>> HELLO AND WELCOME TO THE
273rd MEETING OF THE NATIONAL
ADVISORY MENTAL HEALTH COUNCIL.
I AM JOSHUA GORDON, DIRECTOR OF
THE NATIONAL INSTITUTE OF MENTAL
HEALTH.
I'D LIKE TO THANK YOU ALL FOR
JOINING OUR COUNCIL TODAY.
WE HAVE A WONDERFUL, STRONG,
IN-PERSON PRESENCE OF MANY OF
OUR COUNCIL MEMBERS.
WE ALSO HAVE MANY ATTENDEES
JOINING US ONLINE AND WATCHING
THE NIH VIDEOCAST.
AS A REMINDER, OUR COUNCIL
MEETING IS A TIME FOR
INFORMATION EXCHANGE BETWEEN
INSTITUTE STAFF AND COUNCIL
MEMBERS, AS WELL AS AN
OPPORTUNITY FOR THE COUNCIL TO
PROVIDE FEEDBACK TO NIMH AND FOR
ALL OF US TO COMMUNICATE THROUGH
THE VIDEOCAST WITH THE GENERAL
PUBLIC.
WE HAVE A FULL SCHEDULE TODAY
AND I THANK YOU FOR MAKING TIME
TO PARTICIPATE IN THIS OPEN
SESSION OF THE COUNCIL, AS WELL
AS THE CLOSED SESSION TOMORROW
AT WHICH WE'LL DISCUSS GRANTS
THAT ARE UP FOR -- PROPOSED FOR
FUNDING.
BEFORE WE MOVE INTO THE BUSINESS
OF THE MEETING, I WANT TO REMIND
YOU OF A FEW LOGISTICAL ITEMS.
THE OPEN SESSION IS BEING
VIDEOCAST BROADLY TO THE NIH
COMMUNITY AND THE VIEWING
PUBLIC, ALLOWING PEOPLE TO WATCH
AND LISTEN REMOTELY.
THE MEETING IS ALSO BEING
RECORDED WHICH WILL ALLOW
VIEWING ON DEMAND AT A LATER
DATE.
WE ENCOURAGE COUNCIL MEMBERS TO
LOG INTO ZOOM AND KEEP YOUR
VIDEO ON THROUGHOUT THE MEETING
SO THAT YOU CAN BE SEEN BY THOSE
OUTSIDE OF THE MEETING ROOM.
WHEN YOU DO LOG IN, PLEASE DO
NOT CONNECT TO AUDIO THROUGH
YOUR COMPUTER.
ALL OF THE AUDIO WILL TAKE PLACE
THROUGH THE MICROPHONES AND THE
ROOM SPEAKERS.
COUNCIL MEMBERS IN THE ROOM
SHOULD USE THE TABLE MICROPHONE
WHEN SPEAKING.
AND REMEMBER TO PUSH THE BUTTON
UNTIL YOU SEE THE LITTLE GREEN
LIGHT GO ON AND REMEMBER WHEN
YOU'RE DONE SPEAKING TO PLEASE
PUSH IT AGAIN.
IT SHOULD CHANGE BACK TO RED,
INDICATING THAT YOUR MICROPHONE
IS SHUT OFF.
MEMBERS ATTENDING VIRTUALLY
SHOULD UNMUTE TO SPEAK AND
PLEASE MUTE AGAIN WHEN NOT
SPEAKING TO DIMINISH BACKGROUND
NOISE.
IF ANY USING TELEPHONE, YOU CAN
PRESS STAR 6 TO MUTE AND UNMUTE.
WE ASK THAT ALL MEMBERS PLEASE
REFRAIN FROM USE OF THE CHAT
FUNCTION IN ZOOM.
PLEASE RESERVE THAT CHAT
FUNCTION TO COMMUNICATE WITH
ZOOM HOSTS REGARDING ANY
TECHNICAL ISSUES AND PLEASE
REMEMBER THE CHAT FUNCTION IS
NOT A PRIVATE CHANNEL, IT IS A
PUBLIC CHANNEL JUST LIKE
EVERYTHING ELSE.
WHEN WE CALL FOR A VOTE
COUNCILMEMBERS SHOULD USE THE
RAISE HAND FUNCTION IN ZOOM.
IT MAY BE LOCATED IN THE ZOOM
PARTICIPANT MENU, OR AT THE
BOTTOM UNDER THE REACTIONS MENU.
VOTING COUNCILMEMBERS WHO ARE
JOINING BY PHONE SHOULD UNMUTE
BY PRESSING STAR 6 AS I
MENTIONED BEFORE SO WE CAN
CAPTURE YOUR VOTE BY VOICE.
IF YOU EXPERIENCE CONNECTIVITY
ISSUES, YOU HAVE A PHONE NUMBER
TO CALL IN.
PLEASE REFER TO YOUR PERSONAL
ZOOM EY EYE TIN R ITINERARY FOR.
THE NEXT ITEM IS TO ASK FOR
COMMENTS OR CORRECTIONS TO THE
MINUTES FROM OR LAST MEETING.
COPIES OF THOSE MINUTES WERE
PROVIDED TO YOU IN ADVANCE OF
THE MEETING.
I'LL TURN IT OVER TO TRACY TO
CONDUCT THE VOTE ON THAT.
>> THANK YOU.
SO I'M LOOKING FOR A MOTION FOR
APPROVAL OF THE JANUARY 2024
DRAFT MINUTES.
I SEE ONE AND A SECOND MOTION AS
WELL.
ALL IN FAVOR OF ACCEPTING THE
MINUTES AS WRITTEN, PLEASE RAISE
HAND.
IT'S BEST TO DO IT IN ZOOM BUT
MOST OF YOU ARE IN THE ROOM SO
WE CAN DO IT EITHER WAY.
ALL RIGHT.
IT LOOKS LIKE WE HAVE ALL THE
VOTERS.
YOU CAN PUT YOUR HANDS DOWN
VIRTUALLY.
ANY OPPOSED TO ACCEPTING THE
MINUTES?
ALL RIGHT.
ANY AB SENGSES?
ABSTENTIONS?OUR MINUTES ARE ACCK
YOU.
>> THANK YOU.
THE NEXT ITEM ON THE AGENDA IS
THE NIMH DIRECTOR'S UPDATE.
SHOULD I USE THE PODIUM?
AGAIN THANK YOU AND WELCOME AND
IT'S MY PLEASURE AND IT'S A
BITTERSWEET PLEASURE SINCE IT'S
MY LAST TIME TO PROVIDE THIS
NIMH DIRECTOR'S UPDATE FOR THE
NATIONAL ADVISORY MENTAL HEALTH
COUNCIL.
AS USUAL, WE WILL START WITH A
DISCUSSION OF CONGRESSIONAL
INTERACTIONS, GIVE YOU UPDATES
REGARDING APPROPRIATIONS AND
BUDGET.
WE NOW HAVE A BUDGET, VERY
PLEASED, AS WELL AS TO TALK
ABOUT SOME UPDATES FROM HHS AND
NIH, AS WELL AS NIMH NEWS, AND
THEN WE'LL CLOSE WITH A FEW
SCIENCE HIGHLIGHTS.
WE'VE BEEN BUSY IN CONGRESS.
BETWEEN FEBRUARY AND MAY 2024,
NIMH STAFF PARTICIPATED IN
NUMEROUS CONGRESSIONAL BRIEFINGS
AND RESPONDED TO INFORMATION
REQUESTS FROM OVER 10 MEMBERS OF
CONGRESS AND THEIR STAFF.
THE TOPICS THAT OUR LEGISLATORS
ARE INTERESTED IN INCLUDE
GENERAL HEALTH RESEARCH, MENTAL
HEALTH AND SLEEP RESEARCH,
CHILDREN'S MENTAL HEALTH,
SUICIDE PREVENTION, HEALTH
DISPARITIES, AND NOVEL TREATMENT
APPROACHES SUCH AS TRANSCRANIAL
MAMAGNETIC STIMULATION AND
ULTRASOUND.
NIH LEADERSHIP ALSO PARTICIPATED
IN A STAFF ROUNDTABLE HOSTED BY
THE SENATE AND CONGRESSIONAL
MENTAL HEALTH CAUCUSES,
ALONGSIDE REPRESENTATIVES FROM
OTHER FEDERAL AGENCIES IN THE
MENTAL HEALTH SPACE.
FINALLY, NIMH STAFF ATTENDED AND
PARTICIPATED IN CONGRESSIONAL
EVENTS INCLUDING A 10-YEAR
ANNIVERSARY RECEPTION FOR
ADVANCING CURES TODAY FOR NIH,
AND THE NIMH 75TH ANNIVERSARY
CELEBRATION ON CAPITOL HILL
HOSTED BY THE FRIENDS OF THE
NATIONATIONAL INSTITUTE OF MENTL
HEALTH.
AT THAT CELEBRATION, WE WERE
DELIGHTED TO HAVE SENATOR AMY
KLOBUCHAR LAUNCH US OFF AND HOST
US AS WELL AS THE CONGRESSIONAL
NEUROSCIENCE CAUCUS AS A HOST AS
WELL.
APPROPRIATIONS AND BUDGET
UPDATES.
MARCH 9TH, 2024, PRESIDENT BIDEN
SIGNED THE CONSOLIDATED
APPROPRIATIONS ACT OF 2024, AND
ON MARCH 23RD, SIGNED A FURTHER
CONSOLIDATED APPROPRIATIONS.
THESE TWO ACTS FUNDED THE
FEDERAL GOVERNMENT FOR THE
REMAINDER OF THE FISCAL YEAR.
IT WAS A CHALLENGING BUDGET YEAR
FOR NIH IN GENERAL.
WHERE THE DOLLARS FOR NIH HAD A
VERY MODEST INCREASE, GIVEN THE
TIGHT CONSTRAINTS NEGOTIATED
LAST YEAR BY THE PRESIDENT AND
CONGRESSIONAL LEADERSHIP.
THE GOOD NEWS FROM THE MENTAL
HEALTH RESEARCH PERSPECTIVE IS
THAT THE RECOGNITION THAT WE ARE
IN A MENTAL HEALTH CRISIS,
COUPLED WITH THE WORK THAT
CONGRESS HAS DONE UNDERSTANDING
THE MENTAL HEALTH RESEARCH
LANDSCAPE AIDED BY A LOT OF
COMMUNICATION WITH NIMH,
RESULTED IN CONGRESS GIVING A
$75 MILLION INCREASE TO OUR
BUDGET THIS YEAR, WHEN THE
MAJORITY OF INSTITUTES AT NIH
WERE FLAT.
THE INCREASE OF $75 MILLION WAS
WELCOME, AND IT WAS TARGETED,
QUOTE, TO SUPPORT RESEARCH
FOCUSED ON DEVELOPING TARGETED
PREVENTION AND TREATMENT FOR
MENTAL ILLNESSES.
THE SPECIFIC AREAS THAT WERE
MENTIONED IN THE LEGISLATIVE
LANGUAGE WERE CONSISTENT WITH
THE LANGUAGE THAT WE HAD USED IN
WORKING WITH CONGRESS TO
IDENTIFY PRIORITY AREAS FOR
EXPANSION.
AND MANY OF THE PROGRAMS THAT
YOU'LL BE TALKING ABOUT TOMORROW
IN THE CLOSED SESSION ARE A
DIRECT RESULT OF THE PROJECTS
SUPPORTED BY THIS $75 MILLION
INCREASE.
IT INCLUDES FUNDS TO SUPPORT
PRECISION PSYCHIATRY, LEARNING
HEALTHCARE, AND MANY OTHER
PRIORITIES, ESPECIALLY THOSE
ASSOCIATED WITH YOUTH MENTAL
HEALTH.
AND WE'LL TALK MORE ABOUT THAT
TOMORROW, BUT WE'RE REALLY
PLEASED THAT IN THIS CHALLENGING
BUDGET YEAR, CONGRESS FELT IT
IMPORTANT ENOUGH NONETHELESS TO
INCREASE THE RESOURCES AVAILABLE
FOR MENTAL HEALTH RESEARCH
THROUGH THE NIMH BUDGET.
THE PRESIDENT HAS PROPOSED A
FISCAL YEAR 2025 BUDGET WHICH
REQUESTS AN ADDITIONAL INCREASE
TO MENTAL HEALTH RESEARCH AT
NIMH OF TWO HUNDRED MILLION
DOLLARS, AND OF COURSE IT'S UP
TO CONGRESS HOW TO EXECUTE THAT
BUDGET, BUT WE LOOK FORWARD TO
LEARNING MORE ABOUT THIS PROCESS
AS THE SUMMER UNFOLDS.
ACCORDINGLY, WE'VE NOW BEEN
THROUGH APPROPRIATIONS HEARINGS
SEASON ON MAY 23RD, 2024.
DR. MONICA BERTAGNOLLI, WHO AWR
GOINGAWR -- WHO YOU'RE GOING TOR
FROM VERY SOON, TESTIFIED BEFORE
THE SENATE APPROPRIATIONS
COMMITTEE, ALL IN SUPPORT OF
THAT PRESIDENTIAL BUDGET REQUEST
THAT I JUST MENTIONED.
S SO WHAT IS THE NIMH BUDGET FOR
2024?
WE'RE REALLY PLEASED -- SORRY,
I'M GOING TO GO HERE FIRST --
THAT OUR BUDGET OVERALL
NON-BRAIN BUDGET IN LIGHT BLUE,
WENT UP TO APPROXIMATELY
$2.2 BILLION THIS YEAR.
WITH AN EXTRA APPROXIMATELY
$70 MILLION ALLOCATED TO THE
BRAIN INITIATIVE.
THAT REPRESENTS A CONTINUED
INCREASE IN APPROPRIATED DOLLARS
FOR THE NON-BRAIN PORTION OF OUR
BUDGET, AND REPRESENTS A
CONTINUED INCREASE IN BUYING
POWER OVER WHEN I STARTED AT
LEAST IN 2016.
I WILL MENTION SINCE WE'RE ON
THE TOP ECK TOPIC OF THE BRAIN
INITIATIVE, DUE TO THE WAY THE
20TH CENTURY CURES ACT WHICH WAS
PASSED IN 2016 ALLOCATED DOLLARS
OVER THESE ENSUING 10 YEARS,
THERE WAS A DECREASE IN BRAIN
INITIATIVE FUNDING THIS YEAR.
BOTH TO NIMH AND TO THE OTHER
INSTITUTES THAT RECEIVE IT.
AND BRAIN INITIATIVE LEADERSHIP
IS WORKING HARD TO TRY TO
MINIMIZE ANY POTENTIAL NEGATIVE
IMPACT IN THAT DECREASE IN
APPROPRIATIONS.
WHAT ARE WE ABLE TO DO WITH THAT
BUDGET?
WE ANTICIPATE BEING ABLE TO KEEP
SUCCESS RATES STEADY WHILE
INCREASING THE NUMBER OF GRANTS
THAT WE GIVE OUT IN 2024, AND OF
COURSE YOU'VE ALREADY APPROVED
MANY OF THOSE GRANTS FOR FUNDING
IN THE PREVIOUS TWO COUNCIL
ROUNDS, AND WE WILL UNDERGO THE
THIRD COUNCIL ROUND OF APPROVALS
TOMORROW.
WE'RE VERY EXCITED WITH ALL THE
WONDERFUL SCIENCE WE ARE ABLE TO
FUND, AND THE EXPANSION OF THE
PROGRAMS THAT I JUST MENTIONED
FACILITATED BY THE MODEST
INCREASE TO OUR BUDGET THIS
YEAR.
I'LL GIVE YOU SOME UPDATES FROM
HEALTH AND HUMAN SERVICES, THE
DEPARTMENT WE ARE PART OF, THAT
ARE RELEVANT IN PARTICULAR FOR
MENTAL HEALTH.
ON APRIL 23RD, 2024, HHS
RELEASED THE 2024 NATIONAL
STRATEGY FOR SUICIDE PREVENTION.
THIS IS THE FIRST UPDATE TO OUR
NATIONAL STRATEGY FOR SUICIDE
PREVENTION IN ABOUT 10 YEARS.
ITS FOUR STRATEGIC DIRECTIONS
ILLUMINATED ON THE SLIDE ARE
ALIGNED WITH RECOMMENDATIONS
THAT NIMH AND OTHERS HAVE BEEN
MAKING THROUGH ORGANIZATIONS
LIKE THE NATIONAL ACTION
ALLIANCE FOR SUICIDE PREVENTION.
MANY OF NIMHERS WORKED IN
CONCERT WITH MEMBERS OF THE
OFFICE OF SCIENCE AND TECHNOLOGY
POLICY AND THE DOMESTIC POLICY
COUNCIL TO HELP ENSURE THAT THIS
STRATEGY REFLECTS THE LATEST IN
EVIDENCE AND SUICIDE PREVENTION,
AND I'LL JUST SAY AS AN ASIDE,
THIS WAS ONE OF MY PRIORITIES
COMING INTO MY TENURE AT NIMH,
AND WE SUCCEEDED IN DRAMATICALLY
INCREASING THE AMOUNT AND I
THINK ALSO THE QUALITY OF
SUICIDE PREVENTION RESEARCH THAT
NIMH SUPPORTS SUCH THAT WE'RE
FUNDING THREE TIMES AS MUCH
RESEARCH IN THIS AREA AS WE WERE
IN 2016.
THE RESEARCH HAS RESULTED IN
EVIDENCE-BASED APPROACHES THAT
CAN ADDRESS SUICIDE ACROSS
MULTIPLE LEVELS OF SOCIETY AND
ESPECIALLY UNTIL TYPICALLY
UNDERSERVED AND UNDERRESOURCED
AREAS.
THE STRAT STRATEGY IDENTIFIES AL
ACTIONS AGENCIES CAN TAKE AND
NIMH VITAL THERE IN TERMS OF
PRIORITY AREAS FOR OUR FUTURE
RESEARCH ENDEAVORS.
THE NIMH ALSO AS YOU KNOW ON
BEHALF OF HHS RUNS THE
INTERAGENCY AUTISM COORDINATING
COMMITTEE.
WE HAVE AN ACTIVE SPRING WITH A
FULL COMMITTEE MEETING
PUBLICATION OF THE PORTFOLIO
ANALYSIS REPORT AND EVENTS IN
CELEBRATION OF AUTISM ACCEPTANCE
MONTH, AND WE'RE VERY PLEASED
WITH THE WORK THAT IACC HAS BEEN
DOING AS THAT COMMITTEE WILL
SUNSET THIS SUMMER AND THE
CONCLUSION OF THE EXISTING ACT
AND CONGRESS IS HARD AT WORK ON
RENEWAL OF THAT ACT THAT WILL
LIKELY AUTHORIZE A NEW COMING
NEXT YEAR.
A BUNCH TO UPDATE YOU ON FROM
THE NIH.
AND MANY OF THEM WILL AFFECT
MANY OF THE GRANTEES, THOSE OF
YOU IN THE ROOM, AND ALSO THOSE
OF YOU LISTENING MIGHT WANT TO
PAY ATTENTION TO THESE NEXT FEW
SLIDES.
FOR SEVERAL YEARS NOW, THE
CENTER FOR SCIENTIFIC REVIEW AND
OTHERS AT NIH HAVE BEEN WORKING
ON SIMPLIFYING THE REVIEW
FRAMEWORK FOR NIH RESEARCH
PROJECT GRANTS.
IN ORDER TO MAKE SURE THAT THE
REVIEWERS ARE GRADING
APPLICATIONS BASED UPON THE
QUALITY OF RESEARCH AND THE
LIKELIHOOD OF SUCCESS, AS
OPPOSED TO REPUTATIONAL FACTORS
OF INDIVIDUAL INVESTIGATORS OR
INSTITUTIONS, THE PREVIOUS FIVE
REVIEW CRITERIA HAVE BEEN
REORGANIZED INTO THREE FACTORS.
AND THE FACTORS SUBJECT TO THAT
BIAS, INVESTIGATORS OR THE
ENVIRONMENT WILL BE EVALUATED AS
SIMPLY SUFFICIENT OR GAPS
IDENTIFIED AND THOUGH IT WILL BE
CONSIDERED IN THE OVERALL IMPACT
SCORE, THERE WILL NO LONGER BE
INDIVIDUAL SCORES IN THE REVIEW
PROCESS ASSIGNED TO INVESTIGATOR
AND ENVIRONMENT.
ADDITIONAL REVIEW CRITERIA
INCLUDING INCLUSION STUDY
TIMELINES, ET CETERA, RELATED TO
HUMAN SUBJECTS, WILL BE
EVALUATED WITHIN THE FACTOR TWO
WHICH INVOLVES THE QUALITY AND
RIGOR OF THE SCIENCE TO ENSURE
THAT THOSE FACTORS ARE TAKEN
INTO CONSIDERATION WHEN THE
APPLICATION IS SCORED.
MOST OTHER ADDITIONAL REVIEW
CONSIDERATIONS THAT REALLY DON'T
HAVE MUCH TO DO WITH THE QUALITY
OF THE SCIENCE BUT RATHER WITH
OPERATIONAL DETAILS HAVE BEEN
SHIFTED IN RESPONSIBILITY FROM
THE REVIEWERS TO NIH STAFF WHO
CAN JUST MAKE SURE THAT THOSE
REQUIREMENTS ARE MET.
THESE CHANGES WE HOPE WILL
BETTER FACILITATE THE
OVERARCHING GOAL PEER REVIEW,
WHICH IS TO IDENTIFY THE
STRONGEST AND HIGHEST IMPACT
RESEARCH.
THERE'S A PUBLIC WEBSITE THAT
DESCRIBES THESE REVIEW
FRAMEWORKS.
IT'S GOING TO BE A WORK IN
PROGRESS, OF COURSE, AS WE TRAIN
REVIEWERS, AND WE ENSURE
APPLICANT KNS KNOW WHAT TO EXPET
THROUGH THE REVIEW PROCESS, AND
WE WELCOME FEEDBACK ALONG THE
WAY.
NEXT I WANT TO MENTION AN
EXCITING NEW PROGRAM THAT IS A
PRIORITY OF THE NEW NIH
DIRECTOR, DR. BERTAGNOLLI, IN
RECOGNITION THAT MANY HEALTH
INDICES OF THE U.S. POPULATION
ARE IN DECLINE AND THAT THAT
DECLINE STEEPEST AMONGST THE
UNDERSERRSESERVED AND
UNDERREPRESENTED.
DR. BERTAGNOLLI HAS INSPIRED THE
NIH TO WORK ON DEVELOPING A
CLINICAL RESEARCH NETWORK
EMBEDDED WITHIN PRIMARY CARE
SETTINGS TO ENSURE, ONE, AN
ACTIVE DISEASE-AGNOSTIC CLINICAL
RESEARCH NETWORK THAT CAN
FACILITATE CLINICAL RESEARCH
RELEVANT TO ALL THE INSTITUTES
AND CENTERS, AND TWO, TO MAKE
SURE THAT THAT INNOVATIVE
RESEARCH IS INTEGRATED WITH AN D
ENGAGED IN COMMUNITIES WITH
UNDERREPRESENTED CLINICAL
RESEARCH.
WE'VE BEEN GATHERING FEEDBACK
FROM THE COMMUNITY ON IDEAS THIS
SPRING WITH A PLAN TO LAUNCH
THIS NETWORK WITH SOME EXISTING
AND SOME NEW CAPABILITIES
STARTING IN THE FALL OF 2024
WITH FUTURE EXPANSIONS AS BUDGET
PERMITS.
WE'RE REALLY EXCITED ABOUT THE
POTENTIAL FOR THIS APPROACH.
WHILE NIMH HAS FOR LOTS OF
DIFFERENT REASONS BEEN -- NOT
BEEN PARTICULARLY INTERESTED IN
FUNDING CLINICAL RESEARCH
NETWORKS, IT'S OFTEN BECAUSE WE
FOUND THOSE NETWORKS IN THE PAST
TO BE UNDERUTILIZED.
AND THIS WILL ALLOW US TO HAVE
ACCESS TO CLINICAL RESEARCH
NETWORKS WITH ESTABLISHED
ABILITIES TO REACH INTO
COMMUNITIES THAT ARE OTHERWISE
UNDERREPRESENTED IN SCIENCE TO
TAKE ADVANTAGE OF THOSE NETWORKS
BUT NOT HAVE TO FUND THEM OR
THEIR INFRASTRUCTURE ON OUR OWN.
SO WE LOOK AT THIS AS AN
EXCITING DEVELOPMENT THAT WE
HOPE WE'LL SUCCEED OVER THE NEXT
SEVERAL YEARS.
IN ADDITION OF COURSE TO OUR NEW
DIRECTOR WHO CAME ON BOARD LAST
FALL AND WHO WILL SPEAK TO US
SOON, -- I'M TRYING TO GET THIS
TO ADVANCE AND IT'S NOT.
THERE YOU GO.
OKAY.
THERE ARE SOME OTHER LEADERSHIP
CHANGES TO MAKE YOU AWARE.
ON MAY 6, 2024, DR. KATHLEEN
NEUZIL BEGAN HER ROLE AS
DIRECTOR OF THE FOGARTY
INTERNATIONAL CENTER, SUCCEEDING
PETER KILMARX, WHO HAD SERVED AS
ACTING DIRECTOR SINCE JANUARY OF
2023.
WE'RE VERY EXCITED TO WELCOME
DR. NEUZIL TO OUR FAMILY OF
INSTITUTE AND CENTER DIRECTORS,
AND ALSO GREATLY APPRECIATED DR.
FOR THOSE OF YOU WHO DON'T KNOW,
FOGARTY INTERNATIONAL CENTER
OVERSEES AND FACILITATES HEALTH
RESEARCH ON THE GLOBAL SCENE,
PRARLY IN LOWER AND MID ILL MIDE
INCOME COUNTRIES AND ALSO
DIPLOMATIC ARRANGEMENTS AND
RELATIONSHIPS WITH HEALTH
ORGANIZATIONS THROUGHOUT THE
GLOBE.
THEY'VE BEEN A TREMENDOUS
PARTNER FOR US OVER THE LAST 15
YEARS OR SO, AS WE HAVE EXPANDED
OUR EFFORTS IN GLOBAL MENTAL
HEALTH, AND WE LOOK FORWARD TO
CONTINUED COLLABORATION UNDER
DR. NEUZIL.
ANOTHER SENIOR LEADER AT NIH IS
DR. SHAWN MOONEY, NAMED DIRECTOR
OF THE NIH'S CENTER FOR
INFORMATION TECHNOLOGY,
SUCCEEDING DR. D'SOUZA, ACTING
DIRECTOR SINCE SEPTEMBER OF
2022.
AND THAT'S IT FOR LEADERSHIP
CHANGES.
I DID MENTION, OF COURSE, THE
BRAIN INITIATIVE BEFORE, AND
THEY HAVE AN ANNUAL CONFERENCE
THAT'S GOING TO TAKE PLACE IN
JUST A FEW WEEKS.
HERE IN ROCKVILLE, AS WELL AS
VIRTUALLY, AND I ENCOURAGE THOSE
OF YOU HAVE WITH INTEREST IN
THIS AREA TO REGISTER.
IT'S FREE, AND TO ATTEND EITHER
IN PERSON OR VIRTUALLY.
ANOTHER CONFERENCE ON ANOTHER
TRANS-NIH INITIATIVE THAT NIMH
IS ACTIVE IN IS THE CLIMATE AND
CHANGE HEALTH INITIATIVE WHICH
IS SPONSORING THEIR FIRST ANNUAL
CAFE, CLIMATE AND HEALTH
CONFERENCE, LED JOINTLY BY THE
GRANTEES OF THE CLIMATE CHANGE
AND HEALTH INITIATIVE BOSTON
UNIVERSITY SCHOOL OF PUBLIC
HEALTH AND THE HARVARD CHAN
SCHOOL OF PUBLIC HEALTH.
THIS CLIMATE CHANGE AND HEALTH
INITIATIVE WHICH IS LED BY A
GROUP OF INSTITUTE DIRECTORS
INCLUDING DR. RICK WOYCHIK, IS
HEAVILY INVESTING IN TRYING TO
UNDERSTAND AND MITIGATE THE
IMPACTS OF CLIMATE CHANGE ON
HEALTH INCLUDING MENTAL HEALTH,
AND IT'S AN EXCITING INITIATIVE
WHICH NIMH -- SEVERAL NIMH
STAFFERS PARTICIPATE IN.
LET'S FOCUS DOWN THEN NOW ON
NIMH.
YOU KNOW ALREADY BECAUSE IT WAS
ANNOUNCED IN FEBRUARY, ON
FEBRUARY 29TH, I ANNOUNCED MY
DECISION, MY PAINFUL DECISION TO
STEP DOWN AS NIMH DIRECTOR
EFFECTIVE JUNE 14TH, 2024, WHICH
IS TWO WEEKS FROM TOMORROW.
WHEN I ANNOUNCED IT IN FEBRUARY,
IT SEEMED SO FAR AWAY, NOW IT
DOESN'T SEEM SO FAR AWAY
ANYMORE.
I'M PLEASED TO ANNOUNCE THAT
SHELLEY ASHESHELLEY WILL SERVE G
NIMH DIRECTOR.
I'M ALSO PLEASED TO ANOWS THAT
NIH IS ABOUT TO LAUNCH -- THEY
GOT THE SEARCH COMMITTEE
TOGETHER ALREADY -- A NATIONAL
SEARCH FOR A NEW DIRECTOR WHICH
THEY HOPE TO PROCEED
EXPEDITIOUSLY.
LET ME JUST SAY FROM TWO
PERSONAL NOTES, ONE, THIS IS
REALLY BITTERSWEET FOR ME, I'M
EXCITED ABOUT WHAT COMES NEXT
BUT I'M ALSO COGNIZANT OF THE
FACT THAT THIS IS THE BEST JOB
IN THIS FIELD, PERIOD, END OF
STORY.
I'VE LOVED MY TIME HERE, I'VE
LOVED WORKING WITH THE NIMH
STAFF, MY FELLOW NIH DIRECTORS,
AND ALL OF YOU AROUND THE TABLE
AND OTHERS WHO HAVE SERVED ON
THE COUNCIL IN THE PAST, AND IT
WILL BE DIFFICULT IF NOT
IMPOSSIBLE TO REPLICATE THE JOY
THAT I'VE EXPERIENCED OVER THESE
PAST EIGHT YEARS.
THE SECOND THING I WANT TO SAY
IS I'M REALLY PLEASED THAT
SHELLI HAS AGREED AND WILL BE
STEWARDING THIS ORGANIZATION
OVER THE COMING MONTHS AND
HOPEFULLY NOT YEARS.
YOU ALL KNOW SHELLI.
SHE IS AN OUTSTANDING LEADER, A
BRILLIANT SCIENTIST, AND REALLY
COMMITTED TO THE NIMH MISSION
AND I KNOW THAT SHE WILL DO AN
OUTSTANDING JOB AS THE FIRST
FEMALE DIRECTOR OF NIMH.
WE'RE VERY PLEASED THAT SHE IS
DOING THIS.
THANK YOU, SHELLI.
THERE'S ALSO HAPPINESS THIS
YEAR.
THIS YEAR IS OUR 75TH
ANNIVERSARY.
MANY OF YOU HAVE ATTENDED ONE OR
MORE EVENTS THAT MARK THIS.
I MENTIONED, OF COURSE, THAT WE
HAD AN EVENT ON THE HILL
CELEBRATING IT WITH HILL
STAFFERS AND OTHER SUPPORTERS OF
NIMH HOSTED BY THE FRIENDS OF
NIMH.
WE HAVE -- WE HAD OUR SECOND
SYMPOSIUM ENTITLED AMPLIFYING
VOICES AND BUILDING BRIDGES
TOWARD A MORE INCLUSIVE FUTURE
ON MARCH 18TH.
IT WAS A PROVOCATIVE DAY IN
DOWNTOWN D.C. AT THE NATIONAL
ARCHIVES.
