NAMHC Minutes of the 266th Meeting
January 31 and February 1, 2022
Department of Health and Human Services
Public Health Service
National Institutes of Health
National Advisory Mental Health Council
Introduction
The National Advisory Mental Health Council (NAMHC) held its 266th meeting at 12:00 noon, February 1, 2022, via a virtual videocast. In accordance with Public Law 92-463, the session was open to the public until approximately 4:30 pm. The closed session was held on January 31, 2022, from 12:30 pm until approximately 4:00 pm. Joshua Gordon, M.D., Ph.D., Director of the National Institute of Mental Health (NIMH), presided as Chair.
Chairperson
Joshua Gordon, M.D., Ph.D.
Executive Secretary
Tracy Waldeck, Ph.D.
Council/Ad Hoc Members Present
- Edwin Abel, III, Ph.D.
- Laura Almasy, Ph.D.
- Marjorie Baldwin, Ph.D.
- Pamela Collins, M.D., M.P.H.
- David Goldstein, Ph.D.
- Kamilah Jackson, M.D.
- Cheryl King, Ph.D.
- Marguerita Lightfoot, Ph.D.
- Joel Nigg, Ph.D.
- Yael Niv, Ph.D.
- Matthew Nock, Ph.D.
- Bryan Roth, M.D., Ph.D.
- Brandon Staglin, M.S.
- Joseph Telfair, DrPH, M.P.H.
- Sophia Vinogradov, M.D.
- Hongkui Zeng, Ph.D.
Ad Hoc Member:
Patricia Recupero, M.D., J.D.
Department of Veteran Affairs (Ex Officio Member)
- Amy Kilbourne, Ph.D., M.P.H.
Liaison Representative
- Anita Everett, M.D.
Others Present at the Open Policy Session (Others Roster)
Others present at Closed Grant Review Session (Closed Session Roster)
Open Policy Session Call to Order & Opening Remarks
Joshua Gordon, M.D., Ph.D.
NIMH Director Dr. Joshua Gordon opened the NAMHC meeting and welcomed Council members, NIMH staff, NIH staff, and members from various stakeholder communities. Public comments were collected in written format and distributed to Council members prior to the meeting (See Appendix C).
Dr. Gordon welcomed seven new Council members: Ted Abel, Ph.D., Pamela Collins, M.D., M.P.H., Marguerita Lightfoot, Ph.D., Joel Nigg, Ph.D., Matt Nock, Ph.D., Patricia Recupero, M.D., J.D. (ad hoc) and Bryan Roth, M.D., Ph.D. He thanked four Council members who are completing their terms of service with today’s meeting: Cheryl King, Ph.D., Yael Niv, Ph.D., Neil Risch, Ph.D., and Brandon Staglin, M.S.
Following introductions, the Council unanimously passed a motion approving the final Summary Minutes of the September 2021 meeting.
NIMH Director’s Report, Joshua Gordon, M.D., Ph.D. (NIH Videocast @04:49)
Congressional Interactions with NIMH
Dr. Gordon reviewed the latest NIMH congressional activities. In November 2021, NIMH briefed Senator Sherrod Brown’s staff (D-OH) on adolescent participation in clinical trials. This age group is of particular interest, as there is major concern for child and adolescent mental health in the context of the COVID-19 pandemic. In December 2021, NIMH Deputy Director, Shelli Avenevoli, Ph.D., and the National Institute of Minority Health and Health Disparities (NIMHD) Deputy Director, Monica Webb Hooper, Ph.D., briefed staff from the Senate Health, Education, Labor, and Pensions Committee on mental health and substance use disorder research, including a focus on pediatric mental health and health disparities. In January 2022, NIMH staff briefed staff for Representative Ami Bera (D-CA) on early psychosis research. These interactions helped inform Congress on policy and funding necessary for NIMH to carry out its research mission.
Budget and Appropriations Update
Dr. Gordon reviewed the overall success rates of NIMH applications across the past six years, which have shown slight growth in the overall number of applications and a modest increase in the number of funded applications. NIMH maintains a success rate around 20 percent.
On December 3, 2021, President Joseph Biden signed the Further Extending Government Funding Act , a continuing resolution to extend the fiscal year 2022 spending level through February 18, 2022. The Senate Appropriations Committee released the text of their version of the House-approved budget in October 2021, which included a 12 percent increase for NIH and a 5.5 percent increase for NIMH. The proposed NIMH budget increase included $25 million specifically to expand research on the mental health impacts of the COVID-19 pandemic.
