TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine A2 - Jeanne C. Rivard A2 - Krisztina Marton TI - Measuring Specific Mental Illness Diagnoses with Functional Impairment: Workshop Summary SN - DO - 10.17226/21920 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21920/measuring-specific-mental-illness-diagnoses-with-functional-impairment-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The workshop summarized in this report was organized as part of a study sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services, with the goal of assisting SAMHSA in its responsibilities of expanding the collection of behavioral health data in several areas. The workshop brought together experts in mental health, psychiatric epidemiology and survey methods to facilitate discussion of the most suitable measures and mechanisms for producing estimates of specific mental illness diagnoses with functional impairment. The report discusses existing measures and data on mental disorders and functional impairment, challenges associated with collecting these data in large-scale population-based studies, as well as study design and estimation options. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Steve Olson TI - Improving Care to Prevent Suicide Among People with Serious Mental Illness: Proceedings of a Workshop SN - DO - 10.17226/25318 PY - 2019 UR - https://nap.nationalacademies.org/catalog/25318/improving-care-to-prevent-suicide-among-people-with-serious-mental-illness PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences AB - Suicide prevention initiatives are part of much broader systems connected to activities such as the diagnosis of mental illness, the recognition of clinical risk, improving access to care, and coordinating with a broad range of outside agencies and entities around both prevention and public health efforts. Yet suicide is also an intensely personal issue that continues to be surrounded by stigma. On September 11-12, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, to discuss preventing suicide among people with serious mental illness. The workshop was designed to illustrate and discuss what is known, what is currently being done, and what needs to be done to identify and reduce suicide risk. Improving Care to Prevent Suicide Among People with Serious Mental Illness summarizes presentations and discussions of the workshop. ER - TY - BOOK A2 - Meredith F. Small TI - The Culture of Our Discontent: Beyond the Medical Model of Mental Illness DO - 10.17226/11632 PY - 2006 UR - https://nap.nationalacademies.org/catalog/11632/the-culture-of-our-discontent-beyond-the-medical-model-of PB - The National Academies Press CY - Washington, DC LA - English KW - Explore Science KW - Health and Medicine AB - By many estimations, the Western medical model of mental health is dangerously incomplete. If we step outside of the traditional disease model there are many new and different ways to understand, treat, and even accept mental illness. Culture--how we collectively live, interact, and view the world--frames our mental outlook. Arguably, culture even creates it. Western culture, for example, has completely embraced the medical model of mental illness. We quickly turn to physicians if we are unhappy or otherwise mentally discomfited, seeking solutions on a prescription pad. We expect brain chemistry to be at the root of any mental malady, forgetting the deeply entwined relationship between the biology of the brain and the environment in which we think, feel, and react. But every culture has a different view of the world, a lens through which normal or insane are viewed and defined. Anthropologist Meredith Small contends there is much to be learned from stepping away from the traditional Western medical model to explore and embrace alternative perspectives. By examining culture itself, rather than focusing on biology and medicine, we can fully understand the nature of our discontent. Looking at social, evolutionary, cross-cultural, and nutritional influences, Small deconstructs mental illnesses like depression and anxiety conditions that appear in different forms and for different reasons within the culture that defines them. By rethinking assumptions and questioning standard treatment programs, she helps us gradually relax our grip on the medical model to discover a new perspective on mental illness. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Alan I. Leshner A2 - Layne A. Scherer TI - Mental Health, Substance Use, and Wellbeing in Higher Education: Supporting the Whole Student SN - DO - 10.17226/26015 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26015/mental-health-substance-use-and-wellbeing-in-higher-education-supporting PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Education AB - Student wellbeing is foundational to academic success. One recent survey of postsecondary educators found that nearly 80 percent believed emotional wellbeing is a "very" or "extremely" important factor in student success. Studies have found the dropout rates for students with a diagnosed mental health problem range from 43 percent to as high as 86 percent. While dealing with stress is a normal part of life, for some students, stress can adversely affect their physical, emotional, and psychological health, particularly given that adolescence and early adulthood are when most mental illnesses are first manifested. In addition to students who may develop mental health challenges during their time in postsecondary education, many students arrive on campus with a mental health problem or having experienced significant trauma in their lives, which can also negatively affect physical, emotional, and psychological wellbeing. The nation's institutions of higher education are seeing increasing levels of mental illness, substance use and other forms of emotional distress among their students. Some of the problematic trends have been ongoing for decades. Some have been exacerbated by the COVID-19 pandemic and resulting economic consequences. Some are the result of long-festering systemic racism in almost every sphere of American life that are becoming more widely acknowledged throughout society and must, at last, be addressed. Mental Health, Substance Use, and Wellbeing in Higher Education lays out a variety of possible strategies and approaches to meet increasing demand for mental health and substance use services, based on the available evidence on the nature of the issues and what works in various situations. The recommendations of this report will support the delivery of mental health and wellness services by the nation's institutions of higher education. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Lisa Bain A2 - Chanel Matney A2 - Sheena M. Posey Norris A2 - Clare Stroud TI - Exploring Psychedelics and Entactogens as Treatments for Psychiatric Disorders: Proceedings of a Workshop SN - DO - 10.17226/26648 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26648/exploring-psychedelics-and-entactogens-as-treatments-for-psychiatric-disorders-proceedings PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Psychiatric illnesses - such as major depressive disorder, anxiety disorder, substance use disorder, and posttraumatic stress disorder (PTSD) - are widely prevalent and represent a substantial health burden worldwide. Yet, conventional medications for mental illnesses often fail to provide relief to patients' disruptive and disabling symptoms. Existing and emerging evidence that psychedelics (e.g., LSD and psilocybin) and entactogens (e.g., MDMA) may be useful as tools to alleviate mental illness has sparked a renaissance of interest by investigators, clinicians, drug developers, and patient advocates in recent years. While promising data on therapeutic efficacy has energized research and development, resolving the mechanisms of action will be important for optimizing the efficacy and safety of these medicines. Further, evaluating the effect of psychedelics and entactogens on mood and behavior comes with unique challenges still in need of resolution. These include unresolved questions relating to blinding, placebo and nocebo effects, and the impact of psychosocial contexts. In response to this renewed interest, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders convened a workshop on March 29-30, 2022. The workshop brought together a diverse group of stakeholders to explore the use of psychedelics and entactogens as treatments for psychiatric disorders. This Proceedings of a Workshop summarizes the presentations and discussions of the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Thomas J. Plewes TI - Improving the Health of Women in the United States: Workshop Summary SN - DO - 10.17226/23441 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23441/improving-the-health-of-women-in-the-united-states-workshop PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The environment for women's health has changed over the last 25 years. Increased use of automobiles can lead to health risks from lack of physical activity. There has also been an increase in access to and consumption of unhealthy food. Other changes in the past 2 to 3 decades include the significant increase in the number of women who are heads of households and responsible for all aspects of a household and family. Many women now are also having children later in life, which poses interesting issues for both biology and sociology. The growing stress faced by women and the effect of stress on health and illness are issues that need a more comprehensive examination, as do issues of mental health and mental illness, which have been more common and thus increasingly prominent issues for U.S. women. In September 2015, the National Academies of Sciences, Engineering, and Medicine convened a workshop to shed light on important determinants, consequences, effects, and issues attending the relative disadvantage of women in the United States in comparison with women in other economically advanced nations. This report summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Research Council A2 - Mark H. Moore A2 - Carol V. Petrie A2 - Anthony A. Braga A2 - Brenda L. McLaughlin TI - Deadly Lessons: Understanding Lethal School Violence SN - DO - 10.17226/10370 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10370/deadly-lessons-understanding-lethal-school-violence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences AB - The shooting at Columbine High School riveted national attention on violence in the nation's schools. This dramatic example signaled an implicit and growing fear that these events would continue to occur—and even escalate in scale and severity. How do we make sense of the tragedy of a school shooting or even draw objective conclusions from these incidents? Deadly Lessons is the outcome of the National Research Council's unique effort to glean lessons from six case studies of lethal student violence. These are powerful stories of parents and teachers and troubled youths, presenting the tragic complexity of the young shooter's social and personal circumstances in rich detail. The cases point to possible causes of violence and suggest where interventions may be most effective. Readers will come away with a better understanding of the potential threat, how violence might be prevented, and how healing might be promoted in affected communities. For each case study, Deadly Lessons relates events leading up to the violence, provides quotes from personal interviews about the incident, and explores the impact on the community. The case studies center on: Two separate incidents