Posts by Former NIMH Director Thomas Insel

In his farewell post, Dr. Insel looks back at six years of the director’s blog and reflects on the tasks ahead in mental health research and practice.

Results from a major NIMH project provide evidence that coordinated specialty care can improve outcomes for first episode psychosis. Dr. Insel blogs about the RAISE project and other recent studies of coordinated care.

Tech companies are bringing their ability to extract knowledge from data to health care. Dr. Insel gives some examples that show the potential of new tech-based approaches to diagnosis and treatment.

Despite its reputation as a month for slowing down, August is busy at NIMH as the end of the fiscal year approaches. Dr. Insel takes time out to give an update on NIMH-supported clinical trials.

The BRAIN Initiative is supporting scientists aiming to understand how the 86 billion neurons in the brain act together to enable consciousness and behavior. Dr. Insel gives a snapshot of recent work and its implications for understanding normal and disordered brain function.

The Institute of Medicine has issued a report looking at the effectiveness of psychosocial treatments for mental disorders. Dr. Insel blogs about the need to ensure that consumers needing treatment receive evidence-based therapies.

Last week, two important research events unfolded without fanfare and without headlines. June 30 marked the end of the first phase of Army STARRS, the largest study of mental health risk and resilience ever conducted among military personnel. July 1 marked the release of Army STARRS data for use by the broad scientific community.

Researchers were able to reverse some of the behavioral effects of stress in mice by stimulating brain cells activated by pleasure. Dr. Insel describes the work and its implications for understanding depression.

Dr. Insel blogs about recent breakthroughs from the BRAIN Initiative, which show the promise of what we can accomplish with investment focused on new tool development to better  understand and treat brain disorders.

Dr. Insel discusses how the Precision Medicine Initiative will create a new kind of patient-driven research, which is similar to how innovative companies have created a new share economy based on trust.

Dr. Insel talks about the importance of incorporating neuroscience in the training of psychiatric residents and a new initiative to do that. The clinician of 2025 will need to know about the science of the brain.

Statistics paint a picture of the impact of mental illness in the United States; Dr. Insel reviews the numbers for Mental Health Awareness Month.

NIMH’s RDoC initiative is in keeping with current interest in precision medicine. In his latest blogpost, Dr. Insel invites the research community to engage in discussion on the RDoC online forum.

A London neuroscientist suggests two kinds of causes for disease; Dr. Insel talks about the implications of this view for understanding mental disorders.

Suicide only occasionally makes the national news, but it is the 10th leading cause of death in the U.S. Dr. Insel talks about the need for research targeted directly at suicide and recent efforts to raise awareness and marshal research.

NIMH’s new Strategic Plan for Research is a broad roadmap for the Institute’s priorities for the next five years; Dr. Insel provides context and an overview.

March 16-22 is Brain Awareness Week, an opportunity to celebrate neuroscience. Dr. Insel talks about some exciting areas of research underway on the brain.

Dr. Insel introduces a white paper posted on the NIMH website which provides answers to many of the most common questions NIMH receives about how it makes funding decisions.

Dr. Insel lauds University of Washington psychiatrist and researchers Wayne Katon and the collaborative care approach for depression he helped develop.

A recent paper reports findings on the reduction in life expectancy among people with mental illness relative to the general population; Dr. Insel discusses the magnitude and reasons for this excess mortality.

We tend to assume that the secrets to understanding individual differences in resilience to stress must be sought in the brain. Now, findings in mice suggest that the peripheral immune system might play a pivotal role.

In his latest blog, Dr. Insel discusses precision medicine, which is the new hot topic in research and what it means for mental health.

At the recent World Economic Forum, brain research was a hot topic; Dr. Insel reports on statistics presented at the conference that inspire optimism that progress can be made on difficult problems, including mental disorders.

Relative to other countries, U.S. funding of science has declined in recent years; Dr. Insel talks about the need for research and development related to mental illness.

Dr. Insel discusses the idea that chance may have as much to do with the development of mental illness as do genetic and environmental factors.

Dr. Insel offers an overview of his top ten mental health stories for 2014.