The Consolidated Appropriations Act, 2021 , which was signed on December 27, 2020, will provide $42.9 billion to NIH through FY 2021, representing an increase of $1.25 billion from FY 2020. This appropriation includes a $2.103 billion allocation for NIMH, representing an $80 million increase over the FY 2020 appropriation. Dr. Gordon noted that $50 million of this increase was allocated specifically to the BRAIN Initiative , leaving $30 million for the rest of NIMH. This proportion increase to NIMH’s allocation represents is more modest compared to the increase of previous years.
NIH Updates (NIH Videocast @11:34)
Dr. Gordon reported that Francis Collins. M.D., Ph.D., stepped down from his role as NIH Director. He spoke of Dr. Collins’ accomplishments that have advanced mental health research, including the Brain Research Through Advancing Innovative Neurotechnologies® (BRAIN) Initiative , which has been instrumental in revolutionizing technologies to address the neurobiology underlying mental illness; the All of Us Research Program , which will expand the understanding of the behavioral underpinnings of mental illnesses; and the Helping to End Addiction Long-term® (HEAL) Initiative , which aims to establish a research base to counter the effects of the ongoing opioid epidemic. Dr. Collins also led NIH through its response to the COVID-19 pandemic and advocated for the policies and activities needed to reduce sexual harassment, promote an inclusive workforce, and address issues of structural racism across the biomedical research community. Lawrence Tabak, D.D.S., Ph.D., who has served as the NIH Deputy Director, will assume the role of Acting NIH Director until a successor is named and confirmed by the Senate.
In December 2021, NIH announced the retirement of William Riley, Ph.D., Director of the NIH Office of Behavioral and Social Science Research (OBSSR) and NIH Associate Director for Behavioral and Social Science Research. Christine Hunter, Ph.D., ABPP, will serve as Acting Director of OBSSR during the search for his replacement.
President Biden visited NIH on December 2, 2021, to announce the administration’s plan to battle COVID-19 over the winter months. Their plan includes expanding COVID-19 testing, keeping schools safely open, and protecting economic recovery. HHS Secretary Xavier Becerra and HHS Deputy Secretary Andrea Palm visited NIH on November 4, 2021, to visit the NIH Clinical Center and the Dale and Betty Bumpers Vaccine Research Center and meet with patients, staff, and leadership.
NIMH has been working with the Foundation for the National Institutes of Health and their Accelerating Medicines Partnership ® to initiate the Bespoke Gene Therapy Consortium , which aims to accelerate the development of gene therapies for rare diseases including rare neurodevelopment disorders. NIH and its partners plan to contribute approximately $76 million over five years to optimize and streamline the gene therapy development process to meet the needs of people with rare disease.
NIMH has also played an important role in the NIH UNITE Initiative , which aims to increase the inclusivity, equity, and diversity within the NIH workforce, as well as the wider scientific workforce. Inspired by the UNITE Initiative, the Community Partnerships to Advance Science for Society (ComPASS) initiative is a Common Fund Concept comprising community-based partnerships that will study interventions to target the structural determinants of health inequalities.
NIMH has helped launch the NIH REsearching COVID to Enhance Recovery (RECOVER) Initiative, a large population study of diverse participants to better understand and address the post-acute sequelae of COVID-19.
Dr. Gordon reviewed updates from the Brain Research Through Advancing Innovative Neurotechnologies® (BRAIN) Initiative. Six of the Initiative’s scientists were selected for the NIH High-Risk, High Reward Research Program for their highly innovative research.
The BRAIN Initiative has also led efforts to enhance workforce diversity by requiring certain grant applicants to submit a Plan for Enhancing Diverse Perspectives. Notably, in October 2021, the BRAIN Initiative Cell Census Network (BICCN) published an atlas of the motor cortex, an effort fueled by a collaboration of more than 250 scientists from nearly 50 institutions. This publication sets a path for understanding the diversity of cell types underlying cortical and other brain regions to understand their functional impact.
NIMH News to Know
Dr. Gordon provided an update on NIMH’s continued efforts to address the impact of the COVID-19 pandemic on mental health, including a Director’s Message focused on supporting children and adolescents, and directing the public to resources. Also, a Notice of Special Interest , and two Urgent Award notices were released soliciting research aimed at understanding and mitigating the mental health impact of COVID-19. The impact of the COVID-19 pandemic on youth mental health was also addressed by the Office of Vivek Murthy, M.D., M.B.A., which released a new U.S. Surgeon General’s Advisory providing guidance on actionable recommendations that can be taken to address these challenges. Dr. Gordon also reviewed recent activity from the newly re-appointed Interagency for Autism Coordinating Committee (IACC). The IACC previously held virtual meetings in October 2021 and January 2022 and has issued a Request for Information to inform the development of the next version of the IACC Strategic Plan.
