NIMH is the largest research organization in the world specializing in mental illness. Joshua A. Gordon is the current director of NIMH.[2] The institute was first authorized by the U.S. government in 1946, when then President Harry Truman signed into law the National Mental Health Act, although the institute was not formally established until 1949.[3][4]
NIMH is a $1.5 billion enterprise, supporting research on mental health through grants to investigators at institutions and organizations throughout the United States and through its own internal (intramural) research effort.[citation needed] The mission of NIMH is "to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure."[5]
In order to fulfill this mission, NIMH "must foster innovative thinking and ensure that a full array of novel scientific perspectives are used to further discovery in the evolving science of brain, behavior, and experience. In this way, breakthroughs in science can become breakthroughs for all people with mental illnesses."[6]
Research priorities
NIMH has identified four overarching strategic objectives for itself:
Promote discovery in the brain and behavioral sciences to fuel research on the causes of mental disorders
Chart mental illness trajectories to determine when, where and how to intervene
Develop new and better interventions that incorporate the diverse needs and circumstances of people with mental illnesses
Strengthen the public health impact of NIMH-supported research[7]
History
Organizational history
NIMH had passed through a series of name changes and organizational arrangements with in the United States Public Health Service (PHS) throughout its history:[8]
In 1992, when the Alcohol, Drug Abuse, and Mental Health Administration was abolished, NIMH was transferred to NIH, retaining its research functions while its treatment services were transferred to the new Substance Abuse and Mental Health Services Administration.[8]
Functions
Mental health has traditionally been a state responsibility, but after World War II there was increased lobbying for a federal (national) initiative. Attempts to create a National Neuropsychiatric Institute failed. Robert H. Felix, then head of the Division of Mental Hygiene, orchestrated a movement to include mental health policy as an integral part of federal biomedical policy. Congressional subcommittees hearings were held and the National Mental Health Act was signed into law in 1946. This aimed to support the research, prevention and treatment of psychiatric illness, and called for the establishment of a National Advisory Mental Health Council (NAMHC) and a National Institute of Mental Health. On April 15, 1949, the NIMH was formally established, with Felix as director. Funding for the NIMH grew slowly and then, from the mid-1950s, dramatically. The institute took on a highly influential role in shaping policy, research and communicating with the public, legitimizing the importance of new advances in biomedical science, psychiatric and psychological services, and community-based mental health policies.[9]
In 1955 the Mental Health Study Act called for "an objective, thorough, nationwide analysis and reevaluation of the human and economic problems of mental health."[4] The resulting Joint Commission on Mental Illness and Health prepared a report, "Action for Mental Health", resulting in the establishment of a cabinet-level interagency committee to examine the recommendations and determine an appropriate federal response.
During the mid-1960s, NIMH launched a campaign on special mental health problems. Part of this was a response to President Lyndon Johnson's pledge to apply scientific research to social problems. The institute established centers for research on schizophrenia, child and family mental health, suicide, as well as crime and delinquency, minority group mental health problems, urban problems, and later, rape, aging, and technical assistance to victims of natural disasters.
Alcohol abuse and alcoholism did not receive full recognition as a major public health problem until the mid-1960s, when the National Center for Prevention and Control of Alcoholism was established as part of NIMH; a research program on drug abuse was inaugurated within NIMH with the establishment of the Center for Studies of Narcotic and Drug Abuse.
In 1967, NIMH separated from NIH and was given bureau status within PHS. However, NIMH's intramural research program, which conducted studies in the NIH Clinical Center and other NIH facilities, remained at NIH under an agreement for joint administration between NIH and NIMH. Secretary of Health, Education, and WelfareJohn W. Gardner transferred St. Elizabeths Hospital, the Federal Government's only civilian psychiatric hospital, to NIMH.
In 1970 the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act (P.L. 91-616) established the National Institute of Alcohol Abuse and Alcoholism within NIMH.
In 1972, the Drug Abuse Office and Treatment Act established a National Institute on Drug Abuse within NIMH.
In 1973, NIMH went through a series of organizational moves. The institute temporarily rejoined NIH on July 1 with the abolishment of HSMHA. Then, the DHEW secretary administratively established the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) – composed of the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and NIMH – as the successor organization to HSMHA. ADAMHA was officially established in 1974.
