FY 2010 Budget

• Organization chart
• Appropriation language
• Amounts available for obligation
• Budget mechanism table
• Budget authority by activity
• Major changes in budget request
• Summary of changes
• Budget graphs
• Justification narrative
• Budget authority by object
• Salaries and expenses
• Authorizing legislation
• Appropriations history
• Detail of full-time equivalent employment (FTE)
• Detail of positions
• New positions requested

Organization Chart

DEPARTMENT OF HEALTH AND NUMAN SERVICES

National Institutes of Health
National Institute of Mental Health

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Appropriation language

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Amounts available for obligation

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Budget mechanism table

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

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Budget authority by activity

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

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Major changes in budget request

Major Changes in the Fiscal Year 2010 Budget Request

Major changes by budget mechanism and/or budget activity detail are briefly described below. Note that there may be overlap between budget mechanism and activity detail and these highlights will not sum to the total change for the FY 2010 budget request for NIMH, which is $24.185 million over the FY 2009 estimate, for a total of $1,474.676 million.

Research Project Grants (+$14.566 million; total $870.535 million): NIMH will support a total of 2,110 RPG awards in FY 2010. Non-competing RPGS will decrease by 99 awards and decrease by $.382 million. Competing RPGs will increase by 27 awards and increase by $14.455 million. The NIH Budget policy for RPGs in FY 2010 provides a 2% inflationary increase in noncompeting awards and a 2% increase in the average cost for competing RPGs.

Adult Translational Research and Treatment Development Program (+$2.501 million; total $266.857 million): NIMH will support research on novel approaches to identify, characterize, and validate biomarkers and/or biosignatures (integrated profiles of biomarkers and behavioral indicators) of major mental disorders. For conditions such as diabetes and cardiovascular disease, biomarkers are available for use in routine medical practice of diagnosis, prevention, and treatment. However, despite tremendous progress in basic neuroscience, no biomarkers have been developed with established clinical use in the management of major mental disorders. This initiative aims to break this logjam by reaching beyond NIMH’s typical applicant pool and encouraging innovation.

Developmental Translational Research Program (+$5.979 million; total $136.774 million): NIMH will stimulate neurodevelopmental research in humans and animals that will increase our understanding of the neurobiology underlying developmentally sensitive periods for risk, resilience, and intervention. This initiative will address sensitive periods in the development of normal function or psychopathology, sensitive periods for intervention to prevent, pre-empt, and/or treat mental illness, and the mechanisms underlying the interaction between genetics, experience, and development.

Services and Intervention Research Program (+$1.711 million; total $182.628 million): Several large longitudinal epidemiologic surveillance programs (such as those supported by CDC and SAMHSA) conduct annual, ongoing surveys in the U.S. general population. NIMH will support an initiative to leverage the power of these existing surveys on behavioral health in order to further assess psychopathology, functioning and service use. Longitudinal nature of these data would give NIMH the ability to track, over time, the prevalence, incidence, and severity of mental disorders, and would enable analysis of trends in service use and outcomes. The start-up phase of this initiative will require a small investment in the first year ($.300 million), but during subsequent phases, the investment will increase to several million per year over six years, totaling approximately $15.000 million.

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Summary of changes

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Budget graphs

Fiscal Year 2010 Budget Graph

History of Budget Authority and FTEs:

Distribution by Mechanism:

Change by Selected Mechanisms:

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Justification narrative

National Institute of Mental Health

Authorizing Legislation:   Section 301 and title IV of the Public Health Service Act, as amended.

Budget Authority:

This document provides justification for the Fiscal Year (FY) 2010 activities of the National Institute of Mental Health (NIMH), including HIV/AIDS activities. Details of the FY 2010 HIV/AIDS activities are in the "Office of AIDS Research (OAR)" Section of the Overview. Details on the Common Fund are located in the Overview, Volume One. Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; Contracts; Direct Federal/Intramural and Other.

DIRECTOR’S OVERVIEW

As the lead federal agency for research on mental and behavioral disorders, the mission of the National Institute of Mental Health (NIMH) is to transform the understanding and treatment of mental illnesses through basic and clinical research paving the way for prevention, recovery, and cure. The burden of mental illness is enormous. In a given year, an estimated 13 million American adults (approximately 1 in 17) have a seriously debilitating mental illness.^{1, 2} Mental disorders are the leading cause of disability in the United States and Canada, accounting for 24 percent of all years of life lost to disability and premature mortality (Disability Adjusted Life Years or DALYs).³ Moreover, suicide is the 11^th leading cause of death in the United States, accounting for the deaths of approximately 30,000 Americans each year.⁴ Schizophrenia, bipolar disorder, depression, post–traumatic stress disorder, eating disorders, autism, and other disorders are serious, life-threatening illnesses for which we need reliable diagnostic tests, new treatments, and effective strategies for prevention.

