A recent reorganization at NIMH is expected to increase the amount of behavioral research that the institute conducts.

By Beth Azar
Monitor staff

Behavioral research has a new, better organized home at the National Institute of Mental Health (NIMH) that is expected to foster the translation of basic research into practice and boost prevention research, say institute administrators.

So far, behavioral researchers say they are cautiously optimistic about the restructuring. Until the institute has gone through its first round of funding under the new organization, they won?t be able to assess whether the changes will benefit or harm behavioral science as a whole. In fact, several behavioral research areas may be de-emphasized, administrators admit.

But NIMH director Steven Hyman, MD, asserts that the revamping of the institute will benefit the field and, even more importantly, the health of Americans.

Researchers need to use basic neuroscience and behavioral research to help diagnose and develop treatments and prevention interventions for mental disorders, he says.

Nuts and bolts
NIMH reorganized its extramural research program last September, consolidating basic and applied behavioral and psychological research into a new division of Mental Disorders, Behavioral Research and AIDS. As part of the reorganization, behavioral research is also represented, but to a lesser degree, in two other new divisions: the Division of Basic and Clinical Neuroscience Research and the Division of Services and Intervention Research. (See chart below.)

The three new divisions replace the Division of Neuroscience and Behavioral Science; the Division of Clinical and Treatment Research; and the Division of Epidemiology and Services Research.

To foster the translation of basic research into applied interventions, the neuroscience and behavior divisions fund both basic research and more applied research aimed at designing interventions and therapies. The Division of Services and Intervention Research then funds large-scale clinical and prevention trials in real-world settings.

Until now, no NIMH division had been charged with translating basic behavioral research on attention, cognition, emotions and other basic behavioral constructs into application and clinical practice. As a result, mental illness advocacy organizations criticized NIMH for funding basic behavioral research, saying it was irrelevant to mental health and should be funded by the National Science Foundation, says Hyman.

?Without some evidence that we?re making an effort to apply basic behavioral science to human health, we would continue to have questions about why we support basic behavioral research,? says Hyman.

The reorganization should provide that evidence. The behavioral research division, directed by psychologist Ellen Stover, PhD, is set up to encourage interaction between the various branches within the division. Program officers who fund basic behavioral research through the Behavioral Science Research Branch interact daily with program officers who fund more applied behavioral research. This cross-fertilization will help promote translation of basic research on attention and cognition into research on potential interventions, says Stover.

Prevention research
The reorganization will also strengthen prevention research at the institute, says Thomas Coates, PhD, the chair of the NIMH Advisory Council?s Workgroup on Mental Disorders Prevention Research. Rather than being off in the corner by itself, prevention research is integrated into several different branches.

The reorganization is designed to take a broad view of prevention, says psychologist Doreen Koretz, PhD, director of the Prevention, Early Intervention and Epidemiology Research Branch. Her branch focuses on adult psychopathology, beginning with the epidemiology of disorders and including research on the process and risk factors leading to mental illness in adults. Armed with this information, her branch will encourage the creation of new intervention and prevention strategies and will fund research that tests hypothesized mechanisms of action and effects.

?We want to tell the story of how people move from risk to psychopathology,? says Koretz. ?We want to know how, and how much, different risk factors contribute to the development of a disorder, and use that to develop interventions.?

The Developmental Psychopathology Research Branch, directed by Peter Jensen, MD, takes the same approach to research on children and adolescents. And two parallel branches in the Division of Services and Intervention Research fund large-scale clinical and cost-effectiveness trials of promising interventions for children and adults.

The new organization appears to bode well for prevention research, says APA President Martin E.P. Seligman, PhD, who has made prevention the theme of his presidency. However, he would like to see some kind of ?prevention czar? appointed who could oversee the research program to ensure it isn?t diluted by research that isn?t truly prevention research.

At what cost?
While these changes sound favorable for behavioral research, the reorganization also includes some potential losses. For example, NIMH will not be increasing its funding of behavioral genetics research. The field needs to develop better, more powerful methodologies before NIMH will make it a major priority, says Hyman.

Also, although NIMH will still fund some behavioral medicine research, much of it will now be done through collaborations with other institutes, such as the National Cancer Institute and the National Heart Lung and Blood Institute.

NIMH funded the bulk of research proving that mental health has a significant effect on physical health, but now it?s time for the institutes that focus on physical diseases to co-fund behavioral medicine grants, says Norman Anderson, PhD, director of the NIH Office of Behavioral and Social Sciences Research. His office is working with NIMH and other institutes to broker these collaborations, says Anderson. And he believes that, in the long run, it will result in more funding for behavioral medicine, within and outside of NIMH.

A split with neuroscience?
Another concern of behavioral researchers is that, with the administrative split between neuroscience and behavioral research caused by the reorganization, the neuroscience division will become exclusively molecular and the behavioral division will lose funding because it no longer deals with the brain.

Untrue, say Hyman. He believes that the link between behavior and neuroscience is strong enough to withstand the organizational partition. Branch directors from the neuroscience and behavioral divisions agree. ?Inevitably there?s a permeable and fuzzy boundary between behavior and neuroscience,? says Stephen Foote, PhD, director of the Behavioral and Integrative Neuroscience Research Branch within the neuroscience division.

His branch will continue to support behavioral research, and the behavioral division will continue to back neuroscience research. He also plans to collaborate with the Behavioral Science Research Branch, directed by psychologist Mary Ellen Oliveri, PhD.

One of the biggest concerns to branch directors like Oliveri is a severe shortage of program staff. She has five programs in her branch and only two permanent program officers. Hyman recently gave her permission to hire for one of the three positions from outside the institute, and she?s hopeful that he?ll soon approve the others. It?s also still unclear how NIMH will divide its budget among the various sciences. The NIMH budget for 1998 is $750 million, an increase of 7.1 percent over 1997. But at Monitor press time, the institute hadn?t allocated the money to individual programs.

Hyman admits that the neuroscience division will get the largest share, with the behavioral division right behind, but he wouldn?t say how disparate the two would be.

?It will be important to examine the plan for allocating funds before we can say how behavioral research was affected by the reorganization,? says Paula Trubisky, the APA legislative and federal affairs officer who covers NIMH.