in East New York in which three students were killed and a teacher was seriously wounded. A shooting on the south side of Chicago in which one youth was killed and two wounded. A shooting into a prayer group at a Kentucky high school in which three students were killed. The killing of four students and a teacher and the wounding of 10 others at an Arkansas middle school. The shooting of a popular science teacher by a teenager in Edinboro, Pennsylvania. A suspected copycat of Columbine in which six students were wounded in Georgia. For everyone who puzzles over these terrible incidents, Deadly Lessons offers a fresh perspective on the most fundamental of questions: Why? ER - TY - BOOK TI - Research on Mental Illness and Addictive Disorders: Progress and Prospects DO - 10.17226/19362 PY - 1984 UR - https://nap.nationalacademies.org/catalog/19362/research-on-mental-illness-and-addictive-disorders-progress-and-prospects PB - The National Academies Press CY - Washington, DC LA - English KW - KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine TI - Public Financing and Delivery of HIV/AIDS Care: Securing the Legacy of Ryan White SN - DO - 10.17226/10995 PY - 2005 UR - https://nap.nationalacademies.org/catalog/10995/public-financing-and-delivery-of-hivaids-care-securing-the-legacy PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Each year it is estimated that approximately 40,000 people in the U.S. are newly infected with HIV. In the late 1990s, the number of deaths from AIDS dropped 43% as a result of highly active antiretroviral therapy. Unfortunately, the complex system currently in place for financing and delivering publicly financed HIV care undermines the significant advances that have been made in the development of new technologies to treat it. Many HIV patients experience delays in access to other services that would support adhering to treatment. As a result, each year opportunities are missed that could reduce the mortality, morbidity, and disability suffered by individuals with HIV infections. Public Financing and Delivery of HIV/AIDS Care examines the current standard of care for HIV patients and assesses the extent the system currently used for financing and delivering care allows individuals with HIV to actually receive it. The book recommends an expanded federal program for the treatment of individuals with HIV, administered at the state level. This program would provide timely access and consistent benefits with a strong focus on comprehensive and continuous care and access to antiretroviral therapy. It could help improve the quality of life of HIV/AIDS patients, as well as reduce the number of deaths among those infected. ER - TY - BOOK AU - Institute of Medicine A2 - Lawrence O. Gostin A2 - Cori Vanchieri A2 - Andrew Pope TI - Ethical Considerations for Research Involving Prisoners SN - DO - 10.17226/11692 PY - 2007 UR - https://nap.nationalacademies.org/catalog/11692/ethical-considerations-for-research-involving-prisoners PB - The National Academies Press CY - Washington, DC LA - English KW - Policy for Science and Technology AB - In the past 30 years, the population of prisoners in the United States has expanded almost 5-fold, correctional facilities are increasingly overcrowded, and more of the country's disadvantaged populations—racial minorities, women, people with mental illness, and people with communicable diseases such as HIV/AIDS, hepatitis C, and tuberculosis—are under correctional supervision. Because prisoners face restrictions on liberty and autonomy, have limited privacy, and often receive inadequate health care, they require specific protections when involved in research, particularly in today's correctional settings. Given these issues, the Department of Health and Human Services' Office for Human Research Protections commissioned the Institute of Medicine to review the ethical considerations regarding research involving prisoners. The resulting analysis contained in this book, Ethical Considerations for Research Involving Prisoners, emphasizes five broad actions to provide prisoners involved in research with critically important protections: • expand the definition of "prisoner"; • ensure universally and consistently applied standards of protection; • shift from a category-based to a risk-benefit approach to research review; • update the ethical framework to include collaborative responsibility; and • enhance systematic oversight of research involving prisoners. ER - TY - BOOK AU - Institute of Medicine TI - The Role of Co-Occurring Substance Abuse and Mental Illness in Violence: Workshop Summary DO - 10.17226/9748 PY - 1999 UR - https://nap.nationalacademies.org/catalog/9748/the-role-of-co-occurring-substance-abuse-and-mental-illness-in-violence PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine ER - TY - BOOK AU - Institute of Medicine A2 - Marion Ein Lewin A2 - Stuart Altman TI - America's Health Care Safety Net: Intact but Endangered SN - DO - 10.17226/9612 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9612/americas-health-care-safety-net-intact-but-endangered PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety net—with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety net—public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the system—rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environment—detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populations—children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless. ER - TY - BOOK AU - Institute of Medicine TI - Care Without Coverage: Too Little, Too Late SN - DO - 10.17226/10367 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10367/care-without-coverage-too-little-too-late PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital--based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million -- one in seven--working--age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Gulf War and Health: Volume 11: Generational Health Effects of Serving in the Gulf War SN - DO - 10.17226/25162 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25162/gulf-war-and-health-volume-11-generational-health-effects-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the National Academies of Sciences, Engineering, and Medicine has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes. Some of the health effects identified by past reports include post-traumatic stress disorders, other mental health disorders, Gulf War illness, respiratory effects, and self-reported sexual dysfunction. Veterans' concerns regarding the impacts of deployment-related exposures on their health have grown to include potential adverse effects on the health of their children and grandchildren. These concerns now increasingly involve female veterans, as more women join the military and are deployed to war zones and areas that pose potential hazards. Gulf War and Health: Volume 11 evaluates the scientific and medical literature on reproductive and developmental effects and health outcomes associated with Gulf War and Post-9/11 exposures, and designates research areas requiring further scientific study on potential health effects in the descendants of veterans of any era. ER - TY - BOOK AU - National Research Council TI - Symposium on Preventive and Social Psychiatry DO - 10.17226/20228 PY - 1958 UR - https://nap.nationalacademies.org/catalog/20228/symposium-on-preventive-and-social-psychiatry PB - The National Academies Press CY - Washington, DC LA - English KW - KW - Health and Medicine ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change SN - DO - 10.17226/23442 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23442/ending-discrimination-against-people-with-mental-and-substance-use-disorders PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - 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. ER - TY - BOOK TI - Rural Health in the People's Republic of China: Report of a Visit by the Rural Health Systems Delegation, June 1978 DO - 10.17226/20472 PY - 1980 UR - https://nap.nationalacademies.org/catalog/20472/rural-health-in-the-peoples-republic-of-china-report-of PB - The National Academies Press CY - Washington, DC LA - English KW - KW - Health and Medicine ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Deepali Patel TI - Violence and Mental Health: Opportunities for Prevention and Early Detection: Proceedings of a Workshop SN - DO - 10.17226/24916 PY - 2018 UR - https://nap.nationalacademies.org/catalog/24916/violence-and-mental-health-opportunities-for-prevention-and-early-detection PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences AB - On February 26–27, 2014, the National Academies of Sciences, Engineering, and Medicine’s Forum on Global Violence Prevention convened a workshop titled Mental Health and Violence: Opportunities for Prevention and Early Intervention. The workshop brought together advocates and experts in public health and mental health, anthropology, biomedical science, criminal justice, global health and development, and neuroscience to examine experience, evidence, and practice at the intersection of mental health and violence. Participants explored how violence impacts mental health and how mental health influences violence and discussed approaches to improve research and practice in both domains. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Jeanne C. Rivard A2 - Adrienne Stith Butler TI - Lessons Learned from Diverse Efforts to Change Social Norms and Opportunities and Strategies to Promote Behavior Change in Behavioral Health: Proceedings of Two Workshops SN - DO - 10.17226/24824 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24824/lessons-learned-from-diverse-efforts-to-change-social-norms-and-opportunities-and-strategies-to-promote-behavior-change-in-behavioral-health PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences AB - In 2015, the National Academies of Sciences, Engineering, and Medicine convened two workshops with oversight from the Committee on the Science of Changing Behavioral Health Social Norms. The workshops provided input to the committee’s deliberations and contributed to the development of the report Ending Discrimination against People with Mental and Substance Use Disorders. That report was issued to help the Substance Abuse and Mental Health Services Administration and the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, utilize the scientific evidence base in improving public attitudes toward and understanding of behavioral health, specifically in the areas of mental health and substance use disorders. This publication summarizes the presentations and discussions at the two workshops. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Krisztina Marton TI - Measuring Recovery from Substance Use or Mental Disorders: Workshop Summary SN - DO - 10.17226/23589 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23589/measuring-recovery-from-substance-use-or-mental-disorders-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences KW - Surveys and Statistics AB - In February 2016, the National Academies of Sciences, Engineering, and Medicine held a workshop to explore options for expanding the Substance Abuse and Mental Health Services Administration’s (SAMHSA) behavioral health data collections to include measures of recovery from substance use and mental disorder. Participants discussed options for collecting data and producing estimates of recovery from substance use and mental disorders, including available measures and associated possible data collection mechanisms. This publication summarizes the presentations and discussions from the workshop. ER -