To inspire and support research that will continue to make a difference for those living with mental illness, and ultimately, promote recovery, NIMH recently developed a Strategic Plan to guide future research efforts. This plan outlines four overarching strategic objectives that can be viewed as a cumulative progression of the Institute’s priorities for the next five years. In FY 2009 and 2010, NIMH will target research initiatives to address the four objectives of the Strategic Plan. The objectives and a selection of initiatives are described below:

Objective 1: Promote discovery in the brain and behavioral sciences to fuel research on the causes of mental disorders
Mental disorders are complex brain disorders—disorders of specific brain circuits. Today, there are powerful discovery tools, such as genome mapping and neuroimaging, which will help us to understand the underlying causes of these disorders. Genomic analyses will be critical for determining who is at risk for a disorder; pointing to key cellular and neural pathways involved in pathophysiology; and identifying novel targets for treatment. Therefore, beginning in FY 2008 and continuing through FY 2013, NIMH will support several initiatives to enrich the NIMH Center for Collaborative Genetic Studies—a repository of DNA, cell cultures, and clinical data that serves as a national resource for researchers studying the genetics of complex mental disorders. These initiatives will support the collection of new biomaterials and clinical data from large cohorts to enrich pre-existing resources and support the analysis of existing data sets to further our understanding of the molecular etiology of mental disorders. Resources in the repository have allowed NIMH-funded investigators to participate in several promising projects, including a public-private partnership called the Genetic Association Information Network (GAIN). GAIN studies are investigating the genetic roots of several common diseases, including four mental disorders—schizophrenia, major depression, bipolar disorder, and ADHD. In 2008, genomic data for these disorders were deposited into a publicly accessible database to encourage further analyses by the scientific community.

Objective 2: Chart mental illness trajectories to determine when, where and how to intervene
Mental disorders are chronic changing conditions. The symptoms often begin in childhood and adolescence and ebb and flow over the course of an individual’s life. Charting trajectories of mental disorders across stages of risk, to early symptoms, to full symptoms or syndromes, and to remission, relapse, and recovery will allow us to pinpoint the best times and techniques to preempt the onset of symptoms or halt and reverse the progression and recurrence of illness. With this objective in mind, from FY 2009 to FY 2013, NIMH will continue to support a project to predict, characterize, and preemptively treat schizophrenia. This prospectively designed study will identify genomic and biological markers to define risk and to develop interventions to prevent psychotic symptoms and functional disability. Through previous support by NIMH, these investigators have already determined that psychotic illness can be predicted in up to 80 percent of high-risk youth.⁵ Predicting who is likely to develop the illness could provide a critical window of opportunity for treating these youth to preempt serious functional disability.

Objective 3: Develop new and better interventions that incorporate the diverse needs and circumstances of people with mental illnesses
In general, traditional intervention research has focused on comparing how groups of individuals receiving an experimental treatment fare against a comparison group that does not receive the intervention. However, individual responses to treatment may vary from what is observed in the group. Therefore, we need a new generation of innovative clinical studies focused on personalized care, recovery, and diverse populations. To address this objective, in FY 2010, NIMH will support projects to develop personalized treatments for depression. Studies will create models and test new approaches that account for individual patient characteristics, such as their specific symptoms, co-occurring disorders, age, personal history, social background, and genetic variation.

Objective 4: Strengthen the public health impact of NIMH-supported research
Through research, evaluation, and collaboration, NIMH will work to promote the dissemination and implementation of research-tested interventions and their widespread use by those most in need. This objective will require NIMH to encourage partnerships and leverage existing resources to stimulate efficient and cost-effective research studies. In 2010, NIMH will launch an initiative to encourage information technology bridges among health care networks to identify thousands of subjects for basic and applied studies of mental illness in practice settings. Very large, well-characterized, and representative clinical samples are necessary to rapidly and cost-effectively pursue many mental health research questions, including tests of effective treatments within large patient populations; implementation of systemic interventions within large health care systems; and methods for delivering personalized care. This initiative will support studies of interventions to improve treatment across large mental health systems.

