By Steven Hyman, MD
Director of the National Institute of Mental Health

This is a time of rapid change and great opportunity for NIMH as well as the psychology research community, which represents the institute?s largest disciplinary block of grantees. It is critical that any changes that affect behavioral science have a great deal of input from psychology researchers. The NIMH is striving to ensure such input as we engage three crucial developments for our field. The first change was the 1992 termination of the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) and the reunion of NIMH with the National Institutes of Health (NIH), with its provision that within five years, NIMH would integrate our previously independently administered peer-review system with the larger NIH peer-review system. The second was the establishment within NIH of the Office of Behavioral and Social Sciences Research (OBSSR), with its mandate to spread behavioral research throughout NIH. And a third significant change?internally initiated?was the recent reorganization of the extramural funding divisions within NIMH, a move that will better prepare us to seize the scientific opportunities and meet the public health challenges of the 21st century (see article page 13). While the reorganization of NIMH?s peer-review systems and its internal NIMH structure are independent events, with unrelated origins, we naturally are trying to make both as synergistic as possible.

Reorganizing peer review
As a researcher myself, I realize that changes in the peer-review system can provoke a great deal of anxiety. The statutory requirement that the formerly independent ADAMHA peer-review study sections be integrated with those of NIH could certainly be seen as threatening. But I prefer to see this process as a timely opportunity to improve the review of behavioral research at NIH. For each broad area of science affected by the merger into NIH of the former ADAMHA institutes, we are creating entirely new study sections that better represent the science they will review.

How will we draw up a new map for review of behavioral science? Directors of the institutes with substantial behavioral science portfolios and the director of the Center for Scientific Review (CSR, formerly the Division of Research Grants, DRG) met to work out general principles. We decided that:

? Study sections should be organized around scientific problems or levels of analysis rather than around research methods because specific research tools change rapidly and are significant only in the context of the problems they are enlisted to solve.

? Ideally, no study section should represent a single academic department, academic degree or professional society since this may give rise to parochialism.

? Whenever possible the purview of study sections should overlap somewhat to ensure that no application will become an orphan, and any application could be potentially reviewable in more than one study section.

We also agreed that extramural scientists should be involved from the very beginning to help structure the change. Accordingly, behavioral scientists will have the greatest say over the structure of the study sections as they emerge from this reorganization.

Soul searching at NIMH
The establishment of OBSSR has had salutary effects on NIH and behavioral science research. It also has created the need for a great deal of soul searching within NIMH.

I agree with OBSSR Director Norman Anderson, PhD, that each institute should be responsible for the behavioral science research most central to its mission. Thus, for example, the National Cancer Institute (NCI) and the National Heart, Lung and Blood Institute should be front and center in research on smoking prevention. And NCI should be involved in research on the role of behavioral therapy in cancer treatment, since this is a component of comprehensive cancer care. Over time, this approach will increase NIH?s overall commitment to behavioral research and will result in behavioral research gaining important exposure in the arenas in which it will be applied.

For NIMH, however, this mandate means that other institutes are now funding outstanding grants that we once funded. In response to this shift, I would like to increase NIMH?s commitment to funding behavioral science research that provides a framework for all research on health and behavior. That is, above and beyond applications of behavioral science to research on mental illness, we should nurture an unparalleled expertise in the mechanisms by which we can motivate sustained behavioral changes for health. Behavioral research conducted under the aegis of our HIV/AIDS behavioral portfolio?studies focused, for example, on the development of strategies and mechanisms for enhancing treatment adherence?convincingly demonstrate that this is an achievable goal, one that will be realized through the continuing partnership of NIMH and the behavioral science community.

A new emphasis on behavioral science

By Ellen Stover, PhD
Director of the NIMH Division of Mental Disorders, Behavioral Research and AIDS

With the significant advances in neuroscience and behavioral research in the last two decades, it became evident that NIMH?s organizational structure needed significant modification to enable it to respond to emerging scientific challenges and opportunities. Over the past year, NIMH reorganized its extramural research programs, putting in place mechanisms that better facilitate the translation of basic science into clinical practice. The reorganization will foster interactions between basic and clinical scientists, encourage knowledge transfer from the bench to clinical practice and support research with practical implications for those who suffer from such problems as depression, schizophrenia, conduct disorders or HIV. NIMH?s reorganization provides opportunities for psychologists in three areas, defined by the new divisions:

? The Division of Basic and Clinical Neuroscience Research, which focuses on genetic research, molecular, behavioral and integrative neuroscience, and clinical and preclinical therapeutics. Stephen Koslow, PhD, is director.

? The Division of Services and Intervention Research, which supports treatment and services research, clinical epidemiology and preventive intervention research. Grayson Norquist, MD, is acting director.

? The Division of Mental Disorders, Behavioral Research and AIDS (DMDBA), which focuses on understanding problems that affect people such as schizophrenia, depression, conduct disorders, violence and traumatic stress, emotional development and HIV. I direct this division.

Opportunities for psychologists
A major emphasis in the new behavioral division will be on identifying risk factors from a lifespan perspective. It is our goal to develop Phase I and II studies to better understand which methods are effective before conducting large clinical trials.

Along with NIMH?s Office of AIDS Research DMDBA?s branches include Behavioral Science Research; Developmental Psychopathology; and Prevention, Early Intervention and Epidemiology. The Behavioral Science Research Branch, headed by psychologist Mary Ellen Oliveri, PhD, focuses on areas in basic behavioral science such as learning, perception, cognition, temperament and the basic aspects of behavioral medicine. Peter Jensen, MD, a child psychiatrist, heads the Developmental Psychopathology Branch, which focuses on understanding the risk factors for psychopathology, conduct disorders, autism and attention-deficit/hyperactivity disorder, from infancy through late adolescence. Psychologist Doreen Koretz, PhD, heads the Prevention, Early Intervention and Epidemiology Branch, which supports research on risk factors for schizophrenia, mood and anxiety disorders, and aggressive behavior, as well as studies on epidemiology, behavioral medicine and comorbidity.

The Office on AIDS, which I have directed since 1983, supports research on the development of behaviorally based interventions to prevent the spread of HIV. We believe many of the new HIV interventions may have broader applicability to other diseases, and psychologists have played a major role in developing these successful interventions. In addition, with the development of therapeutics such as the protease inhibitors, we have become particularly interested in studies that focus on adherence to treatment regimens and research that investigates how various drugs affect the immune system and the central nervous system.

The division needs to train the next generation of researchers to have skills in multiple disciplines such as psychology, genetics and neuroscience. Training programs should include mentors who foster creativity and train scientists who can apply basic research to treat or prevent major mental and behavioral disorders.

Real-world applications
NIMH priorities cut across the three divisions. These priorities emphasize support for basic science, translation of knowledge into practice, and preventive interventions and treatment research. We encourage efforts that take information from basic studies and move them into the community or clinic. Findings from basic research must be translated into effective real-world strategies to reach people in their communities. Division staff will encourage the integration of basic behavioral and clinical science, prevention, and the dissemination and application of findings.

We hope to emphasize the applicability of behavioral sciences to our nation?s most pressing problems, such as child abuse, suicide, violence and mental illness. We must determine what kinds of interventions work for people and under what conditions.

I look forward to expanding my work with psychologists to gain a better understanding of mental and behavioral disorders and to reduce the burden of these disorders on our society.