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The Center Cannot Hold: My Journey Through Madness Hardcover – August 14, 2007

4.7 4.7 out of 5 stars 4,181 ratings

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A much-praised memoir of living and surviving mental illness as well as "a stereotype-shattering look at a tenacious woman whose brain is her best friend and her worst enemy" (Time).

Elyn R. Saks is an esteemed professor, lawyer, and psychiatrist and is the Orrin B. Evans Professor of Law, Psychology, Psychiatry, and the Behavioral Sciences at the University of Southern California Law School, yet she has suffered from schizophrenia for most of her life, and still has ongoing major episodes of the illness.

The Center Cannot Hold is the eloquent, moving story of Elyn's life, from the first time that she heard voices speaking to her as a young teenager, to attempted suicides in college, through learning to live on her own as an adult in an often terrifying world. Saks discusses frankly the paranoia, the inability to tell imaginary fears from real ones, the voices in her head telling her to kill herself (and to harm others), as well as the incredibly difficult obstacles she overcame to become a highly respected professional. This beautifully written memoir is destined to become a classic in its genre.
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From Publishers Weekly

In this engrossing memoir, Saks, a professor of law and psychiatry at the University of Southern California, demonstrates a novelist's skill of creating character, dialogue and suspense. From her extraordinary perspective as both expert and sufferer (diagnosis: Chronic paranoid schizophrenia with acute exacerbation; prognosis: Grave), Saks carries the reader from the early little quirks to the full blown falling apart, flying apart, exploding psychosis. Schizophrenia rolls in like a slow fog, as Saks shows, becoming imperceptibly thicker as time goes on.- Along the way to stability (treatment, not cure), Saks is treated with a pharmacopeia of drugs and by a chorus of therapists. In her jargon-free style, she describes the workings of the drugs (getting med-free, a constant motif) and the ideas of the therapists and physicians (psychologist, psychiatrist, psychoanalyst, cardiologist, endocrinologist). Her personal experience of a world in which she is both frightened and frightening is graphically drawn and leads directly to her advocacy of mental patients' civil rights as they confront compulsory medication, civil commitment, the abuse of restraints and the absurdities of the mental care system. She is a strong proponent of talk therapy (While medication had kept me alive, it had been psychoanalysis that helped me find a life worth living). This is heavy reading, but Saks's account will certainly stand out in its field.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From Booklist

At eight years old, Saks began suffering hallucinations and obsessive fears of being attacked. An adolescent experimentation with drugs provoked her parents to enroll her in a drug treatment program. But Saks' incredible self-control masked the fact that she was suffering from a debilitating mental illness. By the time she entered graduate school at Oxford University, her symptoms were so severe—including full-blown psychotic episodes and suicidal fantasies—that she was hospitalized. Through Oxford, law school at Yale, and a move to Los Angeles to work in the law school of the University of California, Saks struggled mightily to balance her ambitions with her illness, which was eventually diagnosed as schizophrenia. Never wanting to concede to her mental illness, Saks founds calm and comfort in a rigorous work routine. An analyst characterized her as having three lives: as Elyn, as Professor Saks, and as the Lady of the Charts mental patient. As Saks battled to get off medication and leave behind the Lady of the Charts, she fought for the rights of mental patients, and came to terms with her own limitations. Bush, Vanessa
Copyright © American Library Association. All rights reserved

Product details

  • Publisher ‏ : ‎ Grand Central Publishing; 1st edition (August 14, 2007)
  • Language ‏ : ‎ English
  • Hardcover ‏ : ‎ 352 pages
  • ISBN-10 ‏ : ‎ 140130138X
  • ISBN-13 ‏ : ‎ 978-1401301385
  • Reading age ‏ : ‎ 13 years and up
  • Grade level ‏ : ‎ 8 and up
  • Item Weight ‏ : ‎ 1.1 pounds
  • Dimensions ‏ : ‎ 5.5 x 8.25 inches
  • Customer Reviews:
    4.7 4.7 out of 5 stars 4,181 ratings

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Elyn R. Saks
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Elyn R. Saks is the Orrin B. Evans Professor of Law and Psychiatry and the Behavioral Sciences at the University of Southern California Law School and a research clinical associate at the Los Angeles Psychiatric Society and Institute. She is the author of Jekyll on Trial: Multiple Personality Disorder and Criminal Law and Interpreting Interpretation: The Limits of Hermeneutic Psychoanalysis.

