Looking Back, Moving Forward
The calendar has rolled over to a new year, and here we are in 2023. Many people greet January as an opportunity for a fresh start, a time to look ahead and think about what they want to do and achieve over the next 365 days.
To set promising goals for the future, I think it’s essential to reflect on the past. When we take a moment to revisit the previous year, it gives us a chance to recognize the results of our collective hard work. And it reminds us of the advances that we can make through focused efforts, motivating us to continue pushing toward a world in which mental illnesses are prevented and cured.
In 2022, we saw many exciting NIMH-supported developments across the full spectrum of research—from basic science to translational research to services and implementation science. Here I highlight just a few examples.
Mapping the brain in detail
Basic science provides the foundational knowledge we need to understand the complex workings of the human brain. In 2022, we saw the launch of ground-breaking projects that aim to transform our understanding of the brain on the most granular level. These projects, supported in part by NIMH under the auspices of the Brain Research Through Advancing Innovative Neurotechnologies® (BRAIN) Initiative , will give us unprecedented insight into brain cell types and the precise tools needed to access them.
The first project, The BRAIN Initiative® Cell Atlas Network (BICAN) , focuses on illuminating the full range of brain cells and circuits in humans and other species. Building on findings from the BRAIN Initiative Cell Census Network, this project will generate a complete reference atlas of cell types in the human brain across the lifespan, including a “parts list” spanning the entire range of neurons and other cells that make up the complex organ that guides our behavior. The project also aims to map the connections between cells that underlie a wide range of behaviors.
In parallel, the second project, the Armamentarium for Precision Brain Cell Access , focuses on developing a toolkit that will allow scientists to reach inside each of the many cell types identified by BICAN to assess the roles these cell types play in behavior, in both health and disease. This unprecedented degree of access to the interiors of the brain’s building blocks will enable a more detailed picture of how the brain produces behavior and will clarify the roles these cell types play in brain-based disorders. Importantly, the project includes a component that specifically supports efforts to build research capacity at historically under-resourced institutions .
Rounding out the trio of innovative projects is the BRAIN Initiative Connectivity Across Scales (BRAIN CONNECTS) Network , with the first round of awards to be issued in 2023. Together, the projects promise to transform neuroscience research, illuminating underlying principles governing the circuit basis of behavior and informing new approaches to the treatment of human brain disorders.
Developing targeted interventions
With translational science, we’re building on findings from basic science to develop and improve interventions for people with mental illnesses. The past year marked the launch of participant recruitment for the Accelerating Medicines Partnership® Program Schizophrenia (AMP® SCZ). This partnership reflects an unprecedented large-scale effort, uniting federal agencies such as NIMH and the U.S. Food and Drug Administration (FDA), the Foundation for the National Institutes of Health (FNIH), and numerous private and non-profit organizations with the shared goal of improving outcomes for people at clinical high risk for schizophrenia. Currently, the AMP SCZ program consists of a coordination center and two research networks with 42 study sites across the globe. Two years after launch, 2022 marked a banner year for AMP SCZ.
In June, AMP SCZ study sites began enrolling the first wave of participants and enrollment proceeds apace. I’m excited to report that, as of January 17, 2023, 220 participants across 25 sites have completed the consent process. Of those participants, 101 have also completed screening and are in baseline or months 1-6 of the study. In the spring, we also saw the launch of a dedicated AMP SCZ website , which serves as a comprehensive information hub for prospective study participants and researchers interested in joining the study.
The progress continues. In December, FNIH issued a request for information to identify “candidate” therapeutic drugs that can be used in AMP SCZ early clinical trials. AMP SCZ investigators have also been working on research publications that report on the development of a harmonized clinical outcome assessment. A letter of intent to propose FDA qualification for this clinical outcome assessment was submitted to FDA earlier this month. And the first published AMP SCZ manuscript, “Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Developing tools to enable early intervention in the psychosis high risk state ,” recently made its online debut in World Psychiatry.
Improving strategies for suicide prevention
At NIMH, we also recognize the demand for better intervention and prevention strategies that meet the diverse needs of people with mental health concerns. NIMH has long prioritized suicide prevention research, but the urgency of this work has become abundantly clear in recent years. In my September message, I reflected on what we have learned about suicide prevention amid the COVID-19 pandemic and what we know about ongoing trends. Available data indicate a real cause for concern: Rates of suicidal thoughts and behaviors are high or increasing among racial, ethnic, and sexual and gender minoritized groups, and particularly among youth.
To better understand and address these trends, in 2022, NIMH issued notices of research interest in preteen suicide risk (e.g., NOT-MH-22-085 , NOT-MH-22-086 ), as well as funding announcements focused specifically on suicide risk among Black youth (e.g., NOT-MH-20-055 , RFA-MH-22-140 , RFA-MH-22-141 ). The goal of these funding announcements is to characterize risk trajectories and protective factors, which can, in turn, inform better evidence-based interventions
Given the urgent need for effective crisis interventions, NIMH also collaborated with the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration to encourage research focused on the entire continuum of crisis services, including emergency medical services, therapeutic interventions, and follow-up care (NOT-MH-22-110 , NOT-MH-23-240 ). NIMH continues to seek research that advances suicide prevention practices in health care, as well as in legal, educational, and other systems that are already serving people who may be at risk. For example, in 2022, we funded three additional Practice-Based Suicide Prevention Research Centers, and several more will be funded in the coming months. These centers are national resources for understanding optimal strategies for implementing suicide prevention practices.
Suicide prevention requires a multi-faceted approach—research on its own is not enough. To ensure that NIMH-supported research has a direct impact on people’s lives, NIMH continues to be involved in interagency efforts that reflect growing recognition of the nation’s mental health and suicide prevention needs. These federal efforts are further leveraged by public-private partnerships such as the National Action Alliance for Suicide Prevention that continues to strive for improved evidence-based suicide prevention efforts across various clinical and community settings.
Reflecting on these and many other areas of progress over the past year, I move into this new year with a sense of purpose and optimism. In 2023, we plan to launch new initiatives in precision psychiatry and depression biomarkers, continue our efforts to expand research in health disparities, and support new efforts to translate genetic knowledge into actionable neurobiology. As we continue the momentum of 2022 throughout 2023, we hope to build on previous advances and encourage innovative science. I believe these efforts will offer hope and solutions to people with mental illnesses, their families, and their communities over the year to come.