WE WILL HOST OUR NEXT EVENT ALSO
I BELIEVE AT THE ARCHIVES ON
SEPTEMBER 20TH, 2024 IN
WASHINGTON, D.C., AND I HAD BEEN
GIVEN SPECIAL DISPENSATION TO BE
ALLOWED TO ATTEND THIS EVENT,
I'M VERY MUCH LOOKING FORWARD TO
IT.
YOU CAN ALSO -- THERE'S A LOT
MORE THAN JUST THESE EVENTS.
THERE ARE PODCASTS, STORIES AND
DIGITAL RESOURCES THAT HIGHLIGHT
NIMH'S IMPACT ON MENTAL HEALTH
RESEARCH AVAILABLE THROUGH OUR
WEBSITE, NIMH.NIH.GOV/75YEARS.
ENCOURAGE YOU TO VISIT THAT FOR
THOSE RESOURCES AND SHARE THEM
WITH YOUR FRIENDS, FAMILY,
NEIGHBORS AND WHOEVER ELSE IS
INTERESTED.
WE ALSO HAVE OUR ANNUAL UPDATE
TO THE NIMH STRATEGIC PLAN FOR
RESEARCH.
MUCH OF THIS UPDATE
RE-EMPHASIZES PRIORITY AREAS AND
CLARIFIES OUR DESCRIPTION TO
PRIORITIES, FOR EXAMPLE, WITHIN
A GLOBAL MENTAL HEALTH RESEARCH
PROGRAM THAT HAVE BEEN UPDATED
BY OUR CENTER DIRECTOR, AND HIS
STAFF AND THE GLOBAL MENTAL
HEALTH TEAM.
ALSO SOME CHANGES TO EMPHASIZE
CURRENT APPROACHES IN REACHING
THE NEEDS OF INDIVIDUALS FROM
UNDERSERVED POPULATIONS AND DATA
AND DIGITAL HEALTH.
WE ALSO PUBLISH ANNUALLY A
STRATEGIC PLAN PROGRESS REPORT
WHICH HAS JUST COME OUT.
IT SPOTLIGHTS THE 75TH
ANNIVERSARY YEAR EVENTS, SEVERAL
DIFFERENT SCIENCE HIGHLIGHTS AND
SOME STATISTICS FROM LAST YEAR,
LAST FISCAL YEAR 2023 IN TERMS
OF FUNDING AND PROJECTS, ET
CETERA.
THIS IS A TWO-PAGE DOCUMENT.
YOU CAN EASILY PRINT AND HAND
OUT.
I ENCOURAGE YOU TO SHARE THAT AS
WELL.
IT'S ABOUT TIME WE DO A THOROUGH
REWRITE OF OUR STRATEGIC PLAN.
AS WE THINK ABOUT DOING THAT,
LOOKING FORWARD TO 2025 AND
2026, WHICH WILL BE THE FIFTH
AND SIXTH YEAR SINCE WE TURNED
THE PLAN INTO A LIVE DOCUMENT
LISTED ON THE WEB.
WE ARE PUTTING OUT A REQUEST FOR
INFORMATION ON THE USABILITY,
EFFECTIVENESS AND IMPACT OF THE
CURRENT STRATEGIC PLAN SO THAT
WE CAN LOOK TO DECIDE HOW TO
MOVE FORWARD WITH THE EXTENSIVE
REVISIONS THAT WE PLAN IN 2025
OR 2026.
THIS RFI IS LIVE ON THE STREET.
PLEASE SUBMIT FEEDBACK BY
JULY 24TH, AND IF YOU HAVE ANY
QUESTIONS, PLEASE REACH OUT TO
OUR STAFF AT NIMHSTRISTR
NIMHSTRATPLAN@MAIL.NIH.GOV.
WE HAVE TWO ADDITIONAL RFIs
THAT I WANT TO MAKE CLEAR TO
YOU.
ON APRIL 8TH WE RELEASED AN RFI
ON RESEARCH GAPS ON THE IMPACT
OF RACISM.
THIS WAS AUTHORED BY STAFF IN
OUR OFFICE OF DISPARITIES
RESEARCH AND WORKFORCE
DIVERSITY.
AS WELL AS OUR DISPARITIES --
MENTAL HEALTH DISPARITIES
RESEARCH TEAM.
WE'RE ASKING FOR INPUT ON
RESEARCH APPROACHES THAT COULD
ADDRESS THE IMPACT OF STRUCTURAL
RACISM ON BRAIN COGNITIVE AND
BEHAVIORAL FUNCTION.
AND THE ROLE OF STRUCTURAL AND
SYSTEMIC RACISM ON BRAIN AND
BEHAVIORAL HEALTH RESEARCH.
AND ON APRIL 5TH WE RELEASED AN
RFI ON RESEARCH GAPS IN MENTAL
HEALTH SERVICES RESEARCH,
INVITING INPUT ON STRATEGIES TO
ADVANCE THE RELEVANCE AND IMPACT
OF MENTAL HEALTH SERVICES
RESEARCH AND OUTCOMES THAT ARE
MOST IMPORTANT AS WE TRY TO
DEMONSTRATE OR IMPROVE THE
QUALITY OF MENTAL HEALTHCARE,
AND THOSE RESPONSES ARE
REQUESTED BY SEPTEMBER 1ST.
FINALLY, AND YOU ALL ON THE
COUNCIL ARE WELL ACQUAINTED WITH
THIS, AS THIS HAS BEEN AN
ONGOING ENDEAVOR FOR THE LAST
SEVERAL YEARS AND WE DISCUSSED
AND GOT APPROVAL FOR THESE
CHANGES MOST RECENTLY AT THE
LAST COUNCIL MEETING, WE PUBL
PUBLISHED A REVISION, A REVISED
NOTICE CLARIFYING NIMH'S FUNDING
PRIORITIES FOR AWARDS SUPPORTING
EXCEPTIONALLY WELL-FUNDED
INVESTIGATORS.
THE NIMH NOW DEFINES
APPLICATIONS WITH WELL-FUNDED
INVESTIGATORS -- SORRY --
DEFINES WELL-FUNDED
INVESTIGATORS AS THOSE WHO
RECEIVE NIH FUNDING SUPPORT OF
AT LEAST $2 MILLION IN TOTAL
COSTS IN ACTIVE AWARDS AT THE
TIME OF REVIEW, AND THE NEW
CHANGES CLARIFY THAT ALL
APPLICATIONS WITH ANY
WELL-FUNDED INVESTIGATOR WILL
NEED TO GO THROUGH THE SPECIAL
COUNCIL REVIEW PROCESS AND WE
WILL NO LONGER ACCEPT
APPLICATIONS THAT HAVE MULTIPLE
PIs, ONLY ONE OR NOT ALL OF
WHOM HAVE -- ARE WELL-FUNDED.
THIS IS BECAUSE WE RECOGNIZE AS
WE'VE CONSULTED WITH YOU ON THIS
THAT MANY INVESTIGATORS SEEM TO
BE USING THIS MULTIPLE PI
PROCESS AS A WAY TO GET AROUND
OUR CONCERNS ABOUT THE
CONCENTRATION OF FUNDS.
WE WILL STILL BE ABLE TO FUND
SUCH INVESTIGATORS IF THE
APPLICATIONS MEET THE CRITERIA
YOU ALL HELPED US ESTABLISH, BUT
THIS WAY, IT WILL MAKE SURE WE
BRING MORE OF THESE APPLICATIONS
INTO CONSIDERATION IN THIS BODY.
I WANT TO JUST HIGHLIGHT A
COUPLE OF INITIATIVES THAT YOU
ALL HAVE WORKED ON, IN
PARTICULAR THE IMPACT INITIA
INITIATIVE, IMPACT MH
INITIATIVE.
THIS IS, OF COURSE, THE ONE THAT
SEEKS TO FUND RESEARCH IN A
COORDINATED FASHION THAT
INVOLVES DELIVERING BIOMARKERS
AND OTHER MEASURES TO LARGE
COHORTS OF INDIVIDUALS WITH
ACCESS TO CLINICAL RECORDS TO
TRY TO DO BETTER WITH ADDITIONAL
INFORMATION.
WE'RE STILL WORKING THROUGH
FUNDING, THE AWARDS THAT YOU
APPROVED BACK IN FEBRUARY, BUT
ABOUT HALF OF THEM HAVE BEEN
AWARDED TO DATE, AND JUST IN
TERMS OF AN OVERVIEW OF THESE
AWARDS, THE AGE RANGES INCLUDE
BOTH KIDS AND ADULTS.
THE POPULATIONS ARE GENERAL
POPULATIONS, GENERAL POPULATION
OR HEALTHCARE SYSTEM POPULAT
POPULATIONS.
CONSTRUCTS TO BE EXPLORED
THROUGH THESE BIOMARKERS AND
OTHER MEASURES ARE VERY -- BY
THE MEASURES THEMSELVES AND THE
OUTCOMES THAT WILL TRY TO BE
PREDICTED FROM THESE MEASURES.
WE'RE VERY EXCITED ABOUT THESE.
A FEW OF THE AWARDS THAT HAVE
BEEN GIVEN OUT SO WE CAN MAKE
THEM PUBLIC INCLUDE EFFORT TO
DEVELOP DATA-DRIVEN CLINICAL
SIGNATURES FOR PEOPLE WITH
PSYCHOSIS, PARTICULARLY THOSE
WHO EXPERIENCE HALLUCINATIONS,
AND AN EFFORT TO LEVERAGE
MULTIPLE TYPES OF DATA TO
DEVELOP AND VALIDATE SLEEP
SIGNATURES IN PERIADOLESCENT
CHILDREN.
ANOTHER HIGHLIGHT FROM THE WORK
THAT YOU ALL HAVE DONE OVER THE
YEARS, THIS BODY AS WELL AS NIMH
HAS SUPPORTED THE PSYCHENCODE
INITIATIVE, WHICH IS AN EFFORT
TO UNDERSTAND THE RELATIONSHIP
BETWEEN GENETIC RISK AND GENE
EXPRESS AND OTHER BIOLOGICAL
FACTORS AT THE CELLULAR LEVEL.
THE PHASE ONE RESULTS WERE
TREMENDOUS, PUBLISHED BETWEEN
2015 AND 2019.
AND PHASE TWO JUST WAS PUBLISHED
WITH A TOTAL OF 14 PAPERS,
SPECIFICALLY DETAILING WHERE,
HOW AND WHEN IN THE BRAIN
GENETIC RISK FOR PSYCHIATRIC
CONDITIONS AFFECT THE HUMAN
BRAIN.
I ENCOURAGE YOU TO VISIT THESE
PUBLICATIONS, BUT JUST TO
SUMMARIZE THE MAIN FINDINGS, THE
SCIENTISTS FOUND THAT POPULATION
LEVEL SINGLE CELL MULTI-OMIC
ANALYSES CAN MAP GENE VARIANTS,
REGULATORY ELEMENTS AND
TRANSCRIPTIONAL ISOFORMS TO
SPECIFIC REGULATORY NETWORKS AT
CELLULAR RESOLUTION IN DEVEL
DEVELOPMENT.
WE'VE NOW IN PHASE TWO EXTENDED
THESE FINDINGS FROM BOTH TISSUE
TO SINGLE CELLS, SO THAT WE CAN
MAP DIFFERENT CELL TYPES
AFFECTED BY GENETIC RISK FOR
HUMAN NEUROPSYCHIATRIC DISORD
DISORDERS.
THEY ESTABLISHED THE VALIDATION
OF VARIOUS FUNCTIONAL READOUTS
IN NEUROPSYCHIATRIC DISORDERS AS
WELL AS TOOLS TO ANALYZE AND
EXPLORE THE DATASETS.
I CAN'T EMPHASIZE MORE WORK LIKE
THE SECOND INITIATIVE.
THIS IS A TEAM-BASED APPROACH
OVER YEARS TO DELVE DEEPER, AND
WE KNOW THIS IS GOING TO BE
REALLY IMPORTANT.
IT'S A LONG-TERM GAME, THOUGH,
SO IT'S UP WITH OF THE AREAS
THAT WE HAVE INVESTED IN IN THE
LONG TERM.
TURNING FROM SCIENCE A MOMENT --
FOR A MOMENT TO PEOPLE, I'M
REALLY SAD TO RECOGNIZE THE
PASSING OF DR. HERB PARDES, WHO
SERVED AS DIRECTOR OF NIMH IN
THE LATE 1970S AND EARLY
1980s.
HERB WAS A GIANT IN OUR FIELD.
NOT ONLY HAD HE BEEN DIRECTOR OF
NIMH BUT HE WAS CHAIR OF
MULTIPLE DEPARTMENTS OF
PSYCHIATRY AS WELL AS DE DEAN OA
MEDICAL SCHOOL AND CEO OF A
HOSPITAL.
IMPORTANTLY FOR MENTAL HEALTH
RESEARCH, HE ALSO FOUNDED WHAT
WAS THEN CALLED THE NATIONAL
ALLIANCE FOR RESEARCH IN
SCHIZOPHRENIA AND DEPRESSION,
WHICH HAS BEEN A TREMENDOUS
SOURCE OF SUPPORT, ESPECIALLY
FOR EARLY CAREER INVESTIGATORS,
INCLUDING MYSELF, I RECEIVED
AWARDS EARLY ON IN THE COURSE OF
MY TRAINING, AND IT HELPED ME
DEVELOP AS A SCIENTIST
TREMENDOUSLY.
SO HERB HAS HAD AN IMPACT ON
MANY IN THE FIELD AND WILL BE
MISSED.
WE ALSO HAVE SEVERAL NIMH STAFF
WHO HAVE MOVED ON FROM WORK AND
INTO RETIERM.
DR. SUSAN AZRIN, CHIEF OF THE
EARLY PSYCHOSIS PREDICTION AND
PREVENTION UNIT IN NIMH RETIRED
FROM FEDERAL SERVICE IN MARCH.
AND DR. ELLEN LEIBENLUFT RETIRED
AFTER 34 YEARS OF SERVICE IN
JULY.
ON A HAPPIER NOTE, SARAH MORRIS,
BRANCH CHIEF OF THE ADULT
PSYCHOPATHOLOGY AND PSYCHOSOCIAL
INTERVENTIONS RESEARCH BRANCH
HAS BEEN HEADED THE HEAD OF THE
RDOC UNIT.
SARAH HAS BEEN SERVING IN THAT
CAPACITY FOR SOME TIME BUT
RECOGNIZED FORMALLY IN MAY.
MAY.
SHE HAS PLAYED AN IMPORTANT
ROLE, AS WELL AS IN
COLLABORATIONS WITH THE
ALL-OF-US COHORT.
OTHER NEWS IN THE IRP,
INTRAMURAL RESEARCH PROGRAM,
JANET CLARK HAS BEEN NAMED A
FELLOW IN THE AMERICAN SOCIETY
FOR PHARMACOLOGY AND
EXPERIMENTAL THERAPEUTICS AS
WELL AS A FELLOW OF THE AMERICAN
COLLEGE OF
NEUROPSYCHOPHARMACOLOGY.
AND DR. ARMIN RAZNAHAN ELECTED
TO THE AMERICAN SOCIETY FOR
CLINICAL INVESTIGATION.
FINALLY, AS ALWAYS I'LL CLOSE
WITH A FEW SCIENCE HIGHLIGHTS
FROM THE WORK THAT'S DONE WITH
NIMH SUPPORT AND WORK THAT IS
DONE HERE AS WELL IN THE
INTRAMURAL RESEARCH PROGRAM.
THE FIRST SCIENCE HIGHLIGHT
ACTUALLY FOCUSES ON A HIGHLIGHT
THAT I SHOULD SAY BUILDS UPON A
HIGHLIGHT THAT I GAVE SOME TIME
AGO.
AND THIS IS NOT THE RIGHT
PRESENTATION.
OH, WELL.
I'LL MAKE DO.
SO IT IS THE RIGHT PAPER,
THOUGH, BY SERGIU PASC A AND
COLLEAGUES AT STANFORD WHO HAVE
BEEN PIONEERING APPROACHES FOR
THE STUDY OF PARTICULARLY
GENETIC RISK FOR PSYCHIATRIC
DISORDERS AND NEURODEVELOPMENTAL
DISORDERS USING ORGANOIDS.
ORGANOIDS ARE, OF COURSE, SMALL
ASSEMBLIES OF BRAIN TISSUE THAT
ARE BUILT, IF YOU WILL, OR GROWN
FROM HUMAN STEM CELLS, AND THEY
CAN BE GROWN FROM THE STEM CELLS
OF PATIENTS, OF INDIVIDUAL
PATIENTS.
AND I TOLD YOU SOME TIME AGO
ABOUT A PROCESS THAT HE
DEVELOPED TO ENSURE A
GREATER DEGREE OF MATURATION OF
THESE ASSEMBLIES, SO-CALLED
ORGANOIDS.
SO IF YOU GROW HUMAN STEM CELLS
IN A DISH AND DIFFERENTIATE THEM
INTO NEURAL TISSUE, THEY CAN
DEVELOP AND MATURE SOMEWHAT,
MAYBE TO THE POINT WHERE THE
NEURONAL ASSEMBLIES KIND OF LOOK
LIKE HUMAN TISSUE THAT'S ABOUT
THE AGE THAT A BRAIN IS WHEN A
BABY IS BORN.
BUT WE NEED TO BE ABLE TO STUDY
HUMAN TISSUE IN A MORE MATURE
STATE, SO TO UNDERSTAND THE FULL
NEURODEVELOPMENTAL PROCESSES
THAT RESULT IN
NEURODEVELOPMENTAL DISORDERS.
AND SO WHAT I TOLD YOU ABOUT
BEFORE IS THE TECHNIQUE THAT DRS
DEVELOPED TO BE ABLE TO TAKE
THESE ASSEMBLIES OF HUMAN TISSUE
AND IMPLANT THEM INTO A MOUSE
BRAIN THAT WILL ALLOW THAT
TISSUE TO FURTHER DEVELOP TO
MAYBE A YEAR OF LIFE OR TWO
YEARS OF LIFE.
WE'RE NOT EXACTLY SURE YET HOW
MATURE THIS TISSUE CAN GET.
BUT IT GETS MATURE ENOUGH THAT
YOU CAN IDENTIFY -- SORRY, THIS
IS THE SLIDE THAT DIDN'T MAKE IT
INTO THE PRESENTATION I TRIED TO
ADD THIS MORNING.
MY FAULT FOR BEING LATE AT THIS.
IT DEVELOPS IN A MATURE ENOUGH
WAY THAT YOU CAN DEMONSTRATE
DIFFERENCES IN THE STRUCTURE AND
FUNCTION OF NEURONS, HUMAN
NEURONS THAT ARE GROWING UP IN
THESE ASSEMBLIES, BASED UPON
GENETIC RISK, FOR EXAMPLE, IN
THIS CASE, A GENETIC RISK FOR A
NEURODEVELOPMENTAL SYNDROME
CALLED TIMOTHY SYNDROME, WHICH
DR. PASCA AND COLLEAGUES HAVE
BEEN STUDYING FOR SOME TIME.
AND LET ME MOVE FORWARD JUST A
LITTLE BIT.
THIS IS WHAT I SHOWED YOU
BEFORE, YOU CAN GROW ON THE
LEFT-HAND LOWER SIDE A CHUNK OF
HUMAN TISSUE ON TOP, IN THIS
CASE OF A RAT CORTEX, AND IT
MATURES AND ON THE RIGHT-HAND
SIDE, YOU CAN SEE THAT TISSUE
THAT'S DERIVED FROM A HUMAN -- A
HUMAN TISSUE WITHOUT THIS
TIMOTHY SYNDROME, THE NEURONS
DEVELOP THESE QUITE COMPLEX
ARBORS OF DENDRITES, THOSE ARE
THE THIN BLACK LINES EMANATING
FROM THE NEURON THAT YOU SEE ON
THE LEFT-HAND SIDE OF THAT LOWER
RIGHT PANEL.
ON THE RIGHT-HAND SIDE, YOU SEE
A NEURON THAT'S DERIVED FROM
HUMAN TISSUE FROM A STEM CELL
THAT DERIVED FROM A PATIENT WITH
TIMOTHY SYNDROME, AND YOU CAN
SEE THAT THAT ARBOR OF DENDRITES
IS NOT AS ELABORATE.
THAT'S ONE OF SEVERAL PHENOTYPES
THAT DR. PASCA'S GROUP WAS ABLE
TO IDENTIFY BY STUDYING THIS
HUMAN TISSUE IN A MOUSE.
BUT NOW HE'S GONE ONE STEP
FURTHER AND TRIED TO USE THIS
TOOL TO SEE IF HE CAN DEVELOP A
POTENTIAL TREATMENT.
SO IT TURNS OUT THAT ONE OF THE
CONSEQUENCES OF THE MUTATION IN
A CALCIUM CHANNEL GENE THAT
CAUSES TIMOTHY SYNDROME IS THE
OVEREXPRESSION OF ONE PARTICULAR
FORM OF THIS CALCIUM CHANNEL,
IT'S A FORM THAT INCLUDES A
PIECE OF THE GENETIC CODE CALLED
AXON 8A.
AND YOU CAN REDUCE THIS ABNORMAL
FORM OF THE PROTEIN WITH A SMALL
MOLECULE CALLED AN ANTISENSE
OLIGONUCLEOTIDE, WHICH HAVE BEEN
USED ALREADY IN TREATMENT OF
GENETIC DISORDERS IN THE
NEUROLOGY SPACE.
SO WE KNOW THEY CAN BE USED IN
THE CENTRAL NERVOUS SYSTEM TO
TREAT GENETIC DISORDERS.
SO THIS ANTISENSE OLIGOKNEW CLEE
OLIGONUCLEOTIDE ON THE LEFT
PANEL REDUCES THE EXPRESSION OF
THIS ABERRANT EXON 8A CONTAINING
CALCIUM CHANNEL PROTEIN IN RATS,
AND IT ALSO DOES IT ON THE RIGHT
SIDE IN HUMANS.
WHERE THE GREEN BAR IS THE HIGH
LEVELS OF EXON 8A CONTAINING
PROTEIN IN HUMAN TISSUE DERIVED
FROM TIMOTHY SYNDROME PATIENTS
AND IN THE PURPLE IS THE REDUCED
LEVEL OF THAT EXON 8A CONTAINING
PROTEIN ONCE THAT HUMAN TISSUE
IS TREATED WITH THE ANTISENSE
OLIGONUCLEOTIDE.
IT TURNS OUT OF COURSE YOU'RE
NOT JUST REVERSING THIS PROTEIN.
YOU'RE ALSO REVERSING SOME KEY
PHENOTYPES THAT WE THINK MAY BE
RESPONSIBLE FOR THE
NEURODEVELOPMENTAL CHALLENGES
THAT INDIVIDUALS WITH TIMOTHY
SYNDROME FACE.
SO HERE ON THE UPPER PART OF THE
RIGHT SIDE IS AN EXAMPLE NEURON
GROWN IN ONE OF THESE ASSEMBLIES
IN A RAT FROM A CONTROL
INDIVIDUAL WITHOUT TIMOTHY
SYNDROME, TISSUE GROWN FROM AN
INDIVIDUAL WITH TIMOTHY
SYNDROME, NOT TREATED WITH THE
OLIGONUCLEOTIDE.
AND THEN ON THE RIGHT, YOU CAN
SEE AN EXAMPLE NEURON FROM
NEURAL TISSUE DERIVED FROM
TIMOTHY SYNDROME, BUT NOW
TREATED WITH THIS ANTISENSE
OLIGONUCLEOTIDE, AND IT RESTORES
THAT ELABORATE DENDRITIC GROWTH
THAT IS CHARACTERIZED AS NEURONS
AT THAT STAGE OF MATURITY.
THAT'S QUANTIFIED IN THE LOWER
GRAPH OF THE AFICIONADOS, BUT
THE BOTTOM LINE IS WE CAN USE
THESE TOOLS IN A VERY EXCITING
WAY TO FIGURE OUT HOW WE CAN
POTENTIALLY TREAT INDIVIDUALS
WITH NEURODEVELOPMENTAL
DISORDERS.
SO THAT'S THE FIRST SCIENCE
HIGHLIGHT, A PATH FROM GENETICS
TO TREATMENT THROUGH TOOLS AND
TECHNOLOGIES THAT HAVE BEEN
DEVELOPED OVER TIME WITH THE
SUPPORT OF NIMH FUNDS AND WITH
THE SUPPORT OF IN THAT
PARTICULAR CASE ALSO BRAND
INITIATIVE FUNDS.
ALSO GRANT
INITIATIVE FUNDS.
NOW WE'RE GOING TO TURN TO -- WE
KNOW BIPOLAR DISORDER -- ONE OF
THE MANY TOOLS THAT NIMH
RESEARCH HAS BROUGHT TO THE
COMMUNITY FOR TREATMENT OF
VARIOUS MENTAL ILLNESSES IS
DIALECTICAL BEHAVIORAL THERAPY,
WHICH IS PARTICULARLY GOOD AT
ASSISTING IN EMOTIONAL
REGULATION AND REDUCING SELF
INJURIOUS BEHAVIORS.
THIS GROUP TESTED THE ABILITY OF
DIALECTICAL BEHAVIORAL THERAPY
TO HELP INDIVIDUALS WITH BUY BIR
DISORDER.
AND IN PARTICULAR WHAT THEY
SHOWED IS THAT DIALECTICAL
BEHAVIORAL THERAPY AND STANDARD
OF CARE BOTH IMPROVE MOOD STATES
AND SYMPTOMS.
BUT DIALECTICAL BEHAVIORAL
THERAPY ADDED TO STANDARD OF
CARE REDUCES THE NUMBER OF
SUICIDE ATTEMPTS IN INDIVIDUALST
INDIVIDUALS WITH BIPOLAR
DISORDER WILL EXPERIENCE.
SO IT SUGGESTS THAT DBT MIGHT
HAVE A PARTICULAR ROLE IN THE
CARE OF INDIVIDUALS WITH BIPOLAR
DISORDER AT REDUCING SUICIDAL
BEHAVIORS.
FINALLY ONE LAST HIGHLIGHT,
RETURNING EVEN MORE BASIC TO
NEUROSCIENCE BUT THIS IS A
HIGHLIGHT THAT WAS RESEARCH DONE
IN OUR INTRAMURAL PROGRAM BY ONE
OF OUR VERY PROMISING
INVESTIGATORS, DRR ARASH AFRAZ.
ARASH IS REALLY INTERESTED IN
TRYING TO DEMONSTRATE THE ROLE
OF PARTICULAR COMPLEX FORMS OF
NEURAL ACTIVITY IN PERCEPTUAL
EXPERIENCES AND CONSCIOUSNESS.
HE DOES THIS IN A NUMBER OF
DIFFERENT WAYS.
THIS IS A PARTICULARLY CLEVER
EXPERIMENT, TRYING TO LINK A
PARTICULAR PATTERN OF NEURAL
ACTIVITY WITH A PARTICULAR
PERCEPTUAL EXPERIENCE, AND DOING
IT IN A VERY MECHANISTIC WAY IN
NON-HUMAN PRIMATES.
WE'VE KNOWN FOR A LONG TIME THAT
BOTH HUMANS AND NON-HUMAN
PRIMATES HAVE NEURONS IN THEIR
VISUAL SYSTEM CALLED THE FACE
PATCH AREA WHERE THE NEURONS ARE
PARTICULARLY SENSITIVE TO FACES,
AND INDEED A GIVEN NEURON MIGHT
BE RESPONSIVE TO A PARTICULAR
FACE.
SO THEY'RE KIND OF THE CANONICAL
GRANDMOTHER NEURONS IF YOU WILL,
WHEREAS YOU'LL HAVE NEURONS IN
YOUR BRAIN THAT RECOGNIZE FACES
AND EVEN RECOGNIZE SPECIFIC
FACES.
BUT JUST BECAUSE YOU HAVE THESE
NEURONS DOESN'T NECESSARILY MEAN
THAT THEY PARTICIPATE IN YOUR
ABILITY TO PERCEIVE A FACE.
MAYBE THEY'RE JUST AN ACCIDENT
OF THE FACT THAT THEY RESPOND TO
CIRCLES AND LINES OR SOMETHING
LIKE THAT, OR MAYBE THEY HAVE
SOME OTHER FUNCTIONAL PURPOSE.
SO FROM A SCIENTIFIC
PERSPECTIVE, IT'S REALLY
IMPORTANT THAT WE TRY TO
DEMONSTRATE CAUSAL RELATIONSHIPS
BETWEEN SPECIFIC PHENOMENA LIKE
FACE NEURONS AND THE PERCEPTUAL
EXPERIENCES THAT WE HYPOTHESIZE
THEY MEDIATE.
OTHERWISE, LET'S SUPPOSE WE'RE
TRYING TO HELP PEOPLE WITH
FACIAL AGNOSIA AND WE TRY TO
ENHANCE FACE NEURONS, WE MIGHT
NOT BE ABLE TO HELP THEM IN THAT
WAY, WE MIGHT NEED A DIFFERENT
WAY, SO IT'S REALLY IMPORTANT TO
ESTABLISH THOSE KINDS OF CAUSAL
RELATIONSHIPS.
THAT'S WHAT THIS EXPERIMENT DID.
SO DR. AFRAZ USED VARIOUS
METHODS TO ESTABLISH THE
LOCATION OF THE FACE PATCH IN
NON-HUMAN PRIMATES AND MACAQUE
MONKEYS.
THEN USING A DRUG CALLED
MUSCIMOL WHICH REVERSIBLY
SILENCES THIS BRAIN REGION, HE
INJECTED DIRECTLY INTO THE FACE
PATCH AND THEN MEASURED THE
ANIMAL AS THE ANIMAL LOOKED AT
PICTURES OF FACES.
NOW, WHEN YOU LOOK AT A PICTURE
OF A FACE, YOU DON'T LOOK AT ALL
THE PARTS OF THE FACE EQUALLY.
YOU LOOK AT THE EYES AND THE
MOUTH MORE THAN OTHER PARTS OF
THE FACE.
THAT'S A WELL-KNOWN PHENOMENON,
BECAUSE YOU PERCEIVE AS A FACE,
YOU PERCEIVE THOSE EYES AND YOU
FOCUS YOUR ATTENTION ON THE EYES
AND THE MOUTH.
NOW, EACH FACE PATCH, YOU HAVE
ONE ON EACH SIDE OF YOUR BRAIN,
AND THE FACE PATCH CONTROLS
PERCEPTIONS OF THE OPPOSITE SIDE
OF THE VISUAL WORLD.
SO DR. AFRASH HYPOTHESIZED THAT
INHIBITING THESE FACE-SELECTIVE
NEURONS SHOULD AFFECT THE
PERCEPTION OF THE OTHER SIDE OF
THE FACE WHEN THEY'RE LO LOOKINT
PICTURES, SO HE HYPOTHESIZED
THAT THE MONKEYS WOULD NOT BE
ABLE TO FOCUS ON THE EYES ON THE
OPPOSITE SIDE AND THAT'S EXACTLY
WHAT HE FOUND.
WHEN HE INHIBITED THE FACE PATCH
IN ONE SIDE OF THE BRAIN, THE
MONKEY'S ATTENTION TO THE EYE ON
THE OTHER SIDE OF THE FACE WAS
DISRUPTED.
IT DIDN'T MATTER WHICH SIDE, IT
ONLY MATTERED THE DOSE OF
MUSCIMOL HE INJECTED.
SO THIS AGAIN IS AN EXPERIMENT
WHICH HELPS US ESTABLISH A
CAUSAL RELATIONSHIP BETWEEN
ACTIVITY OF FACE CELLS AND THE
PERCEPTION OF A FACE.
SO WITH THAT I'M GOING TO CLOSE
THIS DIRECTOR'S UPDATE AND OPEN
IT UP TO QUESTIONS.
WE HAVE A FEW MINUTES, WE CAN BE
GENEROUS WITH QUESTIONS AND
COMMENTS FROM COUNCIL.