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4.7 out of 5 stars
4,181 global ratings

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Customers say

Customers find the book insightful and inspiring, providing a unique look into the author's experiences. They describe it as an engaging and well-written memoir that is worth reading. Readers praise the author's courage and honesty in disclosing her journey. The story is described as gripping and interesting. Customers appreciate the author's honesty, truthfulness, and enduring strength.

AI-generated from the text of customer reviews

372 customers mention "Insight"363 positive9 negative

Customers find the book provides insightful and compelling information about schizophrenia. They appreciate the author's honest account of her life journey and how she navigates disruptive psychotic episodes. The topic is interesting and the author's ability to navigate the disorder effectively is praised.

"...This book can teach all of us to be more sensible and solidary to mental ill people, but it is a distressful reading, because we suffer together..." Read more

"...Overall this book is a captivating and compelling story of one woman's journey to happiness and success...." Read more

"I really enjoyed reading this memoir. It gave a real and candid glimpse into the condition of Schizophrenia and detailed how the author overcame the..." Read more

"...To make a long story short, I think this is a great book with a lot of insight." Read more

238 customers mention "Readability"238 positive0 negative

Customers find the book engaging and well-written. They say it's a good memoir for anyone struggling with psychotic illness and worth reading. The author provides a candid glimpse into schizophrenia and her accomplishments are top-notch.

"Well, I think this book is maybe the best book that I read in my whole life...." Read more

"I really enjoyed reading this memoir. It gave a real and candid glimpse into the condition of Schizophrenia and detailed how the author overcame the..." Read more

"...This is a book about living with schizophrenia, and it is a great book, remarkable in many respects...." Read more

"...Her accomplishments are objectively top notch. Yale Law is impossible to get into, for instance, and she was 99% in the Law Boards...." Read more

190 customers mention "Writing quality"175 positive15 negative

Customers find the book engaging and well-written. They appreciate the author's skill and transparency in writing about her thoughts and personal experiences. The book is described as an informative yet conversational read that allows readers to feel connected to the author's perspective.

"...emphasis is welcome and is not a sign of poor writing, but of good writing abilities...." Read more

"...Obviously she has a brilliant mind to remember with such clarity...." Read more

"...I appreciate how the author did not hold back, and painted how intense and frightening psychosis can be, and how even more frightening and..." Read more

"...This book was a joy to read, but it was also incredibly hard...." Read more

55 customers mention "Courage"55 positive0 negative

Customers appreciate the author's courage and honesty in sharing her journey. They find the book an interesting memoir of human persistence and achievement. The author bares her vulnerabilities and reveals her pure heart.

"...at how creative a writer Elyn R. Saks is and how she remembers precises details of her life, even down to conversations she had with numerous people...." Read more

"...I cannot express my gratitude towards this courageous author for sharing her experience. I could not have found this book at a better time...." Read more

"...I highly recommend this courageous and brilliant memoir." Read more

"...I was moved by her courage, inspired by her tenacity and brilliance and uplifted by her loving community...." Read more

53 customers mention "Engaging story"53 positive0 negative

Customers find the story engaging and interesting. They describe it as gripping, gratifying, and memorable. The author's writing style captures readers from the beginning and allows them to witness the journey.

"...Overall this book is a captivating and compelling story of one woman's journey to happiness and success...." Read more

"...The book read quick and was gripping along the way, going from normal moments of life at an Ivy League school to stark moments of disoriented..." Read more

"...read many other mental health memoirs before, but I must say this book was MOVING. Seriously...." Read more

"...book, but just following her on that journey was very absorbing and gratifying...." Read more

43 customers mention "Honesty"43 positive0 negative

Customers appreciate the author's honesty. They find the memoir candid and genuine, providing an intimate look into her life. The account is believable, frank, and insightful. Readers describe it as a first-hand self-portrait that provides a vivid picture of what life is like.

