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Discrepant results are the most common results of mental health research, and may even occur multiple times in a single study. But what do discrepant results mean? How are researchers to make sense of them? Do they tell us something important about mental health, and if they do, how would we know? Discrepant Results in Mental Health Research challenges all that we think we know about mental health.
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.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Neuroscience of Nicotine: Mechanisms and Treatment presents the fundamental information necessary for a thorough understanding of the neurobiological underpinnings of nicotine addiction and its effects on the brain. Offering thorough coverage of all aspects of nicotine research, treatment, policy and prevention, and containing contributions from internationally recognized experts, the book provides students, early-career researchers, and investigators at all levels with a fundamental introduction to all aspects of nicotine misuse. With an estimated one billion individuals worldwide classified as tobacco users—and tobacco use often being synonymous with nicotine addiction—nicotine is one of the world's most common addictive substances, and a frequent comorbidity of misuse of other common addictive substances. Nicotine alters a variety of neurological processes, from molecular biology, to cognition, and quitting is exceedingly difficult because of the number of withdrawal symptoms that accompany the process. - Integrates cutting-edge research on the pharmacological, cellular and molecular aspects of nicotine use, along with its effects on neurobiological function - Discusses nicotine use as a component of dual-use and poly addictions and outlines numerous screening and treatment strategies for misuse - Covers both the physical and psychological effects of nicotine use and withdrawal to provide a fully-formed view of nicotine dependency and its effects
Includes statistics.
This is a major international textbook for psychiatrists and other professionals working in the field of mental healthcare. With contributions from opinion-leaders from around the globe, this book will appeal to those in training as well as to those further along the career path seeking a comprehensive and up-to-date overview of effective clinical practice backed by research evidence. The book is divided into cohesive sections moving from coverage of the tools and skills of the trade, through descriptions of the major psychiatric disorders and on to consider special topics and issues surrounding service organization. The final important section provides a comprehensive review of treatments covering all of the major modalities. Previously established as the Essentials of Postgraduate Psychiatry, this new and completely revised edition is the only book to provide this depth and breadth of coverage in an accessible, yet authoritative manner.