Patients with mental illness are much better off now than they were only a few decades ago. Diagnostic methods are more reliable, and treatments are more effective. Only a minority of psychiatric patients require long-term hospitalization, and the practice of psychiatry is now more like the practice of other medical specialties. At the same time, the prevalence of psychiatric disease is more clearly recognized. Five of the world’s 10 leading causes of disability are psychiatric: depression, alcohol abuse, bipolar mood disorder, schizophrenia, and obsessive-compulsive disorder. 1 Each of these disorders has important genetic determinants and biologic correlates. In the past 40 years, specific effective treatments for each have replaced nonspecific concern and support. 2 We have developed pharmacologic agents for depression, mania, psychosis, obsessions, and panic, as well as agents that block the craving for drugs of abuse, calm hyperactive children, and slow the progress of Alzheimer’s dementia. We have also developed psychological treatments for depression and methods of psychosocial management for patients with schizophrenia. This progress has been based on the immense growth of both basic and clinical psychiatric research. By 1995, academic departments of psychiatry were second only to departments of medicine in terms of funding for research. 3