"...For those who had issues with this honest, heart-wrenching story, I pray that you never have to experience how a loved one suffers with this disease..." Read more

"At times you think you’re reading Stephen King, but everything in it is real. It’ll really make you rethink our treatment of the mentally I’ll." Read more

"What an amazing, honest, brave, and inspiring account of one woman's life journey - her struggle with her mental illness and the process she went..." Read more

"...The book is an honest, clearly-written and compelling look into the experience of schizophrenia. And what's especially affecting..." Read more

32 customers mention "Strength"28 positive4 negative

Customers appreciate the author's strength and determination. They find her stubbornness and intelligence admirable. The book is described as well-written and received in good condition.

"...I appreciate her fighting for her life and continuing to fight despite all odds. She give me renewed courage. Thanks for sharing your journey." Read more

"...Carthy Awardee, which is a fitting honor for this monumental yet fragile woman...." Read more

"...Her stubbornness and intelligence were great assets. It was a very hopeful well-written description of one woman’s experience." Read more

"...I am in awe of the authors enduring strength and conviction...." Read more

29 customers mention "Heartbreaking"20 positive9 negative

Customers have different views on the book. Some find it thought-provoking and humorous, while others describe it as depressing and boring. The story of pain, perseverance, and success resonates with some readers while raising issues about how we treat others.

"...As I finished this book I was so glad I had read it. The ending is profound and when Elyn R. Saks comes to terms with her illness you will feel a..." Read more

"...It's a cliff hanger until the end and throughout the book I wondered "Will she be able to meet this challenge too?..." Read more

"...be more sensible and solidary to mental ill people, but it is a distressful reading, because we suffer together with the author, chapter after..." Read more

"...brilliant mind, and only such a person can write a work so sincere, humane, and profound as The Center Cannot Hold...." Read more

