Federal Funding of Mental Illness Research
The National Institute of Mental Health (NIMH)
NIMH is the principal federal agency in charge of funding biomedical research into brain disorders. Through its $978.4 million budget, NIMH supports and conducts an integrated program of basic and clinical research and research training in biology, neuroscience, and epidemiology. Research initiatives include programs in major brain disorders such as schizophrenia, major depression, bipolar disorder, panic disorder, and obsessive-compulsive disorder. Over the past four years, NIMH has received important increases in funding through the bipartisan leadership of Representatives John Edward Porter (R-IL) and David Obey (D-WI) and Senators Arlen Specter (R-PA) and Tom Harkin (D-IA). The agency's FY 2000 budget was increased by more than 14 percent, up to its current level of $978.4 million. This increase continues the bipartisan goal of doubling the federal biomedical research budget (including that of NIMH) by the year 2005.
The impact of underfunded research
However, research on serious mental illnesses remains markedly underfunded, when
you consider either its cost to society or the disability it causes. The World Bank, the World Health Organization, and the Harvard School of Public Health recently published an extensive study The Global Burden of Disease, which examined the impact of a wide range of disease on the loss of years of healthy life.
Several key findings deserve emphasis:
- The burden of psychiatric conditions has been heavily underestimated.
- Four of the top ten causes of disability in the world are mental illnesses (unipolar major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorders)
- Among women in developed countries aged 15-44, the leading causes of disease burden are: unipolar major depression, schizophrenia, road traffic accidents, bipolar disorder, and obsessive-compulsive disorder. Across all age groups worldwide, depression will produce the second largest disease burden in the year 2020.
A recent study in the New England Journal of Medicine concludes that, compared with a range of other disorders, mental illnesses are among the conditions that are underfunded by the NIH in relation to their burden on society. NIH funding priorities should, of course, also be influenced by scientific promise. There is little issue about the promise of research on the brain and mental illnesses: Nobel Prize laureates have given telling testimony before Congress ranking research on the brain and brain disorders as top scientific priorities.
Assuring increased funding of research into mental illnesses
NAMI has actively promoted a greater investment in research on serious mental illnesses, ranging from basic neurosciences to services research. NAMI has pressed for a series of National Plans to guide the development of these research programs and has monitored the NIMH grant portfolio over the past decade. Although greater attention has been paid to research on serious mental illnesses, a significant part of the research funded by NIMH has little or no relevance to these illnesses. A recent review of 1997 NIMH grants, conducted by the Stanley Foundation and the NAMI Research Institute, raises significant questions about research priorities within NIMH, about the low level of funding of clinical research on these disorders, and about the large number of studies judged irrelevant to serious mental illnesses.
Former NIMH Director Steve Hyman took major steps to improve the focus of the institute. Since 1997, NIMH has funded large clinical research contracts addressing treatment issues in schizophrenia and bipolar disorder and developed a program to translate basic neuroscience findings into ideas about the causes of and treatments for serious mental illnesses. NAMI needs to help assure that this increasing focus on serious mental illnesses will continue. Because of the impact of serious mental illnesses on society, on individuals, and on their families, and because of the long-standing underfunding of research on these illnesses, NAMI advocates that all increases in NIMH funding be directed to research relevant to serious mental illnesses.
Sound science, sound public policy, and sound advocacy
Some groups have claimed that NAMI’s focus on serious mental illnesses ignores individuals with depression or eating disorders or PTSD, or ignores the needs of children. This is simply wrong. Serious mental illnesses include all those that have a substantial impact on the individual, the family, the society. Serious mental illnesses include both episodic illnesses, such as depression, and persistent illnesses, such as autism and schizophrenia. We believe this focus on serious mental illnesses brings together sound science, sound public policy, and sound advocacy.