Executive Director's Column

The Imbalance of Priorities at NIMH

As NIMH begins to spread its wings and embrace translational research, the Institute must not forget that it still has considerable work to do in finishing what it started - in completing its foundation.

By Steven Breckler, PhD

It seems like everyone is talking about NIMH lately. New leadership and a major re-organization is causing many to believe that NIMH funding of basic research in psychology is going to disappear. By some accounts, grant support has completely evaporated. Others are getting the word that NIMH funding will only be available for "translational" research. Familiar program officers are gone, and their replacements seem to be nowhere in sight. Is this a crisis, or are the scientists of psychology blowing it out of proportion? I think there is a cause for concern, but the real worry is what the changes will mean for our long-term understanding of mental health and mental illness.

New Construction
At the heart of the new organization at NIMH is the idea of utilizing basic behavioral research to answer important clinical questions. The newly focused goal of NIMH is to "facilitate translation of basic science discoveries into new interventions." This is great news. It is an important development, and we should all feel a sense of pride that our collective research efforts have finally matured to the point of being translatable and put into action in relieving the burden of mental illness. The work of translating basic knowledge into practical solutions is incredibly important, and we have a responsibility as scientists to contribute to that enterprise.

But let's not get carried away. There is plenty of work still to do -- the foundation of basic science is only partially completed. This point seems to be lost on NIMH. Its new Director, Thomas Insel, recently told The Scientist magazine, "We are looking for areas where people can complete a study and go on - not just add a brick to the wall, but start a new wall and finish it." At the risk of pushing this metaphor too far, it is worth pointing out that brick walls are only as good as the foundation on which they rest. I would offer that NIMH has not yet completed its foundation. As it begins to spread its wings and embrace translational research, the Institute must not forget that it still has considerable work to do in finishing what it started - in completing its foundation.

The Forest and the Trees
I like the building metaphor, but I think another one better captures a productive approach. Perhaps NIMH should think of its responsibility in much the same way as the tree farmer. It is appropriate - even expected - that some resources be invested in exploiting the mature trees, the ones that are ready to bring to market. In the case of NIMH, to invest some money in translational research. It would not be prudent, however, to raze the entire crop - for NIMH to invest all of its resources in translational research. I have no doubt that this would produce an enormous short term windfall, but what a terrible price to pay - with little or no investment in future maturing research, there will quickly cease to be any future knowledge to translate.

To be fair, the new organization at NIMH does continue to provide a home for basic behavioral research. Yet, the relative priorities seem to be out of proportion. Most of the resources appear to be destined for translational research, with only meager investments in basic research. I think NIMH is better advised to take a cue from the tree farmer, and devote relatively more of its resources to basic research just as the tree farmer invests most resources in nurturing and protecting future crops. Otherwise, NIMH is pursuing a strategy of short-term gains that will carry long-term pains.

A Narrowing Mission
The current mission statement of NIMH states that the Institute aims to "reduce the burden of mental illness and behavioral disorders." This does indeed reflect the legislative mandate to "further the treatment and prevention of mental illness". But that is only one part of the mandate. NIMH is also charged with responsibility for supporting research aimed at promoting positive mental health, and research on the psychological, social, and legal factors that influence behavior. It would appear that NIMH has elected to focus on only a portion of its legislative mandate - the portion having to do with mental illness. Without diminishing the importance of this facet of the mandate, NIMH should be reminded that its responsibility is much broader.

This is an important point, because I suspect that most (not all) of the psychology research funded in the past by NIMH has focused on understanding psychological and social factors that influence behavior, often with the ultimate goal of learning how to promote positive mental health. It is this facet of the legislative intent that NIMH, through its actions and its re-organization, threatens to diminish or even eliminate.

The changes at NIMH threaten the future vitality of basic research in psychology. But that is not why we need to be vocal and vigorous in expressing our concerns. Rather, it is the long-term cost to society and to science that we need to worry about. Our goal should be to produce the best outcome in support of the NIMH mission. We must continue to pursue our basic research aims, but we must also be prepared to engage in the difficult work of translation. In the end, we will all be winners.