Drug testing in mice has been a poor guide to effectiveness in humans; Dr. Insel talks about the need for research approaches that can more reliably guide medication development.

In his blog, Dr. Insel discusses the need for early and accurate prediction of psychosis risk and for effective preventive treatments.

In his blog, Dr. Insel talks about the reasons for problems with reproducibility in research, among them flawed use of statistical analysis.

An early sign of depression risk may provide not only a biomarker for depression but a clue to the relationship between depression and risk for medical illnesses; Dr. Insel blogs.

In his blog for Mental Illness Awareness Week, Dr. Insel talks about the complexity of mental disorders and the need for scientists, clinicians, patients, and families to work together in searching for better treatment.

Ongoing research is investigating the long-term efficacy and safety of the anesthetic drug ketamine, which studies have shown can rapidly lift depressive symptoms; Dr. Insel talks about the status of ketamine in his blog.

Dr. Insel discusses the importance of data sharing within the scientific community and highlights how NIMH is encouraging this process.

In his blog, Dr. Insel talks about on new NIMH grants that will support research on services for people of all ages with autism.

Dr. Insel discusses a newly released World Health Organization World Suicide Report, an overview of the impact of and factors involved in suicide globally and strategies for preventing suicide.

Neurotechnologies are making it possible to finely tune brain circuitry to manipulate memory.

In referring to the recent death of Robin Williams, Dr. Insel talks about the continuing need for research to develop better treatments for serious mental illness.

In his blog, Dr. Insel talks about the importance of recent large philanthropic gifts to fund basic research on the brain.

In this blog, Dr. Insel describes the results of two new genetics studies and why they are milestones in our understanding of the genetics of autism and schizophrenia.

There are many obstacles to controlling illnesses such as HIV/AIDS, even when effective treatment is available; Dr. Insel talks about what is needed to ensure that effective health care is delivered to those who need it.

Dr. Insel and SAMHSA Administrator Pamela Hyde provide an update on funding to support evidence-based programs that address the needs of individuals with early serious mental illness across the country.

The BRAIN Working Group unveiled an extraordinary report last week, providing a 12-year roadmap for the development of a new generation of neuroscience tools. Dr. Insel discusses how their vision provides hope for preventing and treating brain diseases and disorders.

Despite common assumptions about why more children are being treated with medications for mental disorders, the reasons remain unclear; Dr. Insel discusses the possibilities in his blog.

Recent changes in health care law are prompting consideration of how to ensure that treatments provided are evidence-based; Dr. Insel talks about the implications for mental health care.

Dr. Insel talks about common themes at some major national meetings taking place during Mental Health Awareness Month in May: changes in the health insurance climate, technology in health care, and possibilities both create for “learning” health care systems.

NIMH Director Thomas Insel and SAMHSA Administrator Pamela Hyde detail how the two agencies are implementing evidence-based early psychosis treatment programs across the United States.

In a blog celebrating National DNA Day, NIMH Director Thomas Insel shares new insights about DNA, and emphasizes that, for mental disorders, DNA is less about simple heritability and more about complex mechanisms of risk.

Dr. Insel discusses a new report that compares the number of people with serious mental illness who are incarcerated vs. the number being treated in hospitals.

A new map of where and when genes are expressed in the developing human brain—the transcriptome—is already enabling scientists to gain insights into the role of risk genes in neurodevelopmental disorders. Dr. Insel talks about the implications of this work.

Dr. Insel describes new scientific findings on autism, including new CDC prevalence data, being reported just as Autism Awareness Month begins.

At a recent awards dinner, Research!America honored patients who worked with researchers to find cures for disease; Dr. Insel shows what we can learn from these collaborations and gives an example of how genetic research can lead to effective treatment.

In a blog about Brain Awareness Month, NIMH Director Thomas Insel talks about the complexity of the brain and challenges ahead for research to understand it.

Dr. Insel talks about just published findings coming out of Army STARRS, a joint Army-NIMH effort to understand risk factors for suicide in the military.

NIMH is changing how it will support clinical trials. Dr. Insel summarizes the changes and the reasons behind them.