The NIMH Strategic Plan aims to close the gap between basic biological knowledge and effective mental health care in the United States. NIMH will use the plan as a guide to ensure that basic and clinical research goals are highly applicable to the development and implementation of new and effective mental disorder treatments. NIMH will continue to build and strengthen partnerships with stakeholders, working together to help advance the science of mental health and to find ways to ensure that interventions and information generated by research can be used by patients, families, health care providers, and the wider community involved in mental health care.

Overall Budget Policy: NIMH will continue to support new investigators and to maintain an adequate number of competing RPGs. NIMH is providing a 2 percent inflationary increase for non-competing and competing grants. In addition, the NIMH has targeted a portion of the funds available for competing research project grants to support high priority projects outside of the payline, including awards to new investigators, and early stage investigators. The Institute also seeks to maintain a balance between solicitations issued to the extramural community in areas that need stimulation and funding made available to support investigator-initiated projects. Intramural Research and Research Management and Support receive conservative increases to help offset the cost of pay and other increases.

FY 2010 JUSTIFICATION BY PROGRAM ACTIVITY DETAIL

Program Descriptions and Accomplishments

Health, Behavior, and AIDS Research

The program supports research and research training to: (1) reduce the burden of mental illness due to non-adherence to treatment, unhealthy behaviors, stigma and discrimination, health disparities, and co-occurring medical conditions; (2) develop and disseminate behavioral interventions that prevent HIV/AIDS transmission; and (3) clarify the biological, psychological, and functional effects of HIV/AIDS infection and alleviate the associated consequences.

In FY 2008, NIMH, NICHD, and NINR issued a Program Announcement (PA) inviting research to enhance the science of technology transfer, dissemination, implementation, and operational research for evidence-based HIV-prevention interventions. To articulate the research scope for this announcement, staff from NIH and the Centers for Disease Control and Prevention (CDC) identified research gaps and opportunities in the field. NIMH and CDC staff frequently collaborate to ensure strong linkages between the NIMH/NIH research on evidence-based prevention interventions and the prevention services and training that the CDC provides in community and clinical settings.

Budget Policy: The FY 2010 budget estimate for this program is $225.551 million, an increase of $2.114 million or +0.9 percent over the FY 2009 estimate. Broadening research on mental disorders to better address issues of daily functioning will be a high priority. FY 2010 program plans will emphasize research projects in which biobehavioral science methods and approaches are applied to better measure daily functional outcomes. NIMH plans to develop and test novel interventions that target functional capacity and performance deficits. NIMH will continue to encourage research on mental disorders in people with other physical disorders, such as cancer. For example, in FY 2010, NIMH will support studies on preventing depression in patients undergoing cancer treatment. NIMH will also encourage research on behavior change in people with mental disorders to reduce risk factors for cancer such as smoking, poor nutrition, and sedentary lifestyles. In addition, projects that tailor preventive interventions for those with acute human immunodeficiency virus (HIV) infection will be given a high priority. NIMH will support studies on domestic efforts to identify and intervene with those with acute HIV infection, building upon research that has been conducted primarily in the international arena.

Adult Translational Research and Treatment Development

The program plans, supports, and administers programs of research, research training, and resource development aimed at: (1) understanding the biological, psychological, and functional changes that occur with mental illness and (2) hastening the translation of science advances into innovations in clinical care. The program supports a broad research portfolio, which includes studies of the risk factors for major psychiatric disorders; clinical neuroscience studies to elucidate causes and functional effects of these disorders; and research on psychosocial, pharmacological, and somatic treatment development.

In FY 2008, NIMH continued to support funding opportunities for research in geriatric mental health. The PA "Clinical Research in Mental Illnesses in Older Adults" seeks to expand translational research aimed at understanding the etiology and pathophysiology of late-life mental disorders; identifying risk and protective factors and their relationship to the development of various disorders; and accelerating the translation of behavioral science and neuroscience advances into clinical practice. The PA “Pathophysiology and Treatment Response in Late-Life Mood and Anxiety Disorders” encourages studies on the neurobiology of these disorders and the development of potential new treatments (psychosocial, psychopharmacologic, and somatic) or predictors of treatment response.

