FY 2011 Budget - Congressional Justification

• 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

1/. The Health and Behavior components of the Division of AIDS and Health and Behavior Research have been dissolved. The Health and Behavior components have been absorbed by the other NON-AIDS Research divisions.

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Appropriation language

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Amounts available for obligation

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Budget mechanism table

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Budget authority by activity

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Major Changes in the Fiscal Year 2011 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 2011 budget request for NIMH, which is $50.553 million over the FY 2010 enacted level, for a total of $1,540.345 million.

Research Project Grants (RPGs) (+$20.350 million; total $921.742 million): NIMH will fund 583 competing RPGs in FY 2011, an increase of 37 over FY 2010. About 1,529 noncompeting RPG awards, totaling $656.286 million also will be made in FY 2011.

Adult Translational Research and Treatment Development Program (+$9.638 million; total $295.826 million): NIMH will continue to 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. Identifying biomarkers for major mental disorders would facilitate prediction of disease risk, disease course, and therapeutic responses, ultimately leading to knowledge-based treatment and prevention strategies.

Developmental Translational Research Program (+$4.834 million; total $148.375 million): NIMH will continue to support neurodevelopmental research in humans and animals that will increase our understanding of the neurobiology underlying developmentally sensitive periods for risk, resilience, and intervention. Projects 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 (+$6.343 million; total $194.708 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. The 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.

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Summary of changes

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Budget graphs

Fiscal Year 2011 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) 2011 activities of the National Institute of Mental Health (NIMH), including HIV/AIDS activities. Details of the FY 2011 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

The National Institute of Mental Health (NIMH) is the lead federal agency for research on mental and behavioral disorders, with a mission 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) suffer from 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 11th leading cause of death in the United States, accounting for the loss of approximately 33,000 American lives each year.⁴  Schizophrenia, bipolar disorder, depression, autism, post-traumatic stress disorder, eating disorders, and other disorders are serious, life-threatening illnesses for which we need reliable diagnostic tests, new treatments, and effective strategies for prevention.

With the FY 2009 release of the Institute’s new Strategic Plan, NIMH is working to accelerate the next generation of mental health research. This research is aimed not only at further expanding our understanding of the brain and causes of brain disorders, but also is directed toward generating knowledge that can tangibly improve mental healthcare and the lives of people living with and affected by mental illness. To advance these goals, in FY 2010 and 2011 NIMH will support initiatives ranging from basic research in the brain and behavioral sciences to research on mental healthcare networks and delivery systems that is truly global in scope.

Genomics and Other High Throughput Technologies

Over the past several years, the technology used in genomics research has progressed at an astounding pace, and has been matched with equally impressive reductions in cost. Recognizing the opportunities that these advances and cost savings present, NIMH supports research that uses these new approaches to study the brain and mental disorders in ways that are truly comprehensive. For example, in FY2010 and FY2011, NIMH will support several innovative genomics studies of autism spectrum disorder (ASD), utilizing data from thousands of samples from the NIMH Center for Collaborative Genetic Studies. In the first study of its kind, researchers will sequence the entire genomes of individuals with ASD. This work will help to identify specific subtypes of ASD based on genomics; provide the first molecular targets for treatment development; and yield a robust strategy for the study of environmental factors (which interact with genetic risk).

Translating Basic Science into New and Better Treatments

Discoveries in basic science are exciting not only for the knowledge they generate, but for the opportunities they present for developing new treatments, and improving existing ones, that can enhance the quality of life for people living with mental illness. NIMH supports a broad range of translational research, from improving and personalizing preventive interventions to validating potential medication targets and undertaking medication safety and efficacy research. In FY 2011, NIMH will support an initiative to leverage and link large existing healthcare networks so that they can be used to conduct treatment effectiveness trials. When completed, this infrastructure will be able to more efficiently identify, recruit, and enroll participants than “one-shot” clinical trials, saving taxpayer dollars and allowing for more rapid translation from bench to bedside.

Using Science to Enable Mental Healthcare Reform

The basic, clinical, and translational research supported by NIMH can only impact the Nation’s public health if it ultimately leads to improved mental healthcare for those in need. NIMH supports a broad portfolio of services research aimed at making meaningful improvements in mental healthcare. In FY 2011 and beyond, NIMH will be funding a series of grants that pair state agencies with researchers to analyze existing state and national administrative datasets and track the impact of state-level policy initiatives, such as the State Children’s Health Insurance Program. These research teams will be studying the effects of changes in mental health policies, financial policies, delivery systems, and other policies that affect the cost, quality of care, and outcomes for persons with mental disorders. NIMH will also be supporting a national mental health tracking system in FY 2011 that will leverage existing national surveys to provide timely data on the prevalence, severity and age of onset of mental disorders, and allow for the assessment of mental health service use, the quality and outcomes of care, and disparities among people from diverse populations.