Dr. Insel talks about the numerous ways in which devices like computers and smartphones could be used to diagnose and treat mental disorders.

Dr. Insel talks about a just-published paper that offers the first picture of a growth chart for cognitive development. As long-term studies add information on different facets of cognitive function, such a map has the potential to be just as vital a tool for evaluating growing children as charts for height, weight, and head circumference.

Dr. Insel discusses the impetus behind a newly released prioritized agenda for research on suicide prevention, and what the task force that developed the agenda hopes to achieve in terms of reducing suicide rates.

From the World Economic Forum in Davos, Switzerland, Dr. Insel reports that there was notable attention paid to mental health at this year’s meeting. He explains the interest of both developing and developed countries in preventing and treating mental illness.

Dr. Insel talks about the latest group of young investigators to receive funding through NIMH’s BRAINS program, an effort to support young scientists undertaking innovative, exploratory research.

Dr. Insel looks forward to what’s ahead in 2014 for neuroscience and mental health: both challenges and promise.

Dr. Insel reviews his “top ten” selections for 2013, including research advances and historic policy changes affecting mental health care.

Dr. Insel explains the importance of post-mortem brain donation to research and how the new NIH NeuroBioBank initiative will support research on human brain tissue.

Dr. Insel talks about the need for research taking place in academic settings to be in line with the desire of the public for advances in prevention and treatment of disease.

Dr. Insel recaps the annual Partners for Cure (P4C) meeting, where the theme is to speed the delivery of new cures through innovative research models.

The discovery that mutations unique to an individual are common in the brain changes, and complicates, the search for genes underlying brain disorders.

We have missed a cycle of grant review, but we should be able to recover this year. Research projects will be delayed but in most cases not irreparably harmed. For most scientists, coming to NIMH means sacrificing salary and working very long hours for the opportunity to have enormous impact. There was something about the furlough that left even the most self-sacrificing public servant feeling dispensable and devalued. No job, no impact. The long-term impact of the shutdown may be on morale.

With more than 100 common gene variants recently implicated in schizophrenia and autism, the problem now is to pinpoint how they might change brain circuits. A promising new tool is a sort of budding brain in a dish. What’s amazing – eclipsing earlier “disease-in-a-dish” discoveries – is that, over weeks and months, differentiating cells in these “organoids” organize themselves according to the architecture that we see in a functioning human brain.

In his blog, Dr. Insel discusses the challenge of assessing the quality of scientific research in a new era of open access publishing.

Antipsychotics help people through the crisis of acute psychosis, but the long-term management of chronic mental illness is another matter. It appears that what we currently call “schizophrenia” may comprise disorders with quite different trajectories. For some people, remaining on medication long-term might impede a full return to wellness. For others, discontinuing medication can be disastrous.

Dr. Insel describes how insights from research into why we do not retain memories from the first four years of life may help shed light on many aspects of memory.

In his blog, Dr. Insel talks about the National Research Action Plan, an effort announced by President Obama aimed at improving prevention, diagnosis, and treatment of mental health conditions and traumatic brain injury in military personnel.

Dr. Insel reports in his blog about intriguing findings published this summer on the genes and disruptions in brain circuitry involved in schizophrenia.

Dr. Insel explains the nuances of the term, “serious mental illness.”

Dr. Insel talks about the value of data sharing and collaboration to promote innovation and scientific discovery.

Dr. Insel talks about the President’s launch on June 3 of the National Dialogue on Mental Health, and NIMH’s role in this effort.

NIMH is committed to new and better treatments, but this will only happen by developing a more precise diagnostic system. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system. RDoC is nothing less than a plan to transform clinical practice by bringing a new generation of research to inform how we diagnose and treat mental disorders.

Dr. Insel talks about how a powerful new brain imaging technique will make it possible for scientists to investigate the brain in in an entirely new way, offering a preview of what scientists hope to achieve with tools developed as a result of the new BRAIN initiative.

Dr. Insel blogs about what epidemiological research in Sweden tells us about premature mortality experienced by people with serious mental illness and what we need to do to change that.