Dr. Gordon announced staff awards and news. Elisabeth Murray, Ph.D., Chief of the Section on Neurobiology of Learning and Memory and the Laboratory of Neuropsychology received the Brain and Behavior Research Foundation’s Goldman-Rakic Prize for Outstanding Achievement in Cognitive Research. Leslie Ungerleider, Ph.D., former NIH Distinguished Investigator and Chief of the Laboratory of Brain and Cognition and the Section on Neurocircuitry, received the Society for Neuroscience’s Patricia Goldman-Rakic Hall of Honor Award posthumously . Silvia Lopez-Guzman, M.D., Ph.D., joined the NIMH Intramural Research Program (IRP) as a tenure-track investigator and Chief of the Unit on Computation Decision Neuroscience.
Robert Heinssen, Ph.D., ABPP, Director of the Division of Services and Intervention Research, will step down from this role in June 2022. Dr. Heinssen is known for key initiatives aimed at early and first episode psychosis, suicide prevention, and the rapid implementation of evidence-based services in real-world settings. He was the principal architect of the Early Psychosis Intervention Network (EPINET) and helped to transform care for first episode psychosis through coordinated specialty care. Although he is stepping down from his current role, Dr. Heinssen will be joining the Office of the Director as a Senior Advisor to Dr. Gordon.
Dr. Gordon also reviewed staff retirements from the NIMH IRP including Robert Cox, Ph.D., Director of the Scientific and Statistical Computing Core; Barbara Lipska, MSci, Ph.D., Director of the Human Brain Collection Core; Christian Grillon, Ph.D., Chief of the Section on Neurobiology of Fear and Anxiety; and Carolyn Beebe Smith, Ph.D., Chief of the Section on Neuroadaptation and Protein Metabolism.
Last, Dr. Gordon announced the passing of two former NIMH staff: Mortimer Mishkin, Ph.D., former Chief of the IRP Laboratory of Neuropsychology, and David Shore, M.D., former Acting Director of both the Division of Services and Intervention Research and the Division of Clinical and Treatment Research. Both were recognized for their lifelong commitment and outstanding contributions to science.
Science Highlights (NIH Videocast @31:25)
Dr. Gordon shared three science highlights. The first was a study on controllability of social environments. Social environments and behaviors are intertwined with mental health, as evidenced by our emotional reactions to changes in social connectedness during the pandemic. The research team used a computational approach to elucidate the neural mechanisms that enable us to navigate complex social environments. Using this approach to determine how many steps in the future participants consider before deciding what to share, they found that the best predictions were made by thinking two steps ahead. Dr. Gordon noted that these findings may have clinical relevance for better understanding impaired social behaviors.
Dr. Gordon reviewed a second science highlight on mental health treatment in HIV care in South Africa, where depression is highly prevalent and associated with suboptimal adherence to antiretroviral therapy (ART). Researchers sought to uncover if improved depression is associated with improved adherence to ART. The researchers found that in addition to treatment as usual (TAU, anti-depressants), cognitive behavioral therapy provide by non-specialists improved both symptoms of depression and adherence to ART compared to TAU. The results highlight a potential implementation pathway in which the treatment of depression through non-specialist care may be expanded in areas, including the United States, where access to specialized mental health care is limited.
Last, Dr. Gordon reviewed a study on deep brain stimulation (DBS) therapy for obsessive-compulsive disorder (OCD) that aimed to characterize neural patterns to identify biomarkers and improve the efficacy of DBS. The research team used multi-site electrophysiological recordings of neural activity in individuals with OCD as they were undergoing DBS. They found correlations between electrophysiological parameters and the timing and intensity of OCD symptoms. Although their results are preliminary, the techniques used in this study indicate a future in which treatment may be customized to individuals based on their specific symptoms and experiences.
Discussion (NIH Videocast @49:14)
Mr. Staglin asked if the early psychosis and clinical high-risk programs, such as EPINET and the Accelerating Medicines Partnership - Schizophrenia, will continue to grow now that Dr. Heinssen will be taking the role of Senior Advisor. Dr. Gordon answered that there will be no change in NIMH’s prioritization for EPINET and other such efforts. Dr. Heinssen’s advisory role will focus on the sustainability of these programs and working with other federal agencies to expand and improve the efficacy of services across the United States.
