(Oct. 11, 2016) "Who am I, and where is the NIMH headed?"
With those words, Joshua A. Gordon, an MD and PhD from the Columbia University School of Medicine, introduced himself in September to the Alliance for Research Progress, a panel of advocacy organizations the National Institute of Mental Health (NIMH) convenes regularly.
Gordon assumed direction of the NIMH in August.* He succeeds Thomas Insel, who led the nation's $1.5 billion mental health research arm for 13 years until resigning in October 2015 to join Google.
Where Is the NIMH Headed?
Gordon takes over against a backdrop of criticism from psychiatric leaders and others that the NIMH has overinvested in long-term research into the neurobiological mechanisms of mental illness at the expense of an immediate-term search for interventions to improve the lives of people living with serious mental illness today.
The NIMH is the largest source of mental illness research in the world. In June, the British Journal of Psychiatry published an editorial authored by 20 eminent psychiatrists and psychiatric researchers calling for the NIMH to rethink its funding priorities and put more emphasis on research into prevention and treatments. The call echoed dissatisfaction that has grown in recent years among researchers who concentrate more on translating science into practice than on brain science itself.
Gordon, who had an active psychiatry practice treating patients with serious mental illness until he left New York City for the NIMH post, spoke directly to the topic in comments to representatives of the two dozen organizations at the briefing, including the Treatment Advocacy Center.
"I have a balanced portfolio with experience on both ends of the spectrum - clinical and science," he told the gathering. "I recognize that we cannot focus exclusively on long-term investments. We need medium-term investments for next 10 to 20 years and short-term investments to impact treatment patterns and practices in next three to five years. That's how to balance the portfolio for maximum impact on patients now and treatments of the future."
Three Priorities
The new director said he does not have specific priorities - "get rid of this or start up that immediately" - but does have three areas of particular interest.
- "We need to bring more math into psychiatry" by getting better at applying mathematical principles to analyzing massive datasets. An example is President Obama's Precision Medicine Initiative to build a million-person precision medicine study.
- "We need better technologies to observe neurons and modify behavior based on them." An example would be isolating the source weight-gain effects of antidepressant and antipsychotic medications from the symptom-control effects in order to develop better pharmaceuticals.
- "We have to go after the low-hanging fruit in the clinical sphere, where we know enough about treatment to move quickly." An example is the Recovery After Initial Schizophrenia Episode research known as RAISE that the NIMH funded under Insel. The number of early-intervention clinics in the United States skyrocketed from two to 116 in two years after the project was completed.
Gordon said "psychiatry often thinks in terms of research into deficits, not research into what helps people recover or research into resilience." He told the Alliance that more research answering the question of why some people recover and others don't is needed.
As a scientist with a research laboratory at Columbia, Gordon focused on neural activity in mice and pioneered methods used to study brain plasticity in the mouse visual system. "We have to move emerging technologies from animal tests to human tests," he told the audience more than once.
Gordon's overall message to the group for the year ahead: "I want to spend the next year learning from advocates, scientists and NIMH staff what is working, what could use some help. I have some ideas of priorities so I'm not coming in completely blind, but I have a lot of listening to do."
Doris A. Fuller
Chief of Research and Public Affairs
*The author of this report served on the search committee that recommended Gordon for the post.
References:
- Office of Research & Public Affairs. (28 June 2016). RESEARCH WEEKLY: A call for new priorities at the NIMH. Treatment Advocacy Center.
- Lewis- Fernández, R. et al. (June 2016). "Rethinking funding priorities in mental health research." British Journal of Psychiatry.
Next Week: What Precision Medicine Holds for Mental Health
Research Weekly is a summary published as a public service of the Treatment Advocacy Center and does not necessarily reflect the findings or positions of the organization or its staff. Full access to research summarized may require a fee or paid subscription to the publications.
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