Dr. Insel’s blog makes the link between neuroscience and the national conversation on mental illness and gun violence; neuroscience research is the key to our being able to identify psychosis risk early and preempt the development of serious mental illness.

In a blog about Brain Awareness Month, NIMH Director Thomas Insel talks about the mysteries that remain to be solved about how the brain works.

Dr. Insel describes how different perspectives separate the communities interested in autism, and suggests the common ground that would provide an avenue to move forward.

Dr. Insel talks about how NIMH’s RAISE study is exploring an integrated, multi-component approach to health care for schizophrenia.

Dr. Insel talks about the importance of developing ways to identify individuals at high risk of mental disorders before they develop symptoms, making it possible to intervene early and prevent serious illness.

Dr. Insel reflects on the state of mental health care and research 50 years after President Kennedy’s special message to congress on mental health.

Dr. Insel highlights key recent findings in research on autism spectrum disorders.

Dr. Insel describes his top picks in research advances for 2012.

NIMH’s director talks about the need for research that explores the frontiers of science and funding efforts to encourage innovative research.

Dr. Insel introduces an innovative approach that one group is taking to speed up the dissemination of research results into clinical practice.

In looking back at ten years as NIMH director, Dr. Insel talks about the importance of rigorous science as the source of new, sometimes surprising, knowledge and ultimately, more effective means of prevention and treatment for mental illness.

Some barriers to progress are simply linguistic. In mental health, we are stymied by our language. For example, terms like “depression” or “schizophrenia” or “autism” have achieved a reality that far outstrips their scientific value. Each refers to a cluster of symptoms, similar to “fever” or “headache.” Yet the field has imbued these “fictive categories” with biological meaning, which has precluded the development of biomarkers that might confer validity. Is PTSD – or autism – a “disorder” or an injury? We need a broad conversation to help us understand how our language may be holding us back, limiting not only our impact but our imagination.

If genes comprise only 2 percent of our DNA, what is the function of the remaining 98 percent?  A massive ENCODE project has revealed that nearly 80 percent of our genome is read out, or transcribed – much of it devoted to regulating the turning on and off of genes.  Yet, there are also vast stretches of non-coding RNAs, some unique to humans, especially regions that appear active for specifying brain development.  Differences associated with autism and mental disorders are in these areas previously considered “junk.” The new map pinpoints sites where proteins called transcription factors alter the timing and amounts of gene expression – mechanisms that are likely at the heart of mental disorders, whether they are mainly due to environmental stressors or genetic factors.

Dr. Insel provides context for a new National Strategy for Suicide Prevention

Numerous provocative advances in neuroscience were reported during the summer of 2012.

Dr. Insel describes a new behavioral treatment for a neurologically based disorder that has traditionally been difficult to treat. 

Dr. Insel discusses recent efforts made by the NFL and other employers to help prevent suicides, and the importance of suicide prevention research.

NIMH research on HIV/AIDS will be well represented at the XIX International AIDS Conference, being held in the United States for the first time since 1990.

Dr. Insel discusses the crisis of medication development for mental disorders.

Serving Those Who Served

Dr. Insel discusses the dynamics of data sharing in research.

Presentations at a recent meeting in San Diego showed how new technologies are being used to change the culture of science, empowering patients, and fueling innovative research approaches.

While fewer medical students are choosing psychiatry in the U.K., in the U.S. psychiatry is attracting increasing numbers of elite MD-PhD students who want to do research. These young scientists are committed to developing a new scientific basis for clinical care.

Dr. Insel discusses how new research may help tie together seemingly disparate findings in genetic vs environmental risk factors in autism spectrum disorders.

Dr. Insel discusses new functional connectomes and developments in human brain imaging.

Dr. Insel discusses the CDC's latest report on autism prevalence.

Dr. Insel discusses the connection between mental disorders and infection in light of pediatric neuropsychiatric disorders PANS and PANDAS.

Dr. Insel discusses the state of science and math education in the U.S., scientific literacy, and Brain Awareness Week.