Dr. King asked what the ideal level of research funding might be to fund the substantial number of strong grant applications that come in. Dr. Gordon said that he believed the research budget could double without affecting the quality of the science.
Dr. Abel asked for an update about research on the developmental origins of mental illness in the context of funding longitudinal studies. Dr. Gordon answered that NIMH longitudinal studies are typically funded in five-year increments, but many continue to be supported for much longer. NIMH tries to set up longitudinal studies that span periods of high risk or transition like adolescence or early childhood. Dr. Gordon reviewed two such studies – the Adolescent Brain and Cognition (ABCD) Study, which follows more than 10,000 children from age 9 to 19 to study how these children’s brains are developing and the factors that affect the developing brain, and the Healthy Brain and Cognitive Brain (HBCB) Study, which will primarily track children postnatally through the first 10 years. There are also some disease-specific longitudinal studies on attention-deficit hyperactivity disorder (ADHD), anxiety, stress, and depression.
Hongkui Zeng, Ph.D., asked about the long-term strategy for maintaining the BRAIN Initiative and the important resources, such as the BICCN, that it generates. Dr. Gordon said that the data resources are supported by specific grants and NIMH is considering a long-term, sustainable solution for maintaining access to that data, as well as other valuable data resources. He added that NIMH is pivoting away from post-mortem disease studies and towards single-cell analyses. Subsequently, there may come a time in which these data may dwarf BICCN data. NIH has made a commitment to sustain these data for the long-term, but the specific strategy has not yet been determined.
Regarding the ComPASS concept, Dr. Collins asked how else NIMH might lead the science around community partner research and mental health. Dr. Gordon said NIMH is in the process of recruiting a new Director of the Office of Disparities Research and Workforce Diversity, who is familiar with and engaged in community-based research in healthy equity. In this area of research, there is a focus on the mechanisms of health inequities to better understand the underlying determinants and to target interventions.
Social Determinants of Health: A Nursing Research Perspective, Shannon N. Zenk, Ph.D., MPH, RN, FAAN, Director, National Institute of Nursing Research (NINR)
Dr. Zenk presented an overview of social determinants of health (SDoH) research tracing her early nursing experiences to the current status of SDoH work at NINR and the NIH. She explained that with the initial support of an NIMH training grant, she began to conduct research in Detroit and Chicago that exposed significant health inequities based on where people live. Dr. Zenk highlighted a critical need for scientific evidence on the policies and investments that effectively increase resources and reduce risk in communities of color towards improving health outcomes. She and her research team found that policies intended to improve the health of a population subset could impact health outcomes for whole communities.
She then reviewed how SDoH are integrated with nursing. This nursing perspective informs NINR’s research portfolio. Over 75 percent of NINR funding supports research that directly engages with human participants, and over 30 percent of their current portfolio is focused on research to eliminate health disparities. NINR has also committed to funding underrepresented minority scientists.
According to data from a recent NIH study, over 75 percent of their applications focus on research topics for which Black scientists disproportionately apply, which is second only to the NIMHD.
Later, Dr. Zenk provided examples of SDoH research at NINR, followed by an overview of NINR’s impending Strategic Plan . She stated that nursing science could and must have a bigger impact in identifying solutions to end health disparities. Therefore, NINR’s updated mission statement is to lead nursing science to solve pressing health challenges and inform practice and policy – optimizing health and advancing equity into the future. Their Strategic Plan will include a set of Guiding Principles to drive all aspects of NINR-funded science and Research Lenses to examine and identify health challenges. Although nursing science comprises many different perspectives, NINR has identified five Research Lenses that can position the field to increase their impact on health disparities and outcomes.
She concluded by recognizing NIMH’s work in social determinants of health and health equity and expressed her hope for future collaboration. In addition, she is excited that both NINR and NIMH are contributing to other NIH efforts in this area, such as the ComPASS and UNITE initiatives. Finally, she invited Council members to join NINR at the 2022 National Nursing Research Roundtable on March 3 and 4, 2022, which will focus on how emergency departments can address social needs.
Discussion (NIH Videocast @1:42:57)
Following the presentation, Council members offered comments and posed questions to Dr. Zenk.
Joseph Telfair, DrPH, M.P.H., asked about distinguishing the unique role nurses have compared to other providers. The NINR focuses on structural inequities and systems-level change at the population level, the NINR definition of diversity, and if their focus on diversity extends to the workforce. Dr. Nigg commented that there are three opportunities for NINR to collaborate with NIMH – computational models on the complexity of exposure risks, the overlap of mental and physical health, and individual differences in response to conditions. Marjorie Baldwin, Ph.D., thanked Dr. Zenk for her presentation and asked about disparities in the access to healthy food for certain communities. Mr. Staglin commented that the nursing workforce is being challenged with growing demands in health services and widespread burnout due to the challenges of the pandemic.
