2019 Spring Inside NIMH
Welcome to the latest edition of Inside NIMH ! We publish Inside NIMH in conjunction with each meeting of the National Advisory Mental Health Council (NAMHC), which advises the Secretary of Health and Human Services (HHS), the Director of the National Institutes of Health (NIH), and the Director of NIMH on policies and activities relating to the conduct and support of mental health research, research training, and other programs of the Institute. Check out our website for regular updates on timely topics at NIMH. I hope you find this information interesting and helpful. Please let us know if you have questions or comments on this Spring 2019 edition.
Joshua A. Gordon, M.D., Ph.D.
Director, National Institute of Mental Health
I. NIMH Director’s Updates
Happy 70th birthday, NIMH! On April 15, 1949, NIMH was formally established – it was one of the first four NIH institutes. Over the past 70 years, NIMH-supported researchers have made tremendous discoveries to advance the field of mental health. In this edition of Inside NIMH, we continue to celebrate recent therapeutic advances, plan for the future, and note key developments across NIH.
News to Know
- Transformative Therapeutics: In March 2019, the Food and Drug Administration (FDA) approved two new promising neurotherapeutic drugs.
- Esketamine: Ketamine, an anesthetic that was approved by the FDA in 1970, is emerging as a potential rapid onset intervention for acute suicide risk and treatment-resistant depression. Ketamine is associated with rapid–within minutes to hours–decrease in depressive symptoms and suicidal thoughts. The FDA recently approved SpravatoTM, an esketamine (a form of ketamine) nasal spray that should be taken in conjunction with an oral antidepressant, for treatment-resistant depression in adults. This is the first truly novel FDA-approved antidepressant medication in decades (followed quickly by Brexanolone, see next bullet). The makers of Spravato™ are also conducting clinical trials of intranasal esketamine in participants at imminent risk for suicide. NIMH-supported intramural and extramural research helped lay the foundation for the development of this drug.
- Brexanolone: Approximately 1 in 9 women in the United States experiences symptoms of postpartum depression, according to the Centers for Disease Control and Prevention (CDC). The FDA recently approved brexanolone, an analog of the endogenous human hormone allopregnanolone and the first drug specifically designed to treat postpartum depression. FDA approval represents the final phase of a bench-to-bedside journey for this drug — a journey that began in the NIMH Intramural Research Program (IRP).
- NIMH Strategic Planning Efforts: NIMH uses its Strategic Plan for Research to guide the Institute towards achieving its mission. To keep pace with scientific progress, the plan is updated every five years. NIMH leadership and staff are currently working to draft the 2020 NIMH Strategic Plan for Research. NIMH plans to provide a draft to NAMHC members for review and discussion at the 2019 September Council meeting. NIMH will then publish a Request for Information via the Federal Register to solicit public feedback, and the Institute will publish the new NIMH Strategic Plan for Research in 2020.
- Interagency Autism Coordinating Committee (IACC): The IACC met on April 17, 2019. Presentations included a tutorial on the CDC’s new Autism Data Visualization Platform, an update on disability policies from the Federal Communications Commission, as well as a presentation of research to address employment for people with autism spectrum disorder (ASD). On May 21, 2019, the IACC held a workshop addressing the mental health needs of people on the autism spectrum. The workshop highlighted research on anxiety, depression, suicide, and aggressive and self-injurious behaviors in ASD.
- NIH-Wide Initiatives:
- Adolescent Brain Cognitive Development (ABCD) Study: The ABCD study is the largest long-term study of brain development and child health in the United States. On April 2, 2019, NIH released the comprehensive baseline dataset from the ABCD study – available on the NIMH Data Archive. Approximately 100 terabytes of data obtained from the full participant cohort (11,878 youth and their families) can now be accessed by scientists worldwide to conduct research on the many factors that influence brain, cognitive, social, and emotional development.
