NIMH to Implement New Strategy for Evaluating Psychiatric Research Proposals

The National Institute of Mental Health (NIMH) will make several major changes in the way it selects and funds clinical trials to advance the next generation of therapies for mental disorders. “[F]uture trials will follow an experimental medicine approach in which interventions serve not only as potential treatments, but as probes to generate information about the mechanisms underlying a disorder,” said NIMH Director Thomas Insel, M.D., in a new policy announcement. “In the current climate, with funding tight and clinical needs urgent, we will be shifting to trials that focus on targets as a way of defining the next generation of treatments.”

Investigators will have to identify a target or mediator on which the intervention must have some effect, as well as influencing symptoms, said Insel. Researchers will also have to move more quickly through the approval, recruitment, and completion processes. They must meet stringent transparency standards for trial registration, monitoring human protection, and posting their results. Finally, new clinical trials will not be supported under previous funding announcements.

“We believe that better outcomes will require a deeper understanding of the disorders,” he said. “These new clinical trials are designed to provide that.”

To read more in Psychiatric News about clinical trials in psychiatry, see the article, “Psychiatrist Norquist Chairs Outcomes-Research Project.”

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Obama Includes Mental Health Funding Increase in Budget Proposal

In this era in which fiscal belt-tightening has become a political mantra, President Obama has cited mental health care as a key area in which the government needs to spend more money. In his budget proposal that will be released today, Obama has included $235 million to fund new mental health programs with a focus on providing training to teachers and other school personnel receive to prepare them to recognize students who have a mental health problem, according to a report in today's Washington Post. The paper also quotes an administration official who said that some of the money is also intended for the training of many more nonphysician mental health professionals who will be needed to meet an expected increase in demand for mental health care stemming from requirements of the Affordable Care Act.

Specifically, $50 million of the proposed funding would be earmarked to train master's-level mental health specialists such as psychologists, school counselors, and nurses. Commenting on that part of the proposal, APA President Dilip Jeste, M.D., said that APA "is deeply concerned that the Administration’s efforts to expand the supply of mental health professionals appears to stop at master’s level practitioners. Along with the administration we recognize the growing need for mental health providers; however, providing a small amount of training to lesser-qualified health professionals at the expense of utilizing veteran medical psychiatric providers will only serve to exacerbate the problem we are trying to solve."

"While we applaud President Obama's budget proposal, it doesn't come close to restoring the drastic cuts in funds for mental health services that have been imposed over the last several years," Robert Cabaj, M.D., chair of the APA Council on Advocacy and Government Relations, told Psychiatric News. "In particular, billions of dollars for these services have been cut at the state and local levels, and even if the federal programs proposed in this budget do get funded, it will still leave a huge funding gap, and closing that gap will require extensive advocacy work locally as well as nationally."

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