Structural Racism and Black Youth Mental Health: Moving Beyond the “Clown at the Circus,” Enrique W. Neblett, Jr., Ph.D., University of Michigan
Dr. Neblett reviewed conceptual models of racism as they have progressed over time and described his research on racism and health. As a clinical psychologist, his research focuses primarily on racial discrimination and mental health outcomes. Specifically, his interest has been in the resilience and vulnerability factors that mitigate the negative impact of racism on health, such as racial identity, racial socialization, and African-centered cultural values across both individual and structural levels.
He indicated a dearth of research on structural racism and mental health. One critical need is to redefine structural racism to include exemplars of cultural racism. Dr. Neblett and his team consider how to measure cultural racism and how it is associated with disease and mortality outcomes. In addition, they have examined how cultural racism can be measured across different representations or the extent to which people search for certain derogatory terms.
Dr. Neblett stated that identifying these measures allows them to consider changes in policies and how they might affect mental health.
Later, he encouraged the Council to consider how the different forms of structural racism are related to mental health through physiological systems and how resilience factors may moderate this meditational path; how exposure to cultural manifestations is linked to physiological responses over time; and how to conceptualize the life course perspective to include measures of life satisfaction, psychological wellbeing, and positive mental health.
Discussion (NIH Videocast @2:32:40)
Following the presentation, Council members offered comments and posed questions to Dr. Neblett.
Dr. Abel discussed how much structural racism restricts research questions and limits the creativity and clinical impact of science at NIMH. Specifically, the Dr. Abel asked about the clinical impact on the research that is conducted and the questions that investigators ask. Dr. Niv asked about recommendations regarding how NIMH and NIH review grant applications. She also suggested that the considerations for the institution or researcher contributions, such as written papers or data sets, are linked to structural racism and the idea of what is a scientific and community contribution. Dr. Telfair asked what interventions may “move the needle” in structural racism.
Triennial Report of the Inclusion of Women and Minorities in NIMH Research, Ashley Kennedy, Ph.D., Office of Clinical Research
Ashley Kennedy, Ph.D., MSCR, presented data on the inclusion of women and minorities in NIMH-funded clinical research from fiscal years 2019 to 2021. NIH is mandated to ensure the inclusion of women and minorities in a manner appropriate to the scientific question under study and to ensure that research findings can be generalizable to the entire population. Additionally, NIH-defined phase III clinical trials should be designed in a manner sufficient to provide a valid analysis of whether the variables being studied affect women or members of racial/ethnic minority groups differently than other trial participants. Currently, there are five racial categories and two ethnic categories that participants use to self-identify. Participants also have the option to identify with more than one race or not provide their race or ethnicity. Dr. Kennedy reported on three areas: NIMH enrollment in extramural clinical research, intramural clinical research, and NIH-defined phase III clinical trials. Across the fiscal years, NIMH enrollment in extramural clinical research was 54 percent female; 10 percent of participants were Hispanic or Latino. The majority of participants were White, for which enrollment consistently increased over time.
In intramural clinical research, 48 percent of participants were female, and 42 percent were male. The majority of participants were White at an average of 64 percent, and the largest racial minority group was African American at an average of 11 percent. On average, 6 percent of participants were Asian, and 5 percent were Hispanic or Latino.
Finally, Dr. Kennedy reviewed NIMH enrollment for NIH-defined phase III clinical trials. On average, 67 percent of participants were female (with slight fluctuations across time); approximately 7 percent of participants were Hispanic or Latino (with increases in participation across the fiscal years), and the largest racial group was African American.
Discussion (NIH Videocast @2:54:06)
Following the presentation of the report, Council members posed questions to Dr. Kennedy.
Laura Almasy, Ph.D., asked about the number of grants in each category, while Dr. Roth asked if there was a breakdown in terms of diagnosis prevalence across sex.
Following the report, the Council unanimously passed a motion approving the Triennial Report of the Inclusion of Women and Minorities in NIMH Research.
Concept Clearances (NIH Videocast @3:01:20)
Understanding Developmental Processes in Youth Suicide, Eric Murphy, Ph.D.
