The National Institute of Mental Health (NIMH) is proud of its portfolio of research on mental illness. The goals of NIMH research are
to better understand, treat, prevent and, ultimately, cure mental illnesses. This is accomplished by work on many fronts, such as
investigating the basic science of brain and behavior, applying these findings to an understanding of what goes wrong to produce
mental illness, developing and testing treatments, and discovering the best ways to deliver treatments to people with mental illness.
The National Alliance for the Mentally Ill (NAMI) advocates for individuals with severe mental illnesses: schizophrenia,
manic-depressive illness (bipolar disorder), severe depression, obsessive-compulsive disorder and severe panic disorder, altogether
estimated to encompass 5.6 million Americans. NIMH supports substantial and indeed increasing research efforts on the treatment
of these disorders, which are central to our mission. For, example, since 1997 (the year analyzed by NAMI), the NIMH initiated four
large scale clinical trials on schizophrenia, bipolar disorder, serious (treatment-resistant) depression, and adolescent depression,
with a total planned expenditure of $103 million.
Despite our profound concern for people with serious and persistent mental illness, we cannot turn our backs on other mental
illnesses, which affect large numbers of Americans, disabling adults and keeping children from learning. Indeed we have faith that
while most NAMI members would agree that NIMH should attend closely to the research needs of the 5.6 million Americans
described in NAMI’s report, there are both adequate resources and a moral imperative to do more. Nineteen million Americans suffer
from depression. Fortunately, the majority do not suffer from the most severe forms, but this illness nonetheless takes an enormous
toll; indeed it is the leading cause of disability in the United States. We cannot neglect post-traumatic stress disorder. Nor can we
ignore eating disorders, such as anorexia nervosa, an illness that kills 10% of its victims. America’s parents deserve the best
possible information about attention deficit hyperactivity disorder (ADHD) and its treatments. Thus next week, the NIMH will release
the results of the Multimodal Treatment Study of Children with ADHD, the largest and longest clinical trial to date comparing
stimulant medication with behavioral therapies. Similarly we cannot abandon children and families with autism, related developmental
disorders, or conduct problems that may represent the beginnings of a mental illness. We can no more walk away from these
illnesses than we can from the problem of youth violence that the Congress has particularly asked us to address in the wake of
Littleton and other tragic school shootings.
By our calculation, in 1997 of the $440 million appropriated to NIMH for non-AIDS research, $351 million or 80% was spent on
research relevant to mental illness or its underlying brain and behavioral science. The majority of the remainder was spent on other
research topics of concern to the American people as expressed by the Congress, such as child abuse and youth violence.
The NAMI report criticizes the Institute’s AIDS research. This is disingenuous since the AIDS research budget in 1997 was
separately provided and monitored by Congress through the NIH Office on AIDS. As the principal authors of the NAMI report are well
aware, this is money that NIMH would not otherwise have had, and could not have used for other purposes. The report is also cruel
because it invites divisiveness between the mental illness and AIDS advocacy communities. (This, despite the fact that people with
severe and persistent mental illness are among the groups at highest risk for HIV/AIDS). NIMH is proud that behavioral prevention
research on AIDS supported by the Institute has saved many lives.
We strongly disagree with the suggestion of the NAMI report that basic research on brain and behavior could be ceded to other
agencies with no harm to people with mental illness. At the NIH every institute shoulders its part of the overall responsibility for basic
science research—our greatest hope for the future. While other institutes also study basic neuroscience, each does so in the
context of its own research goals. Thus, for example, the National Institute of Neurological Disorders and Stroke has a large basic
neuroscience program, but most of the studies have very specific foci irrelevant to mental illness such as nerve regeneration in the
spinal cord. We cannot expect them to champion the research on thought and emotion that we support, nor can we expect them to
push the basic scientists they fund to look for applications to mental disorders. Indeed, while our current clinical research could
greatly improve the lives of those with schizophrenia, without progress in basic science, it is unlikely to produce a cure. The goals of
NIMH for individuals with schizophrenia and other mental illnesses must be nothing less than cures. To turn our back on basic
science would be to turn our back on hope.