May 3, 2006

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Research Opportunities at the National Institute
of Mental Health

• May 3, 2006

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NIMH Mission

• Reduce the burden of mental illness and
  behavioral disorders through research on mind,
  brain and behavior

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• Mental disorders are arguably the largest source
  of morbidity and mortality for young people in
  the U.S.
• These disorders may be the costliest in terms of
  direct and indirect care.

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Mental Disorders are the Largest Source of
Disability from Medical Causes United States and
Canada15-44 years old
WHO World Health Report 2002
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Discovery to Recovery Translation is the Key
Bench
Bedside
Pathophysiology Diagnostic tests Biomarkers New
treatments
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NIMH Organization
Translational Research - adult
Basic
Translational Research - child
Trials Services
Health Behavior
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NIMH Budget(dollars in millions)
21-Feb-06 n\budget\2007\graphs\
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How do we set priorities?

• Relevance what do we need?

• Traction where are the opportunities?

• Innovation what is new?

Relevance Traction Innovation IMPACT
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Division of Neuroscience andBasic Behavioral
Science (DNBBS)
Supports research and training in the areas of
basic neuroscience, genetics, basic behavioral
science, research training, resource development,
technology development, drug discovery, and
research dissemination.
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High Priorities for DNBBS

• Hormone-induced Changes
• Develop neurobiological models and tools to
  understand hormone-induced changes in mood and
  cognition during life transitional periods.
• Complex Social Behavior
• Elucidate fundamental mechanisms of complex
  social behavior.
• Vertebrate-Invertebrate Models
• Develop vertebrate and invertebrate models to
  understand the biological functions of genes,
  gene products, cellular functions, networked
  circuits, and systems implicated in mental
  disorders.

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High Priorities for DNBBS (continued)

• Genes
• Identify in ethnically diverse populations from
  the US and around the world genetic variants,
  epigenetic mechanisms, and gene-environment
  interactions that influence vulnerability to
  mental disorders, endophenotypes, and
  pharmacologic response profiles..
• Hippocampus
• Identify the role of the hippocampus and related
  circuits in the etiologies of disorders of mood
  and cognition through studies of hippocampal
  development and function at the molecular,
  cellular, neural and behavioral levels.
• Biomarkers
• Identify biological markers in model systems and
  humans that could be further validated as methods
  for diagnosing and/or detecting
  risk/vulnerability, onset, progress, and/or
  severity of mental disorders.

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Division of Adult Translational Research and
Treatment Development (DATR)
Supports research and training aimed at
understanding the pathophysiology of mental
illness and hastening the translation of
behavioral science and neuroscience advances into
innovations in clinical care.
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High Priorities for DATR

• Neural Circuits
• Delineate specific neural circuits contributing
  to one or more mental major mental disorders or
  subtypes of mental disorders.
• Biomarkers
• Develop, test, and validate biological markers
  for diagnosing or detecting risk/vulnerability,
  onset, progress, and/or severity of adult mental
  disorders.
• Models to Predict Treatment Response
• Develop models to predict treatment response and
  vulnerability to side effects of psychotropic
  medications and approaches to prevent or
  ameliorate treatment-emergent side effects.

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High Priorities for DATR (continued)

• Vulnerability Mechanisms Early Interventions
• Identify mechanisms (e.g., genetic, biological,
  behavioral, environmental) that confer
  vulnerability to psychiatric illnesses and
  develop early interventions (pharmacological
  and/or psychosocial) for reducing the severity
  and incidence of psychopathology.
• Novel Interventions
• Evaluate the safety and efficacy of novel
  mechanism pharmacological agents and/or
  behavioral interventions that target domains of
  psychopathology inadequately addressed by current
  therapies or prevention strategies.
• Clinical Trials Methodology
• Develop, test, and validate methods to assess
  domains of psychopathology for use in clinical
  trials in order to increase the efficiency of the
  mental illness treatment development critical
  path, emphasizing approaches based on
  partnerships with the FDA and industry.

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Division of Pediatric Translational Research and
Treatment Development (DPTR)

• Supports research and training with the ultimate
  goal of preventing and curing childhood
  psychopathology.
• Stimulates and promotes an integrated program of
  research across basic behavioral/ psychological
  processes, environmental processes, brain
  development, pediatric psychopathology and
  therapeutic interventions.

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High Priorities for DPTR

• Neurobehavioral Development
• Delineate mechanisms and processes of
  neurobehavioral development relevant to
  understanding pediatric mental disorders with a
  focus on periods of rapid neurobiological change.
  