In 1980 The Epidemiologic Catchment Area (ECA) study, an unprecedented research effort that entailed interviews with a nationally representative sample of 20,000 Americans was launched. The field interviews and first wave analyses were completed in 1985. Data from the ECA provided a picture of rates of mental and addictive disorders and services usage.
The Mental Health Systems Act of 1980 – based on recommendations of the President's Commission on Mental Health and designed to provide improved services for persons with mental disorders – was passed. NIMH participated in development of the National Plan for the Chronically Mentally Ill, a sweeping effort to improve services and fine-tune various Federal entitlement programs for those with severe, persistent mental disorders.
In 1987, administrative control of St. Elizabeth's Hospital was transferred from the NIMH to the District of Columbia. NIMH retained research facilities on the grounds of the hospital. The NIMH Neuroscience Center and the NIMH Neuropsychiatric Research Hospital, located on the grounds of St. Elizabeth's Hospital, were dedicated in 1989.
In 1992, Congress passed the ADAMHA Reorganization Act, abolishing ADAMHA. The research components of NIAAA, NIDA and NIMH rejoined NIH, while the services components of each institute became part of a new PHS agency, the Substance Abuse and Mental Health Services Administration (SAMHSA). The return to NIH and the loss of services functions to SAMHSA necessitated a realignment of the NIMH extramural program administrative organization. New offices were created for research on Prevention, Special Populations, Rural Mental Health and AIDS.
In 1994 The House Appropriations Committee mandated that the director of NIH conduct a review of the role, size, and cost of all NIH intramural research programs (IRP). NIMH and the National Advisory Mental Health Council (NAMHC) initiated a major study of the NIMH Intramural Research Program. The planning committee recommended continued investment in the IRP and recommended specific administrative changes; many of these were implemented upon release of the committee's final report; other changes — for example, the establishment of a major new program on Mood and Anxiety Disorders — have been introduced in the years since.
In 1996 NIMH, with the NAMHC, initiated systematic reviews of a number of areas of its research portfolio, including the genetics of mental disorders; epidemiology and services for child and adolescent populations; prevention research; clinical treatment and services research. At the request of the National Institute for Mental Health director, the NAMH Council established programmatic groups in each of these areas. NIMH (National Institute of Mental Health) continued to implement recommendations issued by these Workgroups.
In 1997, NIMH realigned its extramural organizational structure to capitalize on new technologies and approaches to both basic and clinical science, as well as changes that had occurred in health care delivery systems, while retaining the institute's focus on mental illness. The new extramural organization resulted in three research divisions: Basic and Clinical Neuroscience Research; Services and Intervention Research; and Mental Disorders, Behavioral Research and AIDS.
Between 1997 and 1999 NIMH refocused career development resources on early careers and added new mechanisms for clinical research.
In 1999 The NIMH Neuroscience Center/Neuropsychiatric Research Hospital was relocated from St. Elizabeth's Hospital in Washington, D.C., to the NIH Campus in Bethesda, Maryland, in response to the recommendations of the 1996 review of the NIMH (National Institute of Mental Health) Intramural Research Program by the IRP Planning Committee.
The first White House Conference on Mental Health, held June 7, in Washington, D.C., brought together national leaders, mental health scientific and clinical personnel, patients, and consumers to discuss needs and opportunities. The National Institute on Mental Health developed materials and helped organize the conference.
U.S. Surgeon GeneralDavid Satcher released The Surgeon General's Call To Action To Prevent Suicide, in July, and the first Surgeon General's Report on Mental Health, in December. NIMH, along with other federal agencies, collaborated in the preparation of both of these landmark reports.