Brain seizure, broken brain, head attack, biological dysfunction
5 out of 5 stars
Brain seizure, broken brain, head attack, biological dysfunction
The center that I cannot find is known to my unconscious mind. W H AudenOther informative biographies: Temple Grandin Emmy Best Actress Claire Danes biopic. Dr Grandin has autism, her commentary in Special Features attributes her continuing growth in her 60s to 30 years of antidepressants (with no alcohol nicotine caffeine), My Stroke of Insight: A Brain Scientist's Personal Journey 37yo anatomy instructor in medical school experiences stroke as mental illness, dementia. An Unquiet Mind: A Memoir of Moods and Madness Kay Redfield Jamison professor of psychiatry Johns Hopkins Medical School, world expert on BD bipolar disorder, manic-depressive illness, suffers from BD. Fictional portrayal of alcohol precipitated psychosis: Black Swan.One can never consent to creep when one feels an impulse to soar.Helen KellerThrough excerpts from diaries she has kept since childhood, Elyn Saks narrates recurrent brain attacks, like heart attacks, during which her mind is controlled not by her, thoughts feel imposed, she feels overwhelming guilt for being responsible for killing everyone and anyone. Instead of a seizure in the motor control centers of her brain which leads to muscular flailing, she has seizures in the thinking portion of her brain, which then flails about rhyming non-random words to express terror of frightening change, perceived failure or rejection. Her riveting accounts of her brain's attempts to regain a foothold on reality, and preserve dignity while suffering a biological-biochemical disconnect reflect the organic nature of the illness: repetitive thought scrambles each time the brain filter deteriorates.Her courage in stubbornly fighting for aspirations despite crippling delusions hallucinations and depression must be obvious meeting her in person, as she attracts loyal and supportive friends throughout her life in spite of her frightening psychotic seizures. Her nickname "lunch Mother" for gathering all around her to share good food and fellowship reflects the warmth with which she is held.I have no special gift. I am only passionately curious. The most beauty or experience we can have is the mysterious. . . . It is the fundamental emotion which stands at the cradle of true art and true science.Albert EinsteinRevelation of her broken brain through this book must have come at great cost, since her strength and pride reside in that same organ. But she chooses to share her life suffering publicly in advocacy for humane treatment of those who are unable to speak out for themselves. Her frightened painful restraint by leather straps and body wrap in a US psychiatric hospital which compressed her chest and prevented adequate breathing is terrifying. The contrast with the dignified respectful approach in the UK where a physician sits down and explains clearly what is not acceptable, and offers medication or an opportunity for self-calming is enlightening.Given her brain's dependence on solitude, ritual, routine, regularity, predictability for function and productivity, what is most admirable was her meeting the challenge of cancer not once, but twice, and finding herself able to sustain clarity through treatment. The most informative aspect of her healing appears not solely in talk therapy, medication or abstention from alcohol nicotine caffeine, but in befriending: finding and drawing close a group of confidants who know and accept you just as you are, human and broken and caring and proud and stubborn, and to whom you offer friendship in return.See also Nell with Jodi Foster's commentary.Without deep reflection one knows from daily life that one exists for other people. Albert EinsteinProfessor Saks' lucid account of psychosis allows one to feel the pain of her confusion, fear, sadness as her brain which serves her so nobly in her work as a law professor, betrays her repeatedly. Her advocacy for humane and dignified treatment of the mentally ill is fortified by her courageous memoir, and allows one to see the advantages of Aikido Communication: aligning, agreeing, redirecting, resolving while sharing common ground. Reading this book allows one to enter the realm of fear experienced by the mentally ill and compassionately empathize with the desire to protect oneself from frightening unknowns.Some reviewers comment on the self-absorbed wooden writing style. Professor Saks has a thinking disorder. She controls her life by controlling her thinking. Her field is mental health law, an intellectual pursuit, characterized by writing, editing, revision and re-revision to provide clarity and argue persuasively. She is not bipolar which is the brain seizure suffered by artistic creatives, so her writing does not carry the theatrical dramatic flavor of poets, playwrights, lyricists. Hers is a thought disorder, keeping her thoughts in order is a priority. Saks uses both direct grammar and vocabulary to maintain accessibility for patients and families.Some reviews note the distance sustained by Saks' parents when she was in distress. According to current thought, high expressed emotion, dramarama, theatrical displays of passion and emotionality are associated with relapse, decompensation, aggravation of functional instability. Maintenance of a neutral, low tone atmosphere in relationship devoid of drama is less likely to precipitate the painful decline in brain function called psychosis. Family intrusiveness, invasiveness, conflict, crying screaming high drama is associated with deterioration. Neutral friends and therapists were able to maintain the caring but encouraging environment she needed to acquiesce with treatment advice after 20 years of recurrent psychotic episodes from medication refusal.Temple Grandin acknowledges in her DVD commentary that her mother never felt comfortable with her squeeze machine. The neutral objectivity and distance of her aunt Ann allowed Temple to invent this calming chute, a coping skill which allowed her hours of productive function each day. The protectiveness of her mother cried out against the device. DVD Dhamma Brothers documentary of 10 day meditation training and 10 year follow up. CD Zen Garden, DVD Departures Oscar Best Foreign Film Japanese with English subtitles score CD Okuribito (Departures) gentle music for meditation or Tai Chi.Recovery is creating a "new normal." There is no current cure for schizophrenia, but Professor Saks shows there can be healing.Mental illness is a moment which changes, mental health is a moment which changes. Recovery is not returning to the way you were in the past, it is a collaboration between meeting the demands of illness while continuing to pursue meaningful work, family, friendships, marriage. Her memoir is a gift of sharing from a very private, painfully shy person, a story of suffering and ultimately resilience and hope DVD Happy [HD] documentary interviews with happy people worldwide.If you see yourself in others, then whom can you harm? Buddha5* stars
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Top reviews from the United States

  • Reviewed in the United States on January 30, 2012
    Well, I think this book is maybe the best book that I read in my whole life. Besides tell us the story of her life, Elyn Saks tell us what a person suffering from schizophrenia thinks and feels during her crisis. Off course that each person is different, but to "healthy" people, know about this is a invaluable knowledge. I was very surprised when she describes that she was shamed because while she was tied during a crisis, in the hospital, the door was open and all people that passed in front that door can see her. Usually we think that mental patients do not completely realize the reactions of the others, so, probably a lot of us don't bother in completely hide our discomfort when in presence of their crisis, probably hurting them still more. This book can teach all of us to be more sensible and solidary to mental ill people, but it is a distressful reading, because we suffer together with the author, chapter after chapter. I did a bad choice to decide reading all book in the bus, because in the last chapter I had to use a lot of self control to avoid to cry.