• Gender Differences
• Identify psychosocial and neurobiological
  mechanisms underlying sex differences in, and
  gender influences on, pediatric mental disorders.
• Biomarkers
• Develop, test, and validate biologically based
  markers for diagnosing or detecting
  risk/vulnerability, onset, progress, and/or
  severity of pediatric mental disorders.

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High Priorities for DPTR(continued)

• Characterization
• Improve the phenotypic characterization of
  pediatric mental disorders and refine
  standardized behavioral assessment tools that are
  sensitive to developmental change, cultural
  diversity, and variation in functioning.
• Risk or Protections
• Identify mechanisms and processes that confer
  risk for or protection from childhood
  psychopathology.
• Novel Treatments
• Develop novel therapies for serious mental
  disorders of childhood and adolescence.

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Division of AIDS and Health and Behavior Research
(DAHBR)

• Supports research and training to
• Develop and disseminate behavioral interventions
  that prevent HIV/AIDS transmission.
• Clarify the pathophysiology and alleviate the
  neuropsychiatric consequences of HIV/AIDS
  infection.
• Use a public health model to reduce the burden of
  mental illness from medical comorbidities,
  non-adherence to treatment, societal stigma,
  health disparities and unhealthy behaviors.

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High Priorities for DAHBR

• Health Behaviors
• Identify basic behavioral processes that
  determine health behaviors among people with
  mental disorders in order to develop
  interventions to improve functional outcomes and
  reduce morbidity and mortality.
• Stigma and Discrimination
• Identify the basic behavioral and social
  processes in stigma and discrimination associated
  with mental illness and develop effective
  programs and approaches to reduce or even
  eliminate stigma.
• HIV Prevention
• Support innovative, interdisciplinary HIV
  prevention research designed to better understand
  individual, dyadic, community, social, and
  structural factors that impact HIV risk-reduction
  in order to improve sustained preventive
  behaviors.

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High Priorities for DAHBR (continued)

• Technology Transfer of Prevention Interventions
• Conduct research on expeditious technology
  transfer of preventive interventions for
  HIV-positive persons in treatment and other
  settings, with a focus on diffusion, translation,
  effectiveness and operational research in order
  to bridge research and practice.
• NeuroAIDS
• Support studies to assess the neurologic,
  neuropsychiatric, and neuropathologic
  consequences of HIV in the current therapeutic
  context, particularly in international and
  resource-poor settings, in order to develop new
  therapeutic interventions to prevent or reverse
  these complications.
• Children Affected by AIDS
• Support innovative, interdisciplinary prevention
  science research designed to better understand
  the psychosocial needs of children affected by
  AIDS, particularly in low-resource settings.

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Division of Services and Intervention Research
(DSIR)

• DSIR supports two critical areas of research and
  training
• Mental health services research
• Intervention research to evaluate the
  effectiveness of pharmacologic, psychosocial,
  somatic, rehabilitative and combination
  interventions on mental and behavior disorders
  for children, adolescents, and adults.

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High Priorities for DSIR

• Side Effects and Adverse Events
• Identify side-effects and adverse events from
  interventions used in current practice across
  diverse settings and populations of all ages to
  improve effective, personalized treatment and
  prevention strategies to optimize outcomes.
• Effectiveness
• Test the effectiveness of interventions in
  community and practice settings, with special
  emphases on practical trials and assessment of
  multiple outcomes.
• Suicidality
• Improve the detection, assessment, interventions,
  and services for suicidality in populations of
  all ages.

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High Priorities for DSIR(continued)

• Co-occurrence
• Test the effectiveness of treatments and services
  for people with co-occurring mental, substance
  use, and/or physical health problems.
• Dissemination and Implementation
• Pinpoint effective dissemination and
  implementation processes and mechanisms to
  increase the uptake of scientifically informed
  treatments and services for mental disorders
  across all settings and populations.
• Research Capacity and Infrastructure
• Enhance the research capacity and infrastructure
  to conduct research in diverse mental health
  service settings through strategic partnerships,
  community engagement/participation, information
  technologies, and development of new and
  innovative methods for designing and conducting
  effectiveness and services research.

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National Institutes of HealthFY 2004 Research
Training Career Funds (Fs, Ts Ks)As a
Percent of IC Awards Budget (incl. AIDS)
NIH Average
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www.nimh.nih.gov