Dr. Eric Murphy presented a concept to encourage research on the processes that contribute to suicide risk in youth. There is a lack of developmentally appropriate measures of suicidality across childhood and adolescence, which is needed to better understand precursors to suicidal thoughts and behaviors and the developmental constructs that contribute to suicidality. This concept also aims to consider risk and protective factors through the perspective of intersectional frameworks and the integration of multiple data sources. Initiatives resulting from this concept may help address the barriers to progress in youth suicide research and improve the identification of risk factors and intervention targets to develop more personalized treatments.
Discussion (NIH Videocast @3:06:42)
Discussants: Dr. King, Dr. Nock
Dr. King expressed support for the effort to close substantial research gaps and to include developmental trajectories and characteristics. She also highlighted the intersectional framework approach as critically important for understanding subgroups across the lifespan. Dr. Nock added that this concept is very timely in light of the COVID-19 pandemic and that there is a need for significant improvement in assessment and intervention for this population. He cautioned about the low suicide rate among children under the age of 12 and suggested a focus on tractable problems. Anita Everett, M.D., DFAPA, said that using the term “suicidality” often includes thinking, planning, and attempting, which may be better considered as separate elements.
Expanding Collaborative Implementation Science for the End the HIV Epidemic National Plan Suzy Pollard, Ph.D.
Dr. Suzy Pollard presented a concept to support collaborative implementation science approaches with community partners to strengthen the evidence for HIV interventions that target the social and structural determinants of health and that facilitate their adaptation and uptake.
Discussion (NIH Videocast @3:18:00)
Discussants: Dr. Telfair, Dr. Kilbourne
Dr. Kilbourne supported this next generation of implementation research that involves community engagement. She encouraged reaching out to historically Black colleges and universities (HBCUs), allied health professional schools, and creative community partners.
Dr. Telfair suggested the need for concrete definitions and examples of structural issues that can be targeted, such as policies. He recommended considering sociocultural influences and risks that can affect behaviors such as care seeking. He also suggested defining short-, intermediate-, and long-term outcomes. Dr. Lightfoot cautioned that the uptake of interventions is often silent about the influence of institutional racism and that implementation frameworks should be adapted to include these barriers.
NIMH Faculty Development Award to Promote Diversity in Mental Health Research, Ishmael Amarreh, Ph.D.
Dr. Ishmael Amarreh presented a concept for a NIMH faculty development award to promote diversity in mental health. The goal of the concept is to enhance the diversity of mental health research through support for early career research from investigators from underrepresented groups who are not currently nor formerly independent program directors nor principal investigators on any NIH award. The program will provide research support for a period of mentoring and career development in preparation for launching an independent research career.
Discussion (NIH Videocast @3:31:11)
Discussants: Dr. King, Dr. Lightfoot
Dr. King suggested expanding the concept into a suite of initiatives or a multi-pronged approach, similar to the Robert Wood Johnson programs that support the development of a national network of scientists. She also suggested providing incentives to the program, such as research topics that are relevant to underrepresented researchers. Dr. Lightfoot suggested allowing more time for eligibility and extending time for K01 grants to five years. Dr. Abel added that there also should be a mechanism to extend to mid-career and young investigators. Dr. Collins asked about the transition from the end of the award to the next.
Improving Mental Health of Mobile Populations through Diagnosis, Prevention, Treatment, and Implementation Strategies, Holly Campbell-Rosen, Ph.D.
Dr. Holly Campbell-Rosen stated that one in every 95 people had fled their home because of conflict or persecution. Global mental health is rooted in human rights and addresses inequities stemming from the adversity created by these conflicts. Additionally, mobile populations frequently experience unsafe or unlivable conditions and psychological stress, increasing health risks and poor mental health outcomes. Dr. Campbell-Rosen presented a concept that aims to support research to improve diagnosis, prevention, treatment, and mental health services for individuals from mobile populations.
Discussion (NIH Videocast @3:41:23)
Discussants: Dr. Telfair, Dr. Collins
Dr. Telfair said that this work is very important but that it is unclear what approaches and/or collaborations are needed to overcome the complex challenges. He also suggested including a rubric for assessing the quality and feasibility of interventions, especially in terms of level of engagement. Dr. Collins suggested separating pre- and post-migration exposures and the determinants and interventions targeted to both.
Dr. Collins discussed the opportunity to better understand the effective models of cross-sector collaboration for the facilitation of mental health interventions and for NIMH to facilitate cross talk between different groups. She also suggested including comparisons between different types of refugee-receiving countries.
Innovative Mental Health Services Research Not Involving Clinical Trials, Christine Ulbricht, Ph.D., M.P.H.