THANK YOU.
GO AHEAD.
>> THANK YOU.
MY FIRST QUESTION IS REALLY A
COMMENT AND IT REALLY A THANK
YOU, JOSH, FOR GIVING ALL OF
YOUR ENERGY, EFFORT, ENTHUSIASM
AND KNOWLEDGE AND EXPERIENCE TO
THE NATIONAL INSTITUTE OF MENTAL
HEALTH AND THE INDIVIDUALS AND
THEIR FAMILIES THAT STRUGGLE
EVERY DAY WITH MENTAL ILLNESS.
WE ARE GRATEFUL.
THANK YOU.
>> THANK YOU, TED.
>> AND TO SEE ALL THAT HAS
HAPPENED, I'LL JUST TAKE A
MINUTE TO HIGHLIGHT THAT FROM
COMPUTATIONAL PSYCHIATRY TO
PRECISIONAL PSYCHIATRY TO
ADVANCES IN SUICIDE TO
UNDERSTANDING MORE ASPECTS OF
THE GENETIC BASIS OF DISEASE, TO
THERAPEUTIC APPROACHES THAT YOU
DESCRIBED.
I REMEMBER BEING IN ROOMS,
ARGUING ABOUT FACE-SELECTIVE
NEURONS AT NIMH, IN FACT, SO
IT'S SO STRIKING TO SEE THIS
HAPPEN.
BUT WHAT IS PROBABLY MOST
DRAMATIC, REALLY, IS KIND OF
HIDDEN IN A PHOTO AT THE
INTERAGENCY AUTISM COORDINATING
COMMITTEE MEETING.
AND THAT IS THE WORD
"ACCEPTANCE" AFTER AUTISM.
IT'S CHANGED FROM AUTISM
AWARENESS TO AUTISM ACCEPTANCE,
AND I HOPE THAT THAT CAN HAPPEN
FOR ALL OF MENTAL ILLNESS, THAT
IT BECOMES SCHIZOPHRENIA
ACCEPTANCE AND BIPOLAR
ACCEPTANCE, MUCH MORE BROADLY.
THAT IS A REALLY, REALLY HUGE
IMPACT THAT CHANGES THE WAY
PEOPLE ARE ABLE TO BE INVOLVED
IN SOCIETY.
SO THANKS SO MUCH.
>> THANK YOU, TED.
APPRECIATE IT.
>> QUITE A GROUP THIS MORNING.
AFTERNOON.
IT AFTERNOON.
QUIET GROUP.
PLEASE.
>> I WON'T REPEAT WHAT TED SAID,
ELEGANTLY SAID.
SO I'LL JUST ASK A QUESTION.
I WAS REALLY IMPRESSED BY ALL OF
THE WORK THAT WILL BE COMING OUT
AND NIMH'S EFFORTS TO ASK THE
COMMUNITY WHAT THEY THINK ABOUT
VARIOUS THINGS, INCLUDING RACISM
AND ITS IMPACT ON HEALTH, THAT
WAS REALLY EXCITING.
ONE OF THE THINGS YOU'VE SHARED,
JOSH, WAS ALSO LOOKING AT MENTAL
HEALTH SERVICES RESEARCH.
AND REALLY TRYING TO UNDERSTAND
THAT.
AND IT MADE ME CURIOUS ABOUT
WHAT PERCENTAGE OF THE CURRENT
NIMH PORTFOLIO IS ON MENTAL
HEALTH SERVICES RESEARCH.
>> THAT'S A GOOD QUESTION.
I'M LOOKING AROUND TO SEE IF
JOEL OR PAT ARE THERE.
I DON'T REMEMBER THE MOST RECENT
NUMBERS FOR THE DIVISION OF
SERVICE INTERVENTION RESEARCH IN
TERMS OF THE PERCENTAGE.
THAT'S NOT ONLY -- IT CAN BE A
NUMBER OF DIFFERENT THINGS.
I'LL HAVE TO GET BACK TO YOU ON
THAT UNLESS ANYONE CAN POP UP
AND SAY.
FROM TIME TO TIME, I HAD
PROVIDED UPDATES ON THE
PERCENTAGE THAT GOES TO MORE
NEAR TERM RESEARCH THAT'S
INTERVENTION AND SERVICES FOCUS
COLLECTIVELY, BUT I THINK THE
LAST TIME I DID THAT WAS ABOUT
TWO YEARS AGO, SO WE COULD USE
AN UPDATE THERE AS WELL.
WE CAN GET THAT OUT TO YOU.
>> I WOULD SECOND THAT,
ESPECIALLY IT WAS VERY
INSIGHTFUL TO SEE WHAT THE
POLICY MAKERS ARE ASKING ABOUT
AND THINKING -- I'M GUESSING THE
PORTFOLIO IS MAYBE SMALLER THAN
SOME OF THE OTHER AREAS AND
THINKING ABOUT HOW TO GROW THAT,
ESPECIALLY SINCE IT'S SO
IMPORTANT AND IMPACTFUL FROM A
SOCIETAL PERSPECTIVE, SO I WOULD
LOVE TO SEE THAT.
>> THAT'S ONE OF THE THINGS THAT
I'VE COMMENTED ON IN THOSE
BLOGS, AND THAT WE HAVE FOCUSED
TREMENDOUSLY ON.
AND WE'VE BEEN BARELY SUCCESSFUL
AT INCREASING THE NUMBER OF
APPLICATIONS INTO DESR AND,
THEREFORE, INCREASING THE
DOLLARS THAT WE'RE SPENDING ON
IT.
BUT AS YOU MAY KNOW, RINAD,
PRIOR TO MY COMING, THERE WAS A
SUBSTANTIAL DECREASE OVER TIME
IN THAT PART OF THE PORTFOLIO,
AND WHAT I WOULD SAY IS FROM
THE -- JUST THINKING ABOUT THE
DATA THAT I PRESENTED A COUPLE
YEARS AGO, WE'RE BACK TO WHERE
WE WERE MORE OR LESS, BUT WHAT I
DON'T KNOW IS LIKE HOW MUCH OF
THAT IS REALLY IN THE SERVICES
REALM, HOW MUCH OF IT IS IN
IMPLEMENTATION RESEARCH, FOR
EXAMPLE, RINAUD, AND HOW MUCH IS
IN THE SORT OF MORE ADVANCED
STAGES OF CLINICAL TRIALS WHICH
ARE ALSO INCLUDED IN THOSE
NUMBERS.
PAMELA.
>> I ALSO WANT TO ECHO TED'S
THANKS FOR YOUR SERVICE, JOSH.
APPRECIATE THE WAY THAT YOU'VE
ALSO HIGHLIGHTED WORKFORCE
DIVERSITY AND MADE IT A POINT TO
REALLY TRY AND BE TRANSPARENT
ABOUT THAT WITH THE COUNCIL.
I HAVE A QUESTION ABOUT THE
75 MILLION INCREASE TO NIMH, AND
JUST WANTED TO HEAR A FEW MORE
DETAILS IF THESE ARE THINGS THAT
HAVE ALREADY BEEN FUNDED THAT
YOU CAN TALK ABOUT.
CAN YOU TELL US MORE ABOUT THE
LEARNING HEALTHCARE AND
PRIORITIES THAT HAVE COME OUT OF
THAT $75 MILLION?
>> LET ME SAY THIS THIS YEAR,
THE BULK OF THOSE $75 MILLION
WENT TO THE PRECISION PSYCHIATRY
INITIATIVES.
WHICH WE HAD LAUNCHED.
WITH SMALLER AMOUNTS GOING TO
THE TWO AREAS THAT YOU
IDENTIFIED AS WELL AS THE FOURTH
AREA, WHICH IS IN DIVERSIFYING
GENETICS.
SO LET ME START THERE REALLY
QUICKLY.
IN THAT REGARD, WE HAVE FUNDED A
NUMBER OF GRANTS IN THE
ANCESTRAL -- DIVERSE ANCESTRAL
POPULATIONS NETWORK, AS WELL AS
SOME OTHER EFFORTS TO MOVE FROM
GENES INTO BIOLOGY.
USING THAT
DATA.
AND THEN IN PRECISION
PSYCHIATRY, OF COURSE, WE FUNDED
THE IMPACT INITIATIVE AND THE
INNOVATION FUNNEL WHICH WILL BE
COMING TO YOU TOMORROW.
THAT'S ALL PART OF THE
$75 MILLION.
IN THE LEARNING HEALTHCARE
NETWORK AREA, WE WERE ABLE TO --
ALTHOUGH WE HADN'T FINALIZED IT
BECAUSE WE'RE WAITING FOR THOSE
GRANTS TO BE -- THEY WILL COME
TO YOU IN A RAPID AUGUST
COUNCIL, WE HAVE SEVERAL
RENEWALS OF THE EPINET PROGRAM
WHICH WE'RE GOING TO MOVE, IF WE
CAN, MOVE FORWARD TO FUND IN
THIS FISCAL YEAR.
AS WELL AS ADDITIONAL ONES THAT
WE WILL FUND IN NEXT FISCAL YEAR
ANTICIPATING THAT THE BUDGET
WILL BE AT LEAST STABLE AND
WE'LL BE ABLE TO DO THAT NEXT
YEAR.
THEN ALSO IN LEARNING
HEALTHCARE, WE ARE DEVELOPING
PLANS TO EXPAND BEYOND EPINET
INTO OTHER AREAS.
I CAN'T TALK ABOUT THOSE
DETAILS -- THAT'S NOT PUBLISHED
YET, RIGHT?
I WON'T TALK ABOUT THE DETAILS,
BUT I WOULD SAY THAT PART OF THE
PLAN IS TO EXPAND BEYOND JUST
EPINET.
BUT THAT'S NOT THIS FISCAL YEAR.
IN YOUTH MENTAL HEALTH, THERE'S
BEEN A NUMBER OF THE EFFORTS IN
SYSTEMS OF CARE THAT WE'VE
INVESTED IN YOUTH MENTAL HEALTH
IN GENERAL THAT WE DON'T HAVE A
SPECIFIC INITIATIVE IT IS TIED
TO, AND THEN ALSO COMING TO YOU
IN THE AUGUST COUNCIL WILL BE
THE RESULTS OF A REISSUE OF THE
YOUTH AND SOCIAL MEDIA, WHICH
WAS SPECIFICALLY CALLED OUT FOR
SUPPORT AGAIN BY CONGRESS,
ALTHOUGH NO SPECIFIC DOLLAR
AMOUNT THIS YEAR WAS
APPROPRIATED TO IT.
SO THOSE ARE THE AREAS WE'RE
ACTIVE IN AND WE'RE PLANNING A
NUMBER OF DIFFERENT INITIATIVES
IN THAT YOUTH MENTAL HEALTH AND
LEARNING HEALTHCARE SPACE OVER
THE NEXT COUPLE OF YEARS.
ANGUS.
IS THERE ONE ONLINE?
SORRY?
OKAY, GREAT.
LET'S GO WITH ANITA AND COME
BACK TO ANGUS.
>> SO THANK YOU, DR. GORDON, AND
I ALSO WANT TO SHARE MY SORROW
THAT YOU'RE LEAVING BUT ALSO JOY
FOR YOU WITH WHERE YOU'LL BE
GOING.
I DID JUST WANT TO ADD FOR THOSE
WHO ARE INTERESTED IN THE
SERVICES COMPONENT THAT WE'VE
BEEN WORKING ON A COUPLE OF
NOSIs THAT CONNECT OUR GRANTS
WHICH ARE SERVICES-RELATED TO
RESEARCH OPPORTUNITIES.
SO WE'RE HOPEFUL THAT WILL GROW.
AND JUST WANT TO LET YOU KNOW
THAT THAT'S BEEN A SUPPORTED WAY
OR ACTUALLY BRING TO FRUITION
THAT CLOSE ENING OF
OPPORTUNITIES WE MIGHT HAVE
THROUGH OUR SERVICES GRANTS TO
ANSWER IMPORTANT RESEARCH
QUESTIONS IN THE SERVICES AREA.
>> COLLABORATION WITH SAMHSA
BEGINNING WITH EP EE NET AND
MOVING INTO OTHER AREAS
INCLUDING THE WORK THAT ANITA
ALLUDED TO IS REALLY HELPING
BUILD THAT PROGRAM IN GENERAL.
ANGUS.
>> ACTUALLY THAT WAS QUITE
TIMELY BECAUSE ONE OF MY
QUESTIONS WAS ABOUT
COLLABORATION WITH SAMHSA.
BUT FIRST I WANTED TO JUST
MENTION, I REMEMBER WHEN YOU
WERE APPOINTED AND WE WERE LIKE,
WAIT, THE JOSH -- IS THAT OUR
JOSH GORDON?
HE'S SO DOWN TO EARTH.
WHAT'S GOING TO HAPPEN WHEN HE
SHIPS OFF TO WASHINGTON AND -- I
WANT TO ADMIRE THAT YOU HAVE
BROUGHT THAT DOWN TO EARTH TO
THIS POSITION, AND I THINK IT'S
BEEN TO THE BENEFIT OF THE
RESEARCH IN THIS AREA, IT'S BEEN
TO THE BENEFIT OF THE INSTITUTE,
AND SO YOU LEAVE WITH SOME OF
THAT SAME DOWN TO EARTH AND
HAVING BROUGHT ALL OF THAT
SCIENTIFIC SENSIBILITY THAT YOU
HAD AT THE TIME AND DEPLOYED IT
BROADLY ACROSS MENTAL HEALTH
RESEARCH.
SO VERY -- YOU'RE GOING TO BE
MISSED.
YOU'RE GOING TO LEAVE SOME BIG
SHOES HERE.
IN TERMS OF SUBSTANTIVE
QUESTIONS, NOW I GET TO TURN UP
THE HEAT, THE CAPACITY TO HAVE A
BUDGET RISE IN THIS ENVIRONMENT
IS TOTALLY NON-TRIVIAL.
AND SO I GUESS ONE OF MY
QUESTIONS WAS, DID SAMHSA GET
SIMILAR LO LOVE AND HOW ARE THOE
INITIATIVES COMING TOGETHER,
WHAT I DOES THE TOTAL PICTURE LK
LIKE IN TERMS OF INCREASES IN
THE CAPACITY FOR SERVICE, AND
ALSO HOW DOES THAT IMPACT A
NUMBER OF THE BROADER TRENDS
THAT ARE IN BIOMEDICAL
PSYCHIATRIC RESEARCH DOMAINS
SUCH AS INCREASES IN SALARIES
FOR POSTDOCS, A LEVEL -- IS
THERE DISCUSSION OF CHANGING
CAPS, SO ON AND SO FORTH, WHICH
NOW ARE BECOMING SORT OF THE
NORM, YOU KNOW, THOSE HAVEN'T
BEEN TOUCHED IN THE CONTEXT OF
INFLATION.
HOW IS THE BROADER INSTITUTE
THINKING ABOUT THOSE HOUSED IN
NIH THINKING ABOUT THIS?
>> OKAY.
FIRST, THANK YOU FOR THOSE
QUESTIONS, THANK YOU FOR YOUR
REMARKS.
I'M GOING TO CREDIT MY DOWN TO
EARTHINESS THE TWO YEARS I SPENT
WHEN I WAS 9 AND 10 LIVING IN
MINNESOTA.
THOSE OF YOU THAT DON'T KNOW,
THAT'S WHERE ANGUS IS.
OKAY.
NOW SAMHSA, I DON'T KNOW WHAT
SAMHSA'S BUDGET WAS IN 2024, BUT
AS MOST OF YOU KNOW, SAMHSA'S
BUDGET HAS DRAMATICALLY
INCREASED IN THE LAST SEVERAL
YEARS SINCE THE PANDEMIC WITH
INCREASING RECOGNITION OF THE
NEED FOR MENTAL HEALTH SERVICES.
ONE OF THE RESULTS OF THAT IS
EXPANSION OF CERTIFIED COMMUNITY
BEHAVIORAL HEALTH CENTERS, WHICH
REPRESENTS AN OPPORTUNITY
WHETHER THEY WENT UP AGAIN THIS
YEAR OR NOT FOR US TO ACCESS
THAT IN TERMS OF COMMUNITY-BASED
RESEARCH.
SO THE COLLABORATIONS THAT WE'RE
TALKING ABOUT AREN'T NECESSARILY
DEPENDENT UPON INCREASES IN
SAMHSA'S BUDGET, BECAUSE WHAT
WE'RE TRYING TO DO IS FIGURE OUT
WAYS THAT RESEARCHERS CAN TAP
INTO THAT NETWORK AND CONTRIBUTE
TO THE EFFICIENT AND EFFECTIVE
OPERATION OF THE CLINICAL
SERVICES THAT SAMHSA PROVIDES
THROUGH COLLABORATIONAL
RESEARCH.
SO IT'S NOT NECESSARILY DEPEND
DDEPENDENT UPON INCREASES THERE.
THE THIRD THING IS HOW DOES THE
BUDGET PICTURE, BOTH OUR MODEST
INCREASE AND THE OVERALL
LIKELIHOOD PERHAPS OF NOT SEEING
INCREASES IN THE NEAR FUTURE,
HOW DOES THAT AFFECT THINGS --
THE GENERAL FUNDING PICTURE?
YOU MENTIONED A COUPLE OF
FACTORS, RIGHT, ONE OF WHICH WAS
THE INCREASE IN POSTDOCTORAL
SALARIES.
SO AS YOU KNOW, THE ADVISORY
COUNCIL OF THE DIRECTOR
RECOMMENDED TO THE NIH DIRECTOR
THAT POSTDOC SALARIES BE
INCREASED TO A MINIMUM OF
$70,000.
WE AS INSTITUTE DIRECTORS MET
WITH TOGETHER AND DISCUSSED WITH
THE INSTITUTE DIRECTOR AND MADE
A COLLECTIVE DECISION THAT THAT
IS OUR GOAL BUT WE CANNOT DO IT
OVERNIGHT, AND ONE OF THE
REASONS WHY WE CAN'T DO IT
OVERNIGHT IS BECAUSE OF THE
BUDGET PICTURE.
SO WE HAVE A PLAN TO GET TO 70K
OVER THE NEXT SEVERAL YEARS.
I DON'T REMEMBER IF IT'S TWO
YEARS OR FIVE YEARS, BUT IT'S
OVER THE NEXT SEVERAL YEARS AS A
MINIMUM POSTDOC SALARY.
WE COULD GET THERE FASTER IF THE
BUDGET WENT UP MORE BECAUSE IF
THE BUDGET DOESN'T GO UP THEN
HAVING HIGHER POSTDOC SALARIES
MEANS PAYING FEWER POSTDOCS, AND
THAT HAS ITS DISADVANTAGES.
NONETHELESS, WE'RE COMMITTED TO
INCREASING IT REGARDLESS OF THE
BUDGET PICTURE, SO IF THE BUDGET
PICTURE REMAINS STAGNANT, IT
DOES MEAN WE'LL HAVE FEWER
FELLOW SHIPS TO MORE
INDIVIDUALS.
IT'S NOT A HUGE FIGHT IN TERMS
OF THE NUMBERS -- HUGE BITE.
IT'S A MODEST DECREASE AT LEAST
IN THE NEXT YEAR OR TWO IN TERMS
OF THE NUMBER OF SLOTS IF WE
HAVE A STEADY BUDGET.
WHAT IT MEANS FOR NIMH TO HAVE
HAD A MODEST INCREASE THIS YEAR
IS THAT WE CAN ACTUALLY PROVIDE
THAT INCREASE AT LEAST THIS
YEAR'S INCREASE WITHOUT
DECREASING THE NUMBER OF SLOTS
WE FUND.
SO WE DO HAVE SOME MORE MONEY
THAT WE CAN ATTRIBUTE TO
TRAINING, NOT NECESSARILY
BECAUSE CONGRESS SAID TO SPEND
$75 MILLION ON IT, BUT BECAUSE
THAT CREATES A LITTLE MORE
FLEXIBILITY IN OUR OVERALL
BUDGET.
WHAT THE FUTURE -- WHERE THE
FUTURE LIES, I DO NOT KNOW.
BUT AGAIN, WE'VE COMMITTED TO
RAISING THE POSTDOC SALARY TO
THAT $70,000 MARK.
AND FOR THOSE OF WHO YOU ARE
INTERESTED, OF COURSE, GRAD
STUDENT STIPENDS HAVE BEEN
INCREASED AGAIN AND THEY WILL
CONTINUE TO INCREASE MODESTLY
EACH YEAR BUT WE DON'T HAVE A
PARTICULAR TARGET FIGURE FOR
THAT.
IN TERMS OF THE QUESTION ABOUT
MODULAR BUDGETS OR BUDGET CAPS
AND WHETHER THERE'S TALK OF
INCREASING THEM, I WOULD SAY THE
ANSWER IS STILL NO.
YES, I MEAN, YOU CAN LOOK
THROUGH YOUR GRANT LIST
TOMORROW, YOU WILL SEE VERY,
VERY, VERY FEW MODULAR BUDGETS
IN TOMORROW'S ALLOCATION.
IN FACT, I'M ALWAYS SURPRISED
WHEN ONE COMES ACROSS MY DESK.
I ONLY REMEMBER ONE OR TWO IN
THE GRANTS THAT WE HAD TO
DISCUSS.
SO THAT'S REALLY GONE AWAY.
THERE'S REALLY VERY FEW PEOPLE
THAT ARE SUBMITTING THAT.
SO REALLY THE NEXT QUESTION IS
DO WE WANT TO INSTITUTE A
MODULAR BUDGET, A HIGHER LEVEL,
AND WE HAVEN'T REALLY -- THERE'S
NOT A LOT OF ENTHUSIASM FOR
DOING THAT BECAUSE THE
PERCEPTION AT LEAST THAT WE HEAR
FROM OUR COMMUNITIES IS THAT THE
MODULAR BUDGET DOESN'T ACTUALLY
SAVE PIs OR INSTITUTIONS'
WORK.
IF WE THE NEXT QUESTION BECOMES,
ALL KINDS OF CAPS WE HAVE, THE
$500,000 CAP WHERE YOU HAVE TO
ASK US TO COME IN A GRANT HIGHER
THAN THAT. THE $2 MILLION TOTAL
COST THAT -- NOT CAP BUT
THRESHOLD FOR SENDING THINGS TO
CONGRESS.
THAT $2 MILLION WAS INCREASED,
IT USED TO BE LOWER, JUST
RECENTLY.
SO I DON'T SEE THAT CHANGING
MUCH, AND WE HAVEN'T HAD ANY
DISCUSSIONS ABOUT CHANGING THAT
$500,000 CAP.
IF THOSE THINGS ARE BECOMING
IMPEDIMENTS TO DESIGNING GOOD
RESEARCH, PLEASE GIVE US THAT
FEEDBACK, GIVE NIH, THE
DIRECTOR'S OFFICE THAT FEEDBACK,
AND WE CAN START HAVING THOSE
DISCUSSIONS.
>> I DON'T WANT TO REPEAT WHAT
WAS SAID BUT THANK YOU JOSH
GROWR BRIL YONT AND WELCOMED
LEADERSHIP OVER THE YEARS,
REALLY APPRECIATE YOUR WONDERFUL
SERVICE.
I WANTED TO COMMENT ON ONE OF
THE THINGS SEVERAL COLLEAGUES
HAVE MENTIONED AND THAT'S THE
INCREASED FUNDING IN SERVICES IN
INTERVENTIONAL RESEARCH,
BEHAVIORAL RESEARCH DURING YOUR
TENURE, ALSO WANT TO JOIN THE
COURSE OF PEOPLE ASKING FOR MORE
OF THIS.
THERE'S A WAY TO BUILD THIS IN,
HAVE IT BE PART OF THE SEARCH
FOR THE NEXT DIRECTOR, AND I
NOTE THAT OUR PRIOR DIRECTOR OF
NIMH SAID AFTER HE STEPPED DOWN
AFTER BRILLIANT LEADERSHIP AS
WELL, REALLY SHOULD HAVE
INVESTED MORE IN BEHAVIORAL
RESEARCH.
OUR FORMER NIH DIRECTOR SAID
THIS PAST WEEK, COVID, SHOULD
HAVE FOCUSED MORE ON BEHAVIORAL
RESEARCH.
IT'S NICE AS A BEHAVIORAL
RESEARCHER HEARING THIS BUT IS
THERE ANY WAY TO HAVE THIS BUILT
IN MOVING FORWARD?
YOU SAID AS WELL THERE'S BEEN AN
INCREASE.
AND FUNDING TO SERVICES
INTERVENTION BASED RESEARCH, SO
HOW CAN WE ENSURE THIS CONTINUES
TO BE A FOCUS MOVING FORWARD?
>> I AM BLESSED WITH THE
INABILITY TO TELL MY SUCCESSOR
WHAT TO DO.
AND IN FACT, I CAN'T EVEN LOBBY
FOR THAT FOR AT LEAST A YEAR
AFTER I LEAVE THE GOVERNMENT,
SO --
>> HE OR SHE IS PROBABLY
LISTENING.
[LAUGHTER]
>> SO, YOU KNOW, IT'S BEEN MY
POLICY AS I STATED VERY EARLY ON
IN MY TENURE TO HAVE THE
EXCELLENCE OF THE SCIENCE
DICTATE THE PORTFOLIO BALANCE
WITHIN REASON AND TO WORK HARD
TO INCREASE THE PRESSURE -- THE
GRANT PRESSURE IN AREAS WHERE WE
THINK THERE ARE GAPS, AND THAT'S
BY MY APPROACH IN THIS SERVICES
AND BEHAVIORAL RESEARCH AREAS
YOU'RE MENTIONING.
I WANT TO BE VERY, VERY
SPECIFIC, I DON'T THINK WE
ACTUALLY HAVE A PROBLEM IN
BEHAVIORAL RESEARCH BUT IN THAT
MORE NEAR TERM RESEARCH.
YOU AND I MIGHT DIFFER ABOUT
THAT, THAT'S FINE.
BUT I WOULD SAY, YOU KNOW, THIS
IS AN OPPORTUNITY WHEN YOU HIRE
A NEW DIRECTOR TO HAVE A
DIRECTOR WHO MIGHT COME IN WITH
DIFFERENT PRIORITIES.
AND THAT IS PART OF THE REASON I
AM LEAVING.
I'VE HAD MY TURN, BEEN HERE
EIGHT YEARS, I'VE GOTTEN
ACCOMPLISHED MOST OF THE THINGS
I WANT TO ACCOMPLISH AND IT'S
TIME FOR SOMEONE WITH NEW IDEAS
AND NEW PRIORITIES TO COME IN.
SO CERTAINLY THERE'S AN
OPPORTUNITY NOW.
HOW CAN YOU INFLUENCE THAT
OPPORTUNITY?
FIRST AND FOREMOST, YOU CAN
ENCOURAGE YOUR COLLEAGUES OR
CONSIDER YOURSELF APPLYING TO
TAKE ON THIS POSITION.
I SEE YOU SHAKING YOUR HEAD.
I'M HAPPY TO TELL YOU ALL THE
WONDERFUL REASONS WHY I THINK
YOU SHOULD, MATT, BUT I RESPECT
THAT.
BUT YOU KNOW, THE SEARCH
COMMITTEE WILL BE ABLE TO PICK
FROM MANY QUALIFIED CANDIDATE,
AND IF YOU ARE PEOPLE THAT YOU
FEEL WOULD LEAD THE INSTITUTE IN
THE WAY YOU'D LIKE TO SEE IT
LED, ENCOURAGE THEM TO APPLY.
LET'S START THERE.
AND THE SECOND THING I THINK IS
YOU CAN, YOU KNOW, CERTAINLY
MAKE YOUR VOICES HEARD TO THE
NIH DIRECTOR ABOUT WHAT YOU
THINK THE PRIORITIES ARE.
I CAN TELL YOU AT THE
FUNDAMENTAL BASIS THAT NIH STILL
REMAINS A BIOMEDICAL RESEARCH
INSTITUTION, AND I THINK WE'RE
GOING TO SEE THAT THAT'S GOING
TO BE AN IMPORTANT PART OF THE
SEARCH.
, BUT THAT LEAVES TREMENDOUS
LEEWAY, AND AS I SAID, THE
HIRING OF A NEW DIRECTOR IS A
WAY -- IS WHEN BIGGER CHANGES IN
PRIORITIES HAPPEN.
I'VE CHANGED MY PRIORITIES ALONG
THE WAY.
I'VE LEARNED A LOT FROM ALL OF
YOU IN THIS ROOM, BOTH NIHERS
AND COUNCILMEMBERS AS WELL AS
FROM THE PUBLIC, THE IACC, MANY
OTHER VENUES.
SO MY PRIORITIES HAVE CHANGED,
BUT BIGGER CHANGES HAPPEN WHEN
NEW PEOPLE TAKE OVER.
MARGUERITA.
LET ME JUST SAY TO THOSE -- SO
NO ONE FEELS LEFT OUT, THERE ARE
ALSO PEOPLE OUT THERE WHO ARE
ARGUING THAT WE VEERED AWAY FROM
THESE AREAS OF BASIC SCIENCE OR
THESE AREAS OF TRANSLATIONAL
SCIENCE, SO YOU KNOW, MY IDEAL
VERSION OF THE PERSON IS SOMEONE
WHO CAN UNDERSTAND AND
APPRECIATE ALL TH THE DIFFERENT
FACETS OF THE PORTFOLIO AND
THOSE THAT WILL BRING PRIORITIES
INTO MENTAL HEALTH.
MARGUERITA.
>> I SECOND THAT YOU SHOULD
APPLY FOR THE POSITION.
>> JOSH, I WANTED TO ALSO ADD,
WAYS REALLY INTERESTED IN THE
CLINICAL RESEARCH NETWORK THAT'S
BEING FORMED.
I KNOW THAT YOU'VE BEEN VERY
INVOLVED IN THE NIH COMMON FUND
AND NIMH HAS BEEN INVOLVED, AND
I ALSO WAS REALLY APPRECIATING
THE SENSE OF WANTING TO FOCUS ON
UNDERSERVED AND UNDERREPRESENTED
POPULATIONS, AND I'M WONDERING
HOW -- WHAT ARE THE STRATEGIES
THAT AS YOU'RE BUILDING THE
NETWORK, THE STRI STRATEGIES THE
GOING TO ENSURE THAT THAT IS
ACTUALLY THE CASE AS OPPOSED TO
IT BEING LARGE FOLKS WHO ALWAYS
GET THE MONEY FROM NIMH OR NIH
IN GENERAL, AND THEY TRY TO
ENGAGE THE COMMUNITY.
BUT REALLY AREN'T ACTUALLY
REACHING THOSE FOLKS THAT WE
NEED.
SO I'M WONDERING WHAT KIND OF
STRATEGIES ARE BEING EMPLOYED TO
ENSURE THAT WE'RE REACHING THE
INTENDED AUDIENCE AND JUST ALSO
ADDING THAT YOU ALSO -- THE
GROUP MAY WANT TO CONSIDER WHAT
KIND OF CAPACITY BUILDING
ACTIVITIES COULD BE DONE SO THAT
NEW COMMUNITY MENTAL HEALTH
CENTERS AND ALL THE COMMUNITY
CLINICS COULD ALSO BE INCLUDED
SO THAT THE FOLKS WHO AREN'T
TYPICALLY GETTING FUNDING FROM
NIMH BUT WHO ARE ACTUALLY,
WOULDING WITH THE POPULATIONS
THAT WE'RE SEEKING TO REACH.
I THOUGHT MAYBE GET BACK TO --
CAN'T DO IT THAT QUICKLY, KIND
OF -- OKAY.
SO THIS IS THE PROGRAM YOU'RE
TALKING ABOUT.
THIS IS DR. BERTAGNOLLI'S SORT
OF SIGNATURE EFFORT AS NIH
DIRECTOR AND SHE'S USING A
COMMON FUND AS A MECHANISM FOR
THAT.
