Psychiatrists Warn Congress About Danger of Cutting Research Funds

J. Raymond DePaulo, M.D., took time from his many obligations in March to visit Capitol Hill and talk about the “little things” of life. In his case, the little things are genomics and genetics, research that needs additional funds at a time when Congress is considering leveling off or cutting back medical research support.

“The research progress made in the last 30 years has changed the nature of cancer treatment. We can make that kind of progress in psychiatry—create options—if we progress in our understanding of how the drugs we use do what they do,” said DePaulo, chair of the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine.

He talked to Psychiatric News while on the way to Capitol Hill in early March as part of APA's 23rd Annual Academic Consortium, which brings medical researchers to Washington, D.C., to learn about health policy and contact members of Congress.

DePaulo urged members of Congress to help continue medical research that has begun to delve into understanding how treatments affect patients on the molecular level. A deeper understanding of mental illness through genetics and genomics will allow researchers to understand why some drugs work in some patients and not others.

The efforts of DePaulo and other researchers to raise the issue of mental health research in Congress came as it began considering President Bush's Fiscal 2007 budget request, which includes funding the National Institutes of Health (NIH) at the Fiscal 2006 level, or $28.6 billion. Mental health advocates consider this a reduction, in light of an expected 3.5 percent increase in biomedical costs this year.

“We want a 5 percent increase in NIH funding in order to not lose the momentum of the last decade and a half,” said James H. Scully Jr., M.D., APA's medical director. “There's a huge commitment to it, so you can't turn off medical research like a TV.”

Scully said the aim of the Capitol Hill visits is to put a human face on the research and those who make financial sacrifices to conduct publicly funded research, which may otherwise appear only as a line item to legislators.

Thomas Insel, M.D., director of the National Institute of Mental Health (NIMH), told Academic Consortium attendees that the doubling of NIH's research budget since 1998 has allowed the development of tools to identify which patients will best benefit from psychotherapy and which require medication. The feeling among policy-makers is that NIH's consistent budget increases in recent years have given it a lead over other agencies and departments that now lag by comparison.

Research over the last decade has given the NIMH a 10,000-patient dataset, and now funding is needed to analyze how those data can inform mental health care.

Insel suggested that psychiatrists approach lawmakers with specifics and focus on topical issues, such as increased funding for veterans. Recent studies report about 60,000 returning Gulf War veterans could have posttraumatic stress disorder, and up to 5 percent of those may commit suicide.

Cindy Miner, Ph.D., deputy director of the Office of Science Policy and Communications at the National Institute on Drug Abuse (NIDA), told symposium attendees that the surge in NIH research funding in recent years allowed solid advances, such as the study and perfection of buprenorphine for office-based treatment of opioid addiction. Such research and treatment are at least partially responsible, she said, for a 19 percent drop in drug abuse by youth since 2000.

NIDA's 2006 priorities include research on preventing drug abuse, developing better methamphetamine treatment programs, and cutting the rise in AIDS rates among adolescent girls stemming from intravenous drug use, Miner said. NIDA also aims to better support young researchers, who have difficulty obtaining funds when competing with established colleagues.

John Nurnberger Jr., M.D., Ph.D., a medical researcher at Indiana University, said his work is heavily dependent on continued support from NIH and NIDA. He visited members of Congress with the message that research on treatments for mental illness is very cost-effective because it alleviates substantial costs incurred by those left untreated. His research has identified genes linked to bipolar disorder and substance abuse, but another“ funding push” is needed to clarify the association of those genes with specific disorders.

“We're in serious danger of having investigators drop out of the system because of the budget cuts,” Nurnberger said.

James Harris, M.D., urged members of Congress to support the training of more child psychiatrists through a federal loan-forgiveness program. The shortage of such specialists, who number about 6,700, will grow worse since four child psychiatry training programs have closed in the last 10 years.

The decline in numbers has coincided with a surge in prescriptions for children and adolescents by pediatricians and general practitioners, who sometimes lack a comprehensive understanding of potentially harmful side effects of antipsychotics and antidepressants. ▪