Focusing on Global Mental Health

As the world’s largest mental health research organization, NIMH has a significant role not only in improving the mental health of Americans, but also in improving the mental health of people throughout the world. Through collaboration with other countries and non-governmental organizations (NGOs), NIMH has the opportunity to ensure that culturally appropriate, evidence-based programs to prevent HIV/AIDs and diagnose and treat mental disorders are disseminated and implemented in the developing world. To advance these goals, in FY 2011 NIMH will continue to collaborate with other countries and NGOs on the Mental Heath Global Action Plan (mhGAP); an international effort by the World Health Organization to develop evidence-based mental health ‘packages of care’ that can be easily and efficiently used in developing countries.

Reinvigorating the Mental Health Research Community

NIMH is initiating several programs to reinvigorate the NIMH research community and fuel the next generation of mental health researchers. For example, in FY 2011 NIMH will continue to support several exciting grants through the new Biobehavioral Research Awards for Innovative New Scientists (BRAINS). This initiative is based on the successful Pioneer Award program intended to support the research and career development of outstanding scientists who are in the early stages of their careers and who are making a long term career commitment to mental health research. NIMH remains committed to expanding opportunities for students from diverse backgrounds and in FY 2011will continue to support mentoring programs for underrepresented minority graduate students in high priority fields for the Institute.

Overall Budget Policy: In FY2011 NIMH will support new investigators on R01 equivalent awards at success rates equivalent to those of established investigators submitting new R01 equivalent applications. NIMH will continue to maintain competing RPGs in order to further the research priorities of the NIMH Strategic Plan. 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. Intramural Research and Research Management and Support receive increases to support program growth. Funds are included in R&D contracts to support several trans-NIH initiatives, such as the Therapies for Rare and Neglected Diseases program (TRND), the Basic Behavioral and Social Sciences Opportunity Network (OppNet), and support for a new synchrotron at the Brookhaven National Laboratory, as well as increased support for other HHS agencies through the program evaluation set-aside.

FY 2011 Justification by Program Activity Detail

Program Descriptions and Accomplishments

AIDS Research⁵

The program supports research and research training to develop and disseminate behavioral interventions that prevent HIV/AIDS transmission and to clarify the biological, psychological, and functional mental health effects of HIV/AIDS infection and alleviate the associated consequences. Through FY 2011, NIMH, NICHD, and NINR will continue to support a Program Announcement (PA) that invites 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 2011 budget estimate for this program is $185.390 million, an increase of $5.549 million or +3 percent over the FY 2010 estimate. FY 2011 program plans will emphasize innovative, interdisciplinary HIV prevention research designed to better understand individual, community, social, and structural factors that impact HIV risk-reduction in order to improve preventive behaviors. The program will further support innovative, interdisciplinary prevention science research that examines the psychosocial needs of children affected by AIDS, particularly children in low-resource settings. NIMH will support studies to assess the neurologic, neuropsychiatric, and neuropathologic consequences of HIV in the current therapeutic context, particularly in international and resource-poor settings, in order to develop new therapeutic interventions to prevent or reverse these complications.

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 are involved in the causes and course of 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 2009, NIMH issued two new Requests for Applications (RFAs) to accelerate scientific progress on the treatment and prevention of Post-Traumatic Stress Disorder (PTSD), a potentially debilitating and complex psychiatric disorder experienced by a substantial percentage of people exposed to a range of traumatic and life threatening events (e.g., war/combat, disasters, assaults, accidents). One RFA focuses on developing highly predictive sets of risk indicators to allow for the identification of trauma survivors at highest risk for developing PTSD. The other RFA encourages research on novel treatment targets and existing, but unproven, treatments for PTSD.

Budget Policy: The FY 2011 budget estimate for this program is $295.826 million, an increase of $9.638 million or +3.4 percent over the FY 2010 estimate. High priority will be given to studies that advance the understanding of the biological underpinnings of mental illness and hasten the translation of behavioral science and neuroscience advances into innovations in clinical care. Program plans include the development of models to predict the treatment response and vulnerability to side effects of medications for mental disorders, and will support studies on the prevention or amelioration of treatment-related side effects. In FY 2011, the program will emphasize studies evaluating the safety and efficacy of novel pharmacological agents and behavioral interventions that target features of mental illness that are inadequately addressed by current therapies and prevention strategies.

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 science to discover the developmental origins of mental disorders and 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 2009, NIMH issued a RFA titled "Identification and Characterization of Sensitive Periods for Neurodevelopment in Studies of Mental Illness." This RFA encourages research on the developmental periods during which the brain is maximally sensitive to environmental and experiential factors that affect the development of cognitive and affective functions associated with psychiatric disorders. The initiative’s ultimate goal is to use knowledge of brain development and plasticity to design novel interventions that can be used to prevent or mitigate the onset of mental disorders.

Budget Policy: The FY 2011 budget estimate for this program is $148.375 million, an increase of $4.834 million or +3.4 percent over the FY 2010 estimate. Priority will be given to studies that delineate the neurobehavioral mechanisms responsible for the development of mental disorders, including critical and sensitive periods in brain development and the effects of behavior and experience on the brain. In FY 2011, NIMH will also support research to develop, test, and validate biologically based markers (e.g., genetic indicators, brain imaging) to improve diagnosis, identify risk indicators in order to preempt disorder, serve as criteria to personalize treatment, and evaluate treatment response.