I CAN'T SPEAK TO THE STRATEGIES
THEY'RE GOING TO USE BECAUSE I
DON'T REALLY KNOW AND THEY JUST
HIRED A DIRECTOR FOR THIS
INITIATIVE.
THE NAME ESCAPES ME AT THIS
MOMENT BUT IT'S A LONG-TIME
NIHER.
I WILL TELL YOU WHAT THEY'RE
DOING SO FAR.
SO THE FIRST THING, BECAUSE
THERE'S NOT NEW MONEY FOR THIS
JUST YET, RIGHT, THERE'S SOME
MODEST FUNDS FROM THE COMMON
FUND TO SUPPLEMENT ESSENTIALLY
EXISTING CLINICAL NETWORKS, SO
THEY ASKED ALL THE NIH
INSTITUTES TO SEND THEM PLACES
WHERE THEY HAVE INVESTMENTS IN
RESEARCH BEING DONE AT PRIMARY
CARE SETTINGS.
SO WE DID SEND IN OUR EPINET
NETWORK, WE FELT LIKE IT WAS
RELEVANT ENOUGH, AND THEY CULLED
THROUGH THOSE AND ARE LOOKING AT
THOSE EXISTING NETWORKS AS
PLACES WHERE THEY CAN SUPPLEMENT
TO BUILD INFRASTRUCTURE THAT
COULD FORM THE BASIC BONES OF
THIS NETWORK.
THE SECOND PHASE OF THAT IS
GOING TO BE THE INTERESTING
PART, WHERE THEY'RE GOING TO
THEN TRY TO SOLICIT NEW NETWO
NETWORKS.
NOW, IN CONTRAST TO THE COMPASS
INITIATIVE, YOU RECALL FROM ME
DISCUSSING THAT, THIS IS COMMON
FUND INITIATIVE AT NIMH THAT I'M
DEEPLY INVOLVED IN THAT SEEKS TO
FUND COMMUNITY-BASED
ORGANIZATIONS AND NOT HEALTHCARE
ORGANIZATIONS, PER SE, TO
CONDUCT RESEARCH ON STRUCTURAL
FACTORS, INTERVENTIONS THAT
AFFECT STRUCTURAL FACTORS OF
HEALTH DISPARITIES.
THIS ONE IS REALLY ABOUT
BUILDING NETWORKS OF -- CLINICAL
RESEARCH NETWORKS, SO IT'S GOING
TO BE HEALTHCARE FACILITIES,
IT'S GOING TO BE CLINICS, SO
WHAT THEY'RE GOING TO BE
FOCUSING IN ON IS WHAT ARE THE
NETWORKS THAT CAN REACH THE
COMMUNITIES WE NEED TO REACH?
SO IT MAY BE A LITTLE LESS ABOUT
WHO WE'RE FUNDING AND A LITTLE
MORE ABOUT WHERE THOSE DOLLARS
ARE GOING AND WHAT ARE THE
COMMUNITIES THAT ARE BEING
SERVED.
I KNOW THERE'S DISCUSSION AS
INDICATED IN THAT THIRD BULLET
POINT AROUND ENSURING THAT THESE
COMMUNITY -- BASED CLINICS ARE
ENGAGED WITH THE LOCAL COMMUNITY
AND THAT RESEARCH QUESTIONS THAT
ARE BEING ADDRESSED ARE RELEVANT
TO THOSE COMMUNITIES, BUT THEY
HAVEN'T FIGURED OUT YET HOW
THEY'RE GOING TO EXSTANTIATE
THAT.
>> I'LL KEEP IT BRIEF.
THANK YOU, JOSH.
SO FAR THIS MORNING, WE HAVE
HEARD A LOT ABOUT NIMH
INVESTMENTS TOWARDS RESEARCH.
COULD YOU COMMENT A BIT MORE ON
INVESTMENTS FOR PREDOCK, POSTDOC
TRAINING OPPORTUNITIES, IN
PARTICULAR I'M INTERESTED TO SEE
IF THERE ARE ANY IDEAS FOR THE
BUDGET INCREASE AND ALLOCATIONS
TOWARDS TRAINING PROGRAMS.
>> THAT'S A GOOD QUESTION.
THE BUDGET INCREASE WAS
SPECIFICALLY TARGETED AND DID
NOT INCLUDE LANGUAGE AROUND
TRAINING.
AS I MENTIONED THE FACT THAT WE
RECEIVED AN INCREASE ALLOWED US
TO BE A LITTLE MORE FLEXIBLE AND
WE COULD TAKE SOME OF THE
DOLLARS THAT OTHERWISE WOULD
HAVE HAD TO HAVE BEEN SPENT TO
SUPPORT THINGS LIKE IMPACT AND
PUT A MODEST INCREASE IN OUR
TRAINING BUDGET.
SO I WOULD SAY WE'RE BETTER
OFFER IN TERMS OF OUR TRAINING
GRANTS THAN OTHER INSTITUTES
WHICH RECEIVED A FLAT BUDGET,
BUT THE BUDGET WAS NOT -- DID
NOT SPECIFY CHANGES IN TRAINING
APPROACHES.
WHAT I WOULD SAY IS WE'VE BEEN
NOW INVOLVED FOR ABOUT A YEAR IN
REALLY LOOKING AT OUR TRAINING
PORTFOLIO, AND I JUST RECEIVED A
COUPLE WEEKS AGO THE REPORT OF
THAT WORK OF OUR TRAINING TEAM
REALLY DETAILING THE INVESTMENTS
AND WHERE THEY ARE.
THAT REPORT IS GOING TO BE
HANDED RIGHT OVER TO SHELLI AND
HANDED RIGHT OVER TO OUR NEW
DIRECTOR, AND I'M CERTAINLY
HOPEFUL THAT WE CAN LOOK AT
WHERE OUR INVESTMENTS ARE, AND
HOW THEY ARE ACHIEVING OUR
STATED GOALS IN TRAINING.
SO WE'VE STATED THAT WE WANT TO
IMPROVE -- INCREASE THE NUMBER
OF CLINICIAN-SCIENTISTS THAT WE
WE -- WE WANT TO BE ABLE TO
ENSURE THAT THE HAVE-NOTS IN THE
RESEARCH ECOSYSTEM ARE
EQUITABLY, YOU KNOW, EQUITABLY
TREATED ESPECIALLY IN THIS
TRAINING DOMAIN, ARE THESE
MECHANISMS ACHIEVING THAT GOAL.
AND SO WE'RE AT THE STAGE NOW
WHERE WE HAVE THE INVENTORY AND
THE DETAILS AND NOW WE NEED TO
DO SOME ANALYSES TO FIGURE OUT
WHERE ARE WE ACHIEVING OUR
GOALS, SO I EXPECT THAT TO COME
BEFORE THIS BODY IN THE COMING
YEARS.
>> I REALLY JUST WANT TO ECHO
YOUR QUESTION AND ALSO HOW CAN
WE CONTINUE TO ADVOCATE FOR THAT
BECAUSE I WORRY THAT JUST AS
POSTDOCS ARE AT RISK OF
DIMINISHING, THE SAME WILL BE
TRUE FOR GRADUATE STUDENTS,
T32s ARE NOT KEEPING UP WITH
THE COST OF TRAINING.
SO IT'S A REAL CONCERN.
>> WELL, YOU KNOW, I WOULD SAY
THAT YOUR AID IN FIGURING OUT
THE BEST WAYS TO SPEND DOLLARS
THAT WILL BE LIMITED WILL BE --
I SAID I'D ACHIEVE MOST OF WHAT
I SET OUT TO DO.
ONE OF THE THINGS I REALLY
DIDN'T ACHIEVE IS THE ABILITY TO
FIGURE OUT THIS ISSUE OF --
PARTICULARLY AROUND HAVEs AND
HAVE NOTs IN THE MECHANISMS
THAT WE HAVE.
WE HAVE WONDERFUL INDIVIDUAL
FELLOWSHIPS, AND THOSE
INDIVIDUAL FELLOWSHIPS ARE VERY,
VERY COMPETITIVE AND THEY'RE
FUNDED AT VERY, VERY LOW RATES,
WHICH MEANS ONLY OUTSTANDING
PEOPLE GET THEM.
BUT DOES THAT MEAN THAT
OUTSTANDING PEOPLE WHO WOULDN'T
BE OUTSTANDING OR WOULDN'T
DEVELOP IN AN OUTSTANDING WAY IF
THEY DIDN'T GET IT, MIGHT THOSE
DOLLARS BE BETTER SPENT WHERE
PEOPLE -- AT INSTITUTIONS OR IN
LABS THAT AREN'T WELL-FUNDED,
AND DO WE HAVE A MENG NISM FOR
THAT, CAN WE DO THAT?
THAT'S AN AREA I'VE BEEN REALLY
INTERESTED IN AND I'VE NOT BEEN
ABLE TO CRACK.
SO THERE ARE OTHER THINGS LIKE
THAT.
YOU MAY HAVE DIFFERENT
PRIORITIES WHEN YOU LOOK AT OUR
TRAINING PORTFOLIO.
AS MEMBERS OF COUNCIL, YOU CAN
ASK TO CONTINUE DOWN THIS PATH
AND EVALUATING THE TRAINING
PORTFOLIO AND IS IT GOING TO
ACHIEVE WHAT WE WANT TO ACHIEVE,
WHAT OUR GOALS ARE AS AN
INSTITUTE, SO I ENCOURAGE YOU TO
DO THAT.
OF COURSE AS A MEMBER OF THE
SCIENTIFIC COMMUNITY AND MEMBER
OF THE PUBLIC, I JUST TOLD YOU
THE LIMITING FACTOR, THE BIGGEST
LIMITING FACTOR IN EX-PENDING
OUR TRAINING PORTFOLIO IS OUR
OVERALL BUDGET.
IF SALARIES AND STIPENDS GO UP
AND OUR OVERALL BUDGET DOES NOT
GO UP, THAT MEANS THE NUMBER OF
SLOTS WILL GO DOWN.
AND SO THAT'S -- WHATEVER YOU
CAN DO AS A MEMBER OF THE PUBLIC
TO SUPPORT THE BUDGET, THAT'S
ANOTHER WAY YOU COULD DO IT.
HOPE I DIDN'T CROSS ANY --
>> THANK YOU, JOSH, FOR BEING A
CHAMPION FOR IMPLEMENTATION
SCIENCE AND IMPACT.
I JUST WANT TO PIGGY BACK OFF
WHAT DR. LIGHTFOOT SAID ABOUT
THIS PROGRAM AND I UNDERSTAND
IT'S NIH WIDE BUT ON MY WISH
LIST, I'D LIKE TO SEE A SCALE UP
ON IMPLEMENTATION SCIENCE AND
ALSO THINK NING TO REALLY MAXIME
THE POTENTIAL IMPACT WE CAN HAVE
FOR OUR COMMUNITIES.
>> THANK YOU FOR THAT COMMENT.
I'M NOT 100% SURE THAT THAT'S
THE GOAL OF THIS NETWORK.
SO IF YOU'RE INTERESTED IN THAT,
THAT MIGHT REQUIRE SOME ACTIVE
ENGAGEMENT ON YOUR PART.
BECAUSE I'LL BE HONEST, THAT'S
NOT THE WAY IT BEEN
CONCEPTUALIZED.
IT'S A WAY TO CONCEPTUALIZE
DOING CLINICAL TRIALS, LIKE
GENUINE CLINICAL TRIALS, NOT
IMPLEMENTATION SCIENCE, BUT
TRIALS OF NOVEL THERAPIES OR
EFFECTIVENESS TRIALS, ET CETERA.
IN REAL WORLD SETTINGS WITH THE
POPULATIONS THAT WE FIND VERY,
VERY DIFFICULT TO REACH.
SO IT DOES HAVE THE GOAL OF
MAKING TREATMENTS MORE
ACCESSIBLE BUT IN AN EARLIER
TRANSLATIONAL PATHWAY THAN
IMPLEMENTATION -- THAT'S JUST TO
ME, FROM WHAT I'VE HEARD ABOUT
THIS PROGRAM, THAT'S THE GOAL.
SO IF YOU THINK THAT THIS
PROGRAM COULD BE USED IN OTHER
WAYS, THAT MAY REQUIRE SOME
ACTIVE ADVOCACY.
>> THAT'S THE PERFECT PLACE FOR
IMPLEMENTATION SCIENCE.
SO THANK YOU.
>> ALL RIGHT.
WELL, THANK YOU VERY MUCH FOR
ALL YOUR QUESTIONS AND COMMENTS
AND ALSO FOR YOUR HEARTFELT
WORDS.
AND I'M GRATEFUL THAT NONE OF
YOU WENT ON TOO LONG IN THAT W
WAY.
AGAIN, THIS HAS BEEN THE BEST
JOB.
I CAN'T IMAGINE A BETTER ONE,
AND I'M MOVING ON FOR MANY OTHER
REASONS AND REALLY EXCITED ABOUT
THAT, BUT ALSO SAD, AND LOOK
FORWARD TO THE REST OF THE
PROGRAM.
I THINK NEXT WE HAVE A VIDEO
STATEMENT FROM DR. BERTAGNOLLI.
SO WE DID INVITE DR. BERTAGNOLLI
TO OUR COUNCIL MEETING AND SHE
ACCEPT AND WE WERE VERY EXCITED
AND UNFORTUNATELY, SHE HAD
OFFICIAL TRAVEL THAT HAD TO TAKE
PRECEDENCE AND IS UNABLE TO JOIN
US IN PERSON.
SO SHE HAS PREPARED SOME VIDEO
REMARKS, WHICH WE WILL NOW PLAY
FOR YOU.
>> HELLO, EVERYONE.
I'M HONORED TO BE SPEAKING TO
YOU TODAY AS THE 17TH DIRECTOR
OF THE NATIONAL INSTITUTES OF
HEALTH.
WHEN I GOT THE CALL ASKING ME TO
COME WORK AT NIH, I DID NOT
HESITATE TO SAY YES.
I'VE ALWAYS ADMIRED NIH AND I AM
THRILLED TO BE IN A PLACE WHERE
EVERYTHING WE DO REVOLVES AROUND
A SINGLE GOAL, IMPROVING THE
HEALTH OF THE AMERICAN PEOPLE.
OUR JOB AT NIH IS CLEAR, IF NOT
STRAIGHTFORWARD.
WE ARE HERE TO SEEK FUNDAMENTAL
KNOWLEDGE ABOUT LIVING SYSTEMS
AND TO APPLY THAT KNOWLEDGE TO
ENHANCE HEALTH FOR ALL.
AS NIH DIRECTOR, I'M CONCERNED
ABOUT SOME DISTURBING TRENDS IN
THE OVERALL HEALTH OF THE
AMERICAN PEOPLE.
LIFE EXPECTANCY IN THE U.S. IS
LOW COMPARED WITH PEER NATIONS,
EVEN THOUGH WE SPEND MUCH MORE
THAN OTHER COUNTRIES ON OUR
HEALTH SYSTEM.
U.S. LIFE INSPECT SEAL ACTUALLY
DECLINED OVER THE LAST DECADE,
AND THIS DECLINE APPEARS LARGELY
TO BE DUE TO AN INCREASE IN
DEATHS OF DESPAIR, CAUSED BY
DRUG POISONING, SUBSTANCE USE,
SUICIDES, AND CARDIOMETABOLIC
DISEASES IN WORKING-AGE ADULTS.
WE NEED BEHAVIORAL AS WELL AS
BIOMEDICAL RESEARCH TO ADDRESS
THE CHALLENGES TROUBLING
AMERICAN HEALTH.
MENTAL HEALTH RESEARCH IS
PARTICULARLY DEMANDING, BECAUSE
OF CHALLENGES SUCH AS ACCURATE
DIAGNOSIS AND THE LONG DURATION
OF MENTAL ILLNESS.
BUT IT'S SO IMPORTANT THAT WE
MAKE PROGRESS IN UNDERSTANDING
IN COMBATING MENTAL ILLNESSES
WHICH CAUSE SO MUCH DISABILITY
AND, TOO OFTEN, DEATH.
TO IMPROVE THE HEALTH OF THE
AMERICAN PEOPLE, I SEE TWO MAJOR
CHALLENGES THAT NIH NEEDS TO
RESPOND TO.
FIRST, MANY COMMUNITIES ARE
UNDERREPRESENTED IN RESEARCH.
DATA IS ESPECIALLY LACKING FOR
POPULATIONS THAT ARE OLDER,
UNINSURED, BELONG TO MINORITY
GROUPS OR LIVE IN RURAL
LOCATIONS.
SECOND, RESEARCH KNOWLEDGE IS
NOT BEING EFFECTIVELY HARNESSED.
FUNDAMENTALLY FOR ALL THE WEALTH
OF DATA WE ARE ABLE TO COLLECT,
WE LACK SUFFICIENT INFORMATION
TO GUIDE CLINICAL CARE.
AMONG MY GUIDING PRINCIPLES AS
DIRECTOR OF NIH, ONE OF MY VERY
FIRST ONE IS OUR WORK IS NOT
FINISHED WHEN WE MAKE SCIENTIFIC
DISCOVERIES, IT'S WHEN ALL
PEOPLE ARE LIVING HEALTHY LIVES.
FUNDAMENTAL SCIENCE IS THE
FOUNDATION OF ALL THAT NIH DOES.
WE'RE LEARNING SO MUCH ABOUT
HUMAN BIOLOGY IN OUR BASIC
RESEARCH LABORATORIES.
BUT AS THE RUSH OF INFORMATION
COMES IN, WE MUST BECOME MORE
EFFECTIVE IN CONNECTING WHAT WE
LEARN, UNDERSTANDING THE
INTERPLAY BETWEEN THE GENES WE
INHERIT AND THE ENVIRONMENTAL
AND SOCIETAL FACTORS THAT
SURROUND US, BEGINNING EVEN
BEFORE BIRTH, AND CONNECTING
THAT KNOWLEDGE TO EVERYDAY LIFE
AND CLINICAL PRACTICE.
WE NEED TO MAKE SURE THAT THE
BIOLOGICAL INSIGHTS IDENTIFIED
IN LABORATORIES ARE RAPIDLY
PURSUED IN WAYS THAT SPEED THEIR
INNOVATION TO IMPROVE THE
CIRCUMSTANCES OF REAL PEOPLE.
NIH RESEARCH ENCOMPASSES THE
LABORATORY, THE CLINIC AND ALL
COMMUNITIES, AND PATIENTS ARE
OUR PARTNERS IN DISCOVERY.
MY HOPE FOR NIH IS THAT IN THE
COMING YEARS, WE WILL BETTER
CONNECT RESEARCH WITH EVERYDAY
PATIENT CARE.
TO TRULY DELIVER EVIDENCE-BASED
HEALTHCARE BY INTEGRATING ALL
FORMS OF RELEVANT DATA.
AND BY GIVING PATIENTS ACROSS
THE COUNTRY THE OPTION TO
PARTICIPATE IN CLINICAL
RESEARCH.
NIH CAN ALSO HELP MAKE ADVANCED
SCIENTIFIC METHODS SUCH AS NEW
TECHNOLOGIES AND NEW DATA
ANALYTICS MORE WIDELY AVAILABLE
TO HELP DELIVER DATA-DRIVEN
HEALTHCARE.
ARTIFICIAL INTELLIGENCE IS
ALREADY REVOLUTIONIZING WHAT IS
POSSIBLE FOR BIOMEDICAL RESEARCH
AND CLINICAL CARE.
BUT TO REALIZE ITS POTENTIAL FOR
IMPROVING HEALTH, WE NEED TO
INVEST IN A SECURE AND
SUSTAINABLE DATA SHARING
INFRASTRUCTURE.
IN SHORT, MY GOAL AS NIH
DIRECTOR IS TO WORK TOWARD
MAKING SURE THAT EVERYONE HAS
ACCESS TO EVIDENCE-BASED
TREATMENTS AND THE OPPORTUNITY
TO PARTICIPATE IN AND BENEFIT
FROM BIOMEDICAL AND BEHAVIORAL
RESEARCH.
BEFORE CLOSING, I HAVE TO
ACKNOWLEDGE THAT THIS IS THE
LAST MEETING OF THIS GROUP WITH
DR. JOSHUA GORDON SERVING AS
DIRECTOR OF THE NATIONAL
INSTITUTE OF MENTAL HEALTH.
WE HAVE BEEN SO FORTUNATE TO
HAVE HAD HIS LEADERSHIP FOR THE
PAST EIGHT YEARS.
A VISIONARY PSYCHIATRIST AND
NEUROSCIENTIST, DR. GORDON HAS
OVERSEEN AN EXTENSIVE PORTFOLIO
OF BASIC, TRANSLATIONAL, AND
CLINICAL RESEARCH.
HE FOCUSED ON RESEARCH
PRIORITIES LIKE SUICIDE
PREVENTION, EXPANDING NEURAL
CIRCUIT RESEARCH TO INCLUDE
TRANSLATION EFFORTS, AND
INCREASING OUR INVESTMENTS IN
COMPUTATIONAL PSYCHIATRY TO
EXPAND THE MATHEMATICAL AND
THEORETICAL APPROACHES TO MENTAL
HEALTH RESEARCH.
UNDER HIS LEADERSHIP, NIMH HAS
BEEN INVOLVED IN DEVELOPING NEW
MEDICATIONS AND OTHER
INTERVENTIONS, NEW APPROACHES TO
SCREENING AND RISK REDUCTION,
AND THE RAPID EVOLUTION OF
TELEMEDICINE.
IT HAS BEEN INSPIRING TO WORK
WITH DR. GORDON BECAUSE OF HIS
COMMITMENT TO ADVANCING MENTAL
HEALTH AND IMPROVING PEOPLE'S
LIVES.
AND I AM DEEPLY GRATEFUL FOR HIS
EFFORTS TO LOOK -- AND I LOOK
FORWARD TO HIS CONTINUED
CONTRIBUTIONS AS HE RETURNS TO
COLUMBIA UNIVERSITY AND NEW YORK
CITY.
I APPRECIATE THE OPPORTUNITY TO
SPEAK WITH YOU TODAY, AND I'M
SORRY THAT BECAUSE OF MY
NECESSARY TRAVELS, I'M NOT ABLE
TO ATTEND IN PERSON AND ENGAGE
IN A DISCUSSION WITH ALL OF YOU.
I WISH YOU ALL A VERY PRODUCTIVE
MEETING.
THANK YOU.
[APPLAUSE]
>> I WANT TO THANK MONICA FOR
HER REMARKS AND THANK YOU ALL
FOR LISTENING.
UNLESS THERE ARE ANY COMMENTS
ABOUT THAT OR QUESTIONS FOR ME,
ON BEHALF OF DR. BERTAGNOLLI,
WE'RE GOING TO MOVE TOO A BREAK.
I'M GOING TO ASK ALL THE
COUNCILMEMBERS PRESENT TO COME
TO THE FRONT BECAUSE WE'RE GOING
TO GET A PHOTOGRAPH.
WE HAVEN'T DONE THAT IN A LITTLE
WHILE.
EVERYONE ELSE, WE CAN ADJOURN
AND RETURN AT 3:00.
THE NEXT ITEM ON OUR AGENDA IS A
REPORT FROM THE OFFICE OF
DISPARITIES RESEARCH AND
WORKFORCE DIVERSITY AT NIMH ON
PROGRESS IN THAT AREA.
PLEASE JOIN ME IN WELCOMING
DR. CHRISTINA BORBA TO OUR
MEETING, DIRECTOR OF THE NIMH
OFFICE FOR DISPARITIES RESEARCH
AND WORKFORCE DIVERSITY.
DR. BORBA JOINED NIMH IN
SEPTEMBER OF 2022.
WE ASKED HER TO COME SPEAK TO
COUNCIL TODAY TO SHARE BOTH HER
VISION FOR THE OFFICE AS WELL AS
PROVIDE INFORMATION ON THE
INITIATIVES THAT THE OFFICE AND
THE DISPARITIES TEAM ARE
PRIORITIZING.
THEY'VE ALREADY MADE SIGNIFICANT
PROGRESS UNDER DR. BORBA'S
LEADERSHIP, WHICH I THINK LU
APPRECIATE FROM HER PRESENTATION
TODAY.
CHRISTINA, PLEASE COME TO THE
PODIUM.
>> GOOD AFTERNOON, EVERYONE, AND
GOOD AFTERNOON, COUNCILMEMBERS
AND MY FELLOW NIMH STAFF
MEMBERS.
I AM REALLY EXCITED TO BE HERE
TODAY TO TALK ABOUT THE PROGRESS
THAT NOT ONLY THE OFFICE FOR
DISPARITIES RESEARCH AND
WORKFORCE DIVERSITY BUT ALSO THE
DISPARITIES TEAM AT NIMH HAS
MADE IN THE PAST COUPLE OF
YEARS.
WE'RE GOING TO GO THROUGH A
QUICK AGENDA.
WE'LL TALK A LITTLE BIT ABOUT
THE CURRENT STATE OF MENTAL
HEALTH DISPARITIES, THE HISTORY
OF ODWD, WHICH IS THE ACRONYM
FOR OUR OFFICE.
I'D LIKE TO INTRODUCE THE
CURRENT STAFF OF ODWD BECAUSE WE
HAVE, I THINK, DOUBLED OUR STAFF
IN THE PAST YEAR AND A HALF.
LOOK AT NIMH'S PRIORITIES FOR
MENTAL HEALTH DISPARITIES AND GO
THROUGH SOME KEY ACCOMPLISH
ACCOMPLISHMENTS, FUTURE
DIRECTIONS FOR ODWD, AND I WOULD
LOVE TO HAVE A DISCUSSION WITH
COUNCILMEMBERS IN TERMS OF NEXT
STEPS.
I DON'T NEED TO TELL THIS GROUP,
BUT WE STILL HAVE A MAJOR
PROBLEM WHEN WE'RE THINKING
ABOUT MENTAL HEALTH DISPARITIES
IN THIS COUNTRY.
THIS PARTICULAR STUDY CONDUCTED
FROM 2016 TO 2020 THAT LOOKED AT
WHAT WOULD BE THE COST AND ALSO
PREMATURE FOR HAVING LACK OF
MENTAL HEALTH EQUITY IN SERVICES
ROW SEARCH,RESEARCH.
I REALLY APPRECIATED THE
CONVERSATION EARLIER THIS
AFTERNOON AROUND MENTAL HEALTH
SERVICES.
AND THIS PARTICULAR STUDY LOOKED
AT ALSO RACE/ETHNICITY AND ALSO
INDIGENOUS POPULATIONS LIKE
AMERICAN INDIAN, ALASKA NATIVE
AND NATIVE HAWAIIAN, AND TOTAL
EXCESS PREMATURE DEATHS IS
116,000, WHICH COST US
$278 BILLION.
SO WE STILL HAVE A HUGE PROBLEM
WHEN WE'RE THINKING ABOUT MENTAL
HEALTH INEQUITIES IN THE UNITED
STATES.
I'D LIKE TO START WITH THE
DISPARITIES TEAM.
THE DISPARITIES TEAM WAS
DEVELOPED IN 2018 UNDER
DR. JOSHUA GORDON'S LEADERSHIP,
AND IT'S REALLY AN
INTERNAL-FACING TEAM THAT REALLY
GATHERS STAFF FROM ALL THE
DIVISIONS FROM OUR BASIC
SCIENCES, TRANSLATIONAL RESEARCH
AND ALSO INTERVENTION AND
SERVICES RESEARCH.
AND IT REALLY ALLOWS US TO WORK
TOGETHER IN THINKING ABOUT HOW
TO FURTHER THE MISSION WHEN
WE'RE THINKING ABOUT MENTAL
HEALTH DISPARITIES.
CURRENTLY OUR DISPARITIES TEAM
HAS OVER 60 MEMBERS ACROSS NIMH
AND THAT'S ALSO FROM THE
INTRAMURAL PROGRAM AS WELL.
AND WE DO MEET ON A MONTHLY
BASIS.
ODWD WAS ALSO CREATED UNDER
DR. JOSHUA GORDON IN 2020.
THIT'S DIRECTLY WITHIN THE OFFIE
OF THE DIRECTOR, AND ODWD REALLY
HAS TWO PREDOM N PREDOMINANT PR,
TO PROMOTE RESEARCH TO REDUCE
MENTAL HEALTH DISPARITIES AND
ADVANCE MENTAL HEALTH EQUITY AND
TO SUPPORT PROGRAMS TO DIVERSIFY
THE MENTAL HEALTH RESEARCH
WORKFORCE.
SO ODWD AND THE DISPARITIES TEAM
AS YOU IMAGINE WORK VERY CLOSELY
TOGETHER.
MYSELF AND DR. STACIA
FRIEDMAN-HILL CO-LEAD THE
DISPARITIES TEAM.
AND SO IT GIVES ME ABSOLUTE
PLEASURE TO INTRODUCE OUR OFFICE
THAT IS FULLY STAFFED NOW.
I'M CHRISTINA.
DR. LAUREN HILL, WHO IS SITTING
IN THE BACK, IS OUR DEPUTY
DIRECTOR FOR OUR OFFICE, SERVED
AS OUR ACTING DIRECTOR FOR THE
OFFICE FOR MANY YEARS PRIOR TO
MY ARRIVAL.
JING TRAN ALSO SITTING IN THE
BACK IS OUR NEW OPERATIONS
COORDINATOR.
SHE JUST MADE HER ONE-YEAR
ANNIVERSARY, AND I HAVE TO SAY
WITHOUT HER, I'M NOT SURE LAUREN
AND CHRISTINA WOULD BE ABLE TO
DO THEIR JOB.
MICHELLE LAY IS A SPECIAL
VOLUNTEER FOR ODWD, MASTERS OF
PUBLIC HEALTH STUDENT AT THE
UNIVERSITY OF MARYLAND.
RANDOMLY EMAILED ME AND ASKED IF
I WOULD BE INTERESTED IN TAKING
A STUDENT AND I SAID YES, AND
SHE SAID I WAS SO SURPRISED THAT
YOU EMAILED ME BACK.
AND SHE HAS ALSO BEEN WITH US
FOR OVER A YEAR AS WELL.
DR. JULIETTE MCCLENDON JOINED US
ABOUT EIGHT MONTHS AGO.
THEY ARE OUR PROGRAM DIRECTOR
FOR SOCIAL DETERMINANTS OF
MENTAL HEALTH DISPARITIES
RESEARCH.
DR. BESHAUN DAVIS IN THE BACK IS
ALSO NEW TO ODWD.
WE RECRUITED HIM ABOUT NINE
MONTHS AGO, AND IS OUR DIRECTOR
FOR MINORITY ADVERTISED
POPULATIONS MENTAL HEALTH
RESEARCH.
DR. BRITTANY HAYNES ALSO SITTING
IN THE BACK IS OUR PROGRAM
DIRECTOR FOR WORKFORCE DIVERSITY
AND EQUITY.
DR. TATIANA MEZA-CERVERA ALSO A
NEW RECRUIT AND OVERSEES OUR
DIVERSITY SUPPLEMENT AND YOUTH
MENTAL HEALTH RESEARCH AND
THERE'S MORE.
TAMARA LEWIS JOHNSON OVERSEES
OUR WOMEN'S MENTAL HEALTH
RESEARCH PROGRAM AND IS ALSO
HERE TODAY WITH US.
DR. DAWN MORALES OVERSEES OUR
RURAL MENTAL HEALTH RESEARCH,
AMERICAN INDIAN AND ALASKA
NATIVE MENTAL HEALTH RESEARCH,
AND DR. JENNIFER VILLATTE
OVERSEES OUR COMPASS PROGRAM,
WHICH YOU GUYS HAVE HEARD ABOUT,
AND ALSO WORKS ON OUR COMMUNITY
ENGAGEMENT HEALTH RESEARCH
INITIATIVES AS WELL.
SO A VERY FULL OFFICE AND
UNBELIEVABLE EXPERTISE.
SO IT GIVES ME GREAT PLEASURE TO
REALLY TALK ABOUT QH WHAT WE'VE
BEEN WORKING ON FOR THE PAST
YEAR AND A HALF.