Since the appointment of Thomas R. Insel as Director of NIMH in 2002, the institute has undergone organizational changes to better target mental health research needs (the expansion from three extramural divisions to five divisions, with the two new divisions focusing on adult and child translational research). NIMH also weathered several years of controversy due to conflict of interest and ethics violations by some of its intramural investigators. This situation cast light on an area that affected all of NIH, and resulted in more stringent rules about conflict of interest for all of NIH. Recently, Congressional interest turned to ethics and conflict of interest concerns with external investigators who receive NIMH or other NIH support. Current federal law has responsibility for managing and monitoring conflict of interests for external investigators with their home institutions/organizations. NIH responded to these new concerns by initiating a formal process for seeking public input and advice that will likely result in a change to the rules for monitoring and managing conflict of interest concerns for externally supported investigators. Finally, the past decade has also been marked by exciting scientific breakthroughs and efforts in mental illness research, as new genetic advances and bioimaging methodologies have increased understanding of mental illnesses. Two notable consequences of these advances are the institute's collaboration with the Department of Army to launch the Study To Assess Risk and Resilience in Service Members (STARRS), a Framingham-like effort scheduled to last until 2014 and the Research Domain Criteria (RDoC) effort, which seeks to define basic dimensions of functioning (such as fear circuitry or working memory) to be studied across multiple levels of analysis, from genes to neural circuits to behaviors, cutting across disorders as traditionally defined.[11][12]
A collection of interviews with directors and individuals significant in the foundation and early history of the institute conducted by Dr. Eli A. Rubenstein between 1975 and 1978 is held at the National Library of Medicine in Bethesda, Maryland.[13]
Noted researchers
In 1970, Julius Axelrod, a NIMH researcher, won the Nobel Prize in Physiology or Medicine for research into the chemistry of nerve transmission for "discoveries concerning the humoral transmitters in the nerve terminals and the mechanisms for their storage, release and inactivation." He found an enzyme that terminated the action of the nerve transmitter, noradrenaline in the synapse and which also served as a critical target of many antidepressant drugs.
In the 1960s and 1970s John B. Calhoun, ethologist and behavioral researcher studied the population density and its effects on behavior in the NIMH facility in Maryland. Later his work become renowned after several publications, including article in Scientific American and a widely known "Universe 25" story predicting anti-utopian future based on rodent experiments in overpopulated environment.
Louis Sokoloff, a NIMH researcher, received the Albert Łasker award in Clinical Medical Research for developing a new method of measuring brain function that contributed to basic understanding and diagnosis of brain diseases. Roger Sperry, a NIMH research grantee, received the Nobel Prize in Medicine or Physiology for discoveries regarding the functional specialization of the cerebral hemispheres, or the "left" and "right" brain.
Eric Kandel and Paul Greengard, each of whom have received NIMH support for more than three decades, shared the Nobel Prize in Physiology or Medicine with Sweden's Arvid Carlsson. Kandel received the prize for his elucidating research on the functional modification of synapses in the brain. Initially using the sea slug as an experimental model but later working with mice, he established that the formation of memories is a consequence of short and long-term changes in the biochemistry of nerve cells Greengard was recognized for his discovery that dopamine and a number of other transmitters can alter the functional state of neuronal proteins, and also that such changes could be reversed by subsequent environmental signals.
Nancy Andreasen, a psychiatrist and long-time NIMH grantee, won the National Medal of Science for her groundbreaking work in schizophrenia and for joining behavioral science with neuroscience and neuroimaging. The Presidential Award is one of the nation's highest awards in science.[19]
Aaron Beck, a psychiatrist, received the 2006 Albert Lasker Award for Clinical Medical Research. Often called "America's Nobels", the Laskers are the nation's most distinguished honor for outstanding contributions to basic and clinical medical research. Beck developed cognitive therapy—a form of psychotherapy—which transformed the understanding and treatment of many psychiatric conditions, including depression, suicidal behavior, generalized anxiety, panic attacks and eating disorders.[20]
In 2010, Mortimer Mishkin was awarded the National Medal of Science. Mishkin is chief of the NIMH's Section on Cognitive Neuroscience, and acting chief of its Laboratory of Neuropsychology. He is the first NIMH intramural scientist to receive the medal. Due in part to work spearheaded by Mishkin, science now understands much about the pathways for vision, hearing and touch, and about how those processing streams connect with brain structures important for memory.[21]
Calhoun's experiments on mouse and rat population dynamics inspired novelist Robert C. O'Brien to write Mrs. Frisby and the Rats of NIMH, a 1971 children's book about laboratory rats who escape from the institute and develop a literate and technological society.[22] The book was adapted for film in 1982 as The Secret of NIMH.
