizophrenia), Mental Health Practice in a teaching hospital setting (referrals to Korle-Bu, how psychiatric illnesses manifest, how people's lives are affected and what skill sets and resources are available for dealing with them) and finally the Department's focus on research includes the Mental Health Information System, Sickle Cell Disease, Medical Ethics, and Liaison Psychiatry. In the concluding paragraph, read about the way forward in mental health care and research.