NIMH JUST RECENTLY REVISED OUR
PRIORITY AREAS FOR MENTAL HEALTH
DISPARITIES RESEARCH.
THIS WILL BE UPDATED ON THE
WEBSITE IN THE COMING WEEKS.
THIS WAS IN COLLABORATION WITH
THE DISPARITIES TEAM.
WE DEVELOPED A STEERING
COMMITTEE TO REALLY THINK ABOUT
WHERE SHOULD WE BE GOING IN THE
NEXT ONE, THREE, FIVE, 10 YEARS
WHILE WE'RE THINKING ABOUT
MENTAL HEALTH DISPARITIES.
THESE ARE OUR FIVE TOP PRIORITY
AREAS.
THE PRIORITY AREA ONE AND TWO
ARE AT THE TOP ACTUALLY FOR A
REASON, REALLY THINKING ABOUT
BUILDING RESEARCH CAPACITY AND
THINKING ABOUT NOT JUST RESEARCH
CAPACITY AT THE INDIVIDUAL LEVEL
WHEN IT COMES TO TRAINING THE
NEXT GENERATION, BUT ALSO
THINKING ABOUT CAPACITY BUILDING
IN OUR INSTITUTIONS AND HAVING
MORE GEOGRAPHIC DIVERSITY IN OUR
PORTFOLIO AT NIMH.
REALLY THINKING ABOUT COMMUNITY
ENGAGED RESEARCH, WHO DO WE HAVE
AT THE TABLE AT ALL STAGES OF
RESEARCH.
HOW ARE OUR RESEARCH QUESTIONS
ASKED, HOW ARE THEY ANALYZED,
HOW ARE THEY DISSEMINATED BACK
TO THE COMMUNITY.
AND SO THINKING ABOUT ALL THE
WORK THAT WE DO AT NIMH,
CAPACITY BUILDING AND COMMUNITY
ENGAGED RESEARCH REALLY BUBBLES
TO THE TOP AS OUR PRIORITIES.
PRIORITY AREA THREE IS
IDENTIFYING MECHANISMS BY WHICH
MENTAL HEALTH DISPARITIES ARISE
AND PERSIST.
AND ADVANCE IMPLEMENTATION
SCIENCE TO REDUCE OR ELIMINATE
MENTAL HEALTH DISPARITIES, AND
THEN PRIORITY AREA FIVE IS
SUPPORT RESEARCH ON INTEGRATED
CARE MODELS, AND THAT'S REALLY
LOOKING AT OTHER SETTINGS LIKE
THE SCHOOL SETTING, OUR
FAITH-BASED ORGANIZATION AND
OTHER COMMUNITY-BASED
ORGANIZATIONS AS WELL.
SO SINCE I ONLY HAVE LIMITED
TIME I CANNOT GO OVER ALL OF OUR
KEY ACCOMPLISHMENTS, BUT THESE
ARE THE TOP ACCOMPLISHMENTS THAT
I REALLY WANTED TO SHARE WITH
COUNCIL TODAY AND REALLY OUR
PROGRESS IN SOCIAL DETERMINANTS
OF HEALTH, HOW NIH HAS RECENTLY
DEG DESIGNATED PEOPLE WITH
DISABILITY AS A DISPARITY
POPULATION.
RESEARCH WORKFORCE DIVERSITY,
OUR DIVERSITY SUPPLEMENT
PROGRAM, WHAT WE'RE DOING IN
WOMEN'S MENTAL HEALTH, RURAL
MENTAL HEALTH AND A LITTLE ABOUT
THE COMPASS AND COMMUNITY
ENGAGEMENT.
SO FIRST IN TERMS OF LIEDER SHIP
AND SOCIAL DETERMINANTS OF
HEALTH, NIMH HAS TAKEN A
LEADERSHIP ROLE IN SEVERAL
DIFFERENT FUNDING ANNOU ANNOUNC.
THESE ARE ALL LINKED BY THE WAY
IF YOU WANT TO TAKE A LOOK.
SO LOOKING AT SOCIAL
DISCONNECTION AND SUICIDE RISK
IN LATE LIFE, WE KNOW THAT THE
U.S. SURGEON GENERAL HAS TALKED
ABOUT SOCIAL ISOLATION AS A
MAJOR PUBLIC HEALTH PROBLEM.
WE ALSO ARE LOOKING AT STIGMA
AND DISCRIMINATION IN HIV
PREVENTION AND TREATMENT AND
THEN IN COLLABORATION WITH NIMH
AS THE LEAD, STILL LOOKING AT
COVID-19 AND THE SOCIAL
BEHAVIORAL AND ECONOMIC IMPACT
OF COVID-19 IN OUR UNDERSERVED
AND VULNERABLE POPULATIONS.
WE, TOO, HAVE AN RFI.
AND WHICH CLOSES TODAY AT
11:59 P.M.
SO WHEN WE'RE DONE HERE,
EVERYONE CAN FILL THIS OUT.
BUT REALLY LOOKING AT MOVING
BEYOND THE INDIVIDUAL LEVEL
DETERMINANTS OF MENTAL HEALTH TO
ADDRESS MENTAL HEALTH
DISPARITIES, REALLY LOOKING TO
IDENTIFY THE DETERMINANTS OF
MENTAL HEALTH DISPARITIES BEYOND
THAT INDIVIDUAL LEVEL AT THE
SOCIAL, SYSTEMIC AND STRUCTURAL
LEVELS, AND THEN DEVELOPING
CULTURALLY RESPONSIVE AND
MULTI-LEVEL INTERVENTIONS TO
ADDRESS MENTAL HEALTH
DISPARITIES.
LIKE I SAID IT CLOSES TODAY AT
11:59, AND REALLY LOOKING
FORWARD TO THE RESPONSE FROM THE
COMMUNITY.
WE ALSO HAVE BEEN SPENDING A LOT
OF TIME COLLABORATING ACROSS
NIH, AND WE HAVE SPENT A LOT OF
TIME REALLY GETTING TO KNOW WHAT
OTHER INSTITUTES AND CENTERS ARE
WORKING ON WHEN IT COMES TO
SOCIAL DETERMINANTS OF HEALTH.
AND WE'RE REALLY HAPPY TO SAY
THAT WE'VE BEEN ABLE TO SIGN ON
TO SEVERAL FUNDING ANNOUNCEMENTS
FROM NCI, NIMHD, NINR AND NHLBI
LOOKING AT STRUCTURAL RACISM AND
DISCRIMINATION, LOOKING AT SGM
POPULATIONS, COMMUNITY-BASED --
COMMUNITY-ENGAGED RESEARCH, AND
SO WE FEEL WITH JULIETTE
MCCLENDON'S LEADERSHIP, WE'VE
REALLY BEEN ABLE TO COLLABORATE
NOW ACROSS NIH IN TERMS OF OTHER
FUNDING OPPORTUNITIES.
NEXT WEEK, ON JUNE 6TH, WE HAVE
A ONE-DAY VIRTUAL WORKSHOP,
DISCRIMINATION AS A SOCIAL
DETERMINANT OF MENTAL HEALTH
DISPARITIES.
I HAVE A "REGISTER HERE" AT THE
BOTTOM.
WE ARE AT A WAIT LIST BECAUSE
WE'VE REACHED 5,000
REGISTRATIONS.
WE MADE 2,000 REGISTRATIONS
WITHIN THE FIRST HOUR AND HAD TO
OPEN UP OUR REGISTRATION TO
3,000 AND THEN FOUR AND THEN
FINALLY THE CONTRACTOR SAYS YOU
HAVE 5,000 MAX.
AND WE NOW HAVE EMAILS COMING IN
AS OF THIS MORNING BEING LIKE,
IS THERE A WAIT LIST?
BECAUSE WE REALLY WANT TO
PARTICIPATE IN THIS.
AND SO WE HAVE WORKED WITH OUR
CONTRACTOR TO NOW DEVELOP A WAIT
LIST TO ALLOW PEOPLE IN ON JUN
JUNE 6TH AND ONCE WE GET TO THAT
5,000 CAP, OBVIOUSLY WE'RE AT
THE CAP.
THIS TO ME SIGNALS A HUGE
INTEREST FROM THE FIELD, AND
IT'S A NUMBER THAT I DON'T THINK
NIMH HAS SEEN BEFORE IN TERMS OF
5,000 PEOPLE REGISTERING FOR A
ONE-DAY WORKSHOP, AND SO WE'RE
REALLY EXCITED.
WE HAVE A FULL DAY OF AMAZING
SPEAKERS AND BREAKOUT ROOMS AS
WELL, SO YOU CAN REGISTER HERE
OR EMAIL ME AND I WILL ADD YOU
TO THE WAIT LIST IF YOU HAVE NOT
REGISTERED YET.
SO I'M MOVING ON TO DISABILITY
RESEARCH AT NIMH.
IN SEPTEMBER OF 2023, NIH
DESIGNATED PEOPLE WITH
DISABILITIES AS A HEALTH
DISPARITIES POPULATION IN
RESEARCH.
AND UNDER DR. DAVIS' LEADERSHIP,
HE DEVELOPED A TASK FORCE IN
NOVEMBER OF 2023 TO REALLY THINK
ABOUT AND DEFINE WHAT ARE OUR
RESEARCH PRIORITIES REGARDING
THE INTERSECTION OF DISABILITY
AND MENTAL ILLNESS.
BASED ON THAT TASK FORCE, WE
WERE ABLE TO -- HE UNDER HIS
LEADERSHIP WAS ABLE TO
COORDINATE THE SIGNING ON TO
NIMHD'S NOTICE OF FUNDING
OPPORTUNITY ON HEALTH AND
HEALTHCARE DISPARITIES AMONG
PEOPLE LIVING WITH DISABILITIES.
THIS PARTICULAR FUNDING
ANNOUNCEMENT REALLY LOOKS AT THE
INTERSECTION OF RACE, ETHNICITY,
AND SOCIOECONOMIC STATUS WHEN IT
COMES TO THE HEALTH OF PEOPLE
EXPERIENCING A DISABILITY.
ADDITIONALLY UNDER DR. BESHAUN
DAVIS' LEADERSHIP HE IS
PREPARING A SERIES THIS AUGUST
INTO FEBRUARY OF 2025 REALLY
THINKING ABOUT WHAT IS NIMH'S
ROLE IN THIS SPACE, BUT ONE OF
THE KEY THEMES OF THESE WEBINAR
SERIES IS PEOPLE WITH LIVED
EXPERIENCE, SO WE'RE OPENING UP
THE WEBINAR SERIES WITH PEOPLE
WITH LIVED EXPERIENCE AND THEN
CLOSING IT OUT AS WELL WITH
PEOPLE WITH LIVED EXPERIENCE.
SO NOW I WANT TO BRING US TO
WORKFORCE DIVERSITY AT NIMH, AND
THIS IS UNDER DR. BRI TSM TANY
HAYNES LEADERSHIP AS WELL.
OUR PROGRAM REALLY COORDINATES
NIMH RESEARCH WORKFORCE
DIVERSITY INITIATIVES, PROMOTES
EQUITY IN THE MENTAL HEALTH
RESEARCH WORKFORCE, AND
DR. HAYNES REALLY WORKS ACROSS
NIH UNDER UNITE AND ALL THE
UNITE INITIATIVES AND
OPPORTUNITIES FOR BOTH
INSTITUTIONAL FUNDING
OPPORTUNITIES FOR WORKFORCE
DIVERSITY BUT ALSO INDIVIDUAL
TRAINING.
WHAT I LOVE IS THIS FIGURE THAT
REALLY SHOWS THE PROGRESS THAT
WE'VE MADE IN TERMS OF SIGNING
ON TO DIFFERENT OPPORTUNITIES ON
ALL THE DIFFERENT CAREER STAGES
FROM UNDERGRAD, PREDOCTORAL,
POSTDOCTORAL AND FACULTY LEVEL,
BUT ALSO AT THE INSTITUTIONAL
LEVEL, REALLY THINKING ABOUT
THAT RESEARCH CAPACITY BUILDING
OPPORTUNITIES FOR OUR
INSTITUTIONS.
AND SO THESE ARE ALSO ALL LINKED
AS WELL IF ANY ONE IS
INTERESTED.
ADDITIONALLY UNDER BRITTANY
HAYNES' LEADERSHIP, SHE
DEVELOPED A SPECIAL INTEREST
GROUP WITHIN NIMH TO PROMOTE
DIVERSITY IN THE NIMH EXTRAMURAL
AND INTRAMURAL RESEARCH
WORKFORCE THROUGH OUTREACH WITH
A PARTICULAR INTEREST IN
BROADENING THE ANTICIPATION IN
INCLUSION OF TRAINEES AND
INVESTIGATORS FROM GROUPS THAT
HAVE BEEN TRADITIONALLY
UNDERREPRESENTED IN THE MENTAL
HEALTH RESEARCH WORKFORCE.
SO THIS PARTICULAR SPECIAL
INTEREST GROUP IS REALLY AN
OPPORTUNITY FOR US TO SHARE OUR
KNOWLEDGE ACROSS THE I.C.,
REALLY THINKING ABOUT
STRATEGIES, EXISTING RESOURCES,
BEST PRACTICES THAT PEOPLE HAVE.
SHE'S LOOKING TO DEVELOP A SET
OF SHARED RESOURCES WE CAN ALL
USE AS WE'RE THINKING ABOUT
OUTREACH TO THE COMMUNITY, AND
THEN REALLY THINKING ABOUT
TRACKING AND EVALUATING OUR
OUTREACH ACTIVITIES AS WE MOVE
FORWARD.
SO DR. TATIANA WHO'S ALSO HERE
TODAY CAME FROM OUR IRP PROGRAM,
SHE JOINED US ALSO ABOUT A YEAR
AGO AND HAS T TAKEN OVER THE
LEADERSHIP OF THE DIVERSITY
SUPPLEMENT PROGRAM.
AS YOU CAN SEE FROM THE LINES,
WE HAVE BEEN QUITE SUCCESSFUL,
AND I WOULD LIKE TO SAY A VERY
BIG THANK YOU TO OUR TRAINING
TEAM HERE AT NIMH.
THE AMOUNT OF TECHNICAL
ASSISTANCE THE TRAINING TEAM HAS
PROVIDED HAS BEEN OUTSTANDING
AND WE CAN SEE THE DIRECT IMPACT
OF THAT TECHNICAL ASSISTANCE.
NOT ONLY HAS OUR NUMBER OF
APPLICATIONS REALLY STEADILY
INCREASED, BUT ALSO THE SUCCESS
RATE AS WELL.
AND SO IN OUR CURRENT FISCAL
YEAR OF 2023, SO OUR PREVIOUS
FISCAL YEAR, 95 APPLICATIONS FOR
THE DIVERSITY SUPPLEMENT
PROGRAM, WE AWARDED 79 WHICH IS
A SUCCESS RATE OF 83.2%, AND
THAT'S REALLY BECAUSE OF
TECHNICAL ASSISTANCE THE
TRAINING TEAM PROVIDES AND ALSO
TATIANA AS WELL IN REALLY MAKING
SURE THAT MENTEES AND MENTORS
ARE PRODUCING REALLY HIGH
QUALITY APPLICATIONS.
AND ALSO PART OF THAT SPECIAL
INTEREST GROUP WITH BRITTANY IS
REALLY HOW DO WE START REACHING
OUT TO THOSE INSTITUTIONS WHO
OTHERWISE WOULD BE HESITANT TO
APPLY FOR A DIVERSITY SUPPLEMENT
PROGRAM AS WELL.
SHE PLOTTED THE NUMBERS HERE AND
SO NO SURPRISE, OUR CALIFORNIA
AND MASSACHUSETTS ARE OUR
HIGHEST STATES IN TERMS OF
DIVERSITY SUPPLEMENTS.
AND IT REALLY DOES SHOW THAT WE
PROBABLY HAVE TO DO SOME MORE
OUTREACH IN THE MIDDLE PART OF
THE COUNTRY AS WELL.
BUT THESE NUMBERS ARE REALLY
IMPORTANT AS WE REALLY THINK
ABOUT WHERE SHOULD WE PUT OUR
EFFORTS IN TERMS OF HOW THE
REACH MOVING FORWARD.
THEN LASTLY FOR THE DIVERSITY
SUPPLEMENT PROGRAM, NIH HOLDS A
PROFESSIONAL DEVELOPMENT IN
NETWORKING WORKSHOP, AND IN
2023, NIMH HAD THE BIGGEST
SHOWING IN TERMS OF OUR
DIVERSITY SUPPLEMENT AWARDEES.
FOR THIS WORKSHOP.
IT IS A TWO-DAY WORKSHOP.
IT'S VIRTUAL TO ALLOW PEOPLE
FROM ALL PLACES IN THE UNITED
STATES TO BE ABLE TO
PARTICIPATE.
WHAT'S WONDERFUL IS THEY GET TO
INTERACT WITH THE PROGRAM
OFFICERS, THEY GET TO INTERACT
WITH THE I.C. DIRECTOR, AND
REALLY AN OPPORTUNITY TO KIND OF
DEMYSTIFY NIH, AND NETWORK
OPPORTUNITY AS WELL.
WE PROMOTE THIS WORKSHOP QUITE A
BIT AND I'M REALLY PROUD TO SAY
NIMH HAD THE BIGGEST SHOWING
LAST YEAR.
THIS UPCOMING ONE IS IN
SEPTEMBER, THIS UPCOMING
SEPTEMBER WE'RE REALLY HOPING TO
HAVE SUCH A BIG SHOWING AS WELL.
SO NOW I'D LIKE TO MOVE TO OUR
WOMEN'S MENTAL HEALTH RESEARCH
PROGRAM UNDER TAMARA LEWIS
JOHNSON AND HER LEADERSHIP.
THIS HAS BEEN A BUSY YEAR, AND
SO THE WHITE HOUSE HAD A WHITE
HOUSE INITIATIVE ON WOMEN'S
HEALTH RESEARCH, AND SO WITH THE
OFFICE OF RESEARCH ON WOMEN'S
HEALTH HERE AT NIH AND SEVERAL
OTHER INSTITUTES AND CENTERS,
SUCH AS NIMH, WE PRODUCED A
NOTICE OF SPECIAL INTEREST IN
HIGHLIGHTING INTEREST IN
RECEIVING RESEARCH APPLICATIONS
FOCUSING ON DISEASE AND HEALTH
CONDITIONS THAT PREDOMINANTLY
AFFECT WOMEN.
SO THAT NOSI IS CURRENTLY LIVE.
ADDITIONALLY, BASED ON THE WHITE
HOUSE INITIATIVE, TAMARA IS
HOSTING A WOMEN'S ROUNDTABLE IN
THE FALL OF 2024.
IT WILL BE AN ALL DAY OR HALF A
DAY EVENT AND IT'S REALLY
SPOTLIGHTING THE PRIORITY AREAS
OF RESEARCH RELATED TO WOMEN'S
HEALTH DURING PREGNANCY AND THE
POSTPARTUM PERIOD AS WELL, AND
WE WILL ALSO HAVE WOMEN WITH
LIVED EXPERIENCE AS PART OF THAT
ROUNDTABLE DISCUSSION.
I'M ALSO VERY PLEASED ABOUT THIS
PROGRAM UNDER TAMARA'S
LEADERSHIP AS WELL.
SO OUR CAREER CONTINUITY
INITIATIVE, IT'S AN NIH-WIDE
INITIATIVE, AND IT'S REALLY AN
OPPORTUNITY FOR PEOPLE WHO HAVE
EXPERIENCED A CRITICAL LIFE
EVENT: PREGNANCY, TAKING CARE
OF A SICK SPOUSE, AILING PARENT,
YOU YOURSELF ARE ILL, BOTH AT
THE K AWARD STAGE OR YOUR FIRST
INDEPENDENT R GRANT, LIKE YOUR
RESEARCH PROJECT GRANT, YOUR
FIRST INDEPENDENT GRANT.
YOU ARE ELIGIBLE TO APPLY FOR A
CAREER CONTINUITY INITIATIVE,
WHICH ALLOWS YOU TO GET
ADDITIONAL FUNDS TO HELP
SUPPLEMENT YOUR KIND OF ABSENCE
FROM THE LAB TO BE ABLE TO KEEP
YOU IN RESEARCH.
AGAIN, I THINK NIMH FALLS AS
NUMBER EIGHT IN TERMS OF NUMBER
OF GRANTS, BUT WE RANK NUMBER
THREE IN HOW MANY CAREER
CONTINUITY APPLICATIONS WE FUND.
SO IT'S A PROGRAM WE TAKE VERY
SERIOUSLY.
IT ALSO PART OF OUR OUTREACH
EFFORT IN TERMS OF LEEING PEOPLE
KNOW THIS IS AN OPPORTUNITY TO
KEEP PEOPLE IN SCIENCE IF THEY
HAVE TO STEP AWAY FOR AN
EXTENDED AMOUNT OF TIME SO WE'RE
VERY PLEASED ABOUT THIS PROGRAM.
IN TERMS OF OUR RURAL MENTAL
HEALTH RESEARCH, WE HAD A
WEBINAR LAST YEAR COMING
FACE-TO-FACE WITH SUICIDE IN
AMERICAN FARMING, AND I WAS SO
SURPRISED, PLEASANTLY SURPRISED,
WE HAD OVER 2,000 PEOPLE
REGISTER FOR THAT.
AND IT WAS OUR REGISTRATION
REPRESENTED NOT JUST ACADEMICS,
BUT PEOPLE IN THE COMMUNITY.
WHO
ARE THINKING ABOUT OUR FARMERS
AND THE LACK OF SERVICES AND
RESOURCES FOR THEM.
AND SO IT WAS AN EXTREMELY WELL
ATTENDED WEBINAR SERIES.
NIMH'S RURAL PORTFOLIO IS
STEADILY INCREASING, AS YOU CAN
SEE FROM 2018 TO 2023, WE'VE
ALMOST DOUBLED OUR PORTFOLIO IN
RURAL MENTAL HEALTH.
THEN I LIKE TO SAY THIS CAME OUT
SO THIS LITERALLY JUST GOT PUT
IN THE SLIDE NOT THAT LONG AGO,
NIMH CONTRACTED -- SUPPLIED A
CONTRACT FOR A RURAL MENTAL
HEALTH IN THE UNITED STATES
BOOK.
IT IS FREE TO THE PUBLIC, AND SO
THIS WAS FUNDED BY US AS A
CONTRACT AND IT'S DOWNLOADABLE
AND FREE AND SO OUR HOPE IS TO
DISSEMINATE THIS WIDELY, BUT IT
REALLY TALKS ABOUT THE STATE OF
RURAL MENTAL HEALTH IN THIS
COUNTRY FROM 2006 TO 2022.
THEN ADDITIONALLY IN TERMS OF
AMERICAN INDIAN AND ALASKA
NATIVE SCIENCE, NIMH IS PART OF
THREE MAJOR PROGRAMS AT NIH.
THE IRINAH PROGRAM REALLY
LOOKING AT INTERVENTION RESEARCH
FOR OUR NATIVE AMERICAN
POPULATION, NARCH, OUR NATIVE
AMERICAN RESEARCH CENTERS FOR
HEALTH, WE DID FUND ONE IN 2021.
AND THIS IS KIND OF A
THREE-PRONGED FUNDING
OPPORTUNITY WHERE IT'S REALLY
LOOKING AT RESEARCH, CAPACITY
BUILDING IN TERMS OF THE
INSTITUTION AND ALSO TRAINING IN
TERMS OF THE NEXT GENERATION AS
WELL.
AND THEN LASTLY, PART OF THE
HEAL INITIATIVE, THE NATIVE
COLLECTIVE RESEARCH EFFORT TO
ENHANCE WELLNESS PROGRAM, IS
REALLY LED IN TERMS OF OUR
TRIBAL ORGANIZATIONS AND WHAT
ARE THEIR PRIORITY AREAS IN
THINKING ABOUT OVERDOSE
SUBSTANCE USE MENTAL HEALTH AND
PAIN, AND SO NIMH IS SIGNED ON
TO ALL THREE OF THESE.
WE HEARD ABOUT COMPASS I THINK
AT THE LAST COUNCIL AND WE'VE
TALKED A LITTLE BIT ABOUT
COMPASS TODAY.
SO I WON'T GO TOO MUCH INTO IT.
BUT BUT AS JOSH SAID EARLIER
THIS MORNING OR THIS AFTERNOON,
IT IS REALLY LOOKING AT FUNDED
COMMUNITY-BASED ORGANIZATIONS TO
REALLY THINKING ABOUT
INTERVENTIONS AND SO WE ARE VERY
PLEASED TO SAY THAT DIRECTION
WILL UNIVERSITY IS NOW OUR
COORDINATING CENTER FOR COMPASS,
DREXEL, SO 25 OF THE GRANTS FOR
THE COMMUNITY-BASED
ORGANIZATIONS WHICH WE CALL
CHESIs HAVE BEEN FUNDED.
JENNIFER VILLATTE IN OUR OFFICE
OVERSEES THOSE SEVEN OF 25 SO
NIMH HAS A CRITICAL ROLE IN THIS
PROGRAM.
AND THEN RIGHT NOW, APPLICATIONS
ARE BEING REVIEWED FOR THE
HEALTH EQUITY RESEARCH HUBS,
WHICH REALLY WILL PROVIDE THAT
TECHNICAL ASSISTANCE BOTH THE A
PHASE ONE AND PHASE -- PHASE TWO
AND PHASE THREE, WHICH IS THE
INTERVENTION PHASE I AND THE
DISSEMINATION FADES, SO WE'RE
HOPING THOSE WILL BE ANNOUNCED
SOMETIME IN JULY.
SO COMPASS IS UP AND RUNNING,
AND LIKE I SAID, JENNIFER IS
OVERSEEING SEVEN OF THESE AS
WELL.
I'M ALMOST RIGHT ON TIME, TRACY.
SO I'D LIKE TO END -- SO THIS IS
A LITTLE SNAPSHOT OF WHAT OUR
OFFICE AND THE DISPARITIES TEAM
HAS BEEN WORKING ON FOR THE PAST
COUPLE YEARS.
AND I'D LIKE TO END TO REALLY
THINKING ABOUT -- AND THIS IS
REALLY WHERE I'D LOVE TO ENGAGE
COUNCIL AND YOUR THOUGHTS AS
WELL, REALLY THINKING ABOUT
CENTERING EQUITY IN EVERYTHING
THAT WE DO AT NIMH.
SO WHAT DO I MEAN BY CENTERING
EQUITY?
IT'S REALLY THINKING ABOUT HOW
WE DO RESEARCH, WHO IS INVOLVED
IN OUR RESEARCH, OUR
PARTICIPANTS, BUT HOW WERE THEY
INVOLVED?
ARE THEY INVOLVED JUST AT THE
BEGINNING, IN AN ADVISORY BOARD
CAPACITY, OR ARE THEY TRULY AT
THE TABLE AND REALLY THINKING
ABOUT OUR QUESTIONS AND WHAT WE
SHOULD BE ASKING HOW DATA IS
COLLECTED, HOW ARE WE ANALYZING
THAT DATA AND HOW DO WE
DISSEMINATE THAT INFORMATION
BACK INTO THE COMMUNITY?
RESEARCH CAPACITY BUILDING AND
WORKFORCE DEVELOPMENT I THINK IS
AT THE CORE OF WHAT WE SHOULD BE
THINKING ABOUT, AND HOW DO WE
BUILD NOT JUST STUDENTS AND
FACULTY MEMBERS BUT INSTITUTIONS
AND COMMUNITY PART NES TO
SUPPORT INCLUSION AND EQUITY IN
ALL THAT WE DO, SO THAT REALLY
IS A TWO-PRONG THINKING ABOUT
INDIVIDUAL TRAINING BUT ALSO
THINKING ABOUT INSTITUTIONAL
DEVELOPMENT AS WELL.
THEN ALSO IN THINKING ABOUT
TAKING AN INTERSECTIONAL LENS IN
EVERYTHING THAT WE DO, AND
LOOKING AT WHAT ARE SOME OF OUR
EXPLORING MORE OF
INTERSECTIONALITY OF
UNDERSTUDIED SOCIAL IDENTITIES,
BUT THEN ALSO REALLY
INVESTIGATING THE MECHANISMS OF
HOW INTERSECTING SYSTEMS OF
OPPRESSION INTERACT WITH MENTAL
HEALTH OUTCOMES, SO IT'S REALLY
LOOKING AT OUR INDIVIDUAL SOCIAL
IDENTITIES BUT ALSO OUR SYSTEMS
AND THAT INTERSECTION OF BOTH.
SO THINKING ABOUT THESE THREE IN
TERMS OF COMMUNITY ENGAGEMENT,
CAPACITY BUILDING, AND
INTERSECTIONALITY, IN ALL THE
WORK THAT WE DO AT NIMH IS
REALLY AN APPROACH WE'RE
THINKING ABOUT IN TERMS OF
FURTHERING MENTAL HEALTH EQUITY
AS WELL.
SO I WANT TO END BY SAYING THANK
YOU.
FOR THOSE OF YOU WHO WANT TO BE
ON THE WAIT LIST FOR THE
DISCRIMINATION WORKSHOP, YOU CAN
EMAIL ME DIRECTLY AND I WILL PUT
YOU ON THE WAIT LIST.
AND THEN I WOULD LOVE TO OPEN IT
UP FOR QUESTIONS FROM COUNCIL
BUT I'M GOING TO LEAVE YOU WITH
THTHREE QUESTIONS AS WELL.
HOW DOES NIMH EFFECTIVELY SHIFT
TO CENTER EQUITY IN ALL STAGES
OF SCIENCE?
WHAT ARE THE NIMH PRIORITIES ON
MENTAL HEALTH DISPARITIES THAT
REALLY RISE TO THE TOP FOR YOU?
AND WHAT ARE YOUR CURRENT
CHALLENGES WITHIN YOUR OWN
INSTITUTIONS IN SUPPORTING
HEALTH DISPARITIES RESEARCH AND
HOW DO WE EFFECTIVELY SHIFT TO
INCLUDE A MORE DIVERSE
PERSPECTIVE IN OUR WORK THAT WE
DO?
THANK YOU.
>> THANK YOU, CHRISTINA.
QUESTIONS OR COMMENTS FROM
MEMBERS OF COUNCIL?
AND I'VE GOT ALREADY A COUPLE
RAISED HANDS SO WE'RE GOING TO
START WITH JYOTI.
>> THANK YOU, THAT WAS A LOVELY
PRESENTATION.
YOU ACTUALLY -- THE LAST TWO
QUESTIONS IN THIS CURRENT SLIDE
IS WHAT I'D LIKE TO HEAR YOUR
THOUGHTS ON.
A BIG ISSUE THAT WE SEE IN TYPE
OF THE WORK THAT I DO AND
BROADLY IN MENTAL HEALTH
SERVICES RESEARCH IS THAT THE
DATA INFRASTRUCTURE IN AND OF
ITSELF INTRODUCES BIASES, SO
TYPE OF DATA THAT WE ARE
COLLECTING, PEOPLE WHO ARE
SEEKING CARE, AND SO AS A
RESULT, ANY FINDINGS THAT WE DO
INTENTIONALLY OR UNINTENTIONALLY
INJECT THAT BIAS.
SO I'M CURIOUS TO SEE WHAT ARE
YOUR THOUGHTS, WHAT ARE SOME
POTENTIAL INVESTMENTS THAT WHEN
IT COMES TO SORT OF FUNDAMENTAL
RESEARCH INFRASTRUCTURE, THAT
YOUR OFFICE OR OTHER NIH ICs
ARE PLANNING TO SUPPORT?
