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RESEARCH WEEKLY: NIMH funding priorities still failing people with SMI
By Shanti Silver
(August 23, 2023) Schizophrenia and bipolar disorder are two of the most difficult mental illnesses to treat. Accordingly, funding for research into treatments that improve quality of life and decrease symptoms for people living with these severe mental illnesses (SMI) is essential.
In a recent article, Treatment Advocacy Center Founder Dr. E. Fuller Torrey, along with co-authors Wendy Simmons and Lisa Dailey, reviewed the National Institute for Mental Health’s (NIMH) funding portfolio to determine how funding for research into schizophrenia and bipolar disorder has changed in recent years. Findings indicate a decrease in NIMH funding for SMI research from 2017 to 2022.
Basic research and clinical research
Basic research and clinical research are two types of SMI research funded by NIMH:
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Basic research seeks to understand underlying causes of SMI but typically does not lead to findings that immediately help people with SMI to recover. An example of basic research might be identifying specific genes that are associated with SMI.
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Clinical research focuses on developing and studying treatments that can be used immediately or in the near future to improve the lives of people with SMI. Drug trials (i.e., the development and testing of new medications) are one type of clinical research.
While insights from basic research may help to develop treatments for people with SMI in the distant future, clinical research is critical for developing treatments for people who currently have SMI, especially those who do not see improvements with existing treatments. According to research from the RAND Corporation, clinical research has had a greater impact on improving treatment for people with schizophrenia than basic research during the twenty years after the research was completed.
However, since the mid-1990s, NIMH has prioritized funding basic research, particularly genetic research, with funding for clinical research making up less than 10% of all research funding. Not only is this skew toward funding basic research much greater than that of other countries, but NIMH-funded genetic studies have also not led to significant improvements in the treatment of schizophrenia.
The present state of NIMH SMI research funding
To determine the current state of NIMH funding for SMI research, the authors of this study reviewed the ClinicalTrials.gov and NIH Research, Condition, and Disease Categorization (RCDC) databases to identify research funded by NIMH from 2017 to 2022.
Findings suggest that throughout this six-year period, NIMH has funded only one drug trial for schizophrenia and one for bipolar disorder. In addition to this low number of drug trials, NIMH has also reduced its funding for all SMI research. The number of funded studies on schizophrenia and bipolar disorder decreased by 21%, from 643 studies in 2016 to 506 studies in 2022. The proportion of NIMH’s budget spent on SMI research also decreased from 19.2% in 2016 to 14.3% in 2022. This decrease in SMI research comes at the same time as a historically large budget increase for NIMH, leading the authors of this paper to say that “it appears that the more money Congress gives to NIMH, the less research it does on schizophrenia and bipolar disorder.”
The impact of deprioritizing SMI research
While NIMH decreases funding for SMI research, people with schizophrenia and bipolar disorder continue to experience homelessness, incarceration, and premature death at rates much higher than the general population. Given the high rates of preventable tragedy and the economic burden of SMI, there is clearly a need to increase research into treatments that can help people with SMI to manage their symptoms. The authors conclude their article by calling for public review of NIMH’s research funding practices.
References
Torrey, E. F., Simmons, W. W., & Dailey, L. (August 2023). NIMH Research Portfolio: An Update. The Primary Care Companion for CNS Disorders, 25.
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