RESEARCH WEEKLY: A call for new priorities at the NIMH

(June 28, 2016) The search for a successor to Dr. Tom Insel as director of the National Institute of Mental Health (NIMH) – the nation’s central agency for mental illness research – is nearing its conclusion.

With an announcement of the new director expected shortly, the British Journal of Psychiatry has published an editorial from 20 eminent psychiatrists and psychiatric researchers calling for the NIMH to put more emphasis on funding research into prevention and treatments that will bring immediate relief to individuals living with mental illness.

“Rethinking Funding Priorities”

The transition to new NIMH leadership, the authors write, “presents a critical opportunity to examine US mental health research funding priorities.”

“Despite spending more than any other country on healthcare ($4,271 annually/person), the USA ranks 37th in global health outcomes and fails to serve even half of its residents needing mental health services.”

The authors laud the search for neurobiological mechanisms of mental illness that someday may result in discovering the causes of diseases such as schizophrenia and lead to new treatments for them.

But they maintain that high-income countries, including the US, “must balance longer-term investment in identifying neurobiological mechanisms of disease with shorter-term funding of novel prevention and treatment strategies to alleviate the current burden of mental illness.”

Calling mental health research funding a “form of social investment,” they call upon the NIMH under its new leadership to “diversify” its investment to avoid over-investing in long-term scientific discovery at the expense of “less risky investments that yield immediate albeit potentially more modest benefits.” Among the research they say merits higher priority:

• developing sustainable interventions to overcome disparities in access to effective treatment and outcomes;
• crafting technologies and implementation strategies to disseminate scalable, cost-efficient interventions; 
• devising approaches to empower people to overcome barriers to engagement and retention in treatment; and 
• deploying preventive interventions to reduce the burden of mental illness, including clarifying how to implement best practices in suicide prevention. 

“In sum, too often our mental health research funding neglects immediate public health needs to focus on future discoveries, reflecting the drive for technological solutions for disorders that are unequally distributed and partly socially determined,” they say.

“Alleviating the Terrible Burden”
In conclusion, the joint statement calls for “an increase in public discussion of how to apportion funding resources across mental health research domains” that is global in scope.

“Paramount in these discussions must be alleviating the terrible burden that individuals and families living with mental illness face every day,” they say in closing. “As Harry Hopkins, co-architect of the 1940s New Deal, replied to members of Congress who opposed allocating federal funds to lift the economy out of the Great Depression, claiming that the economy would sort itself out ‘in the long run’: ‘People don’t eat in the long run, they eat every day.'”

All the authors are current or former members of the NIMH National Advisory Health Council. They include past presidents of the World Psychiatric Association and the American Psychiatric Association.

References:
Lewis- Fernández, R. et al. (June 2016). “Rethinking funding priorities in mental health research.” British Journal of Psychiatry.