>> YEAH, AND I THINK ESPECIALLY
WITH THE MOVEMENT NOW OF
ARTIFICIAL INTELLIGENCE AND BIG
DATA SCIENCE, WHAT I'VE BEEN
PLEASED TO SEE IS THE
DISCUSSIONS AROUND THE TABLE IN
TERMS OF THAT BIAS, AND HOW DO
WE MITIGATE THAT BIAS AS WELL,
AND SO THOSE ARE DISCUSSIONS
THAT WE'RE HAVING, BUT I FIND
THAT HAVING A DIVERSE
PERSPECTIVE AT THE TABLE BEING
OUR CLINICIANS, PROVIDERS,
TRAINEES, THOSE WHO ARE SEEING
PATIENTS ON A REGULAR BASIS BE
PART OF THE CONVERSATION IN
TERMS OF WHAT ARE THE DATA
VARIABLES THAT WE'RE COLLECTING,
HOW ARE WE COLLECTING THEM, I
THINK IS IMPORTANT, AND ALSO
DEPENDING ON WHAT CLINICAL
CENTER YOU'RE AT OR WHAT
HOSPITAL YOU'RE AT WILL
DETERMINE WHAT TYPE OF DATA IS
COLLECTED, AND WE KNOW IT'S JUST
REALLY LOADED WITH BIAS, SO FOR
ME, IT GOES BACK TO THE HEART OF
GETTING THE RIGHT PEOPLE AT THE
TABLE TO HELP THINK THROUGH SOME
OF THESE REALLY COMPLICATED
QUESTIONS.
I HAVE TO SAY WE'RE ALL VERY
SMART IN THIS ROOM BUT WE MISS A
LOT WHEN WE DON'T HAVE THAT
DIVERSE PERSPECTIVE, SO THINKING
ABOUT DIFFERENT TYPES OF
MECHANISMS AND FUNDING
MECHANISMS, MY PRIORITY IS TO
MAKE SURE THAT I'M HEARING FROM
THE EXTRAMURAL WORKFORCE AT ALL
LEVELS BEFORE WE START MAKING
THOSE DECISIONS.
SO THAT'S NOT REALLY AN ANSWER
TO YOUR QUESTION, BUT AN
APPROACH.
>> NEXT IS RINAD.
>> THANK YOU SO MUCH FOR THAT
WONDERFUL PRESENTATION, AND I
LOVE HOW YOU AMPLIFIED YOUR
INCREDIBLE TEAM AS A LEADER AND
INCLUDED PEOPLE OF LIVED
EXPERIENCE AND COMMUNITY
MEMBERS.
I HAVE TWO SUGGESTIONS AND ALSO
A QUESTION.
SO FIRST SUGGESTION IS I LOVE TO
SEE HOW MANY DIVERSITY
SUPPLEMENTS NIMH IS SUPPORTING.
I THINK A NEXT STEP COULD BE
REALLY DOING SOME AUDIT AND
FEEDBACK AND DOING DIRECT
OUTREACH TO INVESTIGATORS,
ESPECIALLY IN THOSE STATES WHERE
THERE AREN'T A LOT OF
SUPPLEMENTS TO ENCOURAGE THEM TO
GET INVOLVED IN THAT PROGRAM.
THE SECOND, AS YOU THINK ABOUT
CENTERING EQUITY FOR YOUR FIRST
QUESTION, I THINK IT HAS TO BE
BUILT INTO THE REVIEW CRITERIA
AND I THINK IT HAS TO BE BUILT
IN THE ONGOING KIND OF
REGULATORY MONITORING, SO THINK
ABOUT DSMV, INCLUDING COMPONENTS
THAT ADDRESS WHETHER OR NOT THE
WORK IS EQUITABLY REACHING
POPULATIONS.
MY QUESTION FOR YOU MAPS ON TO
YOUR QUESTION ABOUT CAPACITY
BUILDING.
THIS IS SOMETHING THAT COMES UP
A LOT FOR ME AS I SUPPORT EARLY
CAREER FOLKS IN MY LAB.
SO STRUCTURAL DETERMINANTS
REQUIRE THE -- THE RESULT IN
INEQUITIES REQUIRE STRUCTURAL
INTERVENTION, AND I'M CURIOUS
ABOUT YOUR THOUGHTS ON HOW WE
ACTUALLY TRAIN THE NEXT
GENERATION OF RESEARCHERS TO BE
DOING WORK ON STRUCTURAL
INTERVENTIONS BECAUSE THAT SCALE
OF WORK IS VERY DIFFICULT FOR AN
EARLY CAREER PERSON OR GRADUATE
STUDENT OR POSTDOC TO TAKE ON.
SO THINKING ABOUT PLACE-BASED
INTERVENTIONS, SCREENING, THE
NUMBER OF COMMUNITIES YOU NEED
TO BE WORKING WITH IS REALLY OUT
OF SCALE FOR WHAT OUR EARLY
CAREER FOLKS CAN DO SO CURIOUS
HOW YOU'RE THINKING ABOUT THAT.
>> I THINK THAT'S ONE OF THE
REASONS WHY HE WITH WE PUT OUTI
AS WELL, TRIED TO DISSEMINATE TO
TRAINEES AND COMMUNITY PARTNERS
AS WELL, AND I THINK THE COMPASS
PROGRAM IS REALLY THAT FIRST
KIND OF PROGRAM TO REALLY SHOW
WHEN WE'RE THINKING ABOUT
STRUCTURAL INTERVENTIONS, WHAT
IS IT GOING TO TAKE, AND WHAT
CAN WE LEARN FROM COMPASS AND
REALLY THINKING ABOUT HOW DO WE
TAKE THOSE LESSONS LEARNED TO
TRAIN THAT NEXT GENERATION.
I ALSO AM A FIRM BELIEVER WHERE
IT REALLY NEEDS TO BE INTEGRATED
INTO THE CURRICULUM IN A VERY
EARLY STAGE IN TERMS OF MEDICAL
SCHOOL OR PUBLIC HEALTH TRAINING
OR WHATNOT IN TERMS OF THE
IMPORTANCE OF THOSE STRUCTURAL
DETERMINANTS, AND THEN WHAT DO
WE DO ABOUT IT.
BUT I DO THINK COMPASS IS THAT
FIRST KIND OF -- IT'S A VERY BIG
PILOT, TO REALLY LEARN FROM THAT
IN TERMS OF WHAT IS NEEDED, AND
I THINK IN JUST A SHORT AMOUNT
OF TIME WE'VE ALREADY LEARNED A
LOT ABOUT THAT PIECE ABOUT
STRUCTURAL INTERVENTIONS BECAUSE
THEY'RE IN THE PLANNING PHASE
RIGHT NOW.
AND I THINK THAT'S REALLY WHY
OUR OFFICE PUT OUT THE RFI
BECAUSE WE ARE STRUGGLING WITH
THAT AND REALLY WANTED TO HEAR
FROM THE COMMUNITY, ESPECIALLY
OUR TRAINEE, IN TERMS OF LIKE
WHAT CAN WE DO BETTER AND HELP
SUPPORT YOUR CAREER TRAJECTORY.
BECAUSE WE'RE ALSO SEEING A HUGE
INTEREST FROM OUR TRAINEES IN
THIS TYPE OF WORK AS WELL.
>> I'M JUST GOING TO POINT OUT
WE'RE RUNNING A BIT OVER SO IF
PEOPLE CAN BE BRIEF WITH THEIR
QUESTIONS, WE'LL TRY TO GET TO
EVERYONE TO MARGUERITA.
JOEL.
>> I WANT TO APPLAUD YOUR WORK,
AND ECHO THE PREVIOUS COMMENTS.
FIRST I WANT TO ECHO THE
IMPORTANCE OF EVIDENCE-BASED
STRUCTURAL INTERVENTION.
I THINK ONE OF THE ACTUALLY
IRONIC CHALLENGES IS THERE'S SO
MUCH INTEREST AND DESIRE FOR
CONSCIOUSNESS-RAISING WORKSHOPS
WITHOUT EDUCATING TRAINEES ABOUT
THE IMPORTANCE OF STRUCTURAL
CHANGE AND HOW YOU ACTUALLY CAN
PROVIDE EVIDENCE FOR THAT, THAT
WILL ACTUALLY BE EFFECTIVE IN
CREATING CHANGE AS OPPOSED TO
JUST EFFECTIVE AT CREATING
CONSCIOUSNESS WHICH CAN CREATE
CHANGE.
EMPHASIS ON EMPIRICAL BASIS.
I ALSO WANT TO APPLAUD THE WORK
ON RURAL, AND I THINK THERE'S A
REAL CONNECTION BETWEEN THE GAPS
IN THE TRAINING ASSIGNMENTS THAT
YOU SHOWED IN RURAL HEALTH AND
THAT GOES RIGHT BACK TO CAPACITY
BUILDING.
THE RAPID CAPACITY IN THE
INSTITUTIONS IN THOSE AREAS IN
RURAL HEALTH TO ACTUALLY PROVIDE
THE TRAINING AND THE SCIENCE
THAT'S NEEDED, SO I REALLY WANT
TO EMPHASIZE THE IMPORTANCE OF
CAPACITY BUILDING IN YOUR
PORTFOLIO.
>> THANK YOU.
>> OH, ONE LAST QUESTION.
DO YOU FEEL THAT THERE'S
INTEREST IN CONGRESS IN THIS
WORK?
BECAUSE THE LONG TERM HERE, IT'S
SUCH A LONG-TERM GAME, AND
CONGRESS IS SO CONCERNED ABOUT
MENTAL HEALTH AND DISPARITIES IS
SUCH A BIG FACTOR IN THAT, SO I
JUST WANTED TO HIGHLIGHT THE
IMPORTANCE OF EDUCATING CONGRESS
IN THIS AREA.
>> ABSOLUTELY.
THANK YOU.
>> LET ME JUST ANSWER THAT
QUICKLY.
THE ANSWER IS YES, THERE IS
INTEREST IN CONGRESS IN
DISPARITIES RESEARCH IN GENERAL,
AND PARTICULARLY MENTAL HEALTH
DISPARITIES.
>> THANK YOU FOR A GREAT TALK.
GREAT TO SEE THE EMPHASIS YOUR
OFFICE IS HAVING.
ALSO PEOPLE WITH LIVED
EXPERIENCE IN MENTAL ILLNESS IN
THE CONCEPT OF DIVERSITY.
RELATED TO THAT I WAS WONDERING
WHAT YOUR THOUGHTS WERE ON
CREATING FUNDING OPPORTUNITIES
WHERE THERE WOULD BE A
REQUIREMENT TO HAVE PEOPLE WITH
LIVED EXPERIENCE AS PART OF THE
INVESTIGATOR TEAM SIMILAR TO
OTHER FUNDING BODIES LIKE THE
WELLCOME TRUST?
>> THOSE ARE ABSOLUTELY
DISCUSSIONS WE'RE HAVING ON A
REGULAR BASIS, BOTH WITHIN ODWD
AND THE DISPARITIES TEAM.
IN TERMS OF WHAT DO WE MEAN BY
COMMUNITY ENGAGEMENT, WHAT IS
THAT?
IS THAT JUST HEY, WE CHATTED
WITH SOMEONE ON THE STREET, AND
NOW IT'S COMMUNITY ENGAGED AND
HOW DO WE DEFINE THAT AT NIMH
AND WHAT IS THE ROLE OF LIVED
EXPERIENCE SO THOSE ARE THE
DEPTH OF CONVERSATIONS WE'RE
CURRENTLY HAVING AND I'D LOVE TO
BRING UPDATE TO YOU IN A COUPLE
YEARS.
>> PAMELA.
>> FIRST I JUST WANT TO GIVE YOU
A HUGE CONGRATULATIONS.
THIS IS A BEAUTIFUL PORTFOLIO
AND VERY EXCITING WORK THAT
YOU'RE LEADING AND YOUR TEAM AS
WELL.
SO CONGRATS TO ALL OF YOU.
I HAVE TWO QUESTIONS.
ONE IS JUST FOLLOWING UP ON THE
STRUCTURAL INTERVENTION PIECE,
WHICH IS AROUND -- IT SEEMS TO
ME AN IMPORTANT PART OF THAT
WOULD BE BOTH FUNDING FOR
CAPACITY BUILDING BUT ALSO
FUNDING FOR RESEARCH THAT HELPS
PEOPLE TO TRANSLATE SCIENCE TO
POLICY THAT GIVES PEOPLE THE
SKILLS TO COMMUNICATE THAT WELL
BECAUSE A LOT OF THIS IS
FIGURING OUT HOW DO YOU CHANGE
STRUCTURES, HOW DO YOU BRING
THAT EVIDENCE TO POLICY MAKERS
AND HOW DO YOU DO THAT IN A WAY
THAT CAN BE HEARD AND ACCEPTED
SO THINKING ABOUT THAT AS PART
OF THE REMIT FOR NIH AS WELL.
THE SECOND QUESTION I HAVE IS
THINKING ABOUT LOOKING AT THE
NIMH PORTFOLIO ON DISPARITIES
RESEARCH, CAN YOU LOOK AT THAT
AND DO SOME SYSTEMS ANALYSES TO
UNDERSTAND, OKAY, WHAT ARE THE
MOST IMPORTANT LEVERS THAT YOU
ACTUALLY NEED TO PUSH TO BE ABLE
TO GET THE OUTCOMES THAT WE WANT
FOR -- AT LEAST IF WE START WITH
DISPARITIES IN CARE, RIGHT, AND
MAYBE GO BY DIFFERENT DOMAINS OF
DISPARITIES.
BUT IT WOULD BE REALLY
INTERESTING TO DO SOME OF THAT
LOOKING AT THE COMPLEXITIES OF
THE PORTFOLIO AND THE SCIENCE TO
FIGURE OUT WHERE --
>> I'M REALLY GLAD YOU BROUGHT
THAT UP BECAUSE DR. JULIETTE
MCCLENDON IS DOING THAT AS WE
SPEAK, WITH SOME HELP WITH
INTERNS AND STUFF LIKE THAT, BUT
THAT IS ONE OF THE REASONS WHY
WE RECRUITED JULIETTE, IS REALLY
THINKING ABOUT THAT STRUCTURAL
PIECE, AND SO THEY'RE DOING A
DEEP DIVE RIGHT NOW IN OUR
PORTFOLIO, SO THANK YOU FOR
THAT.
>> GREAT.
GREAT.
AND THAT MIGHT JUST BE ANOTHER
REALLY LOOKING AT SYSTEMS
ANALYSES, RIGHT, SYSTEMS
RESEARCH AS PART OF DISPARITIES
RESEARCH?
>> EXACTLY.
>> VELMA.
>> I, TOO, WANT TO ECHO, THIS
PORTFOLIO IS REALLY ENCOURAGING.
I HAVE ONE -- I GUESS TWO
QUESTIONS.
ONE IS, THE SELECTION OF DREXEL
AS COORDINATING CENTER IS ONE.
OR MAYBE THREE.
AND THE OTHER ONE -- WHICH YOU
CAN ANSWER LATER.
THE OTHER ONE IS THE ENGAGEMENT
OF HBCUs IN THE PROCESS OF
ADDRESSING ISSUES OF DISPARITY
IN WORKFORCE TRAINING, AND THEN
WAYS IN WHICH THERE MIGHT BE
SOME ACCOUNTABILITY TO NIH GRANT
HOLDERS IN UNIVERSITIES THAT
AREN'T INCLUDING DIVERSITY
SUPPLEMENTS BECAUSE THAT'S ONE
WAY -- HAVE SOME TYPE OF
REQUIREMENT THAT PEOPLE SHOULD
REALLY BE THOUGHTFUL ABOUT
INCLUDING DIVERSE POPULATIONS
FOR SUPPLEMENTS, AND YOU CAN
RESPOND LATER BECAUSE THERE ARE
LOTS OF QUESTIONS.
>> LET ME QUICKLY RESPOND.
WE CAN'T COMMENT ON THE
SELECTION PROCESS, EXCEPT TO SAY
THAT IT WAS ONE THAT WAS
RIGOROUS INVOLVED OUTSIDE
REVIEW.
JOEL.
NOT JOEL.
MARGUERITA.
THANK YOU.
I KNEW IT WAS OVER THERE
SOMEWHERE.
>> THE OREGON CONTINGENT.
WHAT I WAS GOING TO SAY HAS BEEN
COVERED MOSTLY, BUT I JUST ALSO
WANTED TO ECHO OR I GUESS NOT
ECHO, ONE OF THE THINGS THAT
WE'VE BEEN DOING AT OUR
INSTITUTION AS YOU THINK ABOUT
CENTERING HEALTH EQUITY IS
REALLY THINKING ABOUT HOW WE
TALK ABOUT PEOPLE, AND SO YOU
ALL MAY ALREADY BE DOING SOME OF
THIS INTERNAL WORK, BUT JUST
ELEVATING THIS IDEA THAT
OFTENTIMES WHEN WE TALK ABOUT
HEALTH DISPARITIES, WE
PATHOLOGIZE PEOPLE AND WE DON'T
USE FIRST-PERSON LANGUAGE, SO
THAT -- SO CENTERING HEALTH
EQUITY OFTENTIMES REQUIRES US TO
BE INTROSPECTIVE ABOUT HOW WE'RE
TALKING ABOUT PEOPLE.
>> I COULDN'T AGREE MORE.
>> JOIN ME IN THANKING
DR. BORBA.
NEXT WE'RE GOING TO HEAR FROM
THE COUNCIL WORK GROUP ON HIGH
DIMENSIONAL DATA, A PRESENTATION
OF THEIR RECOMMENDATIONS FOR
YOUR APPROVAL.
PLEASE JOIN ME IN VIRTUALLY
WELCOMING DRS. LAURA ALMASY AND
DAVE DAMIEN FAIR.
THEY'VE BEEN CO-CHAIRING A WORK
GROUP THAT STARTED ABOUT A YEAR
AGO COVERING THE TOPIC OF HIGH
DIMENSIONAL DATASETS AND ASKING
FOR RECOMMENDATIONS THAT WE CAN
ADOPT FROM A FUNDING PERSPECTIVE
TO ENSURE RIGOR AND APPROPRIATE
USE OF THE DATASET AND
APPROPRIATE DESIGN AND
EXPERIMENTS.
I CHARGED THIS WORKING GROUP TO
DEVELOP RECOMMENDATIONS
REGARDING CONCEPTUAL FRAME WORKS
AND EXPERIMENTAL ANALYTICAL
DESIGNS FOR EXPERIMENTS USING
THESE HIGH DIMENSIONAL DATASETS.
THEY HAVE MET DILIGENTLY OVER
THE PAST YEAR AND DEVELOPED
SERIOUS RECOMMENDATIONS THAT ARE
GOING TO BE REPORTED IN BRIEF TO
YOU TODAY.
ALSO YOU'VE BEEN PROVIDED WITH A
DRAFT COPY OF THEIR
RECOMMENDATIONS IN ADVANCE OF
THE MEETING WHICH YOU HOPEFULLY
HAVE HAD A CHANCE TO REVIEW.
DR. FAIR IS GOING TO PROVIDE AN
OVERVIEW AND WILL ENGAGE IN
DISCUSSION TO SEE IF THERE ARE
ANY RECOMMENDATIONS OR CHANGES
TO THE DRAFT AND HOPEFULLY
ACCEPTANCE OF THESE
RECOMMENDATIONS.
I'LL TURN IT OVER TO DAMIEN.
>> OKAY.
CAN YOU ALL HEAR ME?
>> YES, WE CAN.
>> OKAY.
SO MY -- FIRST OF ALL MY BLOOD
PRESSURE JUST WENT UP A LITTLE
BIT AS MY POSTDOC MENTOR JOEL IS
IN THE CROWD SO I HAVE TO
PERFORM, YOU KNOW.
BUT THANKS FOR HAVING US, I'M
GLAD TO SPEAK ABOUT OUR
EXPERIENCE IN SOME OF THE IDEAS
THAT CAME YOU THE FROM THIS
WORKING GROUP, OBVIOUSLY AN
EXTREMELY IMPORTANT TOPIC FOR
NIMH AND REALLY ALL OF OUR
SCIENCE, SO WE'LL GO THROUGH A
FEW, HOPEFULLY THIS WON'T TAKE
TOO LONG, AND LAURA AND I ARE
HERE ONLINE TO ANSWER SOME
QUESTIONS.
SO THE BACKGROUND HERE, OF
COURSE, IS THAT AS WE'VE
ADVANCED OVER THE LAST SEVERAL
DDECADES, OUR DATA HAS BECOME A
LOT BIGGER, A LOT MORE
MULTIDIMENSIONAL, A LOT MORE
COMPLEX.
WE'RE STUDYING DIFFERENT TYPES
OF RELATIONSHIPS.
IT'S GETTING REALLY COMPLICATED.
THE ISSUE IS THAT SOME OF OUR
CURRENT STANDARDS THAT WERE
REALLY PROBABLY ADOPTED FROM
PRIOR TO THIS TIME, ARE
SOMETIMES INEFFICIENT FOR
ENSURING SOME OF THE MORE ROBUST
AND REPRODUCIBLE OR
GENERALIZABLE RESULTS, THINGS
THAT WE ARE THRIVING TO DO.
SO PROBABLY THE MORE RECENT
EXAMPLE THAT I'M MORE -- WHAT
I'VE BEEN MORE USED TO AND BEEN
INVOLVED WITH IS HIGHLIGHTING
HOW BASIC RELATIONSHIPS BETWEEN
THE BRAIN OR BIOLOGY AND OTHER
CONDITIONS LIKE MENTAL HEALTH
CONDITIONS, YOU KNOW, COGNITIVE
BEHAVIORS, THEY TYPICALLY HAVE
SMALL EFFECT SIZES, WHICH MEANS
THAT YOU NEED LOTS AND LOTS OF
PARTICIPANTS TO GET A TRUE
RESULT.
AND SO DEPENDING ON THE STUDY
DESIGN OR THE OUTCOMES, YOU
KNOW, THE EFFECTS MAY APPEAR
LARGE IF YOU'RE UNDERPOWERED,
BUT THEY'RE ACTUALLY NOT REALLY
GENERALIZABLE AND DON'T PROVIDE
INSIGHTS ON THE TRUE EFFECTS.
SO SO TO ASSIST IN PRIORITIZINE
FUNDING OF RIGOROUS REPRODUCIBLE
RESEARCH, WE WERE CHARGED IN
FOUR SPECIFIC AREAS.
ONE, ENSURING THAT STATISTICAL
RIGOR AND ENHANCING -- ENSURING
STATISTICAL RIGOR AND ENHANCING
REPRODUCIBILITY, UNDERSTANDING
THE ROLE OF HYPOTHESES AND CON
CONCEPTUAL FRAME WORKS, GUIDING
STUDIES INVOLVING HIGH
DIMENSIONAL DATA, ASSESSING THE
CLINICAL UTILITY OF STUDIES.
EASY.
[LAUGHTER]
SO WE MET MONTHLY SINCE
JANUARY 2023.
WE HAVE SOME RECOMMENDATIONS
THAT KIND OF REVOLVE AROUND THE
STRUCTURE OF FIVE KIND OF
RESEARCH CATEGORIES AND 10 TOPIC
AREAS AND I'LL DESCRIBE HOW WE
GOT TO THERE SHORTLY.
NOW, I DON'T KNOW, IT'S LIKE 15
MONTHS OR 16 MONTHS SINCE WE
STARTED, SO YOU CAN TELL THAT
THIS WAS NOT ACTUALLY THAT EASY.
IN FACT, I THINK IT WAS PROBABLY
A LOT HARDER THAN I ANTICIPATED
GOING IN.
HERE IS OUR CLAN, OUR GROUP THAT
WAS MEETING MONTHLY.
AND THE FIRST THING THAT I THINK
WE RECOGNIZE AND ACKNOWLEDGE IS
THAT THERE'S JUST, YOU KNOW,
THINKING ABOUT THIS REALLY BROAD
CHARGE REQUIRED EXPERTISE FROM
LOTS OF DIFFERENT DISCIPLINES,
GENETICS, INFORMATICS,
NEUROSCIENCE, IMAGING, YOU CAN
SEE COMPUTATION AND STATS,
NUTRITION, INDUSTRY.
THERE'S JUST A WHOLE HOST OF
FOLKS WHO HAVE EXPERIENCED
SIMILAR ISSUES BUT HAVE
DIFFERENT LANGUAGES, DIFFERENT
CONCEPTUAL FRAME WORKS ABOUT HOW
TO THINK ABOUT SOME OF THESE
THINGS, SO PULLING EVERYBODY
TOGETHER INTO A COMMON FRAMEWORK
WAS ACTUALLY -- TOOK QUITE A BIT
OF TIME BECAUSE A LOT OF
DISCUSSION AROUND JUST MAKING
SURE THEY'RE ON THE SAME PAGE
FOR SOME VERY BASIC PRINCIPLES
THAT YOU THINK WOULD HAVE BEEN
EASY BUT ACTUALLY CAN BE QUITE
HARD.
WE WERE ALSO LUCKY TO HAVE
JONATHAN, LAURA AND TRACY KIND
OF DRAG US ALONG, YOU KNOW, IN
THIS PROCESS BECAUSE LIKE I
SAID, IT WAS QUITE DIFFICULT AND
IT REQUIRED A LOT OF FOLKS
COMING TOGETHER TO GET TO WHERE
WE'VE GOT.
NOW I'D SAY YOU CAN PROBABLY
THINK OF OUR RECOMMENDATIONS
PROBABLY ON TWO EXTREMES.
I THINK THERE WAS -- THERE WAS
A -- HOW DO I SAY, THERE'S A
DESIRE TO MAKE REALLY, REALLY
CRISP AND, LIKE, HEAVY-HANDED
RECOMMENDATIONS BUT AT THE END
OF THE DAY, THEY ENDED UP BEING
A LITTLE BIT MORE WATERED DOWN
BECAUSE IT WAS HARD TO GET
EVERYBODY TO REALLY, REALLY
AGREE ON SOME OF THE BIG
PRINCIPLES.
BUT WITH THAT SAID, WE THINK
THERE'S ENOUGH FRAMEWORK THERE
FOR THE NIH -- OR NIMH TO BE
ABLE TO THINK THROUGH AND MAKE
SOME RECOMMENDATIONS.
NOW THE FIRST ITEM OF BUSINESS
IN HELPING MAKE THESE
RECOMMENDATIONS WAS TO FIRST
THINK ABOUT RESEARCH DESIGN.
IN OTHER WORDS, THAT INSTEAD OF
THINKING ABOUT THINGS LIKE
SAMPLE SIZE AND POWER AND ALL
THE ISSUES THAT I WAS NOTING
EARLIER, YOU CAN'T REALLY DO
THAT WITHOUT HAVING AN
UNDERSTANDING OF THE DESIGN OF
THE EXPERIMENT THAT YOU'RE
TRYING TO RUN.
SO THAT WAS THE FIRST ITEM OF
BUSINESS, TRYING TO LAY OUT NOT
AN EXHAUSTIVE BUT A PRETTY
COMMON FRAMEWORK FOR THE TYPES
OF STUDY DESIGNS.
SO THESE ARE THE FIVE CATEGORY
THE: EXPLORATORY OR DESCRIPTIVE
STUDIES WHICH ESSENTIALLY ASK
QUESTIONS ABOUT THE DATA ITSELF,
INFERENTIAL OR PREDICTIVE
STUDIES, WHICH ARE PROBABLY THE
MAJORITY OF A LOT OF THE
STUDIES, AT LEAST IN HUMAN
RESEARCH THAT WE SEE, WHERE
YOU'RE RELATING HIGH DIMENSIONAL
DATA TO SOME OTHER OUTCOME
VARIABLE, THEN THERE'S DAW SAL
INTERVENTION STUDIES, LONGITUDAL
OR SOME KIND OF INTERVENTION,
EXPLANATORY STUDIES, INVOLVING
USING DATA TO UNDERSTAND THE
MECHANISMS BY WHICH SYSTEM,
CIRCUITS AND INDIVIDUAL
COMPONENTS AND METHODS OF TOOL
DEVELOPMENT.
THEN FROM THERE, THESE OTHER
CATEGORIES, WHAT WE DECIDED TO
DO WAS ESSENTIALLY START TAKING
IN THAT CONTEXT OF THOSE
DIFFERENT TYPES OF STUDY
DESIGNS, SO WALKING THROUGH THE
STUDY PROCESS OR GRANT PROCESS
STARTING WITH, YOU KNOW, GOALS
AND HYPOTHESES AND MOVING ALONG
THROUGH, YOU KNOW, ANALYSES,
METHODS, OUTCOMES, THINGS OF
THAT NATURE.
SO SO I'M GOING TO GO THROUGH
JUST A HANDFUL OF SOME OF WHAT
THE GROUP CAME UP WITH ON EACH
ONE OF THOSE 10 TOPIC AREAS FOR
RECOMMENDATIONS ALONG THAT STUDY
PROCESS.
SO ON GOALS, AIMS AND
HYPOTHESES.
THIS WAS A FUN ONE TO DISCUSS
BECAUSE AGAIN, EVEN SOME OF THE
BASIC THINGS YOU THINK ARE
COMMON ACROSS GROUPS WERE NOT
ALWAYS CONSISTENTLY AGREED UPON
WHAT THEY MEANT, BUT WE ALL
AGREED THAT HYPOTHESES CAN BE
USEFUL AND SOMETIMES ESSENTIAL
FOR FORMULATING CONCEPTIONS IN
AWARDS, NOT ALWAYS REQUIRED
PARTICULARLY FOR DESCRIPTIVE
SPHU DIS AND TSTUDIES AND THINGT
NATURE BUT THEY CAN BE HELPFUL
IN NARROWING SCOPE PARTICULARLY
AMONG HIGH DIMENSIONAL FEATURES
BUT ALL ASPECTS OF THE RESEARCH
DESIGN SHOULD BE WELL JUSTIFIED
AND PREREGISTRATION PLANS IN
GRANTS MAY BE HELPFUL FOR
INVESTIGATORS AND NIH TO THINK
ABOUT.
ONE OF THE -- I'M GOING TO KEEP
MOVING ON TO MAKE SURE WE HIT
TIME.
ON EXPERIMENTAL DESIGN, THE
GRANTS, AN INVESTIGATOR SHOULD
CLEARLY STATE THEIR PROPOSED
EXPERIMENTAL DESIGN, CRITICAL
FOR EVALUATING PROPERLY SAMPLE
SIZES, POWER, THINGS OF THAT
NATURE.
IT'S NOT ALWAYS THE CASE.
IT'S STUDY THAT THE STUDY DESIGN
PROVIDED JUSTIFICATION FOR
HYPOTHESIS-FREE APPROACHES SUCH
AS THE EXPLORATORY DESCRIPTIVE
STUDIES THAT I WAS DESCRIBING.
SO WHEN THE DATA ARE COLLECTED
WITH THE EXPECTATION OF DOING
INFERENTIAL OR PREDICTIVE
STATISTICS, THE STUDY DESIGN
SHOULD BE ALIGNED WITH THE
SPECIFIC OBJECTIVE.
THERE'S A LOT OF TALK ON SAMPLE
SIZES SO YOU'LL HEAR MORE ABOUT
THAT NOW, BUT SO WHEN YOU'RE
RUNNING AN INFERENCE, SAMPLE
SIZE SHOULD BE LARGE ENOUGH TO
PROVIDE - EVIDENCE OF MEANINGFUL
EFFECT IF ONE EXISTS, SIMILARLY,
FOR PREDICTION, THE SAMPLE MUST
BE LARGE ENOUGH TO EXCEED A
MEANINGFUL CRITERION OF
PREDICTIVE ACCURACY IF THE
PREDICTOR IS TRULY EFFECTIVE.
FOR INFERENTIALAL STATISTICS ON
HIGH DIMENSIONAL DATA, IF YOU'RE
TRYING TO IDENTIFY WSH YOU'RE
TRYING TO REALLY PULL OUT THE
RELATIONSHIPS TO GIVEN CELLS OR
ANY GIVEN PREDICTOR IN A HIGH
DIMENSIONAL DATA SET, THAT'S
GOING TO HAVE A HIGHLY DIFFERENT
DESIGN OR SAMPLE OR POWER NEEDS
THAN IF YOU'RE ACTUALLY JUST
PREDICTING AN OUT COME WITH A
MULTIDIMENSIONAL DATASET.