Psychology and the National Institute of Mental Health: A Historical Analysis of Science, Practice, and Policy, Edited by Wade E. Pickren, PhD and Stanley F. Schneider, American Psychological Association, 2004, ISBN1-59147-164-8
The National Institutes of Health, commonly referred to as NIH, is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1880s and is now part of the United States Department of Health and Human Services. Many NIH facilities are located in Bethesda, Maryland, and other nearby suburbs of the Washington metropolitan area, with other primary facilities in the Research Triangle Park in North Carolina and smaller satellite facilities located around the United States. The NIH conducts its own scientific research through the NIH Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program.
The United States Public Health Service is a collection of agencies of the Department of Health and Human Services concerned with public health, containing nine out of the department's twelve operating divisions. The Assistant Secretary for Health oversees the PHS. The Public Health Service Commissioned Corps (PHSCC) is the federal uniformed service of the PHS, and is one of the eight uniformed services of the United States.
The National Institute of Neurological Disorders and Stroke (NINDS) is a part of the U.S. National Institutes of Health (NIH). It conducts and funds research on brain and nervous system disorders and has a budget of just over US$2.03 billion. The mission of NINDS is "to reduce the burden of neurological disease—a burden borne by every age group, every segment of society, and people all over the world". NINDS has established two major branches for research: an extramural branch that funds studies outside the NIH, and an intramural branch that funds research inside the NIH. Most of NINDS' budget goes to fund extramural research. NINDS' basic science research focuses on studies of the fundamental biology of the brain and nervous system, genetics, neurodegeneration, learning and memory, motor control, brain repair, and synapses. NINDS also funds clinical research related to diseases and disorders of the brain and nervous system, e.g. AIDS, Alzheimer's disease, epilepsy, muscular dystrophy, multiple sclerosis, Parkinson's disease, spinal cord injury, stroke, and traumatic brain injury.
The Substance Abuse and Mental Health Services Administration is a branch of the U.S. Department of Health and Human Services. SAMHSA is charged with improving the quality and availability of treatment and rehabilitative services in order to reduce illness, death, disability, and the cost to society resulting from substance abuse and mental illnesses. The Administrator of SAMHSA reports directly to the Secretary of the U.S. Department of Health and Human Services. SAMHSA's headquarters building is located outside of Rockville, Maryland.
The National Institute of Allergy and Infectious Diseases is one of the 27 institutes and centers that make up the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services (HHS). NIAID's mission is to conduct basic and applied research to better understand, treat, and prevent infectious, immunologic, and allergic diseases.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), as part of the U.S. National Institutes of Health, supports and conducts biomedical and behavioural research on the causes, consequences, treatment, and prevention of alcoholism and alcohol-related problems. The NIAAA functions both as a funding agency that supports research by external research institutions and as a research institution itself, where alcohol research is carried out in‐house. It funds approximately 90% of all such research in the United States. The NIAAA publishes the academic journal Alcohol Research: Current Reviews.
The Office of Research Integrity (ORI) is a U.S. government agency that focuses on research integrity, especially in health. It was created when the Office of Scientific Integrity (OSI) in the National Institutes of Health (NIH) and the Office of Scientific Integrity Review (OSIR) in the Office of the Assistant Secretary for Health merged in May 1992. The Office of Research Integrity oversees and directs Public Health Service (PHS) research integrity activities on behalf of the Secretary of Health and Human Services, except for the regulatory research integrity activities of the Food and Drug Administration. Organizationally, ORI is located within the Office of the Assistant Secretary for Health (OASH) within the Office of the Secretary of Health and Human Services (OS), in the Department of Health and Human Services (HHS).
The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function. Today, alcohol use disorder (AUD) is used as a more scientific and suitable approach to alcohol dependence and alcohol-related problems.
The National Mental Health Act (1946) became law on July 3, 1946. It established and provided funds for a National Institute of Mental Health (NIMH).