The RDoC project is an experimental approach to classification of mental disorders that will serve as a framework for ongoing research.

National Eating Disorders Awareness Week starts February 26. Dr. Insel discusses some surprising facts about these disorders, which are among the most fatal.

Dr. Insel discusses the emergence of “big data” and how open sharing of data could impact mental health research.

Dr. Insel talks about how basic research can lead to potential treatments.

Dr. Insel responds to discussion from the National Advisory Mental Health Council concerning the need to balance research funding for basic science and mental health services.

NIMH’s “government bureaucrats” are really dedicated public servants devoted to good patient care, improved  treatments, and scientific discovery.

Dr. Insel discusses opportunities for treatment development.

Dr. Insel shares NIMH’s Top 10 Research Advances for 2011.

Dr. Insel discusses opportunities for treatment development.

Dr. Insel discusses the state of psychiatric research and development (R&D) in the public and private sectors

Dr. Insel discusses the complicated nature of research on the efficacy antidepressants.

Dr. Insel reflects on an exciting neuroscience conference where an increasing interest in neuropsychiatric disorders was evident.

Dr. Insel describes how precision medicine may put us on the path to better diagnosis and treatment of mental disorders.

For Veterans Day, Dr. Insel discusses meeting the mental health needs of those who have so honorably served our country.

Two papers published this week in Nature provide the first maps of the molecular development of the human brain. Mapping brain development by changes in gene expression gives us a new level of precision and raises new possibilities for understanding the mechanisms of neurodevelopmental disorders.

Dr. Insel’s tour to Australia, Singapore, China and Japan reveal heavy investments in science and science education, indicating the time is ripe for collaboration.

Dr. Insel discusses World Mental Health Day and a new approach to meeting the shortage of mental health providers.

Results of the two largest studies of their kind, to date, have identified new common gene variants associated with schizophrenia and bipolar disorder. The results implicate specific pathways and hold promise for development of new treatments.

World Economic Forum report projects staggering costs of non-communicable diseases including mental health.

Dr. Insel discusses the implications of comorbidity among people with serious mental illness.

Dr. Insel discusses achieving diversity in the NIMH workforce and grantee population in light of a report in Science today.

Research on neural circuits is changing how mental illnesses are understood and may ultimately lead to new ways to treat brain disorders early enough to prevent symptoms.

Dr. Insel gives an update in our efforts to reduce suicide in America.

Global commonalities represent an opportunity for us to learn from the experiences in other countries or among other cultures to help improve mental health care in the U.S.

New studies published this Spring provide new insights into the molecular basis of autism, involving the interplay of genetic risk and environmental exposure.

Dr. Insel on investing in research.

A solver of “mysteries” — Howard Nash, M.D., Ph.D.

Dr. Insel discusses the promising future of psychiatry as it integrates new approaches discovered through neuroscience.

Dr. Insel provides a vision for future clinical research.

An emerging research technology using Induced pluripotent stem cells holds promise as a window into the developing brain in mental illness.

NIMH research can have a significant impact on public health through innovations and projects that cross the four objectives outlined in NIMH’s Strategic Plan.

Today, the start of Autism Awareness Month, inspires us to focus on the highlights of our research progress, and look ahead to further strengthening our investigative efforts.

Windows to completely new areas of research have been opened recently by research efforts in basic science. These reports force us to consider factors that have not previously been thought to have any role in mental health or illness.

The first transcription (genetic expression) map of the brain was recently posted. This is a landmark for brain research.

Dr. Insel discusses the impact of difficult budget times on mental health research.

As we mark the 10th anniversary of the human genome’s sequencing, the heightening pace of progress promises to a bright future for psychiatric genetics.

With the charge to become vanguards for the next generation of scientists, NIMH recognized the 12 recipients of the 2010 Biobehavioral Research Awards for Innovative New Scientists—or BRAINS.

Rapid progress in understanding how memory works – from the molecular to the behavioral level – holds promise for improved treatment of memory components of mental disorders.

Dr. Insel discuss what NIMH is doing to support economic research in light of mental health parity and health care reform.

