APA Praises Congress for Funding Mental Health Programs for FY 2019

APA today praised Congress for funding several mental health programs through the passage of HR 6157, a bill which includes funding for the departments of Defense, Labor, Education, and Health and Human Services through the end of September 2019.

The spending package includes funding for the following:

• Substance Abuse and Mental Health Services Administration (SAMHSA): $5.7 billion ($584 million increase)
• National Institutes of Health (NIH): $39.1 billion ($2 billion increase), including $429 for the BRAIN Initiative (Brain Research through Advancing Innovative Neurotechnologies)
• Curbing the opioid epidemic: $3.8 billion ($206 million increase)
• SAMHSA Minority Fellowship Program: $13.2 million ($500,000 increase) through SAMHSA’s Center for Mental Health Services, Center for Substance Abuse Treatment, Center for Substance Abuse Prevention

The bill passed in the House on Wednesday by 361-61, a week after the Senate passed an identical measure by a vote of 93-7. The bill was presented to President Donald J. Trump on Thursday.

“We thank members of Congress from both parties for prioritizing mental health care—including treatment for and prevention of substance abuse—in the FY 2019 Defense-Labor-HHS funding package,” said APA President Altha Stewart, M.D., in a statement released by APA. “The commitment to mental health care shown in these appropriations will advance critical research on psychiatric disorders and improve care for the millions of Americans living with mental illness and substance use disorders.”

“Mental health and substance use treatment are critical to our nation’s well-being,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A., in a statement. “Our members were vocal about the need to fund the Minority Fellowship Program and we thank the members of Congress who worked with us to secure and expand funding for this critical program.”

(Image: David Hathcox)

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Thomas Insel, M.D., Resigns as Director of NIMH

After serving 13 years as director of the National Institute of Mental Health (NIMH), Thomas Insel, M.D., will step down effective November 1. Insel first worked at NIMH from 1980 to 1994 in the Division of Intramural Research and then returned as director in 2002. 

“Dr. Insel provided excellent leadership of NIMH during this critical time in mental health research,” said APA President Renée Binder, M.D. “During his tenure, NIMH has spearheaded the BRAIN initiative [Brain Research through Advancing Innovative Neurotechnologies] and other major research efforts. We look forward to assisting the Obama administration as it works to identify the next director.”

Insel has overseen NIMH during a period of remarkable advances in the understanding of the brain and the genetic and neurobiological underpinnings of mental illness, as well as in clinical research to improve treatment of mental illness. His leadership has helped to advance an appreciation of mental disorders as complex illnesses involving genes, interrelated neurocircuitry, environment, and behavior. He has also been instrumental in the movement toward early identification of mental illness, recognizing that many of the most serious disorders begin well before they typically come to clinical attention. 

In a statement posted on the website of the National Institutes of Health (NIH), NIH Director Francis Collins, M.D., Ph.D., said that under Insel’s leadership, NIMH has “nurtured a culture of science that puts the needs of patients with serious mental illness at the center of its efforts.” 

In addition to the BRAIN initiative, among other major initiatives in which he has been involved are the Psychiatric Genomics Consortium, which involves over 500 researchers in over 80 institutions across 25 countries; the Army STARRS (Study to Assess Risk and Resilience in Servicemembers) project, an unprecedented partnership between NIH and the Department of Defense that is the largest study of mental health risk and resilience ever conducted among military personnel; the National Database for Autism Research (NDAR), considered the most significant repository for autism-related data; and RAISE (Recovery After an Initial Schizophrenia Effort), an NIMH research effort that seeks to change the trajectory and prognosis of schizophrenia through coordinated and aggressive early treatment. 

Collins noted that Insel is planning to join the Google Life Sciences (GLS) team at Alphabet (formerly Google) to lead a new effort that will focus on mental health. The GLS mission is to create technology for earlier detection, better prevention, and more effective management of serious health conditions. In his new role, Insel will be exploring this approach for a wide spectrum of issues in mental health, Collins said. 

“We congratulate Dr. Insel on his service to NIMH and the nation,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “His new opportunity at Alphabet will increase mental health field advances well into the future, and we at APA look forward to continuing to work with him.

During the search for a successor, Bruce Cuthbert, Ph.D., will serve as acting director. 

NIH Proposes Multibillion Dollar Increase in Funding for BRAIN Initiative

Yesterday, the National Institutes of Health (NIH) called for $4.5 billion in new federal funding over 10 years—beginning in Fiscal 2016—for research as part of the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, a White House-sponsored research effort announced by President Obama last year. This would quadruple the initial budget for the multiyear project from $100 million a year for the next five years to $400 million a year.