Dr. Christine Ulbricht presented a concept to address the substantial unmet needs for mental health services in the United States. The concept aims to foster non-clinical mental health services research to inform service delivery and outcomes across diverse settings through the development and testing of new research tools, technologies, measures, and methods. It will also support partnerships with end users, payers, and other stakeholders to inform practices across the patient, clinic, system, and policy levels. Research is needed to improve access, continuity, quality, value, and equity of mental health care, as well as its adoption, scaling, and sustainment to maximize its public health impact.
Discussion (NIH Videocast @3:49:40)
Discussants: Dr. Kilbourne, Dr. Jackson
Dr. Kilbourne said that this concept is important but challenging in its broad scope. She suggested the need to focus efforts on systemic racism in health equity and the importance of including end users in developing implementation strategies. Kamilah Jackson, M.D., added that there may be an opportunity to address urgent needs, such as youth mental health versus a focus on populations. Dr. Baldwin added her perspective as a parent of an individual with schizophrenia and recommended including employment as an outcome for individuals with mental illness.
Novel Assays to Address Translational Gaps in Treatment Development (Reissue), Su Koester, Ph.D.
Dr. Su Koester presented a concept on supporting the development and evaluation of quantitative, robust, reliable measures of assays for specific physiological systems and domains of function. To achieve, this goal, NIMH hopes to support research partnerships to identify measures across non-human preclinical species and humans, as well as through projects that propose potentially translatable assays as alternatives.
Discussion (NIH Videocast @3:59:54)
Discussants: Dr. Vinogradov, Mr. Staglin
Mr. Staglin said that it is extremely important to enhance the efficacy and efficiency of preclinical stages of drug development and that better measures aligned between animal and human models will increase efficiency and support the rationale for using resources to produce new drugs. Sophia Vinogradov, M.D., added that computational models can also be applied to study behaviors in animals and to probe the underlying pathology, behaviors, and pathophysiologic heterogeneity in mental illness. Dr. Nigg suggested funding studies of variation in animal environments to help reproduce human response.
Comments from Retiring Members (NIH Videocast @4:08:15)
Three retiring Council members, Dr. Niv, Dr. King, and Mr. Staglin, delivered public comments regarding their experience while serving on the Council and wishes for the future. Retiring Council member, Dr. Neil Risch, was unable to join the meeting.
Adjournment
Dr. Gordon invited Council members to submit any additional comments or questions regarding the concept clearances. The open session of the meeting adjourned at approximately 4:30 pm.
Closed Session
The grant application review portion of the meeting was closed to the public in accordance with provisions as set forth in Section 552b(c)(4) and 552b(c)6. Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act, as amended.
Members absented themselves from the meeting during discussion of and voting on applications from their own institutions, or other applications in which there was a potential conflict of interest, real or apparent. Members were asked to sign a statement to this effect.
VII. Review of Applications
Refer to Appendix A.
VIII. Adjournment
Dr. Gordon thanked the Council members. The closed session of the NAMHC meeting adjourned at approximately 4:00 p.m. on January 31, 2022.
Joshua A. Gordon, M.D., Ph.D.
Chairperson
National Advisory Council on Mental Health
Tracy Waldeck, Ph.D.
Executive Secretary
National Advisory Council on Mental Health
Department of Health and Human Services
Public Health Service
National Institutes of Health
National Advisory Mental Health Council
Summary of 266th Meeting, February 1, 2022
Others Present
Staff Present Virtually
|
Lisa Alberts
|
Meredith Fox
|
David Panchision
|
Others Present Virtually
Debra Gilliam, Transcriber
Marie Rowland, Science Writer
Candice Martin, Captioner
Department of Health and Human Services
Public Health Service
National Institutes of Health
National Advisory Mental Health Council
Summary of 266th Meeting, January 31, 2022
Staff Present Virtually for Closed Grant Review Session:
|
Susannah Allison
|
Stacia Friedman-Hill
|
Anna Ordonez
|
Appendix A
Summary of Primary MH Applications Reviewed
Council: January 2022
| IRG Recommendation | ||||||||
|---|---|---|---|---|---|---|---|---|
| Category | Scored # | Scored Direct Cost $ | Not Scored (NRFC) # | Not Scored (NRFC) Direct Cost $ | Other # | Other Direct Cost $ | Total # | Total Direct Cost $ |
| Research | 610 | $1,006,235,790 | 441 | $648,394,625 | 2 | $4,996,950 | 1053 | $1,659,627,365 |
| Research Training | 19 | $38,014,339 | 13 | $23,319,542 | 0 | 0 | 32 | $61,333,881 |
| Career | 94 | $75,890,664 | 37 | $30,488,957 | 0 | 0 | 131 | $106,379,621 |
| Other | 0 | 0 | 0 | 0 | 0 | 0 | ||
| Totals | 723 | $1,120,140,793 | 491 | $702,203,124 | 2 | $4,996,950 | 1216 | $1,827,340,867 |
Appendix B
Department of Health and Human Services
National Institutes of Health
National Institutes of Mental Health
National Advisory Mental Health Council
(Terms end 9/30 of designated year)
Chairperson
- Joshua A. Gordon, M.D., Ph.D.
