Over the past decade, the National Institute of Mental Health (NIMH)—the primary source of federal funding for mental health research—has shifted many of its research dollars from psychosocial and clinical research toward neuroscience. Now, as Joshua Gordon, MD, PhD, begins his tenure as the agency's new director, psychologists and other behavioral scientists are asking him to consider rebalancing the agency's more than $1.4 billion budget to increase support for psychosocial and clinical research.
The request comes after a decade of increased spending on neuroscience. According to an agency reviewopens in new window, between 2005 and 2014, the budget for NIMH's Division of Neuroscience and Basic Behavioral Research (which primarily funds neuroscience and genomics research) increased by 28 percent, while the budget for its Division of Services and Intervention Research decreased by 12.8 percent.
In addition, an analysis by Fordham University psychology professor Dean McKay, PhD, found that in 1997, funding was split nearly evenly between biomedical and psychosocial studies, but that by 2015, psychosocial research had shrunk to just under 30 percent of the NIMH portfolio.
To raise awareness of the issue, APA held a briefing in October for more than 100 congressional staff and federal agency officials to discuss the benefits of a diverse NIMH research portfolio.
Overall, it's a trend that many psychologists and other social scientists find worrying.
"Basic research is very important and may lead to applications in the future, but often these applications take years or decades to reach," says Gordon Nagayama Hall, PhD, a professor of psychology and director of the Center on Diversity and Community at the University of Oregon. "Meanwhile, there are urgent mental health needs of a nation, and particularly communities of color, that are not being addressed."
Hall and other advocates are taking advantage of the agency's change in leadership to make their case, in both public forums and private conversations, on several intertwined issues. In June, for example, 20 current and former members of the agency's National Advisory Mental Health Council published an editorial in the British Journal of Psychiatry opens in new window discussing the tradeoff between the long-term potential of neuroscience research and the potential short-term benefits of research on prevention and treatment strategies.
In a Washington Post op-ed in October, one of those former council members, Columbia University psychiatry professor Roberto Lewis-Fernandez, MD, wrote "Such a disproportionate emphasis [on neuroscience] is as unwise an investment approach as a retirement portfolio made up only of high-risk investments."
What the scientists want to make clear is the necessity of psychological science for NIMH to achieve its goals.
"We are not advocating for psychological science as some kind of guild issue, or to protect our turf," says Bethany Teachman, PhD, chair of the Coalition for the Advancement and Application of Psychological Science (CAAPS), an advocacy group for clinical science. "To effectively reduce the burden of mental illness, it's essential to recognize the role of psychosocial, cultural and behavioral research."
For his part, Gordon, who was previously a psychiatry professor at Columbia University and is the agency's first new director in 13 years, says that he does not foresee any immediate large changes in funding strategy, but hopes to spend his first year in the job hearing from those doing research out in the field.
"I want to get out there and listen and learn, to figure out what are the questions that are really affecting care delivery right now ... so that we can hit that short-term pay dirt," he says.
Among the concerns that psychologists and others have already shared with Gordon about care delivery is a shortage of research on diversity and mental health disparities in the NIMH portfolio. In December, Hall and two colleagues sent a letter co-signed by 17 professional organizations, including three APA divisions, underscoring the importance of clinical research with communities of color and other underrepresented groups—which McKay's analysis found comprised less than 7 percent of the agency's grants.
Other researchers are concerned that aspects of the way NIMH evaluates grant proposals make it difficult for psychosocial researchers to receive funding—and may even discourage them from applying. For example, three years ago, the agency changed its guidelines for clinical trials to an "experimental therapeutics" approach, in which researchers must demonstrate that their intervention works through an effect on a specific molecular, cellular, circuit or behavioral target. Many researchers say that this approach is not always possible with psychosocial interventions. "It makes it very difficult for researchers to submit proposals, when something has a lot of promise, but doesn't fit the guidelines," says Patricia Areán, PhD, a professor of psychology at the University of Washington who just finished a term on the National Advisory Mental Health Council.
Gordon says that he would like to explore this and other issues in more conversations. He believes, for example, that the experimental therapeutics approach will help researchers get more useful data out of even failed clinical trials. But, he says, "I need to learn more about why it's more difficult [for psychosocial interventions], and what we need to do at NIMH to make it more straightforward to figure out what target you're trying to hit when you do a psychosocial intervention. If we can't do that, then yeah, we need to make exceptions. But I think it's too early to say it doesn't work."
More broadly, he says, he is looking forward to more discussions with psychologists and others to help figure out the ideal balance of research at the agency. "That's an important question to ask and a very, very challenging one to answer."
For more on APA's recent congressional briefing on the benefits of a diverse research portfolio.
