2021 Strategic Plan Progress Report

The National Institute of Mental Health (NIMH) is the lead federal agency for research on mental illnesses. In fiscal year (FY) 2020, the Institute published the new NIMH Strategic Plan for Research, which serves as a broad roadmap for the Institute’s research priorities, spanning fundamental science to public health impact. Each spotlight in this report showcases the progress toward accomplishing the goals of this plan in FY 2021. NIMH continues to build on these and other scientific advances to achieve our mission to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure.

Download PDF

To read the Strategic Plan in full, please visit www.nimh.nih.gov/strategicplan.

Spotlights

Expanding Access to Resources for Early Psychosis Treatment and Research

People with psychosis experience cognitive impairments and some loss of contact with reality, which can disrupt school, work, and social relations. NIMH-funded research, including results from the Recovery After an Initial Schizophrenia Episode (RAISE) study, has shown that early treatment of psychosis symptoms increases the chance of successful recovery. Building on this foundation, the NIMH-supported Early Psychosis Intervention Network (EPINET) initiative is aimed at enhancing coordinated specialty care delivery to people with symptoms of early psychosis and promoting research to improve diagnosis, interventions, and outcomes in early serious mental illness. EPINET continues to expand its reach by increasing access to resources for researchers, providers, and families.

Aligns with Goal 4: Strengthen the Public Health Impact of NIMH-Supported Research | Challenges and Opportunities

Meeting the Critical Need for Rapid-Acting Interventions for Suicide Risk

Nearly 46,000 Americans died by suicide in 2020, which highlights the urgent need for rapid-acting suicide prevention interventions. NIMH is addressing this need by supporting eight research projects testing the safety, efficacy, and feasibility of recent breakthrough advances in medicine and technology to rapidly reduce suicidal thoughts and behaviors in youth and adults. These breakthroughs include ketamine and esketamine (medications with the potential to reduce suicidal thoughts in hours or days) and transcranial magnetic stimulation (the use of magnets to activate specific parts of the brain with the goal to reduce suicidal thoughts and behaviors). These studies may result in new treatments that can jump-start risk reduction and be used with proven treatments to prevent relapse of suicidal thoughts and behaviors.

Aligns with Goal 3: Strive for Prevention and Cures | Challenges and Opportunities

Addressing Mental Health Disparities: Virtual Workshop

In 2020, NIMH partnered with the National Institute on Minority Health and Health Disparities (NIMHD) to convene a virtual workshop that brought together a diverse group of researchers to highlight innovative approaches to understand and address mental health disparities across major areas of mental health science. Workshop panels spotlighted the impact of discrimination, stigma, and social media on mental health disparities; preventive and treatment interventions; access to and engagement in health services; implementation research to address disparities; and innovation in analytics and methods. NIMH, NIMHD, and the research community are using the information from this workshop to better understand how to support and further expand research on reducing mental health disparities.

Aligns with Cross-Cutting Research Themes

Understanding the Links Between Biology and Behavior in Eating Disorders

Eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder, are serious mental illnesses that can lead to severe complications and death. NIMH-funded researchers advanced what is known about eating disorder behaviors, such as binge-eating, purging, and restricting food intake, by showing that these behaviors alter brain reward response processes and food intake control circuitry. Changes to internal reward responses could result in the maintenance, reinforcement, or progression of eating disorder behaviors, emphasizing how eating disorder behaviors and neurobiology interact to reinforce vicious cycles, often making recovery difficult. Building on this work, researchers are investigating treatments that could target and change behaviors for individuals with eating disorders, with an eye toward achieving lasting recovery.

Aligns with Goal 1: Define the Brain Mechanisms Underlying Complex Behaviors

Identifying Risk Factors for Elevated Anxiety in Young Adults During the COVID-19 Pandemic

While many people may experience situational anxiety, anxiety disorders are characterized by excessive worry or fear and differences in the timeframe of experience of behavioral disturbances. NIMH-supported researchers discovered that people who display high levels of social wariness, caution, fear, and avoidant responses in childhood were more likely to experience excessive worrying in adolescence, which in turn predicted elevated anxiety during the COVID-19 pandemic when the participants were in young adulthood. These findings suggest that observing social wariness in childhood and excessive worrying in adolescence may allow for early intervention to prevent anxiety disorders. Watching for these behaviors may also aid in the identification and prevention for those at risk of heightened anxiety during stressful life events like the COVID-19 pandemic.

Aligns with Goal 2: Examine Mental Illness Trajectories Across the Lifespan |
Challenges and Opportunities