NIMH Releases 2020 Strategic Plan for Research

The National Institute of Mental Health (NIMH) has released an updated Strategic Plan for Research. The 2020 plan builds on successes of previous NIMH strategic plans, remaining focused on the following four core goals:

• Define the brain mechanisms underlying complex behaviors.

• Examine mental illness trajectories across the lifespan.

• Strive for prevention and cures.

• Strengthen the public health impact of NIMH-supported research.

Together, these goals provide a framework to direct institute resources to research that spans the mental health continuum over the next five years—from the fundamental neuroscience underlying human behavior to new treatments for mental illness that can benefit patients today.

There have been significant advances in neuroscience and mental health care since the NIMH released its 2015 strategic research plan, NIMH Director Joshua Gordon, M.D., Ph.D., wrote in the introduction to the plan. “In translational sciences, we celebrated the U.S. Food and Drug Administration (FDA) approval of two of the first truly novel antidepressants in decades—esketamine for treatment-resistant depression and brexanolone for postpartum depression,” he wrote. “And in intervention research, NIMH-sponsored studies proving the utility of coordinated specialty care for first-episode psychosis resulted in the nationwide implementation of this evidence-based care model through state-supported mental health clinics.”

Despite these advances, many challenges—including the continual rise in suicide rates across people of all age groups, genders, races, and ethnicities; inequitable access to mental health care; and stigma—remain, Gordon wrote.

“These challenges must be met by harnessing promising opportunities. The NIMH Strategic Plan for Research maps out our path,” he continued. “From basic research aimed at understanding how the brain produces behavior, to translational efforts to uncover novel treatment targets, to clinical studies testing novel approaches, we’ve charted numerous routes linking these challenges and opportunities. Each has the potential to deliver significant advances in mental health care.”

In a column published in JAMA Psychiatry, Gordon and NIMH colleagues Shelli Avenevoli, Ph.D., and Jane Pearson, Ph.D., expanded on the institute’s vision for suicide prevention. Noting that recent studies have demonstrated the feasibility of suicide screening and interventions in high-risk settings such as emergency departments, Gordon and colleagues hope to bring more suicide prevention into routine care over the next five years. Some research goals include bundling suicide prevention into a collaborative care model, refining algorithms that scan electronic health records to predict people at high suicide risk, and identifying more rapid-acting medications like esketamine that decrease suicide risk.

The 2020 Strategic Plan for Research is not a static document like its predecessors. This version will be a living, web-based document that the institute will update regularly as new priorities, new challenges, and/or new opportunities materialize.

As part of this shift online, NIMH has created “progress pages” for each of the four key research goals, which will highlight key findings by researchers funded by NIMH. Gordon stated that these webpages will enable researchers and the public to see for themselves how well NIMH is following its plan, reinforcing the institute’s commitment to transparency and accountability.

“The COVID-19 pandemic has highlighted the uncertainties we all face, but also the value of a good plan,” Gordon wrote in his director’s blog in May. “A good plan assesses where you’re at and identifies where you want to go. It sketches out a pathway to get there and identifies priorities, opportunities, and anticipated pitfalls. But, as COVID-19 has reminded us, a good plan also remains flexible, because you never really know what you’ll encounter along the way.”

As with previous incarnations, the 2020 Strategic Plan for Research was developed with input from many stakeholders including NIMH leaders and staff, the institute’s National Advisory Mental Health Council, and other federal and private partners. In addition, a draft version was made available for comment this past winter; NIMH noted that the institute received feedback from many stakeholders, including scientists, advocacy groups, and individuals with lived experience, which helped shape the published version. ■