May 8, 2009
NIMH held its fifth annual meeting of the Professional Coalition for Research Progress (The Coalition) on May 8, 2009 in Washington, D.C. The meeting served as an opportunity for representatives from professional organizations with an interest in NIMH research to hear about advances in mental health research and current and new research directions and strategies for NIMH; to network with colleagues; and, to interact with and express their views directly to the NIMH Director, Thomas Insel, M.D. and senior level staff. Invited speakers provided information on a new collaborative study with the U.S. Army, changes in NIMH support for research training and career development, and progress made in genomics research. Welcome remarks were provided by William Safire, Chairman of the Dana Foundation, who spoke briefly about the challenges to the field of science as a result of the current state of the economy.
State of the NIMH
Dr. Insel’s presentation provided Coalition members with a concise update of recent changes and happenings at the Institute. He focused on five topic areas—transitions in leadership, the Research Portfolio Online Reporting Tool (RePORT), the NIMH Strategic Plan, the NIMH Budget, Research Domain Criteria (RDoC), and new initiatives. He announced several new leadership appointments: Deputy Director Philip Wang, M.D., Dr.P.H, Scientific Director Richard Nakamura, Ph.D., Clinical Director Maryland Pao, M.D., and Special Populations Director Pamela Collins, M.D., M.P.H. In addition, he discussed recruitment efforts for two division director positions. Dr. Insel briefly discussed the release of the Research Condition and Disease Categorization (RCDC) project in January and noted the variety of reports and data available through the RePORT web site.
Dr. Insel discussed the development and implementation of the NIMH Strategic Plan and the budget. He told Coalition members that he has traveled the country talking with grantees, reviewers, and the public about the Plan, its objectives, and how the Institute intends to invest strategically to build capacity in areas of need and research that are aligned with the Institute’s mission. Dr. Insel noted the release of the President’s Budget Request for 2010, the day before the meeting, and the administration’s focus on two primary areas of NIH research, cancer and autism. He also discussed the $10 billion appropriated directly to NIH through the American Recovery and Reinvestment Act of 2009 (ARRA) and how NIMH intends to use a portion of these funds to stimulate the economy, create and preserve jobs, and advance biomedical research. To achieve the goals of ARRA, the Institute will accelerate biomedical research in these ways:
- Expanding the payline to fund additional meritorious grants that have already been peer reviewed and approved by the National Advisory Mental Health Council
- Expanding science by funding administrative and competitive revision supplements to existing grants, and by funding new ARRA NIH-wide programs such as Challenge Grants and Grand Opportunity (GO) Grants.
As with all NIMH peer-reviewed research funding decisions, the number of scientifically meritorious applications will influence decisions for using resources from ARRA.
Collaborative Study of Suicidality and Mental Health in the U.S. Army
Robert Heinssen, Jr., Ph.D., A.B.P.P., Acting Director of the Division of Services and Intervention Research provided an overview of a new collaborative study with the U.S. Army. The goal of the study is to develop data-driven methods for mitigating or preventing suicide behaviors of Army personnel, and improving their overall mental health and behavioral functioning during and after their service through the following efforts:
- Identifying modifiable risk and protective factors associated with suicide, mental disorders, and psychological resilience;
- Evaluating active duty and reserve soldiers across all phases of Army service, both cross-sectionally and longitudinally;
- Identifying intervention options based on empirically-identified risk and protective factors; and
- Promoting NIMH collaboration with the Army’s medical research and material community (MRMC) and Center for Health Promotion and Preventive Medicine (CHPPM) to design and evaluate interventions for reducing risk and enhancing resilience.
More specific information about the collaboration between NIMH, MRMC, and CHPPM is outlined in a Memorandum of Agreement entered by all parties in November 2008.
Dr. Heinssen told Coalition members about the importance of a translational epidemiological approach to the study and referenced the National Heart Lung and Blood Institute’s Framingham Heart Study (http://www.framinghamheartstudy.org/) as an example of a program that successfully identified risk and protective factors, as well as targets for new interventions that affected morbidity and mortality rates. He said that while the NIMH study is modeled after the Framingham study, NIMH is “not looking to merely describe and/or to assess the prevalence of risk factors, but rather is looking for a research enterprise that's going to be able to identify the mechanisms by which those risk and protective factors work, either to increase the risk for suicide or mitigate against it.” He further discussed the research platform and noted that there may be multiple risk and protective factors for suicide that accumulate over time or are associated with various aspects of the Army experience—e.g., training or exposure to danger in combat—and that these factors may cluster or work in combination to help predict suicide or identify areas for potential intervention development.