- All of Us Research Program: On March 14, 2019, the All of Us Research Program launched a Speaker Series in partnership with the National Library of Medicine. In the inaugural talk, NIH Director Francis Collins, M.D. discussed the importance of All of Us, noted how far the research program has come, provided a preview of the Program’s future, and answered questions from viewers. On May 6, 2019, one year following the launch of the All of Us Research Program, NIH hosted a mini-symposium to discuss what has been learned about building an engaged and diverse participant community, and its potential for scientific impact.
- Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative®: At the fifth annual BRAIN Investigators Meeting on April 11-13, 2019, over 1,500 BRAIN Initiative awardees, representatives, and investigators joined staff and leadership from the contributing federal agencies, members of Congress, members of the media, and the interested public to advance the understanding of the brain and nervous system. The BRAIN Initiative Multi-Council Working Group met on February 12, 2019 and May 16, 2019. Ongoing meetings of the Advisory Committee to the NIH Director BRAIN Initiative Working Group 2.0 , and its BRAIN 2.0 Neuroethics Subgroup (BNS), as well as public feedback , continue to guide updates to BRAIN 2025: A Scientific Vision. On January 23, 2019, the BNS conducted a portfolio review and held a public workshop on neuroethical issues posed by BRAIN Initiative research. The BNS welcomes comments from the public on draft findings and analysis detailed in a Neuroethics Roadmap.
- Helping to End Addiction Long-term (HEAL) Initiative: The NIH HEAL Initiative is an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. On February 26, 2019, NIH announced the appointment of Rebecca Baker, Ph.D., as Director of the NIH HEAL Initiative. On March 5, 2019, NIH announced the formation of the HEAL Partnership Committee, a subgroup of the HEAL Multi-Disciplinary Working Group, to guide data sharing and information collection efforts.
- NIH Leadership News
- On February 14, 2019, NIH named Noni H. Byrnes, Ph.D. Director of the NIH Center for Scientific Review (CSR). Dr. Byrnes has been with CSR since 2000 and served as Acting Director of CSR since May 2018.
- On April 5, 2019, Norman “Ned” Sharpless, M.D. was named Acting FDA Commissioner. Dr. Sharpless was the Director of the National Cancer Institute (NCI) at NIH. Douglas R. Lowy, M.D. is currently serving as Acting NCI Director. Dr. Lowy previously served as Acting Director between April 2015 and October 2017 and has held the NCI Deputy Director position since July 2010.
- On May 2, 2019, NIH announced the selection of Debara L. Tucci, M.D., M.S., M.B.A. to lead the National Institute on Deafness and Other Communication Disorders (NIDCD) as its new Director. Dr. Tucci is currently a professor of surgery and the Director of the cochlear implant program at Duke University in Durham, North Carolina. She is expected to join NIH on September 3, 2019.
- Fiscal Year (FY) 2019 Budget: On September 28, 2018, President Trump signed the Appropriations Act of 2019 (Public Law No. 115-245) providing funds through September 30, 2019. The law provides $1.870 billion to NIMH (amount includes 21st Century Cures funding), representing a 6.6 percent increase over the FY 2018 appropriation. NIMH anticipates awarding more than 600 new and competing research project grants (RPGs) in FY 2019, with an estimated success rate of 26 percent, as shown in Figure 1 below.
NIMH Applications, Awards, and Success Rates for Research Project Grants Fiscal Year Applications Direct Awards Cures Awards Success Rate 2014 2830 548 0 19 2015 2480 507 0 20 2016 2568 587 0 23 2017 2735 571 0 21 2018 2701 589 23 23 2019 2674 677 30 26
- Although NIMH does not have a specific pay line, the Institute expects to support most of the applications that have an impact score up to the 10th percentile, many between the 10th and 20th percentiles, and some beyond the 20th percentile. Funding decisions are based on factors such as the Institute’s Strategic Plan for Research, programmatic portfolio consideration, and availability of funds. Overall, as in past years, NIMH expects to support approximately three-fourths of the applications under the 20th percentile (or those with comparable impact scores for non-percentiled applications). Moreover, the Institute will give special consideration to certain applications in accordance with the NIH Next Generation Researchers Initiative (NGRI).