Budget Policy: The FY 2010 budget estimate for this program is $266.857 million, an increase of $2.501 million or +0.9 percent over the FY 2009 estimate. High priority will be given to studies that close the gap between advances in basic cognitive neuroscience and practical clinical trial applications for patients with schizophrenia. NIMH will continue to support an initiative to identify promising experimental cognitive tasks in order to further develop and refine cognitive measurements; to develop guidelines for adapting laboratory tasks for use in clinical trials; and to consider how these adapted tasks can be used in behavioral and functional imaging studies to improve treatment of impaired cognition in schizophrenia. High priority will also be given to studies that further the understanding of the biology, genetics, and treatment of eating disorders. NIMH will support a project to examine the role of ovarian hormones in the genetic basis of bulimia and another project to study the psychological and physiological factors associated with food intake in healthy women and women with bulimia and purging disorders.

Developmental Translational Research

The program supports research and research training with the ultimate goal of preventing and curing mental disorders that originate in childhood and adolescence. The program stimulates and promotes an integrated program of research across basic behavioral/psychological processes, environmental processes, brain development, genetics, developmental psychopathology, and therapeutic interventions. The mission of the program is to translate knowledge from basic discoveries on the developmental origins of mental disorders to effect their prevention and cure. This goal will be accomplished through the integration of research on neurobehavioral mechanisms of psychopathology; understanding of the trajectories of risk/illness; and the design and testing of innovative and personalized treatments.

In FY 2008, NIMH issued a request for applications (RFA) titled "Novel Interventions for Neurodevelopmental Disorders." This RFA encourages research to develop interventions that will improve functioning in attention, learning, social interaction, and emotion regulation—domains that are commonly affected by neurodevelopmental disorders. The RFA encourages studies on a variety of disorders, including (but not limited to) autism spectrum disorders, childhood-onset schizophrenia, pediatric bipolar disorder, attention-deficit hyperactivity disorder, and Tourette syndrome. The ultimate goal of this funding opportunity is to develop a broad scope of treatment approaches (e.g. psychopharmacologic, cognitive, psychosocial) with the potential for widespread, cost-effective application.

Budget Policy: The FY 2010 budget estimate for this program is $136.774 million, an increase of $5.979 million or +4.6 percent over the FY 2009 estimate. High priority will be given to studies that identify early signs of risk and develop novel and targeted preventive and treatment interventions, such as projects involving innovative approaches for treating children who have attention deficit hyperactivity disorder (ADHD). In FY 2010, NIMH will also support studies on psychosocial and behavioral treatments for autism spectrum disorders, as well as innovative services research, including the development of instruments to evaluate the impact of interventions on core features of autism spectrum disorders and co-occurring symptoms.

Neuroscience and Basic Behavioral Science

The program provides support for research in the areas of basic neuroscience, genetics, basic behavioral science, research training, resource development, technology development, drug discovery, and research dissemination. In cooperation with other components of the Institute and the research community, the program is responsible for ensuring that relevant basic science knowledge is generated and then utilized to improve diagnosis, treatment, and prevention of mental and behavioral disorders.

Many mental disorders are first diagnosed in adolescents or young adults, indicating that these mental disorders may be disorders of brain development. Comparative studies across time, species, and discipline will be critical for identifying when and how developmental trajectories are changed in mental disorders. Therefore, in FY 2008, NIMH issued an RFA to encourage comparative research on the development of the cerebral cortex and other brain regions in humans or other mammalian model systems. Studies supported in response to this RFA will integrate multiple levels of analysis, linking cortical development with complex behaviors related to mood, cognition, and social function.

Budget Policy: The FY 2010 budget estimate for this program is $417.921 million, an increase of $8.078 million or +2.0 percent over the FY 2009 estimate. High priority will be given to research that defines the genomic variations associated with mental disorders and that determines the biological consequences of these variations. To determine the biological consequences of candidate risk genes, NIMH will support studies to tease apart the genetic components of mental disorders to understand the complex relationship between genes and illness-specific characteristics; interactions between multiple vulnerability genes; gene-environment interactions; and the role of genetic changes that result from environmental influences on gene expression. NIMH will also support exploratory studies to generate and characterize induced pluripotent stem (iPS) cells from healthy populations and patient populations with mental disorders, particularly those in which a genetic linkage has been identified.

Services and Intervention Research

The program supports research to evaluate the effectiveness of pharmacologic, psychosocial, rehabilitative, and combination interventions on mental and behavior disorders. The program evaluates interventions for children, adolescents, and adults, focusing on acute and long-term therapeutic effects. Another important area supported by the program is mental health services research, including services organization and delivery; interventions to improve the quality and outcomes of care; and research on the dissemination and implementation of evidence-based interventions into service settings.