NIMH Support for Research Training and Career Development
Nancy L. Desmond, Ph.D., Associate Director of the Division of Neuroscience and Basic Behavioral Science talked with Coalition members about NIMH support for research training and career development. Her presentation provided information on NIMH support for investigators using multiple funding mechanisms and at various stages along the career path; a snapshot of NIMH training and career development efforts in relation to other NIH Institutes and Centers (ICs); and, an overview of the recommendations found in the 2008 National Advisory Mental Health Council (NAMHC) Workgroup Report on Research Training entitled Investing in the Future (PDF file, 49 pages). She stated that NIMH supported roughly 1500 individuals through research and training programs in fiscal year 2007, and that NIMH has allocated more than 10% of its extramural research budget to training and career development, which is above the NIH average of 6%. She briefly discussed the NIMH training and career development mechanisms and the Institute’s commitment to nurturing and developing researchers from undergraduate through early career investigator stages of the career path.
The NAMHC Workgroup had several charges to pursue. It developed recommendations on how the Institute could shape its training and career development programs, by identifying best practices for research training and the size of the NIMH investment needed to ensure an appropriate future workforce. The Workgroup also developed effective strategies for increasing workforce diversity, and effective strategies to stimulate the recruitment, training and retention of M.D.-Ph.D. scientists as NIMH researchers. Dr. Desmond discussed the following recommendations from the workgroup report:
- Maintain budget for research training and career development
- Build a strong pipeline by revising the approach to undergraduate training for individuals from diverse backgrounds, recruiting and retaining physician-scientists, and including international scholars in endeavors
- Develop national mentoring networks for individuals from diverse backgrounds and an alumni network
- Expand support for systematic research training and education opportunities at NIMH-supported Centers
- Implement efforts to span critical transition points in the career pipeline
- Retain M.D.-Ph.D. scientists in mental-health–related research
- Implement best practices for institutional training
- Strengthen program assessment and monitoring through the establishment of an evidence-based approach to research training and career development programs.
- Strengthen dissemination to and communication with the extramural research community
Coalition members expressed concern over the Workgroup’s recommendations to focus investment of training and career development funds in academic institutions and move away from funding candidate selection by professional societies. Members discussed the importance of mentoring, diversity, interdisciplinary training, and absorption of technology. In response to these concerns, Drs. Insel and Desmond assured Coalition members of the Institute’s commitment to increasing the diversity of the research workforce and the breadth of programs available, and explained how the recommendations are aligned with the NIMH Strategic Plan.
Overview of Progress in Genomics Research
Francis McMahon, M.D., Chief of the Genetics Unit in the NIMH Mood and Anxiety Disorders Program provided a general update on progress made in genomics research. He told Coalition members that there are unique challenges associated with studying mental illnesses from a biological causation perspective. First, major mental illnesses are strongly inherited, but poorly understood. Some genetic markers have been identified, but it is not clear as to how they might contribute to the onset of disease. Finally, genetic risk factors may act at many levels, including through the regulation of gene expression. Dr. McMahon also highlighted the recent advances and knowledge gained through genetic research including the Genome-Wide Association (GWA)External Link: Please review our disclaimer. and Copy Number Variation (CNV) studies which have identified several genes that are reproducibly associated with bipolar disorder and schizophrenia, as well as risk alleles for mental illness. He discussed new understandings gained concerning how gene expression is regulated in the brain, and new data about the mechanisms and importance of genomic imprinting: the way in which instructions to turn genes on and off is passed from generation to generation. Finally, he spoke of how increased access to large treatment samples is reinvigorating pharmacogenetic research toward the goal of personalized medicine in psychiatry.
Dr. McMahon told Coalition members that mental illnesses are not associated with a single deletion, variation, or mutation of a gene, but rather with multiple changes. He described a research study on rare deletions on chromosomes 1 and 15 and their association with schizophrenia. He noted that the findings “tell us that something important could be happening to genes within that deletion region, thus raising a strong hypothesis that there may be more common variations involved that play a role in the more common forms of schizophrenia.” In closing, Dr. McMahon stated that there is much more to be learned through genetic research. The GWA and CNV studies are successfully identifying robust genetic associations in large samples, though the effect sizes are small. He also noted that due to the many alleles and genes associated with mental illnesses, the field is not currently in the position to use genetic testing for diagnostic purposes. Coalition members engaged Dr. McMahon in active dialogue about genomics and potential benefits to the field of mental health research.
Coalition Speakers (L to R): Dr. McMahon,
Dr. Insel, Dr. Heinssen, and Dr. Desmond
Mr. William Safire welcoming participants
Dr. Insel addressing Coalition members
Coalition members engaged in dialogue
Coalition members listening to presentations