Director
National Institute of Mental Health
Bethesda, MD
Executive Secretary
- Tracy Waldeck, Ph.D.
Director
Division of Extramural Activities
National Institute of Mental Health
Bethesda, MD
Members
- Edwin G. Abel, III, Ph.D. (24)
Chair and Departmental Executive Officer
Department of Neuroscience and Pharmacology
Carver College of Medicine
University of Iowa
Iowa City, IA - Laura A. Almasy, Ph.D. (22)
Professor
Department of Genetics
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA - Marjorie L. Baldwin, Ph.D. (22)
Professor
Department of Economics
W.P. Carey School of Business
Arizona State University
Tempe, AZ - Pamela Y. Collins, M.D., MPH (24)
Professor of Psychiatry and Behavioral Sciences
Professor of Global Health
Schools of Medicine and Public Health
University of Washington
Seattle, WA - David Goldstein, Ph.D. (23)
Director
Institute for Genetic Medicine
Columbia University
Hammer Building
New York, NY - Kamilah Jackson, M.D. (23)
Medical Director
PerformCare
Robbinsville, NJ - Cheryl A. King, Ph.D. (21)
Professor and Director
Youth and Young Adult Suicide Prevention Program
Department of Psychiatry
University of Michigan
Rachel Upjohn Building
Ann Arbor, MI - Marguerita A. Lightfoot, Ph.D. (24)
Professor
Associate Dean for Research
OHSU-PSU School of Public Health
Portland, OR - Joel T. Nigg, Ph.D. (24)
Professor and Vice Chair for Psychology
Director, Center for ADHD Research
Department of Psychiatry
Oregon Health and Science University
Portland, OR - Yael Niv, Ph.D. (21)
Professor
Princeton Neuroscience Institute
Department of Psychology
Princeton University
Princeton, NJ - Matthew K. Nock, Ph.D. (24)
Edgar Pierce Professor of Psychology
Harvard College Professor
Chair, Department of Psychology
Harvard University
Cambridge, MA - Patricia R. Recupero, M.D., J.D. (24)
Senior Vice President of Education and Training
Care New England Butler Hospital
Providence, RI - Neil J. Risch, Ph.D. (21)
Professor, Epidemiology and Biostatistics
Lamond Family Foundation Distinguished Professor in Human Genetics
University of California, San Francisco
San Francisco, CA - Bryan L. Roth, M.D., Ph.D. (24)
Michael Hooker Distinguished Professor
Department of Pharmacology School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC - Brandon Staglin, M.S. (21)
President
One Mind Institute
Rutherford, CA - Joseph Telfair, DrPH, MPH, (23)
Professor and Associate Dean for Public Health Practice and Research
Karl E. Peace Distinguished Chair of Public Health
Fellow, Royal Society of Public Health
Jiann-Ping Hsu College of Public Health
Georgia Southern University
Statesboro, GA - Sophia Vinogradov, M.D. (22)
Donald W. Hastings Endowed Chair
University of Minnesota Medical School
Professor and Department Head
Department of Psychiatry
Minneapolis, MN - Hongkui Zeng, Ph.D., (23)
Executive Vice President and Director
Allen Institute for Brain Science
Seattle, WA
Ex Officio Members
Office of the Secretary, DHHS
Xavier Becerra
Secretary
Department of Health and Human Services
Washington, DC
National Institutes of Health
Lawrence A. Tabak, D.D.S., Ph.D.
Acting Director
National Institutes of Health
Bethesda, MD
Department of Veterans Affairs
Amy M. Kilbourne, Ph.D., M.P.H.
Director, Quality Enhancement Research Initiative (QUERI)
U.S. Department of Veterans Affairs
Professor of Learning Health Sciences
University of Michigan Medical School
Ann Arbor, MI
Department of Defense
Liaison Representative
Anita Everett, M.D., DFAPA
Director
Center for Mental Health Services
US, HHS Substance Abuse and Mental Health Services
Rockville, MD