The following outline is provided as an overview of and topical guide to abnormal psychology:
Frederick King Goodwin was an American psychiatrist and Clinical Professor of Psychiatry at the George Washington University Medical Center, where he was also director of the Center on Neuroscience, Medical Progress, and Society. He was a specialist in bipolar disorder and recurrent depression.
Thomas Roland Insel is an American neuroscientist, psychiatrist, entrepreneur, and author who led the National Institute of Mental Health (NIMH) from 2002 until November 2015. Prior to becoming Director of NIMH, he was the founding Director of the Center for Behavioral Neuroscience at Emory University in Atlanta, Georgia. He is best known for research on oxytocin and vasopressin, two peptide hormones implicated in complex social behaviors, such as parental care and attachment. He announced on Sept. 15, 2015, that he was resigning as the director of the NIMH to join the Life Science division of Google X. On May 8, 2017, CNBC reported that he had left Verily Life Sciences. Insel is a Co-founder with Richard Klausner and Paul Dagum of a digital mental health company named "Mindstrong," a Bay-area startup. He has also co-founded Humanest Care, NeuraWell Therapeutics, and MindSite News and is a member of the scientific advisory board for Compass Pathways, a company that is developing the psychedelic drug psilocybin to treat depression and other mental health disorders. His book, Healing: Our Path from Mental Illness to Mental Health was published by Penguin Random House in February, 2022.
Substance use disorder (SUD) is the persistent use of drugs despite the substantial harm and adverse consequences to one's own self and others, as a result of their use. In perspective, the effects of the wrong use of substances that are capable of causing harm to the user or others, have been extensively described in different studies using a variety of terms such as substance use problems, problematic drugs or alcohol use, and substance use disorder. The National Institute of Mental Health (NIMH) states that "Substance use disorder (SUD) is a treatable mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD". Substance use disorders (SUD) are considered to be a serious mental illness that fluctuates with the age that symptoms first start appearing in an individual, the time during which it exists and the type of substance that is used. It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms. Drug classes that are commonly involved in SUD include: alcohol (alcoholism); cannabis; opioids; stimulants such as nicotine, cocaine and amphetamines; benzodiazepines; barbiturates; and other substances.
Lana Skirboll is the former director of the National Institutes of Health Office of Science Policy.
William T. Carpenter is an American psychiatrist, a pioneer in the fields of psychiatry and pharmacology who served as an expert witness in the John W. Hinckley trial for the attempted assassination of U.S. President Ronald Reagan. His primary professional interest is in severe mental illness, especially schizophrenia, to the prevention and treatment of which he has made significant contributions in psychopathology, assessment methodology, testing of new treatments, and research ethics.
Susan G. Amara is an American professor of neuroscience and is the Scientific Director of the National Institute of Mental Health. Dr. Amara is an elected member of the National Academy of Sciences and a fellow of the American Association for the Advancement of Science. She is a Past-President of the Society for Neuroscience. Dr. Amara has a B.S. in Biological Sciences from Stanford University and a Ph.D. in Physiology and Pharmacology from the University of California, San Diego.
Judith L. Rapoport is an American psychiatrist. She is the chief of the Child Psychiatry Branch at the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH) in Bethesda, Maryland.
Kathleen Ries Merikangas is the Chief of the Genetic Epidemiology Research Branch in the Intramural Research Program at the National Institute of Mental Health (NIMH) and an adjunct professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. She has published more than 300 papers, and is best known for her work in adolescent mental disorders.
Between 1966 and 1973, a series of reorganizations occurred of the United States Public Health Service (PHS) within the Department of Health, Education and Welfare (HEW). The reorganization by 1968 replaced PHS's old bureau structure with two new operating agencies: the Health Services and Mental Health Administration (HSMHA) and the Consumer Protection and Environmental Health Service (CPEHS). The goal of the reorganizations was to coordinate the previously fragmented divisions to provide a holistic approach to large, overarching problems.
Karen Faith Berman is an American psychiatrist and physician-scientist who is a senior investigator and chief of the section on integrative neuroimaging, the psychosis and cognitive studies section, and the clinical and translational neuroscience branch of the National Institute of Mental Health's division of intramural research.
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