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. Understanding the normal trajectory of brain development and the genes that shape these processes will be critical for identifying when and how developmental trajectories are changed in mental disorders. Therefore, in FY 2009, NIMH issued an RFA to encourage the research community to construct an atlas of when and where genes are switched on and off during normal brain development. A second RFA encouraged the discovery of genes and gene regulators that control brain development. Studies supported in response to these RFAs will present data that will inform studies of function and dysfunction in the developing human brain that contribute to ADHD, schizophrenia, autism spectrum disorders, and depression.

Budget Policy: The FY 2011 budget estimate for this program is $459.722 million, an increase of $14.977 million or +3.4 percent over the FY 2010 estimate. Priority will be given to projects that seek to understand the biological functions of genes, gene products, cells, and brain circuits in normal and abnormal mental function. Program plans include research to identify biological markers (e.g., genetic, proteomic, imaging) in model systems and humans that could be further validated as methods for diagnosing and detecting risk, onset, progress, and severity of mental disorders. High priority projects also include those that identify in diverse populations (from the U.S. and around the world) genetic variants, epigenetic mechanisms, and gene-environment interactions that influence vulnerability to mental disorders and treatment response. In addition, NIMH will continue to support studies to identify and validate new molecular targets and tools for drug discovery relevant to the treatment of mental disorders.

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. In FY2009, the program launched a major initiative, the Study to Assess Risk and Resilience in Service members (Army STARRS). It is the largest study of suicide and mental health among military personnel ever undertaken. Funded with $50 million from the U.S. Army and additional funding from NIH, its goal is to identify, as rapidly as possible, risk and protective factors that will help the Army develop effective strategies for reducing rising suicide rates and addressing associated mental health problems among service members. The study will evaluate representative samples of soldiers across all phases of Army service, both retrospectively and prospectively, and the results are expected to also inform NIMH’s suicide research and prevention efforts in the civilian population.

Budget Policy: The FY 2011 budget estimate for this program is $194.708 million, an increase of $6.343 million or +3.4 percent over the FY 2011 estimate. High priority will be given to studies that develop innovative interventions, including treatment regimens, prevention strategies, and innovative service delivery approaches to reduce the prevalence and burden of mental disorders. Program plans further emphasize research that will personalize interventions for optimal use among diverse populations, including underserved groups, those with comorbid conditions, across geographic locations, and across age groups. In FY 2011, the program will also emphasize research that will reduce the burden and mortality associated with suicide. This area of emphasis includes studies on early detection, assessment, interventions, and services for individuals at risk for suicide, across populations and ages.

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 2009, IRP researchers discovered that schizophrenia could be linked to the over-expression of a specific gene, called DISC-1, during critical times in fetal brain development.  The DISC1 gene codes for a protein important for brain development, as well as for mood and memory - functions that are disturbed in schizophrenia.  The researchers discovered that a shortened version of DISC 1 was over-expressed in the fetal brain and was more likely to be seen in adults with schizophrenia. These findings suggest that variations in the DISC1 gene are a risk factor for the development of schizophrenia and present exciting opportunities for future research.

Budget Policy: The FY 2011 budget estimate for these programs is $180.232 million, an increase of $5.589 million or +3.2 percent over the FY2010 estimate. Scientists in the IRP will continue with ongoing 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. The IRP will continue to encourage and support cross-disciplinary collaborative efforts in these areas. The IRP will also continue to implement the recommendations of the NIMH 2008 Blue Ribbon Panel on Intramural Research, which included recommendations for strategic recruitments in emerging areas of mental health research.

Research Management and Support (RMS)

The 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 2009, the Institute oversaw 2,795 research grants, 429 training grants and 170 research and development contracts. In FY 2009, the Institute proactively conducted several internal risk management reviews to examine and assess the effectiveness of management controls in seven major areas of responsibility. The focus of the reviews was to identify any weaknesses and detect any fraud, waste, or abuse. A few minor deficiencies were discovered during the reviews and corrective action plans were implemented.  NIMH modified internal policies and/or procedures to avoid reoccurrences of the deficiencies.

Budget Policy: The FY 2011 budget estimate for RMS is $76.092 million, an increase of $3.623 million or +5.0 percent over the FY 2011 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

Total Compensable Workyears

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

Costs by Object Class

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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Details of Full-Time Equivalent Employment (FTEs)

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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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References

¹Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27. PMID: 15939839

²U.S. Census Bureau Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005.

³The World Health Organization. The global burden of disease: 2004 update, Table A2: Burden of disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004. Geneva, Switzerland: WHO, 2008.

⁴Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS).  (www.cdc.gov/ncipc/wisqarsExternal Link: Please review our disclaimer.)

⁵The Health and Behavior components of the Division of AIDS and Health and Behavior Research have been dissolved. The Health and Behavior components have been absorbed by the other NON-AIDS Research divisions.