A Plan for Mental Health Research

There he is! Strains of “Pomp and Circumstance” are drowned out by applause as soon as my wife and I recognize our son’s name. Four years of diligent planning and working hard culminates in this moment as he strides across the stage … or rather, as his name slides slowly across our television screen. Welcome to College Graduation 2020: Coronavirus (COVID-19) edition. While many of his plans came through — he worked hard at his studies, busied himself with internships and part-time jobs, made deep friendships — not all of our son’s plans worked out. Certainly, he did not plan on his last two months of college going online, his only opportunity to say goodbye through Zoom, and his graduation ceremony, speakers and all, happening on YouTube. Yet the core of those plans worked out — and my wife and I couldn’t be prouder of what he’s accomplished, and we look forward with excitement to what he’ll do next.

The COVID-19 pandemic has highlighted the uncertainties we all face, but also the value of a good plan. A good plan assesses where you’re at and identifies where you want to go. It sketches out a pathway to get there and identifies priorities, opportunities, and anticipated pitfalls. But, as COVID-19 has reminded us, a good plan also remains flexible, because you never really know what you’ll encounter along the way.

This week, during Mental Health Awareness Month, the National Institute of Mental Health (NIMH) is unveiling its own plan: the new NIMH Strategic Plan for Research. We’ve been working hard on this iteration of the Strategic Plan for the past year — the last two months, like many of you, through teleworking at home — and we’re pleased to be able to release the final version. The Plan starts with where we currently are, recognizing the advances in knowledge and treatment that got us to where we are today. It reiterates where we want to go–towards prevention, recovery, and cures for mental illnesses. And with some new features, it seeks to enshrine the flexibility necessary to ensure we stay on the cutting edge.

At the centerpiece of this Plan is the notion that biomedical research is critical to the understanding and treatment of mental illnesses. We can see this by looking back at what we have accomplished in just the past five years since the last iteration of our Strategic Plan. Research is rapidly transforming the understanding and treatment of mental illnesses across a broad range of disciplines. In genetics, we have identified hundreds of places in the genome linked to mental illnesses, such as schizophrenia, autism, and depression. In basic neuroscience, the NIH Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative  has fostered the development of new tools and resources that have dramatically increased our ability to study the exquisite complexities of the living brain. In translational sciences, thanks to the hard work of many NIMH-funded investigators, the U.S. Food and Drug Administration (FDA) has approved two of the first truly novel antidepressants in decades — esketamine for treatment-resistant depression, and brexanolone for postpartum depression. And in services research, NIMH-sponsored studies proving the utility of coordinated specialty care for first-episode psychosis resulted in the nationwide implementation of this evidence-based care model through state-supported mental health clinics. 

Looking forward to the next five years and beyond, the NIMH Strategic Plan for Research aims to build on these advances. Integrating input from a broad coalition of stakeholders, including individuals with lived experience, families, providers, advocates, scientists, federal partners, and more, we’ve attempted to identify areas where NIMH-funded science can have the greatest impact. The Plan outlines four high-level goals, which form a broad roadmap for the Institute’s research priorities over the next five years. These goals are:

• Goal 1: Define the Brain Mechanisms Underlying Complex Behaviors
• Goal 2: Examine Mental Illness Trajectories Across the Lifespan
• Goal 3: Strive for Prevention and Cures
• Goal 4: Strengthen the Public Health Impact of NIMH-Supported Research

We will further these goals by supporting investigator-initiated research and through targeted funding announcements. We will also take into account cross-cutting themes — like the need to continue to expand computational and theoretical approaches and to emphasize reaching underserved communities — that inform research throughout our portfolio.

Built into this Strategic Plan are some novel features to ensure that we maintain the flexibility we’ll need to keep pace with ever-evolving scientific approaches and research priorities that may lead to new discoveries. Unlike prior Strategic Plans, which have been static documents, the new NIMH Strategic Plan for Research will be a web-based, living document. This will allow us to highlight key research projects and findings from NIMH and NIMH-funded investigators that advance the Institute’s mission on a linked Progress page for each goal. These Progress pages will allow our stakeholders to follow our scientific advancements over time. The Strategic Plan itself will be updated regularly as we identify and prioritize new opportunities.

At NIMH, we’re incredibly excited about the progress we’ve been making and even more excited to put this Strategic Plan into action. Carefully executed, the Plan should continue to drive the enthusiastic and energetic efforts of the research workforce devoted to our mission. More importantly, it should offer hope and solutions to individuals with mental illnesses, as well as their families and communities. Finally, it should be flexible enough to deal with whatever comes our way over the next five years. We may not have a graduation ceremony at the end, but like my son, we’ve still got plenty to look forward to.