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Strategic Planning Reports

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Overview of NIMH Priorities

NIMH supports innovative research that will profoundly transform the diagnosis, treatment, and prevention of mental disorders, paving the way for a cure. The need for transformative, innovative research is urgent; each year, as many as 44 million Americans meet criteria for some mental disorder, with roughly 12 million reporting symptoms so severe as to cause significant disability and interference with everyday living. Similarly, the economic costs of mental disorders are estimated at over $150 billion, with most due to the loss of economic productivity as a result of the illnesses.1 We know that mental disorders can also be fatal. Each year more Americans die from suicide than from homicide.2 In sum, these are real disorders requiring life-saving treatments.

Our commitment to basic brain-behavior science has never been greater. Along with the rest of NIH, we are also committed to translating the discoveries from basic science to clinical practice. Our clinical research vision focuses on the four Ps of medical research:

The mission of NIMH is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. Mental disorders are brain disorders and that means that achieving progress requires a deeper understanding of the brain and behavior. To fulfill our mission, NIMH is committed to the following priorities:

Since our inception in 1946, NIMH has been the lead agency for research on mental disorders. Through our research, enormous gains have been made over the decades, including: establishing that mental disorders are complex brain diseases and demonstrating that medications and behavioral therapies can relieve suffering and improve daily functioning for many people. Recent groundbreaking discoveries from mapping of the human genome, sophisticated studies of the brain, and investigations of cognition and behavior have provided powerful new insights and approaches.

However, many challenges remain before we realize our vision of recovery, prevention, and cure. For nearly every disorder we need innovative approaches for improving mental health such as improved diagnostic tests, specific biological indicators of disease, more effective, individualized interventions, successful dissemination of effective interventions to mental health professionals, and enhanced strategies for prevention. In addition to reducing the burden of mental illness, these efforts must also aim toward eliminating health disparities.

Science now provides opportunities that promise to deliver for each of these needs. Success will require an understanding of the underlying processes in brain and behavior — from neurons to neighborhoods — to make the discoveries that point the way to new diagnostics and interventions and, eventually to recovery, prevention, and cure. Also required is increased collaboration and sharing of data among our scientific disciplines as well as partnerships with other NIH Institutes, federal agencies, and private organizations. In addition, it is critical that the Institute provide unbiased, accurate, accessible and timely scientific information to enable the American public to make more informed mental healthcare choices.

To fulfill these priorities, the NIMH divisions and programs are designed to emphasize translational research spanning bench, to bedside, to practice. More detailed information about targeted priorities and funding initiatives can be found in the descriptions of each division and program.

(1) New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD: 2003.

(2) Centers 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/wisqars

Setting Priorities

To set the NIMH priorities, we:

In this effort, we have attended to three factors: relevance, traction, and innovation.

Relevance refers to relevance to the mission. Not every grant must focus on a specific disorder, nor will only clinical research be funded. NIMH will continue its strong support of basic science, but as the NAMHC workgroup recommends in its report some research areas are more relevant than others. As one example, the workgroup stressed the need for more information about the neurobiology of adolescence, recognizing that many mental disorders begin during this phase of development but relatively little is known about the concurrent changes in brain function.

Traction refers to the capacity for rapid progress in research areas where new tools, such as high throughput genotyping or 2-photon imaging, can yield definitive answers to long-standing, relevant questions.

Innovation is often endangered during periods of limited budget growth. The innovative project that lacks extensive pilot data often is considered too risky for funding. This is the era of “discovery science”, with the tools to identify the major candidate genes, cells, and systems involved in emotion, cognition, and behavior. This work is highly relevant and we have the traction, but unless a priority is placed on discovery science, this unprecedented opportunity for innovation may not receive the support it deserves.

Investing for the Future: Research Training and Early Career Development

Training the next generation of investigators has always been a high priority for NIMH. Indeed, it is our commitment to not only support young scientists as trainees but also as newly independent investigators that has led to making some difficult, yet important changes in NIMH funding strategies.

In FY 2004 NIMH carefully reviewed its entire research and research training portfolio to plan for the de-escalation in the research budget. This review showed that nearly 10 percent of the NIMH research budget in fiscal year (FY) 2004 was devoted to individual fellowships (Fs), institutional training (Ts), and career awards (Ks) – nearly double the average for other NIH Institutes. Left unchecked, the rate of growth in the research training and career development area would soon out pace the ability to support new competing research grants, including those submitted by newly independent scientists whom we helped train.

Noting these challenges, we determined that it was important to strike a strategic balance between building the pipeline of potential new investigators and maintaining a viable pay line to support research projects. We will continue to invest significant funds to train investigators in areas highly relevant to the Institute's mission. Over the next few years, however, the NIMH is strategically decreasing the percentage of the NIMH budget invested in training from roughly 10 percent to about 8.6 percent.

While we make these changes at NIMH, it is important to note that support for new training and career development opportunities relevant to mental health are available through NIH Roadmap and NIH Neuroscience Blueprint. Also, NIMH is an active participant in the NIH Pathway to Independence Award (K99/R00), a program designed to facilitate more rapid transition from mentored training to research independence.

Investing for High Impact

Setting priorities is useful only if we can ensure that funding follows suit. To achieve this, we are implementing FY 2007 Funding Strategy by using Institute and Division priorities as a key factor when making funding decisions. In addition, we will continue to use Requests for Applications to ensure that funds are available for high priority needs. This is particularly relevant to our commitment to innovation. Some funding will be appropriated each year to support the most promising high-risk, yet potentially high-yield grants.

This is a time of great scientific excitement for mental health research. Building on the Decade of the Brain, we are poised for a Decade of Translation, with new discoveries from genomics, neuroscience, and behavioral science leading to new, more effective treatments, and ultimately to the possibility of preventing and curing mental illness. Our priority setting and new funding strategies are designed to optimize the translation of our best science to the service of those with mental and behavioral disorders.

Previous Reports

For related NIMH reports, visit the National Advisory Mental Health Council home page.