    One reviewer seem a little uncomfortable because the author repeatedly cites her intellectual merits, but I think that is absolutely necessary, because the healthy people usually think of mentally ill people like mentally lame, and probably it is not easy to break this misconception, so, her emphasis is welcome and is not a sign of poor writing, but of good writing abilities. She knows what is important to reiterate to her message can be understood. You don't break prejudices only explaining fact after fact, prejudices are hypnotic standards of thought, so you need treat them according and hit the same key again and again and again...

    Well, I am not that kind of reviewer that put a summary of each chapter, if you want this, try the "Look inside" feature. I think that is much more useful to tell what a person think and feels about the book, because these human reactions are what we share in commom and says more about the books than a summary.

    Now, I want to say some few things about this sickness, and if you are a materialistic person or a Christian person ( the type of person that think that the bible has all answers), stop to read here, to avoid waste your time.

    Elyn Saks describes some situations about her "delusions" that seems clearly psychic attacks and this hypothesis should be checked too, together with the schizophrenia hypothesis. In our materialistic society any time when a person see, hears or feels anything that is not physically present, this is interpreted like madness. It is so with astral projection, with see/hear spirits, auras, elementals, or pre/retrocognition. The materialistic point of view is very ignorant about this matters, so, its conclusions has completely no value in this subject. The fact the medicines were able to control or stop the delusions only shows the the medicines can block the perceptions of the person. Off course, a good part of the psychic attack is nothing more than spiritual bullying, so, if you can prevent the victim of perceive the bullying, you can block the negatives effects of the psychic attack, WHILE YOU TAKE YOUR MEDICINES. However, like the most in the medicine, you are only treating the symptoms, not the cause, that MAY be spiritual.

    A lot of things that Elyn Saks saw or thought during her crisis ( and a lot of mental diseases, but not all of them) , mainly her thoughts about she worth nothing, are the usual technique in psychic attacks, and if she had knew some reliable psychic ( the reliable never will charge any money for this) maybe she can find another answers to her situation, and another solutions.

    I know that this maybe sounds a little strange in the American culture, but if you can tolerates learn about spiritualism, you can discover that there are more facts than beliefs about this situations. However, IF situations the Elyn tells us about were, in fact, psychic attack, not schizophrenia, even so they are very hard to solve, because there are strong reasons to this kind of problem, usually a person never faces hard problems without strong reasons to them, and in this kind of situation, I mean, psychic attack, usually the offenders were, usually, victims in past incarnations, and the actual victim is, usually (but not always), the tormentor. Silt the actual victim with medicines can help her, but will not solve the problem, IF THE PROBLEMS WERE NOT MENTAL. Anyway, only a psychic can say if there were any real entities attacking the victim or if all was only delusion, a materialistic doctor is not able to conclude nothing about this. In a ideal world, the psychiatrist should be a psychic too.

    To those people that has any curiosity about the several problems and nuances of psychic attacks and methods of solutions that SOME GROUPS of spiritualists uses, this book has a lot of study cases:

    Spirit and Matter: New Horizons for Medicine

    I think that people suffering with mental disorders lose a lot to confine themselves to materialistic point of view, but anyone has the right to only accept the solutions that are according with their beliefs, even if this only treat the symptoms, not the cause.
    15 people found this helpful
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  • Reviewed in the United States on May 22, 2013
    "I needed to put two critical ideas together: that I could both be mentally ill and lead a rich and satisfying life." ~ (Locations 5056-58)

    Elyn R. Saks is a professor who has struggled with schizophrenia for most of her life. As a child she became slightly obsessive compulsive and then anorexic. As she grew older she started to have more symptoms of the disease and suffered for many years without medication.

