I am NIMH: Q&A with Dr. Joshua A. Gordon

Joshua A. Gordon, M.D., Ph.D.

NIMH Director

How would you summarize what you do?

I'm the director of NIMH. My most important responsibility is setting the research agenda for the institute and community.

Make a plan but don't be afraid to change it! I never thought about being an institute director. I had to change my plan dramatically, and I am glad I did.

Working with all the wonderful scientists at NIMH and with the support of everyone else at NIMH, I'm in charge of figuring out the right directions for mental health research, prioritizing competing interests and needs, and supporting the research that will help us reach our goals.

In practice, that means meeting with advocates, individuals with lived experience, and scientists from all over the country and world to try to understand where there are research gaps, working with scientists within and outside of NIMH to determine which initiatives and programs will address those gaps, and then prioritizing the applications we receive to determine the best science to fund.

I also have a research lab, which is separate from my work as the director. This work keeps me on my toes and helps me stay abreast of the latest science in my research area.

What motivated you to join NIMH?

I initially didn't think I was interested in this job until my Ph.D. thesis advisor approached me at a meeting and suggested I consider the position. He knew that I cared about service to my community and that I like to think about a broad array of science, not just my specific focus area.

I was skeptical but decided to apply. Through the interview process and talking with the folks who are now my fellow institute directors, I learned how rewarding the position is and how exciting it is to be a director.

How long have you worked at NIMH?

I've been the director since September 2016, almost 7 years.

What is your favorite part of your job?

There are many things I like about this job. I like thinking about different areas of science. I enjoy having the opportunity to learn about different parts of science and master them enough to converse with people and make decisions. I find that intellectually challenging and very stimulating.

What I like most is meeting enthusiastic early career scientists. I love talking with them, learning about their plans, and seeing them thrive. That is the best part of my job.

What's one thing you'd want the public to know about the NIMH?

There are so many things about NIMH that the public probably already knows. They probably know that we are the primary and premier global mental health research organization and that we support a broad range of science, and that science has had a tremendous impact.

They probably don't know how committed and hardworking our staff is. There is a popular idea that government workers are here because it's an easy "9 to 5" job. But that's not true. Everyone here is committed to the mission. They are here to ensure that NIMH succeeds, and that's amazing.

What is your proudest achievement at NIMH?

I try to make decisions and create policies and an environment where people can thrive, and they have. I'm proud of our initiatives, like the Accelerating Medicines Partnership® Program – Schizophrenia, a public-private partnership trying to develop new therapies for schizophrenia, and the Precision Psychiatry program. I've also been working with NIMH staff for several years to launch the RDoC research framework, and it's been rewarding to see that get off the ground. I'm also proud of the diversity, equity, inclusion, and accessibility (DEIA) initiatives we've worked on for the last few years.

At the same time, I can take very little credit for these initiatives because it's the work of everyone. These aren't my achievements, but I am proud of my role in helping NIMH achieve these things.

What's one life lesson you've learned from your career?

Make a plan but don't be afraid to change it! I never thought about being an institute director. I was extremely happy in my previous job as a teacher and researcher. I had that plan for two decades, and everything was going according to plan. But I made changes and tweaks along the way—like the idea of coming to NIMH. I had to change my plan dramatically, and I'm glad I did.

If you weren't doing this job, what would you do?

That's easy—I would still be at Columbia University in a faculty position. However, when I was younger, I did want to write the great American novel, but we probably all did. I also thought a little about politics and policy but mostly wanted to be a scientist.

We're celebrating NIMH's 75th anniversary. What stands out in your mind about the progress we've made?

Looking back, I think some therapies that have come out of the NIMH-funded science have been particularly impactful. These treatments include cognitive behavioral therapy and all the different antidepressants and antipsychotics we have.

Some people tend to think these treatments came about by accident or trial and error. We discovered the first antidepressant by accident, but every single one after that was discovered because we understood something about how the brain worked and could design drugs that targeted specific areas or chemicals in the brain. That knowledge has led to more targeted medicines, dramatically improving the effectiveness of antipsychotic medications and antidepressants.

Neuroscience has also fed an increase in our choices beyond medication. Psychology and cognitive science have increased our options in terms of psychotherapies. I think that's an underappreciated achievement of NIMH.

NIMH, along with other institutes, has also been at the forefront of changing and deepening how we understand how the brain works. I think that will lead to additional therapies for mental disorders.

Additionally, NIMH doggedly pursued psychiatric genetics despite decades of failure and critics saying we were wasting our money. It's tremendously increased our understanding of genetics' role in mental disorders in the last 15 years.

What challenges will NIMH be addressing in the coming years?

We know so much now about the genetic underpinnings of mental illness. I think it's time to turn our attention to other factors of mental illness. We know that even in the most strongly genetic conditions, the environment plays a huge role, and we know some of the basics of that role.

We know the environment plays an important role during development. We know that trauma and adverse childhood experiences impact the risk for mental illness, and we have some idea that certain environmental conditions and toxins also play roles. Still, we don't understand those mechanisms or how they interact with genetics. Furthering our understanding of social and environmental determinants of health will be a big challenge in the future.

Another challenging area is interpreting our understanding of the brain and genetics and developing new therapies based on it. Doing this requires more computational theoretical approaches. The more we analyze the biological mechanisms that come from genetics and the brain, the more we can understand how that interacts with environmental and social determinants of mental health. The more we bring math and theory into the equation, the easier it will be to do that work.

Another challenge we've been working on to great success is finding ways to implement treatments that work. The biggest challenge is understanding how best to offer services to hard-to-reach populations, including homeless individuals, underrepresented minority communities, or people in rural settings. These communities need services that are designed for them.

Why is it important for the public to see the work NIMH does?

It's crucial that the public sees our work and understands its impact on public mental health. There is a common idea that therapies for mental illness have been discovered by accident, and mental health research hasn't helped us. If people think mental health research hasn't helped improve the lives of those with mental illnesses, they may ask why we should fund and support it.

That would be a tragedy because mental health research has dramatically improved our ability to treat mental illnesses. It has resulted in wonderful therapies that work and pathways to delivering those therapies to communities that need them. We must ensure the public knows about our successes so they understand that supporting mental health research will improve their lives and those in their community.

What would be your advice to a young person considering pursuing a career in mental health research?

I always tell them, number one, do what you love. Pursue what interests you. Number two, I tell them to learn more math. I would also add data science since we understand that that's its own discipline now. Three, talk to the program staff at NIMH about how we can support your career development.