When a tragedy occurs like the shooting in Tucson this past weekend, we are reminded of the urgent need for early diagnosis and treatment of people who may suffer from a serious mental illness.

Dr Insel discusses research priorities for 2011.

10 breakthroughs and events of 2010 which are changing the way we approach mental disorders.

Dr. Insel discusses the need for science education and NIMH’s efforts to improve science literacy among all Americans.

NIMH/NIH is nurturing medications development via assays that probe new molecular targets relevant to mental disorders.

This blog outlines recent progress in schizophrenia research, citing a special issue of the journal Nature focusing on schizophrenia.

Dr. Insel summarizes NIMH’s research efforts to better understand and treat postpartum depression.

NIH has created several funding mechanisms aimed at supporting innovative, unconventional research.

Despite promising advances as a research tool, brain imaging is not quite ripe for clinical application in the diagnosis and treatment of mental disorders.

Dr. Insel comments on progress and directions for future studies of attention deficit hyperactivity disorder (ADHD) during ADHD Awareness Week.

Dr. Insel discusses various approaches to the prevention of suicide and what research has revealed on risk and treatment of related mental disorders. Also, HHS announces a new Alliance for Suicide Prevention, which will coordinate a full court press across Federal agencies.

Dr. Insel discusses the evolution of clinical research and changing priorities in clinical research funding.

Dr. Insel provides an update on NIMH's and the U.S. Army's efforts to reduce suicide in the military.

Increasing evidence linking strep infection to OCD in children suggests that microbiomics may prove an important research area for understanding and treating mental disorders.

Dr. insel discusses two important initiatives that will have a broad impact on NIMH’s clinical research portfolio.

While one of America’s greatest strengths is its racial and cultural diversity, this diversity produces complex mental health care issues due to the heterogeneity of the population to be served.

Dr. Insel addresses recent misconceptions pertaining to financial conflict of interest.

Dr. Insel discusses progress in the approaches for identifying and preventing financial conflicts of interest.

People with a major mental illness have a shorter than average life expectancy and each year there are nearly twice as many suicides as homicides in the U.S. A new report now documents that people with mental illness are three times more likely to be in the criminal justice system than hospitals because of a failure to provide services within the mental health care system.

NIMH recognizes the first seven recipients of its BRAINS awards.

NIMH has always and will continue to support cutting edge basic science research. Understanding normal functioning of brain-behavior relationships is critical to providing insight into abnormal brain-behavior relationships. To build a translational bridge we will need a very strong foundation in basic science. This foundation will need to be multidisciplinary and cut across species and levels of analysis.

May is Mental Health Month and this year NIMH teams up with SAMHSA to celebrate and promote Children’s Mental Health Awareness Day on May 6th. Dr. Insel talks about how mental illnesses are the chronic diseases of the young.

As currently defined, borderline personality disorder is considered a reflection of an essential aspect of a person’s character that influences his or her way of seeing and being seen in the world. Recent research, however, has shown that symptoms of the disorder aren’t constant and may not always be as enduring as some researchers and clinicians may think.

NIMH is working to better define the boundaries of pediatric bipolar disorder, discover its causes and develop more effective treatments for such mood related syndromes affecting youth. Cross-cutting comparisons of mania-related and other forms of irritability and functional brain imaging studies will help to disentangle these syndromes so that clinicians can provide children with the best care. Our goal is nothing less than pre-emtive interventions and cures.

Today’s treatments for mental illness may be good but they are not good enough. As industry pulls back, NIMH will have to step in and play a bigger role in fostering development of a new generation of evidenced-based medications for people with mental illness.

In recent years, NIMH-supported researchers have discovered several genes that are associated with autism spectrum disorder (ASD), schizophrenia, attention deficit hyperactivity disorder, and bipolar disorder. Most of these genes were discovered either through a candidate gene approach comparing cases and controls or by looking for linkage to genetic variation associated with occurrence of the disease in a family. However, the genomic variants discovered to date can explain only a small fraction of the genetic risk. So where are the missing genetic signals for mental disorders?

