It is difficult to decide which is the more dispiriting statement: that one person in four suffers from a mental-health problem at some point in their lives, or that the sorry state of care for the millions of people affected is often discussed only in the immediate aftermath of the actions of a single mentally ill individual. One can quibble about statistics and diagnostic standards, but the bottom line is that neuro-psychiatric disorders account for one of the greatest burdens of disease in the developed world, yet patients are not receiving the help they need. Part of the problem is that, for many people, the available therapies simply do not work, and that situation is unlikely to improve any time soon. By the early 1990s, the pharmaceutical industry had discovered -mostly through luck - a handful of drug classes that today account for most mental-health prescriptions. Then the pipeline ran dry. On close inspection, it was far from clear how the available drugs worked. Our understanding of mental-health disorders, the firms realized, is insufficient to inform drug development.
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