Full integration of psychiatry into the rest of medicine remains an unmet need, despite good progress. Because almost every medical illness can cause psychiatric symptoms, DSM-5 mandates that general medical conditions be ruled out before a primary psychiatric diagnosis is made.
Along the same lines, most severely mentally ill persons suffer from medical and neurologic ailments before their first episode,5 and many die prematurely from cardiovascular causes that often are the result of unhealthy lifestyle; iatrogenic complications; and lack of primary care interventions.6 Psychiatric patients must always receive standard general medical evaluation and management, side by side with their psychiatric care.
Philanthropy for psychiatry
Philanthropic support of psychiatry is a salutary trend. Some unmet needs in psychiatry, however, require not only money but a change in attitude (such as eliminating the absurd and discriminatory stigma of mental illness), better training, and forceful political activism by all of us.