RESEARCH WEEKLY: The Decline of Clinical Research on Serious Mental Illness at the NIMH

By Elizabeth Sinclair Hancq

(April 7, 2021) Yesterday, Treatment Advocacy Center founder Dr. E. Fuller Torrey, along with co-authors Wendy Simmons, Elizabeth Sinclair Hancq and John Snook, published an article in Psychiatric Services on the continuing decline of clinical research on serious mental illness at the National Institute of Mental Health (NIMH).

The authors utilized three different publicly available data sources to examine the shift of NIMH resources from clinical toward basic science research: Research Condition and Disease Categorization (RCDC) database, ClinicalTrials.gov, and the NIMH Strategic Plan for Research for 2020–2024.

Utilizing the RCDC database, the authors found that between 2016 and 2019, NIMH decreased research projects related to bipolar disorder by 25% and projects on schizophrenia by 17.5%. Additionally, an analysis of data from ClinicalTrials.gov revealed that between 2003 and 2019, NIMH decreased support for treatment trials on schizophrenia, bipolar disorder and major depressive disorder by 90%. Finally, a careful review of the NIMH Strategic Plan for Research suggests there is little to no plan to shift priorities at the NIMH for the next five years. In total, the assessment reveals a continuing decline of clinical research on serious mental illness at the NIMH and that the shift towards basic research will continue.

The article is published as an open access piece, meaning it is available in full to the public without the subscription paywall that most peer-reviewed articles are published behind. In addition to the published article, online supplemental materials are provided that offer further details, including:

  • Instructions for how to utilize the RCDC database for research,
  • Table of NIMH research expenditures by diseases and conditions, 2016–2019,
  • Table of number of NIMH-funded drug treatment trials by disease, 2006–2019,
  • Graph of the total number of NIMH-funded drug treatment trials for serious mental illnesses, 2006–2019,
  • Analysis of changes to the 2020–2024 Strategic Plan after the public comment period, including a flow chart of the changes, and
  • Instructions for how to use clinicaltrials.gov.

The National Institute of Mental Health was established in 1948 to conduct research on neuropsychiatric disorders targeted to the most serious of psychiatric diseases including schizophrenia, bipolar disorder and depression. The research was expected to include both basic studies of brain function and clinical studies to help individuals currently affected by these disorders. The findings from this article suggest that the NIMH should re-balance its research portfolio so that basic and clinical studies receive more equal weight.
Elizabeth Sinclair Hancq is the director of research at the Treatment Advocacy Center.

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