A picture of the brain’s connections is emerging from an effort to create a reference atlas of the human “connectome.” Much like variation in the human genome, highly individual variation in circuitry occurs within a universal, intrinsic functional architecture.

NIMH is increasing its commitment to global mental health.  The Institute is already invested in research around the globe.  In 2009, NIMH supported nearly 200 grants in 51 countries.  Our portfolio has included AIDS prevention in sub-Sahara Africa, studies of autism in Saudi Arabia, and research on mental health systems in Chile.  With such a broad international portfolio, so many unmet needs for mental health research in the United States, and so little new money available for research, why would NIMH want to invest more globally?

Can we develop a clinically useful diagnostic system based on neuroscience and genetics? Not yet. But, in the spirit of beginning a long journey, NIMH is taking its first step with the Research Domain Criteria (RDoC) project.

NIMH’s aggressive approach towards identifying and preventing financial conflicts of interest.

The U.S. Army recently released new suicide data for December 2009. Last month, there were 10 potential suicides among active duty soldiers, nine of which are pending confirmation. When added to the data for the rest of the year, the total number of reported suicides for 2009 among active duty soldiers is 160, 114 of which have been confirmed. By comparison, in 2008 there were 140 suicides among active duty soldiers.

This week’s issue of Nature, the first of 2010, includes an editorial entitled “A Decade for Psychiatric Disorders ”. Phil Campbell, the editor of Nature, argues that the understanding and treatment of conditions such as schizophrenia are ripe for a revolution. At NIMH, we agree with this assessment. Indeed, the revolution is already underway with extraordinary recent findings from genomics, imaging, and clinical trials. The banner for this revolution is pathophysiology, understanding the mechanism of disease as a critical step to developing novel, effective, and safe treatments and preventive strategies. As Campbell says, “There is much to be done, and a decade is the timescale over which enhanced commitment is required.”

From the extraordinary funding opportunities presented by the passage of the American Recovery and Reinvestment Act of 2009 (Recovery Act)  to significant new investments in research and resource infrastructure — this has been a remarkable year for our Institute. I would like to reflect with you on how the work of 2009 has prepared us for the year ahead.

The National Institute of Mental Health (NIMH) has made a substantial commitment to research designed to discover autism’s causes and improve diagnosis and treatment. Not only has NIMH become the lead institute for autism research at NIH, we have become the largest single source of funding for autism research in the country.

The NIMH Strategic Plan provides a framework to focus and accelerate mental health research so that breakthroughs in science become breakthroughs that can tangibly improve mental healthcare and the lives of people living with and affected by mental illness. For the Institute to pursue most effectively its mission of transforming the understanding and treatment of mental illnesses, we must be able to adapt to and fully explore the constantly changing scientific landscape that comes with the increased pace of research progress.

The horrific events yesterday at Fort Hood leave many Americans stunned and saddened. For those closest to the events, there is both shock and trauma. Natural disasters and violent attacks have combined in recent years to make Americans very much aware of the mental and emotional repercussions of exposure to traumatic events and of the importance of providing support, and when necessary, effective treatment to people who have experienced them. The events at Fort Hood come just as NIMH is launching the Army Study to Assess Risk and Resilience in Service-members (Army STARRS), developed at the request of the U.S. Army in the summer of 2009.

On October 5, 2009, researchers with the Health Resources and Services Administration (HRSA), Centers for Disease Control and Prevention (CDC), and Massachusetts General Hospital published a new estimate of the prevalence of autism spectrum disorders (ASD) among children in the United States. Published online ahead of print in Pediatrics, the new estimate that roughly 1 in 90 U.S. children ages 3–17 were given an ASD diagnosis in 2007 is significantly higher than previous reports.

Last February’s announcement that funding from the American Recovery and Reinvestment Act of 2009 (ARRA)  will be used to support job creation and retention in biomedical research presented an exciting opportunity for NIMH.  These supplemental funds arrived just as the Institute was launching the implementation of its new Strategic Plan.  For some months now, the Institute has been diligently working to implement a series of ARRA funding initiatives that will aggressively pursue the Plan’s objectives.