“How the brain works and gives rise to our mental and intellectual lives will be the most exciting and challenging area of science in the 21st century," said NIH Director Francis Collins, M.D., Ph.D. (pictured above with Obama) "As a result of this concerted effort, new technologies will be invented, new industries spawned, and new treatments and even cures discovered for devastating disorders and diseases of the brain and nervous system.”

The NIH efforts on the BRAIN Initiative will seek to map the circuits of the brain, measure the fluctuating patterns of electrical and chemical activity flowing within those circuits, and understand how such factors interplay to create specific cognitive and behavioral capabilities. The NIH plans to achieve goals through the following core principles:

• Identify and provide experimental access to the different brain cell types to determine their roles in health and disease.
• Generate circuit diagrams that vary in resolution from synapses to the whole brain.
• Produce a dynamic picture of the functioning brain by developing and applying improved methods for large-scale monitoring of neural activity.
• Link brain activity to behavior with precise interventional tools that change neural circuit dynamics.
• Produce conceptual foundations for understanding the biological basis of mental processes through development of new theoretical and data analysis tools.
• Develop innovative technologies to understand the human brain and treat its disorders; create and support integrated brain research networks.
• Integrate new technological and conceptual approaches produced in the other goals to discover how dynamic patterns of neural activity are transformed into cognition, emotion, perception, and action in health and disease.

The NIH emphasized that its cost estimates for the budget for the BRAIN Initiative will be needed to supplement—not supplant—the agency’s existing investment in the broader spectrum of basic, translational, and clinical neuroscience research.

Click here to read the NIH press release for the new budget proposal for the BRIAN Initiative. For more information on the BRIAN Initiative, see the Psychiatric News articles, “BRAIN Initiative Seeks Innovations For Studying Circuits and Cells,” and "Advisory Group Draws Roadmap for President’s BRAIN Initiative.”

(Photo Courtesy of the whitehouse.gov)

Vice President Biden Hails 'Astounding Possibilities' in BRAIN Initiative, Parity Law

Understanding of the brain and treatment of mental illness and brain diseases are at a transformative crossroads. That’s what Vice President Joseph Biden said today as he presented the William C. Menninger Convocation Lecture at APA’s 2014 annual meeting in New York City. Biden said passage of the mental health parity law and the release last year of regulatory guidance for the law, along with the new Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative, announced by the Obama administration last year, are creating a transformative moment for psychiatry and patients with mental illness.

“We are on the cusp of astounding possibilities,” the vice president said. “I know that we are poised to create the tools to find new ways to treat, cure, and even prevent conditions affecting the brain. And we are on the cusp of identifying the biomarkers for mental illness, designing early prevention treatments for psychosis and revolutionizing the understanding of the brain circuitry and function. Imagine the possibilities for millions of young people right at the age when they want to explore the world if we have these tools of early detection to prevent mental illness from taking over their lives.”

Biden continued, “Just as we couldn’t imagine how the moon landing would yield technologies for semiconductors and the iPhone, I don’t think we can begin to imagine the breakthroughs that will occur tomorrow as a consequence of this BRAIN Initiative.”

Similarly, Biden said that the Mental Health Parity and Addiction Equity Act and the Affordable Care Act open new opportunities for patients to access treatment. “A major step forward is breaking down the structural barriers [to care] and expanding access,” he said. “I am fully aware that enforcement is the key, but patients are now empowered to find out more information and to hold their insurer accountable if they are denied coverage. None of us believe that will automatically happen—this is new territory. But rest assured that we know the next step is enforcement and getting it right.”

Biden hailed the work of psychiatrists, recalling a visit he received from a college roommate whose son had serious mental illness. “I remember the metaphor he used…. He said, 'I don’t know what to do. I feel like my boy is at the end of a string, and if I pull too hard it will break. And I will lose him forever.’

“I found the metaphor incredibly compelling,” Biden said. “There are too many people who know that feeling—they don’t know what to do, but they know if they pull too hard that string may break and they will lose their blood. "But you give them hope they are not alone," Biden said to the thousands of psychiatrists sitting before him and watching from monitors placed at a number of annual meeting locations. "We need you more than ever, and frankly we need more of you. You are the only ones who can help pull the string and significantly decrease the prospect that it will break.”