NIMH Budget in Appropriated Dollars and Constant 2000 Dollars Appropriation Appropriation in 2000 Dollars 2000 973.146 973.146 2001 1106.536 1082.716 2002 1248.093 1202.402 2003 1341.014 1270.140 2004 1381.774 1272.352 2005 1411.933 1260.654 2006 1403.515 1216.218 2007 1404.494 1185.227 2008 1411.968 1169.816 2009 1450.491 1191.858 2010 1489.372 1037.167 2011 1476.293 1174.458 2012 1480.265 1155.554 2013 1403.005 1075.924 2014 1446.172 1088.985 2015 1433.603 1068.259 2016 1548.390 1141.881 2017 1604.658 1160.273 2018 1711.434 1213.783 2019 1812.796 1261.514
- Figure 2 (above) shows the NIMH budget in appropriated (current) versus constant (FY 2000) dollars. Constant dollars are “inflation adjusted” for variations in the purchasing power of the dollar over time. Dollar amounts are adjusted based on the Biomedical Research and Development Price Index (BRDPI). The annual change in BRDPI indicates how much the NIH budget must change to maintain purchasing power similar to FY 2000.
- Outlook for FY 2020: In February 2019, the President submitted an outline for the FY 2020 budget request to Congress. The request for NIH is $34.368 billion, a decrease of $4.939 billion from the FY 2019 appropriated level (including 21st Century Cures funding). The request for NIMH is $1.630 billion, a decrease of $240 million from the FY 2019 appropriated level (including 21st Century Cures funding). In April 2019, the House and Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies held appropriations hearings with the NIH Director and several NIH Institute and Center Directors.
NIMH Staff News and Awards
- NIMH Staff News:
- Sue Swedo, M.D., Chief of the Section on Behavioral Pediatrics, retired at the end of March 2019 and is now a Scientist Emeritus. Dr. Swedo came to the NIMH as a Senior Clinical Research Fellow in 1986. She is a board-certified pediatrician who trained at Northwestern University's Children's Memorial Hospital. Dr. Swedo has authored/co-authored over 100 research publications. Her research has focused on diagnosis and treatment of childhood neuropsychiatric conditions, including Sydenham's chorea, Tourette Syndrome, Obsessive-Compulsive Disorder (OCD), and ASD. Dr. Swedo and colleagues were the first to describe a post-infectious etiology for OCD and define criteria identifying the Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) subgroup.
- Judith Rumsey, Ph.D., Chief of the Brain Circuitry and Dynamics Program is retiring at the end of May 2019. Dr. Rumsey began her career at NIMH in the IRP Child Psychiatry Branch in 1980. She served over 25 years as an extramural scientist and program officer. Dr. Rumsey made substantial contributions to many large initiatives, including the Pediatric MRI Extramural Data Repository, the Bipolar & Schizophrenia Consortium for Parsing Intermediate Phenotypes (BSNIP), Psychosis & Affective Research Domains and Intermediate Phenotypes (PARDIP), Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care consortium (EMBARC), and North American Prodrome Longitudinal Study (NAPLS 1-3) and its partnership with international Harmonization of At Risk Multisite Observational Networks for Youth consortium (HARMONY).
- NIMH Staff Awards:
- Robert Heinssen, Ph.D., ABPP, Director of the Division of Services and Intervention Research, was awarded the 2019 Distinguished Service Award from the National Alliance on Mental Illness (NAMI) in recognition of exceptional efforts to further NAMI’s goal of improving the lives of people living with mental illness. This award will be presented at the NAMI national convention in Seattle, Washington on June 19-22, 2019.
- Jeymohan Joseph, Ph.D., Chief of the HIV Neuropathogenesis, Genetics, and Therapeutics Branch in the Division of AIDS Research, received a Distinguished Service Award from the Society of Personalized NanoMedicine in appreciation of several years of service and commitment in Innovative Biomedical Research, particularly in HIV Neuropathogenesis. This award was presented at the 5th Annual Personalized NanoMedicine Symposium in Miami, Florida on November 2, 2018.