    Throughout the book you will read completely honest revelations of what it is like to be on medication and to be off medication. You will be amazed at how creative a writer Elyn R. Saks is and how she remembers precises details of her life, even down to conversations she had with numerous people. Obviously she has a brilliant mind to remember with such clarity.

    At times this book can be shockingly honest but it is never frightening as I thought it might be. Elyn R. Saks always seems to have protections in place so when she falls gravely ill she has a support system and friends to help her.

    For some of the book you may feel frustrated that Elyn R. Saks thinks she can function without medication. Each time she is thrown back into a debilitating psychosis. The triggers are interesting and for that reason I think this book can explain a mentally ill person's basic needs for understanding and support.

    As we watch Elyn R. Saks struggle with her demons we are invited into a very private world of fears most will never experience. People who are mentally ill will however really relate to the hallucinations and voices and feeling of impending doom.

    Overall this book is a captivating and compelling story of one woman's journey to happiness and success. As I finished this book I was so glad I had read it. The ending is profound and when Elyn R. Saks comes to terms with her illness you will feel a great sense of relief.

    ~The Rebecca Review
    11 people found this helpful
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  • Reviewed in the United States on September 29, 2024
    I really enjoyed reading this memoir. It gave a real and candid glimpse into the condition of Schizophrenia and detailed how the author overcame the obstacles of this condition and offered hope to those suffering with the condition as well. I appreciate how the author did not hold back, and painted how intense and frightening psychosis can be, and how even more frightening and frustrating it can be to seek help for this serious condition. My only negative criticism I have is the book did become repetitive at times, especially towards the end when the author kept detailing how she kept going off medication, had a rebound in psychosis, and would then go back on medication. There were also some loose ends in the book that I really wished the author tied up, like what happened with the Tardive Dyskinesia? Lastly, I found that the overall flow of the writing was limited at times. However, despite it’s shortcomings, I found this memoir to be wonderful and would definitely recommend it to anyone who is interested in knowing more about Schizophrenia.
    One person found this helpful
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Top reviews from other countries

  • Cliente Kindle
    5.0 out of 5 stars Greatfull
    Reviewed in Brazil on October 4, 2024
    Please translate for more langages. Im Brazilian! I hope my loved one can read it some day.
    Mais estudantes de psicologia, profissionais da saude, pessoas com essa doença mental e familiares poderia ter acesso.
    We can mourn and than acept our limits while reading.
    I were looking for some good reference. There it is! Hehe im very thankfull.
  • John L.
    5.0 out of 5 stars A fascinating story, told candidly, with warmth and humour.
    Reviewed in the United Kingdom on January 1, 2025
    I am close to someone with schizophrenia, and this book has helped me to see it more clearly from the inside, as well as the outside. This personal story gives understanding, as well as the knowledge that is to be found in technical books. I think people like me who are close to someone would find the book very valuable. People with schizophrenia might also find that it's enlightening and encouraging, while being starkly realistic. For people who have never come across schizophrenia, it will be an eye-opener.
  • Alexandra
    5.0 out of 5 stars Una studentessa in triennale di scienze e tecniche psicologiche
    Reviewed in Italy on May 18, 2024
    I chose this book as an example for my tesi (not sure of what the translation might be), but i could not even imagine how important it might have become for me. It was an incredibile journey, i cried and i was filled with joy for every beautiful and well deserved happiness she encountered. I will love to write about her book, i will encourage my friends and collegues to read it, and i m sure i will think about it a lot in my life. I am gratefull for the decision to write down the details about her journey because i think is the most effective way to, at least, start to understand how hard it might be living with such condition and how much stigma there is to overcome. Thank you from the bottom of my heart.
  • Aturo
    5.0 out of 5 stars Amazing book
    Reviewed in Germany on March 29, 2024
    By far the best book. I‘ve ever read. A very touching and relatable story about living with an mental illness. A must read for any schizophrenic out there.
  • Suzanne
    5.0 out of 5 stars Awesome read
    Reviewed in Australia on January 24, 2023
    One of the best books i have read on the subjet. Elyn is an exceptional writer and storyteller. I highly reccomemd this book to anyone wanting to better understand mental illness.