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This new textbook stems most proximately from George Engel and his remarkable group of biopsychosocial scholars at the University of Rochester where Dr. Smith was fortunate to do fellowship work, later remaining of faculty. We also owe a debt of gratitude to Michigan State University, one of Engel’s initial advocates and the home base for the authors, for the propitious atmosphere they have established encouraging new and different approaches. Paraphrasing Robert Kennedy, Michigan State challenged us not to focus on why mental health is so problematic in the United States, but rather to dream how we could improve it.

The research involved in developing the evidence-based content of this book would not have been possible without the generous support of the Fetzer Institute (Kalamazoo, MI), the National Institute of Mental Health, and the Health Resources and Services Administration. It simply is not possible to develop rigorous educational interventions without such support.

We are so grateful to Amanda Fielding, our intrepid and always timely Senior Editor at McGraw-Hill, and to our long-time McGraw-Hill advisor, Jim Shanahan. Additional thanks go to Kim Davis, Managing Editor; Richard Ruzycka, Senior Production Supervisor; and Madhulika Jain, Project Manager. All contributed considerably to making this a very readable and professional book.

There are two groups of people without whom none of our work would be possible. We mention them together because they are intimately linked: our residents and their patients with mental disorders. The residents, with never a suggestion of resistance, joined us in embarking on this new direction in mental health education, and their mental health patients, many of whom were underserved, willingly participated, and greatly valued their care—and the improvement that followed.

Equally important, two friends and colleagues deserve our deepest thanks for reading and critiquing drafts of the book—and providing input to greatly improve its content and presentation: Patrick Hemming, an internist at Duke and Steve Frankel, a psychiatrist at UC San Francisco.

Finally, the research basis for our work would never have materialized without Judi Lyles, who was always one step ahead in overseeing many of our research projects, and the book itself would not have been possible but for the admirable efforts of Jinie Shirey and Ellyssa Knaggs in the day-to-day work of preparing it.

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