While effective treatments of depression are available, there is considerable individual variation in treatment response with respect to both therapeutic benefit and adverse effects. Many patients with depression do not benefit from the first treatment they receive, thus requiring multiple, sequentially delivered treatments in order to achieve remission. In FY2008, NIMH issued an RFA titled "Innovative Approaches to Personalizing the Treatment of Depression." The purpose of this RFA is to advance research on predictors and moderators of treatment effects in order to develop personalized treatments for depression. Studies will develop models and test new approaches that account for patient characteristics, such as their specific symptoms, co-occurring disorders, age, personal history, social background, and genetic variation.

Budget Policy: The FY 2010 budget estimate for this program is $182.628 million, an increase of $1.711 million or +0.9 percent over the FY 2010 estimate. High priority will be given to studies that develop innovative interventions and designs for intervention studies. To address this priority, NIMH will issue a Request for Applications for projects that will test methods for linking information from multiple health care networks to provide platforms for recruiting very large, well-characterized, and representative clinical samples. In addition, NIMH will provide core infrastructure support for conducting intervention and/or services research. In FY 2010, NIMH will continue to support centers that address the spectrum of intervention and services research—from effectiveness of treatment approaches to the improvement of dissemination, implementation, accessibility, and quality of evidence–based treatments.

Intramural Research Programs (IRP)

The IRP is the internal research arm of NIMH. Its mission is to plan and conduct basic, clinical, and translational research to advance understanding of the diagnosis, causes, treatment, and prevention of mental disorders. IRP scientists study brain function and behavior; conduct state-of-the-art research that complements extramural research activities; and provide an environment conducive to the training of clinical and basic scientists.

In FY 2008, IRP researchers identified potential molecular targets for developing treatments for both the depressive and manic episodes of bipolar disorder.

Budget Policy The FY 2010 budget estimate for these programs is $174.895 million, an increase of $2.585 million or +1.5 percent over the FY 2009 estimate. The IRP will continue to implement the recommendations of the NIMH 2008 Blue Ribbon Panel on Intramural Research. The Panel recommended a number of changes to the structure of the IRP, its funding practices, and its hiring and retention strategies. Scientists in the IRP will also continue with research efforts that address several of the objectives of the NIMH Strategic Plan, which range from studies of normal brain function (conducted at the behavioral, systems, cellular, and molecular levels) to clinical investigations into the diagnosis, treatment, and prevention of mental illness.

Research Management and Support (RMS)

The RMS program provides administrative, budgetary, logistical, and scientific support in the review, award, and monitoring of research grants, training awards, and research and development contracts. RMS functions include strategic planning, coordination, and evaluation of the Institute’s programs, regulatory compliance, international coordination, and liaison with other Federal agencies, Congress, and the public. In FY 2008, the Institute oversaw 2,909 research grants, 438 training grants and 202 research and development contracts.

In FY 2008, the Institute began development of a comprehensive Risk Management Program. All NIMH management analysts were trained in “Internal Controls” and attended training on Federal Managers’ Financial Integrity Act (FMFIA) Assurance requirements. An NIMH team was established, which developed both review processes and reporting tools, and proactively initiated several in-house reviews of potentially vulnerable administrative areas. As a result of these reviews, current policies and procedures were amended to minimize potential future risks.

Budget Policy: The FY 2010 budget estimate for RMS is $70.779 million, an increase of $1.217 million or +1.7 percent over the FY 2009 estimate. RMS costs shall continue to be closely monitored since staff salaries and expenses account for almost half of all RMS costs. Efforts are currently underway to analyze workforce efficiency and productivity to insure that new staff and support contractors are aligned to areas of increased program needs. Controls are in place on travel and equipment purchases and on conference support.

Common Fund

NIMH and NHGRI are the lead Institutes for the Molecular Libraries Roadmap Initiative supported through the NIH Common Fund. This initiative offers public-sector researchers access to high throughput screening (HTS) of libraries of small organic compounds that can be used as chemical probes to study the functions of genes, cells, and biological pathways. This powerful HTS technology provides novel approaches to explore the functions of major cellular components in health and disease.

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Budget authority by object

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

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Salaries and expenses

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Authorizing legislation

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Appropriations history

1/ Reflects enacted supplementals, rescissions, and reappropriations.
2/ Excludes funds for HIV/AIDS research activities consolidated in the NIH Office of AIDS Research.

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Detail of full-time equivalent employment (FTE)

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Detail of positions

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research.

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New positions requested

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