SO MAKING SURE THAT'S SUPER
CLEAR IN THE GRANTS, THAT'S THE
ONLY WAY THAT YOU CAN EVALUATE
THE QUALITY OF THE STUDY DESIGN.
A BIG ONE AND POWER AND SAMPLE
SIZE ESTIMATES, SO WHAT WE CAME
UP WITH IS THAT LARGE SAMPLE
SIZES ARE GENERALLY NECESSARY
FOR POPULATION-LEVEL
ASSOCIATIONS.
NOT ALWAYS BUT GENERALLY IT
TRUE.
THEY'RE OFTEN EXPLORATORY AND
DESCRIPTIVE.
AND IN STUDIES WI WHERE SMALL
EFFECT SIZES ARE TYPICAL.
MORE DESCRIPTIVE STUDY, CENTRAL
TENDENCIES, AVERAGE
DESCRIPTIONS, WE'VE SEEN A LOT
OF WORK COME OUT AT LEAST IN THE
BRAIN SPACE IN FUNCTIONAL
ANATOMY.
SOME INTERVENTIONAL STUDIES.
THEY OFTEN DON'T REQUIRE LARGE
SAMPLE SIZES.
IN FACT, THEY CAN BE VERY SMALL
IN MANY CASES.
SO AGAIN, UNDERSTANDING THE
DESIGN AND INTENT OF THE WORK IS
REALLY IMPORTANT FOR EVALUATING
THE QUALITY OF THE APPLICATION.
THE POWER APPLICATIONS AND
AWARDS SHOULD BE BASED ON KNOWN,
EMPIRICALLY GENERATED EFFECT
SIZES AND STANDARD ERRORS OR
PERCENT VARIANCE EXPLAINED, AND
IMPORTANTLY, WHEN THERE ARE NO
PREVIOUSLY SUFFICIENTLY POWERED
DATA AVAILABLE FOR INVESTIGATORS
TO REFERENCE, POWER SHOULD BE
CONSIDERED ON A RANGE OF
PLAUSIBLE ESTIMATES AND EFFECT
SIZES.
AND AGAIN, IT SHOULD BE LEANING
ON HIGH POWER STUDIES FOR
GUIDANCE FOR THE CONSIDERATION
OF RANGES.
SO A LOT OF TIMES YOU'LL SEE IN
AWARDS WHERE THEY'RE LEVERAGING
EXISTING LITERATURE FOR
PREDICTING POWER AND THINGS OF
THAT NATURE, BUT -- AND THAT'S
THE WORK IN THE LITERATURE IS
ALSO WELL POWERED, EFFECTS ARE
OFTEN INFLATED FOR ALL SORTS OF
REASONS AND THAT CAN LEAD TO
ACTUALLY INSUFFICIENT POWER
STUDIES UNLESS YOU'RE BASING IT
ON STUDIES THAT ARE ACTUALLY
ALREADY POWERED.
ON MEASUREMENTS OF TRAITS AND
PHENOTYPES, SO JUST AS THE LARGE
SAMPLE SIZES CAN INCREASE POWER,
INCREASING MEASUREMENT PRECISION
IS ALSO REALLY IMPORTANT FOR
THAT.
SO THE QUALITY OF THE
PSYCHIATRIC TRAIT, THE PHENOTYPE
DATA IS A KEY DETERMINANT OF
RIGOR AND RELIABILITY, AS WELL
AS THE OTHER GENETICS AND BRAIN
IMAGING AND OTHER HIGH
DIMENSIONAL DATA, AND THAT
SHOULD BE REALLY EMPHASIZED IN
APPLICATIONS.
EVEN WHEN DEERCH IN COMMONLY
USED MEASURES THAT MAY NOT HAVE
HIGH RELIABILITY.
STUDIES SHOULD ALSO INCLUDE
SUFFICIENT BIOLOGICAL AND
TECHNICAL REPLICATES WHERE
APPLICABLE, AND INVESTIGATORS
SHOULD DESCRIBE HOW THE
ROBUSTNESS OF THE DATA
MEASUREMENTS WILL BE EVALUATED.
ON DIMENSIONALITY REDUCTION,
THIS WAS -- KIND OF WENT BACK
AND FORTH A LITTLE BIT, BUT THIS
IS JUST A QUICK ONE.
INVESTIGATORS SHOULD REALLY
PROVIDE DETAILS OF THE SPECIFICS
OF THE METHODS TO MAKE SURE THE
APPROACHES CAN BE REPLICATED AND
APPLIED INDEPENDENTLY.
ON INDEPENDENT REPLICATION AND
GENERALIZABILITY OF RESULTS.
SO BEST PRACTICES, YOU KNOW,
SHOULD BE HIGH PRIORITY OF
AWARDS SO INVESTIGATORS SHOULD
INCLUDE PLANS FOR REPLICATIONS,
YOU KNOW, AND TEST THE
GENERALIZABILITY IN THE
PROJECTS.
THAT WAS MOSTLY AGREED UPON
THROUGHOUT THE GROUP.
BEST PRACTICES INCLUDE PLANS FOR
REPLICATIONS AND TEST OF
GENERALIZABILITY THAT RELY ON
STUDIES THAT RELY ON HIGH
DIMENSIONAL DATA, AND
INVESTIGATORS SHOULD ALSO BE
SHARING PIPELINES AND ANALYTIC
TOOLS AND THINGS OF THAT NATURE.
TO ENSURE THAT REPRODUCIBILITY
IN RESEARCH.
ON PILOT STUDIES AND PRELIMINARY
DATA AND AWARDS.
SO ON THESE, OFTENTIMES WHEN
WE'RE LOOKING AT PILOT DATA, A
LOT OF THEM ARE UNDERPOWERED TO
BEGIN WITH.
AND SO YOU SHOULD BE APPROACHING
MEASURES OF EFFECT SIZE AND STA
STATISTICAL SIGNIFICANCE AND
THESE PILOT STUDIES SHOULD BE
APPROACHED -- IN MANY CASES YOU
PROBABLY SHOULDN'T BE SEEING
SIGNIFICANT RESULTS IF IT'S
UNDERPOWERED DATA.
SO THAT'S NOT NECESSARILY THE
CURRENT STANDARD, BUT STUDY
SECTIONS SHOULD BE EVALUATING
THE QUALITY OF THESE PRELIMINARY
STUDIES AND WHAT THEY'RE
ACTUALLY BEING USED FOR IN THE
AWARDS.
ON DATA SHARING, CODE AND
RESOURCE SHARING, IN THIS,
THERE'S A LOT OF ALREADY NIMH
AND NIH HAS DONE A LOT ALREADY
IN THIS SPACE.
SO WE KIND OF REITERATED SOME OF
THAT AND KIND OF TOOK IT A
LITTLE BIT FURTHER WITH SOME OF
THE CODE AND RESEARCH SHARING AS
WELL.
ON PUBLICATION PLANS, THERE WAS
A MIXED BAG, YOU KNOW, I WOULD
SAY IN THE GROUP, ON THE
IMPORTANCE OF PREREGISTRATION.
SO WHILE IT'S NOT NECESSARILY
REQUIRED, BUT PUTTING TOGETHER
IN AWARDS LIKE A PREREGISTRATION
PLAN WHICH SHOULD BE THOUGHT OF
AS A STRENGTH OF THE RESEARCH
APPROACH AND THEIR GENERAL
PUBLICATION PLANS.
THE ISSUES AROUND EARLY STAGE
INVESTIGATORS AND TRAINING
GRANTS, THIS WAS A HOT TOPIC
THAT WE SPENT MANY MEETINGS ON
BECAUSE AS YOU KNOW, TRAINING
GRANTS AND AWARDS FOR TRAINEES
COULD BE QUITE A BIT SMALLER IN
SIZE WITH REGARD TO RESOURCES,
SO GETTING ADEQUATELY POWERED
STUDIES IS NOT ALWAYS FEASIBLE.
SO THE SUGGESTED PRIORITIZING
PRIORITIES -- FOR RESEARCHERS
THAT USE REPOSITORIES IS REALLY
HIGHLY ENCOURAGED.
THERE SHOULD ALSO BE SUPPORT FOR
INVESTIGATORS TO COLLECT THEIR
OWN DATA, BUT IMPORTANTLY, THE
STUDY DESIGN SHOULD BE DESIGNED
IN A WAY THAT FACILITATE, YOU
KNOW, SMALLER END STU STUDIES BT
THE RESEARCH ALSO SHOULD BE
TAKEN INTO CONSIDERATION THE
TRAINING PURPOSES OF THE WORK,
IN SOME CASES YOU MAY HAVE TO
CHOOSE TO SUPPORT PROMISING
FOLKS THAT REQUIRE UNDERPOWERED
STUDIES OR THE STUDIES THAT NEED
TO BE COMBINED WITH OTHER
DATASETS.
I'M GOING TO END THERE TO TAKE
QUESTIONS FOR MYSELF AND LAURA.
I KNOW WE WENT A LITTLE BIT OVER
LAST SESSION SO TIME IS A LITTLE
BIT SHORT.
I JUST WANTED TO █AGAIN SAY
THANKS FOR REALLY QUITE AN
AMAZING LEARNING EXPERIENCE, YOU
KNOW, FOR THE LAST YEAR IN THIS
SPACE.
AND I DON'T KNOW WHAT LAURA
THINKS BUT I WAS ACTUALLY -- I
PRIDE MYSELF IN BEING BROAD IN
MY THINKING, IN HOW I SEARCH FOR
THINGS AND HOW I TRY TO REACH
OUT TO OTHER DIMENSIONS AND
OTHER DOMAINS THAT ARE OUTSIDE
OF MY WHEELHOUSE IN THE SCIENCE,
BUT I LEARNED QUITE QUICKLY, IN
FACT EVEN IN THE FIRST MONTH,
ABOUT HOW SIMILAR ISSUES ARE
BEING APPLIED IN ALL DIFFERENT
TYPES OF DOMAINS, PAPERS AND BIG
PUBLICATIONS THAT I DIDN'T EVEN
KNOW ABOUT AT ALL.
SO IT WAS QUITE A LEARNING
EXPERIENCE.
I REALLY APPRECIATE IT AND I
HOPE THAT THE RECOMMENDATION
THAT WE WERE ABLE TO PUT
TOGETHER CAN PROVIDE AT LEAST A
FRAMEWORK FOR HOW TO BE ABLE TO
EVALUATE AWARDS THAT COME IN TO
THE NIMH IN THE FUTURE.
THANK YOU.
>> LET ME ECHO MY THANKS TO THE
ENTIRE WORK GROUP AND ESPECIALLY
TO YOU AND LAURA FOR CHAIRING
IT, AND TO OUR NIMH STAFFERS WHO
WERE INVOLVED IN IT AS WELL.
AND WITH THAT, I WILL OPEN IT UP
AND I UNDERSTAND THAT LAURA
SCOTT, YOU'D LIKE TO KICK US OFF
WITH THE DISCUSSION.
>> THANKS VERY MUCH.
THAT WAS A GREAT SUMMARY OF THE
REPORT AND THE WORK THAT WENT IN
TO DOING IT.
SO AS DAMIEN SAID, THERE WERE
MANY DIFFERENT OPINIONS ON SOME
OF THE ISSUES, AND I'M HAPPY TO
SEE IT'S COME TO FRUITION FOR
CONSIDERATION OF ADOPTION.
I WANT TO TAKE JUST A MOMENT TO
TALK ABOUT THE LIFE OF THE
DOCUMENT AS WE GO FORWARD
BECAUSE IT REALLY HAS TWO OR
THREE POTENTIAL AUDIENCES.
SO ONE IS THE NIMH PROGRAM
OFFICERS WHO WOULD USE THE
DOCUMENT TO AID IN THEIR
EVALUATION OF PROPOSALS.
ANOTHER IS MENTAL HEALTH FOCUSED
RESEARCHERS ARE APPLYING FOR
FUNDING AND LOOKING FOR GUIDANCE
BEFORE SUBMITTING OR
RESUBMITTING RESPONSE TO
COMMENTS AND THE THIRD IS
PERHAPS THE BROADER RESEARCH
COMMUNITY WHO MIGHT BE LOOKING
FOR OPINIONS AND GUIDANCE.
AND IN THINKING INTO THE FUTURE,
I THINK IT'S IMPORTANT FOR NIMH
TO KNOW IF THE DOCUMENT HAS DONE
ITS JOB.
SO FOR PROGRAM OFFICERS DURING
OUR DISCUSSION, WE TALKED ABOUT
AN ALTERNATE REPORT STRUCTURE
WHERE WE WOULD USE CASE STUDIES
TO DEMONSTRATE PARTICULAR TYPES
OF ISSUES THAT PROGRAM OFFICERS
ENCOUNTER, AND WE ULTIMATELY
PRODUCED A DOCUMENT THAT HAD
PRETTY GENERAL ALTHOUGH
SOMETIMES PERHAPS MAYBE
CONTROVERSIAL RATIONALS OR
RECOMMENDATION, SO ONE QUESTION
I THINK TO ASK GOING FORWARD IS
HAS THIS DOCUMENT ACTUALLY AID
AIDED, IF WE ADOPT IT, THE NIMH
PROGRAM OFFICERS IN EVALUATING
GRANTS, AND IF NOT, IS THERE
FOLLOW-UP WORK THAT NEEDS TO BE
DONE TO ADDRESS SPECIFIC
QUESTIONS TO MAKE IT MORE -- OR
TO ADD ON TO IT LIKE AFTER THE
CONSTITUTION.
FOR PEOPLE APPLYING FOR GRANTS,
HOW WILL THEY FIND THIS
INFORMATION, WILL IT BE PUT INTO
FUNDING ANNOUNCEMENTS, AND IT
REALLY GOT ME THINKING ABOUT THE
TENSION WHEN YOU WRITE A GRANT
BETWEEN THE AMOUNT OF SPACE IT
WOULD TAKE TO FULFILL ALL THE
RECOMMENDATIONS AND TO DESCRIBE
THE BIOLOGY AND THE RATIONALE
BEHIND THE EXPERIMENTS THAT YOU
WERE DOING, SO IT'S A LITTLE BIT
OF AN ASPIRATIONAL GOAL, AND HOW
COULD NIMH TRACK HOW THIS
DOCUMENT IS BEING USED, HOW
OFTEN IT'S BEING ACCESSED, AND
IS IT POSSIBLE TO GATHER
FEEDBACK AND PUBLIC COMMENTARY
THAT MIGHT ACTUALLY PROVIDE AN
INTERESTING DIALOGUE GOING
FORWARD ON THESE ISSUES.
>> THANK YOU FOR THOSE
CHALLENGES, AND I THINK -- FOR
ELUCIDATING THOSE CHALLENGES, I
SHOULD SAY, AND I THINK WE CAN
DO THAT, WE CAN TRACK AND WE CAN
EXPLAIN AND WE CAN FOLLOW UP.
FIRST AND FOREMOST SO THAT
EVERYONE UNDERSTANDS WHAT
HAPPENS AFTER COUNCIL WORK GROUP
REPORT, ONCE IT'S ADOPTED IN
FINAL FORM FROM THIS GROUP, IT
GETS PUT ON OUR WEBSITE FOR ALL
TO SEE.
SO AT THE VERY LEAST, IT IS A
PUBLIC-FACING DOCUMENT.
SECOND, IT IS OUR INTENTION TO
REVIEW THE RECOMMENDATIONS AND
SEE IF THEY MERIT ANY PARTICULAR
POLICY CHANGES.
OF COURSE MOST OF YOU KNOW IN
THE WAKE OF THE COUNCIL WORK
GROUP REPORT, FOR EXAMPLE, ON
GENOMICS THAT WAS DONE ABOUT
EIGHT OR NINE YEARS A WE CREATED
A SERIES OF DOCUMENTS AND IT
AFFECTED OUR GRANT POLICY TO A
PRETTY SIGNIFICANT DEGREE AND
WE'LL BE LOOKING THROUGH THESE
RECOMMENDATIONS TO SEE WHETHER
THERE ARE THINGS WE NEED TO
ADOPT IN A FORMAL WAY AND LET
PEOPLE KNOW.
BUT I LOVE THE IDEA IN
PARTICULAR OF TRACKING AND
BRINGING BACK TO THIS BODY WHAT
WE SEE AS A CONSEQUENCE OF THE
DOCUMENT.
>> I HAD ONE MORE ACTUALLY, I
LOST THE END OF MY PAGE BUT IT'S
EXACTLY WHAT YOU SAID.
SO IN HAVING THESE DISCUSSIONS,
THE THING THAT KEPT GOING
THROUGH MY MIND IS, WHAT IF I
HAD A TRACKER ON ALL THE
ANALYSES THAT MY GROUP RUNS, AND
HOW ACCOUNTING FOR ALL THE TESTS
WE'VE RUN WOULD ACTUALLY AFFECT
THE NUMBER OF RESULTS THAT WE
CALLED SIGNIFICANT.
I THINK THERE'S ACTUALLY AN
INTERESTING PERHAPS BODY OF
RESEARCH TO BE DONE OR AN RFA ON
GRANTS THAT REALLY DELVE INTO
DEALING WITH THIS ON A VERY
PRACTICAL ISSUE.
>> OTHER QUESTIONS OR COMMENTS
FROM MEMBERS OF COUNCIL?
WHILE YOU'RE FORMULATING THAT, I
ACTUALLY HAVE A FEW I WOULD LIKE
TO ASK MYSELF.
FIRST, YOU MENTIONED IN YOUR
PRESENTATION, DAMIEN, AND MAYBE
SOMEONE ELSE COULD ANSWER IF NOT
YOU, ABOUT -- PARTICULARLY ABOUT
PILOT STUDIES.
I GUESS I WOULD LIKE TO ASK THE
QUESTION, IF A PILOT STUDY IS
NOT AIMED TO FIND A
STATISTICALLY SIGNIFICANT
RESULT, WHAT IS THE GOAL OF A
PILOT STUDY THAT THE GROUP WOULD
ENDORSE?
>> IT'S A GOOD QUESTION, I MEAN,
AND OF COURSE IT ALWAYS DEPENDS,
IT WOULDN'T NECESSARILY BE THAT
THERE WOULD BE NO CASES WHERE
YOU WOULD EXPECT A SIGNIFICANT
RESULT OF COURSE, BUT THINKING
ABOUT FEASIBILITY, LOOKING A AT
TRENDS, IN OTHER WORDS, WHAT DO
YOU VALUE.
IF YOU HAVE AN UNDERPOWERED
STUDY, YOU SEE A NOT SIGNIFICANT
RESULT IF THE TREND, THAT MEANS
YOU MIGHT BE RIGHT, RIGHT?
SO THAT WOULD BE -- BUT WE DON'T
TYPICALLY VALUE PILOT STUDIES
THAT DON'T HAVE THAT
SIGNIFICANCE TAG ON IT IN THE
SAME WAY, EVEN THOUGH YOU
PROBABLY SHOULD CONSIDER THEY'RE
UNDERPOWERED.
DO YOU SEE WHAT I MEAN?
SO IT'S A LITTLE BIT OF A SHIFT
OF HOW YOU'RE THINKING, I THINK.
>> SO OFTEN THE ROLE OF THE
PILOT STUDY IS TO DEMONSTRATE
THE TECHNOLOGICAL FEASIBILITY OF
WHAT'S PROPOSED, OR TO COMPARE
VARIOUS TECHNICAL APPROACHES AND
MAKE DECISIONS BETWEEN THEM.
I THINK WHAT THE GROUP IS
RECOMMENDING IS THAT YOU'VE GOT
A WINNER'S CURSE THING GOING ON
STATISTICALLY.
THE ONLY EFFECTS YOU CAN DETECT
IN A SAMPLE SIZE OF 50
INDIVIDUALS ARE THE REALLY,
REALLY HUGE ONES.
AND YOU CAN'T USE THAT TO SAY
LOOK, ALL THE EFFECTS ARE
REALLY, REALLY HUGE, SO WE HAVE
BASED OUR POWER CALCULATIONS ON
THE EXISTENCE OF GIGANTIC
EFFECTS.
>> THANK YOU.
RINAD.
>> THANK YOU FOR THIS VERY HARD
WORK.
WHEN I WAS READING THROUGH THE
REPORT, THE PIECE ABOUT THE
CLINICAL UTILITY WAS LESS CLEAR
TO ME, AND I WAS WONDERING IF
YOU ALL COULD SPEAK TO THAT A
LITTLE BIT.
I DON'T KNOW IF THAT MEANS CLING
SOME KIND OF DESCRIPTION OF
ENGAGEMENT OF COMMUNITY OR
TRANSLATIONAL SCIENCE BENEFIT OR
ABILITY TO CENTER EQUITY WITH
THE DATA OR IMPLEMENT ABILITY OF
WHAT'S FOUND FROM THE HIGH
DIMENSIONAL DATA, AND I MIGHT BE
COMPLETELY OFF AND THAT'S OKAY,
BECAUSE I DON'T THINK I USE HIGH
DIMENSIONAL DATA, BUT I'M
CURIOUS IF YOU COULD SPEAK A
LITTLE BIT MORE ABOUT THAT
FOURTH CHARGE, WHICH SEEMED TO
BE ABOUT THE CLINICAL UTILITY.
YOU WANT
>> YOU WANT TO TAKE THAT, LAURA?
>> MY ANSWER FOR YOU IS KIND OF
SQUISHY.
A MAJORITY OF THE WORKING GROUP
WAS MORE ON THE BASIC SCIENCE
KIND OF SIDE, THOUGH WE DID HAVE
A FEW REPRESENTATIVES IN THE
CLINICAL SPACE WHO BROUGHT US
BACK TO THAT QUESTION.
AND I THINK SOME OF THE
FUNDAMENTAL THEMES THAT CAME UP
WERE RECOGNIZING THAT THESE ARE
DIFFERENT THOUGHT SPACES AND
THAT WHAT CONSTITUTES A
SIGNIFICANT EFFECT DIFFERENT
WHEN YOU ARE TRYING TO GAIN
INSIGHT REGARDING MECHANISM THAN
WHEN YOU ARE TRYING TO ASSESS
WHETHER AN INTERVENTION HAS
HELPED OR NOT.
SO SOME OF THIS THINKING WENT
TOWARD WHAT'S A SIGNIFICANT
EFFECT SIZE?
AND THE IDEA THAT THE ISSUE OF
POWER IS SOMEWHAT DIFFERENT IN
THE CLINICAL SPACE BECAUSE OFTEN
WE ARE NOT INTERESTED IN WHETHER
IT'S DIFFERENT FROM ZERO, BUT
WHETHER IT IS A CLINICALLY
MEANINGFUL EFFECT.
>> YEAH.
LAURA IT'S IN PART SQUISHY
BECAUSE WE KIND OF FELL OFF A
CLIFF AT THE END OF THIS, LIKE
GETTING THROUGH ALL THE STUFF TO
BE HONEST, BUT WHAT I CAN SAY ON
THIS PARTICULAR TOPIC, WHAT WE
TRIED TO MAKE CLEAR IS THAT NOT
ALL USEFUL SCIENCE HAS TO HAVE
SOME KIND OF CLINICAL UTILITY,
LIKE TODAY.
THAT WAS ONE.
AND THEN NUMBER TWO IS, JUST
SAYING SOMETHING HAS CLINICAL
UTILITY IS MAYBE NOT ENOUGH IN
THESE AWARDS, BUT THAT IF IT
REALLY IS SOMETHING THAT'S GOING
TO BE CLINICALLY -- HAVE
CLINICAL UTILITY, HOW DO YOU
PLAY THAT FORWARD INTO HOW IT
WILL ACTUALLY BECOME CLINICALLY
USEFUL.
THAT REQUIRES A LITTLE BIT
DEEPER THOUGHT THAN WE TYPICALLY
ARE -- HOW WE TYPICALLY THINK
OF, YOU KNOW, IT'S NOT A PIE IN
THE SKY BUT THESE ARE PLAYING
FORWARD A LITTLE BIT WITH -- I'M
JUST GOING TO SAY SOMETHING KIND
OF OUT THERE SO PEOPLE GET IT,
BUT THERE'S PAYORS INVOLVED,
THERE'S -- BECAUSE IT
COMMERCIALIZES, IS THERE ALL
THESE DIFFERENT ASPECTS OF LIKE
MAKING SOMETHING CLINICALLY
USEFUL.
SO THAT SOME OF THOSE
DESCRIPTIONS OF HOW WE MAY WANT
TO VALUE MORE DETAIL ON HOW CAN
WE GET TO THAT CLINICAL UTILITY
THAN JUST SAYING IT IS TO BE SO
BECAUSE IT SOUNDS LIKE IT COULD
BE.
SO SOME OF THOSE ASPECTS, NOT
ALL THAT STUFF MADE TO THE END
OF THE DOCUMENT BUT LIKE I SAID,
FOLKS WERE GETTING TIRED AND WE
WERE -- WE DIDN'T GET INTO
THE -- TOO MUCH INTO THE WEEDS
ON THAT AT THE END OF THE DAY.
>> ANOTHER THEME THAT CAME UP
WAS IN THE CLINICAL UTILITY
SPACE, THE VALUE OF SOMETHING
THAT IS PURELY A PREDICT TER A D
OUR CLINICAL COLLEAGUES TELLING
US THAT THE ROLE OF HYPOTHESES
WERE SOMEWHAT DIFFERENT WHEN
WHAT YOU CARE ABOUT IS
BUILDING -- USING THE BIG DATA
TO BUILD A PREDICTOR THROUGH
YOUR MACHINE LEARNING ALGORITHM,
HAVING A HYPOTHESIS ABOUT WHAT
THE SPECIFIC MECHANISMS WERE
THAT CONNECT BETWEEN THE BIG
DATA AND TH THE OUTCOME WAS REAY
NOT IMPORTANT TO OUR CLINICAL
COLLEAGUES NECESSARILY AS
BUILDING THE PREDICTOR.
SO THINKING ABOUT THOSE KINDS OF
ISSUES AS TO HOW WE MIGHT
DIFFERENTLY PRIORITIZE THE ROLE
OF HYPOTHESIS AND STUDY DESIGN
WHEN WE WERE GOING TOWARD THOSE
DIFFERENT END POINTS.
>> THANK YOU.
ANGUS.
>> THANK YOU, AND THANKS TO THE
WORK GROUP FOR ALL OF THE
EFFORTS THAT YOU'VE PUT IN.
SORT OF PICKING UP ON THE LAST
TWO QUESTIONS IN THIS KIND OF
CATCH-22 AROUND THE POWER
ANALYSIS, IF YOU CAN'T SORT OF
RELY ON THE DATA OR EVEN THE
PUBLISHED DATA THAT ARE OUT
THERE AS WAS MENTIONED, WAS
THERE ANY DISCUSSION IN THE WORK
GROUP AROUND OTHER WAYS TO
THERNGTHINKOF THE PROBLEM, LIKEA
SENSITIVITY ANALYSIS?
ONE OF THE THINGS WE'RE SORT OF
MINDFUL AROUND HERE, WE WERE
JUST TALKING ABOUT BUDGET, SO --
THERE ARE THESE CONSTRAINTS ON
THE KIND OF SCALE THAT PEOPLE
ARE ABLE TO COLLECT DATA AT.
A SENSITIVITY ANALYSIS IS OKAY,
THIS IS WHAT WE ARE
REALISTICALLY ABLE TO DO, WE
THINK THAT WE'RE GOING TO BE
SENSITIVE TO EFFECT SIZES OF
THIS SCALE AND WE THINK THAT
THOSE ARE REASONABLE EFFECT
SIZES TO BE SENSITIVE TO.
AND I WAS WONDERING IF -- WHICH
IS SORT OF TAKING TWO ELEMENTS,
WHICH IS AS OPPOSED TO SAYING
HOW MANY PEOPLE DO I HAVE AND
SAYING THIS IS HOW MANY PEOPLE I
HAVE, THIS IS THE ANALYSIS I'M
GOING TO BE USING, I'M GOING TO
BE -- I HAVE THIS MUCH POWER TO
BE SINCETIVE TO SOMETHING THAT'S
THIS SMALL.
AND THAT IS A WAY OF BACKING
INTO A POWER ANALYSIS.
AND PERHAPS ALLOWS ONE TO SAY,
WELL, THAT EFFECT SIZE IS MUCH
SMALLER OR NO SMALLER OR -- THAN
WHAT WAS PREVIOUSLY OBSERVED IN
THE DATA.
YOUR EXPRESSIONS, SORT OF
SUGGEST TO ME, NO, WE DID
SUGGEST SENSITIVITY ANALYSES OR
YOU'RE JUST WAITING FOR ME TO
STOP TALKING.
[LAUGHTER]
>> WE DID NOT -- WE DIDN'T
DISCUSS SENSITIVITY ANALYSES PER
SE.
BUT AGAIN, LIKE WHAT WE'RE --
WHAT WAS PROPOSED HERE IS NOT
EXHAUSTIVE BY ANY MEANS.
IT DOESN'T MEAN THAT THAT
SHOULDN'T BE CONSIDERED.
I THINK THE MAIN POINT -- THE
RECOMMENDATION WE'RE TRYING TO
SPLIT THE NEEDLE WHERE WE'RE
NOT -- I DON'T THINK THERE WAS A
RECOMMENDATION THAT YOU SHOULD
NOT USE LITERATURE AT ALL.
BUT OFTENTIMES, YOU KNOW, IT'S
USING -- IF IT AVAILABLE, WELL
HIGHER POWERED STUDIES OR AT
LEAST THE PARAMETERS AROUND
THOSE HIGH POWERED STUDIES TO
HELP MAKE REASONABLE ESTIMATES
OF WHAT YOU SHOULD EXPECT FOR A
DIFFERENT EXPERIMENT.
I'D HAVE TO THINK THROUGH A LOT
MORE ABOUT LIKE THE SENSITIVITY
ANALYSIS ANGLE, ANGUS.
BUT I WENT R WOULDN'T RULE IT O.
I'D JUST HAVE TO THINK THROUGH
IT A ILL WILL BIT MORE.
>> TED.
>> CAN I RESPOND TO THAT COMMENT
ALSO?
>> SURE, GO AHEAD.
>> I ACTUALLY THINK THAT
INHERENT IN OUR DISCUSSION OF
THE POWER ANALYSES AND IN
WRITING A GRANT, RIGHT, BECAUSE
YOU'RE STRUGGLING WITH ENOUGH
SAMPLES OFTEN TO MATCH WHATEVER
EFFECT YOU HAVE THAT YOU ARE IN
ESSENCE DOING THAT, RIGHT, AND
IF THERE'S A PLACE WHERE WE
SUGGEST SIMULATIONS, SO I THINK
THAT -- I DON'T THINK IT'S SO
FAR AWAY FROM WHAT WE HAVE IN
HERE IN TERMS OF HOW YOU GO
ABOUT THAT AND MAYBE THERE CAN
BE LANGUAGE THAT WAS EXPLICIT
BUT I THINK IT WOULD FIT WITHIN
A COUPLE SENTENCES OF WHAT WE
HAVE IF WE PUT IT IN.
>> TED.
>> I WANTED TO MAKE A COMMENT
ABOUT THE REPORT REALLY FOR NIMH
STAFF AND FOR PROGRAM.
YOU THINK ABOUT THIS LOOKING AT
IT AND THINK OKAY FOR AN
INVESTIGATOR, WHAT KIND OF GRANT
AM I GOING TO WRITE, PROGRAM
OFFICER, WHAT SORT OF GRANT AM
YOU GOING TO FUND.
BUT THE OTHER THING TO REALIZE
AS YOU READ THROUGH THIS
DOCUMENT, PARTICULAR A LINEAR
THE END OF IT, IS THAT THERE'S
AN ASPECT OF THIS DOCUMENT THAT
SHAKES SCIENCE UP A LITTLE BIT.