APA leaders hailed the vice president’s remarks. “I am delighted that Vice President Biden accepted our invitation to address the thousands of attendees at APA’s 2014 annual meeting,” said APA President Jeffrey Lieberman, M.D. “The vice president has been an ardent advocate for improved mental health services, the elimination of stigma, and increased research on mental illness. The administration's pledge last year to devote $100 million to increasing access to mental health services, convening the White House National Conference on Mental Health in 2013, and the Brain Research Through Advancing Innovative Neurotechnologies Initiative have demonstrated the president and vice president's commitment to addressing this critical public-health need. Vice President Biden has shown great insight and compassion for the plight of individuals with mental illness and appreciation for the ability of health care services to reduce the suffering of the people so afflicted and the burden of illness to our country.”

Incoming APA President Paul Summergrad, M.D., called Biden a “staunch ally in the battle to end the stigma surrounding mental illness and to guarantee that everyone who needs appropriate psychiatric care receives it. It was a rare honor to hear Mr. Biden say this with the true passion that he so clearly feels. We are grateful for the support of the vice president and the administration for making sure that mental health care occurs for all who need it."

APA CEO and Medical Director Saul Levin, M.D., M.P.A., said, “It is to the nation’s benefit that we in the mental health and psychiatric treatment field can look forward to participating in the work with Vice President Biden that will transform the way mental illness is treated in this country with respect to equality of services, access, and network adequacy for persons with mental health needs.”

BRAIN Initiative Urged to Focus on Circuitry and Behavior

President Obama’s BRAIN Initiative, announced in April, should develop new research tools and increased collaborations with non-neuroscientists as it focuses on complex circuits and activity in the brain, said an advisory group's interim report presented yesterday at the National Institutes of Health.

The program should begin by generating a census of cell types and create structural maps of the brain, said committee co-chairs Cornelia Bargmann, Ph.D., a professor at Rockefeller University in New York, and William Newsome, Ph.D., a professor at Stanford University, in a teleconference. “We’re seeking an understanding of the dynamics of the brain: where signals come from and how they are related to internal states,” said Newsome.

Work should begin with animal models, but human research data could come from patients undergoing diagnostic brain imaging or monitoring or those receiving deep brain stimulation or other technological interventions, the group suggested. Key to the suggested approach will be development of new or improved technologies to record brain activity and to manipulate brain circuits. That research and the tools to process the immense quantities of data require close collaboration among neuroscientists and computer specialists, statisticians, physicists, engineers, and other scientists. Rapid dissemination of these tools as they are developed, through training modules and summer courses, would accelerate progress, said Bargmann and Newsome. The focus on technology development fits with the initiative's overarching mission, which is, as the BRAIN acronym suggests, “Brain Research through Advancing Innovative Neurotechnologies.”

The advisory committee will present its final report in June 2014.

For more in Psychiatric News about the BRAIN Initiative, see "Obama Calls for Major Initiative to Advance Brain Research."

(Image: Traffico/Shutterstock.com)

Obama Launches Brain Research Program, Vows Major Investment

“This is a once-in-a-lifetime opportunity for neuroscience to advance,” said APA President Dilip Jeste, M.D., after attending a White House meeting at which President Obama announced a new initiative to further research on the human brain. Such advances can ultimately benefit patients with psychiatric disorders, Jeste told Psychiatric News.

The BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative will link research supported by the Defense Advanced Research Projects Agency, the National Institutes of Health, and the National Science Foundation. “The president will set aside $100 million in next year’s budget for developing knowledge about how the brain functions through the use of innovative neurotechnology,” Jeste said. Private foundations will also contribute substantial funds.

"This new public-private partnership initiative offers a great opportunity to accelerate the support of research that can lead to breakthroughs for the treatment and ultimately prevention and cure of mental illness," said Jeffrey Borenstein, M.D., editor in chief of Psychiatric News and president of the Brain and Behavior Research Foundation, who also attended the White House meeting.

"The more we know about the brain, the more we will know about brain diseases, including serious mental illnesses,” said Jeste, a professor of psychiatry and neurosciences at the University of California, San Diego.

“It will take a lot of effort to achieve this,” he said. “It is more complicated than the human genome project, because that had an outcome in mind. Here, we don’t have an outcome in mind. That makes it much more challenging and, at the same time, much more exciting.”

To read more about the latest developments in brain research, see Psychiatric Newshere. For a fact sheet from the White House about the BRAIN Initiative, click here.