THAT TALKS ABOUT DATA
AVAILABILITY, TALKS ABOUT
PREREGISTRATION, TALKS ABOUT
PREPRINTS, TALKS ABOUT HOW TO
THINK ABOUT YOUNG INVESTIGATORS
WHO ARE 252ND ON AN AUTHOR LIST
OF 290.
AND ALSO TALKS ABOUT RESOURCES
TO BE ABLE TO MAKE DATA
AVAILABLE, TO BE ABLE TO MAKE
CODE AVAILABLE.
FOR EXAMPLE, THERE'S BEEN A LOT
OF INVESTMENT IN WORK OF SPATIAL
TRANSCRIPTOMICS, BUT HOW DO YOU
ACTUALLY SHARE SPATIAL
TRANSCRIPTOMICS DATA?
THERE'S SOME EXAMPLES PEOPLE
HAVE DONE, BUT TO COMBINE THE
SPATIAL INFORMATION AND DO THAT
AKROT THE BRAIN, IT'S BACK TO
THE PROBLEM, NOW IT'S BEEN
SOLVED WITH CONSORTIUMS LIKE
ENIGMA.
THAT TAKES A LOT OF RESOURCES
FROM NIH TO INVEST IN SCIENCE
AND HOW WE DO SCIENCE.
SO I JUST WANT TO MAKE -- I JUST
WANT TO SORT OF POINT THAT OUT,
IF YOU REALLY LOOK AT THIS AND
KIND OF SQUINT A LITTLE BIT, YOU
REALIZE THERE'S SOME PUSHING AT
THE EDGES OF HOW WE DO SCIENCE.
YOU DESCRIBED THE BRAIN
INITIATIVE PROJECTS, SOMETHING
WE ALL HAVE TO THINK ABOUT
THAT'S A LITTLE BIT MORE FUZZIER
THAN JUST WHAT'S MY GRANT AND --
FUNDING.
>> I THINK THAT'S A REALLY GOOD
POINT BUT I TEND TO BE CONCRETE
SO I'M GOING TO TRY TO GET CON
GREET FOR JUST A MOMENT.
DAMIEN, LAURA, ANYONE ELSE ON
THE COMMITTEE, ONE OF THE MOST
ACTUALLY CONCRETE
RECOMMENDATIONS FROM MY
PERSPECTIVE, YOU DIDN'T DETAIL
THE LANGUAGE OF IN YOUR
PRESENTATION BUT IT'S IN ONE OF
THE AREAS THAT YOU TALKED ABOUT,
IT HAS TO DO WITH VALIDATION AND
GENERALIZATION, AND I'M GOING TO
QUOTE FROM THE REPORT.
FOR EXAMPLE, PREDICTIVE STUDIES
SHOULD VALIDATE DEVELOPED
ALGORITHMS USING INDEPENDENT
DATA WITHOUT DEVELOPING ANY
ASPECTS OF THE MODEL IN ORDER TO
PREVENT ALGORITHMIC OVERFITTING.
SO TO MY MIND, THAT IS ACTUALLY
A VERY SPECIFIC AND PROVOCATIVE
SUGGESTION, WHICH IS NOT ADHERED
TO IN THE VAST MAJORITY OF THE
HIGH DIMENSIONAL DATA SET STUFF
THAT WE DO.
I WANT TO MAKE SURE I'M CORRECT,
THOUGH, BECAUSE THE LANGUAGE IS
A LITTLE BIT OBTUSE TO ME.
SO I THINK BHA YOU WHAT YOU'RE S
THAT WHEN YOU DESIGN A
PREDICTIVE MODEL, WHEN YOU BUILD
A PREDICTIVE MODEL, YOU SHOULD
PILD SHOULDBUILD IT ON PART OF R
DATASET, THEN WITHOUT CHANGING
ANY ASPECTS, WITHOUT CHANGING
ANY OF THE PARAMETERS YOU
SHOULD -- IN AN INDEPENDENT
DATASET.
THAT COULD BE A WITHHELD DATASET
OR A WHOLE NEW DATASET.
AM I CORRECT IN THE BASIC
UNDERSTANDING OF THAT
RECOMMENDATION?
>> THAT IS CORRECT.
YOU KNOW, AND THERE'S TWO AN
DWEANGLESWITH THIS.
I STARTED THIS IN MY OWN LAB BUT
ALL THE STATISTICS FOLKS,
EARMUFF, BUT IN MY LAB, WHAT
I'VE BEEN TRYING TO GET ACROSS
TO THE GROUP IS THAT YOU DO
EXACTLY WHAT YOU SAY, YOU DO
EVERYTHING ALL IN A COMPLET
COMPLETELY -- PART OF YOUR
DATASET, ALL THE WAY DOWN, YOU
CAN REPLICATE IT WITHIN THE SAME
DATASET AND THEN IDEALLY, THE
BEST BEST PRACTICE IS YOU HAVE A
COMPLETELY DIFFERENT DATASET,
DIFFERENT COLLECTION EACH AND
YOU VALIDATE IT IN A THIRD ONE.
USUALLY IF YOU CAN GET THROUGH
ALL THOSE PIECES THAT YOU'VE
KIND OF NAILED THE FINDING.
>> TO MY MIND, THAT PARALLELS
THE EVOLUTION THAT WENT IN THE
GWAS ASPECTS OF GENOMICS, I
THINK, RIGHT, WHERE IN ORDER TO
PUBLISH A GENETIC ASSOCIATION
RESULT, YOU NEEDED TO
ESSENTIALLY REPLICATE WHAT YOU
DID IN AN INDEPENDENT DATASET.
IS THAT MORE OR LESS TRUE?
LAURA IS LOOKING AT ME
SKEPTICALLY.
>> THAT WAS CERTAINLY TRUE AT
THE START, BECAUSE WHEN PEOPLE
HAD INDIVIDUAL STUDIES, THEY
WOULD TEST MULTIPLE VARIANTS,
RIGHT, OM UP WITH -- THERE'S
ACTUALLY A PARAGRAPH, THERE'S A
PIECE IN HERE ABOUT
META-ANALYSIS.
SO WHEN YOU GET OUT TO HAVING
MANY, MANY, MANY, MANY, MANY
STUDIES, YOU MAY STILL HAVE BIAS
WHEN YOU PUT THEM TOGETHER FOR
META-ANALYSIS, AND IT TURNS OUT
TO BE LESS TO HAVE A REPLICATION
GROUP.
THE DIFFERENCE, I THINK, BETWEEN
THESE TWO IS THAT WHEN YOU DO
GENETIC STUDIES, YOU HAVE A
REALLY SET THING THAT YOU'RE
DOING.
YOU ARE TESTING THE VARIANTS.
WHEREAS WHEN YOU'RE PREDICTING
AND YOU'VE TWEAKED AND YOU'VE
GONE DOWN THIS PATHWAY, THEN I
THINK IT BECOMES MORE IMPORTANT.
>> RIGHT, WHEN YOU HAVE A MODEL
THAT YOU FIT PARAMETERS TO OR
DIMENSIONALITY REDUCTION THAT
YOU'RE DOING, THAT YOU'RE
FITTING, AGAIN, PERHAPS TERES
TO, YOU NEED TO MAKE SURE THAT
REPLICATES.
LET ME JUST FURTHER CHALLENGE
THE GROUP ON THIS.
IN FACT, THIS IS INHERENT IN
SOME OF THE GRANTS WE'RE GOING
TO TALK ABOUT TOMORROW.
OFTEN IN THESE LARGE DATASET
THINGS, PARTICULARLY IN THOSE
THAT ARE AIMED AT PREDICTION,
YOU'LL SEE A MODEL BUILT AND
THEN WITH 10% OF THE DATA LEFT
OUT.
OR 5% OF THE DATA LEFT OUT.
AND THEN TESTED O ON THE REMAING
5% AND THEN THE MODEL REITERATED
ON A DIFFERENT 95% AND 5%.
I FORGET THE NAME FOR THIS, BUT
TENFOLD --
>> CROSS VALIDATION.
>> TENFOLD CROSS VALIDATION.
WAS THERE -- I DON'T WANT TO
READ IN THE RECOMMENDATION, BUT
IT SEEMS LIKE THIS
RECOMMENDATION DOES NOT SUPPORT
AN END FOLD, A PURE INDEPENDENT
VERSUS AN END FOLD THAT CAN BE
AGREED UPON IN THE FIELD AS
BEING PRER PREFERABLE?
>> WELL, SO I THINK -- SO THE
CROSS VALIDATION IS A VERY TRIED
AND TRUE APPROACH TO ACTUALLY
REPLICATING OUTCOMES DATA, SO I
DON'T THINK YOU'D WABTD TO WANTI
DON'T THINK THAT'S A NEGATIVE,
PER SE.
IT'S JUST ANOTHER METHOD OF
DOING KIND OF THE -- WHAT DID
THEY CALL IT EARLIER, HOLDING
LIKE A DATASET OUT.
SO THOSE ARE IN THEORY, KIND OF
THEY'RE THE SAME, YOU KNOW, SO I
DON'T KNOW IF YOU'D WANT TO --
WE NEVER GOT TO THAT MACHINE
LEARNING PRACTICES OR NOTHING
LIKE THAT, BUT THAT'S JUST MY
EXPERT OPINION THAT MAYBE SOME
PEOPLE DISAGREE, BUT I THINK YOU
HAVE TO BE CAREFUL ON THAT.
>> OKAY.
ANY OTHER COMMENTS?
ALL RIGHT.
THANK YOU.
I THINK WE WOULD LIKE -- I
DIDN'T HEAR ANY SPECIFIC
RECOMMENDATIONS FOR EDITS.
SO I THINK WHAT WE'D LIKE TO
KNOW IS WHETHER THIS REPORT CAN
BE ACCEPTED IN ITS CURRENT FORM.
DO I HAVE A MOTION TO ACCEPT THE
REPORT IN ITS CURRENT FORM?
I SEE A MOTION AND A SECOND.
LET'S TAKE A VOTE.
PLEASE DO USE ZOOM TO VOTE AND
RAISE YOUR HAND IN ZOOM.
SO THIS IS A VOTE TO ACCEPT THE
REPORT IN ITS CURRENT FORM.
HANDS DOWN NOW.
ANYONE VOTING AGAINST ACCEPTING
THE REPORT IN ITS CURRENT FORM?
AND IS ANYONE ABSTAINING FROM
VOTING ON THE ACCEPTANCE OF THE
REPORT?
NO?
ALL RIGHT.
WELL, THANK YOU VERY MUCH, LAURA
AND DAMIEN AND EVERYONE WHO
PARTICIPATED ON THE WORK GROUP,
AND I WANT TO ALSO ESPECIALLY
THANK THE NIMH STAFF, TRACY,
JONATHAN, AND LAURA AND ANYONE
ELSE FROM NIMH?
OR A LOT OF FOLKS FROM NIMH.
GO AHEAD.
>> WE HAD A LARGE GROUP
REPRESENTATIVE FROM EACH
SUBMISSION PARTICIPATED.
>> I KNOW THEY WORKED EQUALLY
HARD IN BETWEEN THE MEETINGS,
MAKING SURE TO PROGRESS THINGS.
SO THANK YOU VERY, VERY MUCH.
WE REALLY APPRECIATE IT.
>> THANK YOU ALL.
>> THANK YOU.
>> LET ME JUST SAY TWO THINGS
BEFORE WE MOVE ON.
NUMBER ONE, NIMH STAFF WILL BE
LOOKING TO THE REPORT TO SEE IN
ADDITION TO PUBLISHING ON THE
WEB WHAT OUR NEXT STEPS AND
WE'LL BRING THAT BACK TO THIS
GROUP SO THAT YOU UNDERSTAND
WHAT THE FOLLOW-UP HAS BEEN AND
WE'LL LOOK AT WAYS OF EVALUATING
THE IMPACT OF THE REPORT AS
WELL, SO THANK YOU.
THE SECOND THING I WANT TO SAY
IS WE'RE RUNNING ALMOST A
HALF-HOUR LATE.
I WANT TO MAKE SURE THAT PEOPLE
IN THE AUDIENCE, PARTICULARLY
THOSE WHO ARE HERE FOR THE
PUBLIC COMMENT SESSION, KNOW
THAT.
WE ARE SCHEDULED TO GO TO
4:30 WITH CONCEPT CLEARANCES,
BUT I IMAGINE IT WILL GO A BIT
BEYOND THAT.
BUT WE WILL GET TO THE PUBLIC
COMMENT SESSION, IT JUST MAY BE
A LITTLE BIT DELAYED.
SO WITH THAT, I THINK WE'LL MOVE
ON TO CONCEPT CLEARANCES.
AS YOU KNOW, EACH COUNCIL
MEETING, NIMH STAFF PRESENTS
SEVERAL CONCEPTS, THE PURPOSE OF
THESE CONCEPT CLEARANCES IS FOR
NIMH STAFF AND LEADERSHIP TO
RECEIVE EARLY FEEDBACK ON THESE
POTENTIAL FUTURE RESEARCH
INITIATIVES.
INCLUDING SUGGESTIONS TO HELP
BRING FURTHER SHAPE TO THEM.
A BRIEF DESCRIPTION OF EACH
COMMENT WAS MADE AVAILABLE TO
YOU VIA THE ASR, THAT'S THE
SOFTWARE WE USE FOR GRANTS.
WITH YOUR FEEDBACK, NIMH AIMS TO
PROCEED WITH THE RESEARCH
ACTIVITY.
HOWEVER, THE PUBLICATION AND
TIMING ARE NOT CERTAIN AND ALSO
DEPEND ON SUFFICIENT FUNDS BEING
AVAILABLE.
ONCE PRESENTED PUBLICLY AT
COUNCIL, CONCEPTS ARE POSTED ON
THE NIMH WEBSITE AND AVAILABLE
FOR FURTHER COMMENT.
FOR THE PURPOSE OF TODAY'S
DISCUSSION, WE'VE ASSIGNED TWO
COUNCILMEMBERS TO EACH CONCEPT,
THOSE WE WELCOME FEEDBACK FROM
ANY MEMBERS OF COUNCIL.
THE FIRST CONCEPT WILL BE
PRESENTED BY THE DIVISION OF
TRANSLATIONAL RESEARCH, AND THE
CONCEPT IS ON NEUROMODULATION
AND NEUROSTIMULATION DEVICE
DEVELOPMENT FOR MENTAL HEALTH
APPLICATIONS.
>> HELLO, I'M LIZZY ANKUDOWICH,
I HAVE THE PLEASURE OF
PRESENTING TWO CONCEPTS ON MAF
BEHALF OF MY COLLEAGUE,
DR. JESSICA TILLMAN.
THE FIRST IS CALLED
NEUROMODULATION AND
NEUROSTIMULATION DEVICE.
THE GOAL OF THIS CONCEPT IS TO
ENCOURAGE THE DEVELOPMENT OF
NOVEL BRAIN STIMULATION DEVICES
TO ENABLE IMPROVED DELIVERY OF
BOTH BRAIN STIMULATION FOR THE
TREATMENT OF DELIVERY OF BRAIN
STIMULATION FOR THE -- WITH THE
OVERARCHING GOALS OF IMPROVING
THE EFFECTIVENESS OF EXISTING
DEVICES, DEVELOPING NOVEL
TECHNOLOGIES, AND DESIGNING
STUDIES IN WAYS THAT WILL
OPTIMIZE FOR EVENTUAL REGULATORY
APPROVAL.
THE USE OF BRAIN STIMULATION
DEVICES PROVIDES A UNIQUE
OPPORTUNITY TO DEVELOP NOVEL
TREATMENTS FOR SERIOUS MENTAL
ILLNESS.
FOR CONTEXT, CURRENTLY USED
DEVICES INCLUDE
ELECTROCONVULSIVE THERAPY OR ECT
WHICH PROVIDES THE MOST
EFFICACIOUS I INTERVENTION FOR
SERIOUS DEPRESSION AND
TRANSCRANIAL MAGNETIC
STIMULATION OR TMS WHICH IS A
MORE RECENTLY CLEARED TREATMENT
FOR DEPRESSION.
HOWEVER, THESE SUCCESSES
DEMONSTRATE THE POTENTIAL TO
IMPROVE CLINICAL CARE,
LIMITATIONS OF A FEW EXISTING
FDA-CLEARED DEVICES SUCH AS
COGNITIVE SIDE EFFECTS OF ECT
AND VARIABILITY IN RESPONSE OF
TMS MAY HAMPER WIDER-SPREAD
CLINICAL USE.
INNOVATIVE BRAIN STIMULATION
DEVICES AND NOVEL APPROACHES TO
EXISTING DEVICES ARE URGENTLY
NEEDED TO DEVELOP EFFICACIOUS
TREATMENTS THAT WILL BE MORE
WIDELY UTILIZED ACROSS THE
SPECTRUM OF DISORDERS.
NEW DEVICES DEVELOPED WITH
SPECIFIC FOCUS ON FEATURES
UNIQUE TO SERIOUS MENTAL ILLNESS
ARE NEEDED TO EXPLORE MORE FULLY
THE POTENTIAL OF BRAIN
STIMULATION THERAPIES.
THIS SLIDE LISTS SEVERAL
CHALLENGES WHICH MOTIVATE THIS
CONCEPT AS WELL AS HOW WE EXPECT
THIS FUNDING OPPORTUNITY CONCEPT
TO ADDRESS THOSE CHALLENGES.
ADDRESSING THE LIMITED NUMBER OF
CURRENTLY AVAILABLE
TECHNOLOGIES, OVERCOMING THE
LIMITATIONS OF CURRENT DEVICES
WHICH HAMPER THEIR WIDER SPREAD
ADOPTION IN CLINICAL PRACTICE,
DEVELOPING DEVICES FOCUSED ON
THE NETWORK PATHOLOGIES SPECIFIC
TO MENTAL DISORDERS AND
FACILITATING A PATH TOWARD
REGULATORY APPROVAL.
TO ILLUSTRATE, DEEP BRAIN
STIMULATION AND VAGAL NERVE
STIMULATION ARE TWO APPROACHES
THAT WERE DEVELOPED FOR THE
TREATMENT OF PARKINSON'S DISEASE
AND EPILEPSY.
THEY HAVE SUBSEQUENTLY BEEN
STUDIED WITH MINIMAL
MODIFICATION FOR USE IN MENTAL
DISORDERS WITH MIXED RESULTS.
NEW DEVICES INFORMED BY BASIC
AND CLINICAL SCIENCE FINDINGS IN
MENTAL HEALTH RESEARCH MAY
PROVIDE IMPROVED TREATMENT.
MOREOVER, WHILE CURRENT DBS
ELECTRODES ARE LIMITED TO ONE OR
TWO STIMULATION SITES,
NEUROIMAGING STUDIES HAVE
DEMONSTRATED THE DISTRIBUTED
NETWORK-BASED NATURE OF MENTAL
DISORDERS.
THEREFORE, DISTRIBUTED
MULTIFOCAL ARRAY ELECTRODES MAY
BE NECESSARY TO MODULATE
NETWORKS BACK TO A DESIRED
STATE.
NEW FORMS OF ENERGY SUCH AS
ULTRASOUND HAVE ALSO HAD THE
POTENTIAL TO BE INCORPORATED
INTO THE NEXT GENERATION OF
BRAIN STIMULATION DEVICES.
THESE FOUNDATIONAL STUDIES AND
DEVICE DEVELOPMENT IN MENTAL
HEALTH MAY STREAMLINE PATHWAYS
TOWARDS REGULATORY APPROVAL.
IN ADDITION TO DEVELOPING NEW
DEVICES, SIGNIFICANTLY ENHANCING
THE CAPABILITIES OF EXISTING
DEVICES ALSO PRESENTS AN
OPPORTUNITY TO IMPROVE CLINICAL
CARE.
THESE DEVICES ARE AMENABLE TO
HARDWARE AND SOFTWARE
MODIFICATIONS THAT CAN READILY
TRANSLATE TO IMPROVE PATIENT
CARE.
FOR EXAMPLE, APPROACHES THAT
IMPROVE THE DEPTH OR DELIVERY OF
TMS CAN IMPROVE RESPONSE RATES.
DEVELOPMENT OF SOFTWARE
CAPABILITY THAT COULD ENABLE US
TO CLOSE THE LOOP WITH A BRAIN
STIMULATION DEVICE USING
NEUROIMAGING OR NEURAL
RECORDINGS FROM INDIVIDUAL
PATIENTS, WE CAN USE THIS TO
GUIDE STIMULATION.
OR WE COULD DEVELOP AUGMENTED
REALITY DELIVERY SYSTEMS TO
ENABLE PRACTITIONERS TO
INTERACTIVELY TARGET REGIONS OF
INTEREST WITH STIMULATION.
AND ALTHOUGH ECT PROVIDES THE
BEST REMISSION RATES FOR
DEPRESSION, THE WIDESPREAD
GENERALIZED SEIZURE INDUCED BY
THE DEVICE PRODUCES COGNITIVE
SIDE EFFECTS THAT LIMIT ITS USE.
THEREFORE, DEVELOPMENT OF
DEVICES THAT COULD DELIVER MORE
FOCUSED STIMULATION RESULTING IN
A SMALLER CONTROLLABLE SEIZURE
COULD PRODUCE HIGH LEVELS OF
THERAPEUTIC RESPONSE WHILE
MINIMIZING SIDE EFFECTS.
THIS FINAL SLIDE LISTS A SET OF
TOPICS THAT INCLUDE BUT ARE NOT
LIMITED TO MULTIFOCAL
CAPABILITIES, DEVICES CAPABLE OF
CLOSED LOOP CONTROL, NEXT
GENERATION ECT DEVICE,
VALIDATION OF NOVEL ENERGY FORMS
SUCH AS TRANSCRANIAL ULTRASOUND,
MACHINE LEARNING SOFTWARE
CAPABLE OF INCORPORATING
PATIENT-SPECIFIC BIOMARKERS, AND
IMPROVED SHAM CONTROLS THAT
ENABLE MORE RELIABLE CONTROLLED
CLINICAL TRIALS.
SO THAT'S WHAT I HAVE FOR YOU
TODAY AND THE DISCUSSANTS FOR
THIS WURNTION ONE I WAS T --
>> I CAN START.
THIS IS AN EXCELLENT CONCEPT
CLEARANCE AND I THINK IT
ADDRESSES A LOT OF REALLY
IMPORTANT DEVELOPMENTS IN THE
FIELD LIKE TRANSCRANIAL
ULTRASOUND.
ONE AREA THAT I THINK WOULD BE
GOOD TO SORT OF FURTHER DEVELOP
IS ACTUALLY STIMULATED, NO PUN
INTENDED, SOBP AND THE WORKSHOP
THAT NIMH HELD ON REALTIME FMRI
NEUROFEEDBACK AND WHETHER THAT
WOULD BE CONSIDERED UNDER THE
PURVIEW OF THIS CONCEPT
CLEARANCE TO INCLUDE REALTIME
FEEDBACK SUPPORT BID POTENTIAL
FUNDING OPPORTUNITY.
>> I THINK THAT'S A GREAT IDEA.
I AM WRITING IT DOWN.
I THINK THAT'S SOMETHING WE
DEFINITELY WANT TO THINK ABOUT
HOW TO INCORPORATE IN THE FUTURE
MOVING FORWARD, ESPECIALLY SINCE
WE'VE GOTTEN SUCH GREAT FEEDBACK
WITH THAT WORKSHOP.
>> MATT?
>> I'LL JUST ADD, ALSO STRONGLY
SUPPORT THIS.
REALLY WELL REASONED, GREAT NEED
FOR T MY ONE SUGGESTION WOULD BE
TO CONTINUE TO FOCUS ON THE USE
OF THESE DEVICES ON REALLY
DIFFICULT TO TREAT CONDITIONS.
YOU MEANT MENGSED DEPRESSION,
SUICIDE IS ANOTHER ONE, WE KNOW
ECT FOR INSTANCE HAS WORKED
REALLY WELL FOR DECADES, NOW
IT'S MUCH SAFER THAN IT USED TO
BE BUT STILL NOT WIDELY USED,
AND WE DON'T HAVE A LOT OF OTHER
TREATMENTS THAT WORK SO QUICKLY,
SO I THINK WORKING ON THESE
DIFFICULT TO TREAT AREAS SHOULD
BE A VITAL FIRST STEP.
NEXT STEP.
GREAT JOB.
>> ANY QUESTIONS OR COMMENTS
FROM OTHER MEMBERS OF COUNCIL?
THANK YOU VERY MUCH, AND LIZZY
IS GOING TO GO AHEAD AND PRESENT
THE NEXT ONE AS WELL, WHICH IS
ON UTILIZING INVASIVE RECORDING
AND STIMULATING OPPORTUNITIES IN
HUMANS TO ADVANCE NEURAL
CIRCUITRY UNDERSTANDING OF
MENTAL HEALTH DISORDERS.
>> DR. GORDON JUST INTRODUCE
THIS HAD SON O'CONNOR SEPTEMBER
THIS CONCEPT.
THE GOAL IS TO ENCOURAGE
RESEARCH UTILIZING INVASIVE
NEURAL RECORDING OPPORTUNITIES
IN HUMANS TO STUDY THE NEURAL
CIRCUITRY UNDERLYING MENTAL
HEALTH DISORDERS.
INVASIVE RECORDINGS PROVIDE A
WINDOW INTO THE HUMAN BRAIN BY
FACILITATING EXPLORATION OF THE
NEURAL CIRCUITRY UNDERLYING
COMPLEX MOODS, EMOTIONS,
COGNITIVE FUNCTIONS AND
BEHAVIORS WITH HIGH SPATIAL
PRECISION.
THE ABILITY TO STIMULATE VIA THE
SAME ELECTRODES ALLOWS FOR
DIRECT CAUSAL TESTS BY
MODULATING NETWORK DYNAMICS.
IN TERMS OF TREATMENT
DEVELOPMENT, ELUCIDATING THE
CIRCUITS UNDERLYING COMPLEX
HUMAN BEHAVIORS AND DETERMINING
HOW TO MANIPULATE THOSE CIRCUITS
INTO DESIRED STATES COULD INFORM
INVASIVE AND NONINVASIVE BRAIN
STIMULATION THERAPIES OF THE
FUTURE.
ALTHOUGH EARLY DEEP BRAIN
STIMULATION STUDIES FOR
TREATMENT REFRACTORY DEPRESSED
PATIENTS SHOW POTENTIAL, LARGER
PIVOTAL STUDIES HAVE BEEN UNABLE
TO DEMONSTRATE EV FA SEE,
HIGHLIGHTING THE NEED TO DEPEP
OUR UNDERSTANDING OF THE NEURAL
CIRCLE TRY OF MENTAL HEALTH
DISORDERS.
DESPITE THE CLINICAL CHALLENGE,
INVASIVE RECORDINGS PROVIDE AN
EXCELLENT OPPORTUNITY TO EXPLORE
THE CIRCUITRY UNDERLYING COMPLEX
HUMAN BEHAVIOR AND TO TRANSLATE
LESSONS FROM ANIMAL RESEARCH.
OPPORTUNITIES ARISE DURING THE
NORMAL TREATMENT COURSE OF A
VARIETY OF CLINICAL CONDITIONS
INCLUDING INTRAOPERATIVE MICRO
ELECTRODE OR STRIP RECORDINGS
DURING DBS SURGERY, SUBACUTE
EPILEPSY MONITORING OR ECOG,
DEPTH ELECTRODE RECORDINGS,
CHRONIC DEEP BRAIN STIMULATION
AND RESPONSIVE NEURAL
STIMULATION OR DBS/RNS DEVICES
CAPABLE OF BOTH RECORDING AND
STIMULATING, AND MANY OF THESE
OPPORTUNITIES ARISE IN PATIENTS
THAT ARE BEING IMPLANTED FOR
NON-MENTAL HEALTH-RELATED
CONDITIONS.
HOWEVER, MANY RELEVANT CLINICAL
POPULATIONS SUCH AS THOSE
WITH -- INDIVIDUALS WITH
EPILEPSY AND PARKINSON'S
REPRESENT PATIENT COHORTS WITH
CO-MORBID MENTAL HEALTH
DISORDERS.
CAREFUL STUDY OF FLUCTUATING
MOOD, COGNITIVE FUNCTION AND
BEHAVIOR OF PATIENTS WITH AND
WITHOUT MENTAL HEALTH DISORDERS
CAN PROVIDE UNIQUE INSIGHT INTO
BEHAVIORAL NETWORK DYNAMICS.
DIRECT STIMULATION WILL
COMPLEMENT RECORDINGS BY
ENABLING RESEARCHERS TO TEST
MECHANISTIC HYPOTHESES AND
EXPLORE THERAPEUTIC OPTIONS.
NETWORKS CORRELATED WITH MOOD,
COGNITION AND BEHAVIOR USING
DENSE BEHAVIORAL ASSESSMENTS CAN
BE MODULATED TO ASSESS FOR
BEHAVIORAL IMPROVEMENTS.
WHILE CURRENT DBS AND
NONINVASIVE BRAIN STIMULATION
THERAPIES TARGET LOCALIZED
AREAS, THIS RESEARCH MAY
DEMONSTRATE THE DISTRIBUTED
NODES AND CIRCUITS INVOLVED IN
DISORDERS AND, THEREFORE, INFORM
THE DESIGN OF NEW DEVICES AND
FUTURE THERAPIES.
THIS CONCEPT WOULD TARGET A GAP
IN THE SCIENTIFIC KNOWLEDGE OF
NEURAL CIRCUIT RELATED TO MENTAL
HEALTH DISORDERS.
RESEARCH RELATED TO THIS CONCEPT
MAY INCLUDE BUT IS NOT LIMITED
TO STUDIES OF ACUTE
INTEROPERATIVE RECORDINGS FROM
SINGLE UNIT OR STRIP ELECTRODES,
SUBACUTE RECORDINGS FROM
EPILEPSY MONITORING UNIT OR
RELATED SITUATIONS, CHRONIC
RECORD TRANSPORTATION RECORDING
AND STIMULATING DBS SYSTEMS,
RESEARCH DOMAIN CRITERIA OR
RDOC-BASED PARADIGMS TO ADDRESS
THE RELEVANT NEURAL CIRCUITS OF
COGNITIVE EFFECTIVE AND SOCIAL
DOMAINS AT HIGH SPATIAL AND
TEMPORAL PRECISION, AND NOVEL
TECHNOLOGICAL APPROACHES TO
NEURAL AND BEHAVIORAL RECORDING
AND STIMULATION THAT
INCORPORATES ARTIFICIAL
INTELLIGENCE AND MACHINE
LEARNING, NOVEL ELECTRODE AND
RECORDING DEVICES, VIRTUAL OR
AUGMENTED REALITY INTERFACES,
AND DIGITAL PHENOTYPING AND
DENSE BEHAVIORAL TRACKERS.
AND WITH THAT, I'D LIKE TO
INVITE DISCUSSION FROM DRS.
MACDONALD AND NIGG, I BELIEVE
WERE ON THIS ONE.
>> ARE YOU PRIEPED FOR PREPARER
NOT?
WE'LL LET JOEL START AND THAT
WILL GIVE YOU SOME MOMENTS TO
PREPARE.
DID ANYONE ELSE GET ASSIGNED
THIS ONE BY ANY CHANCE?
OKAY.
GO AHEAD, JOEL.
>> THAT'S A FANCY WAY TO GET OUT
OF GOING FIRST.
I WARNED TRACY THAT I'M GOING TO
GIVE A DECIDEDLY NON-EXPERT
COMMENT HERE.
THIS IS WELL OUTSIDE MY AREA OF
WORK.
BUT THAT SAID, THE POTENTIAL
THAT YOU HIGHLIGHTED IN YOUR
PRIOR -- SEEMED SO PROMISING
THAT WE ALMOST HAVE TO SUPPORT
THIS TYPE OF EFFORT.
I THINK IF I WAS TO SUGGEST
ANYTHING HERE, IT WOULD BE TO
EMPHASIZE EVEN MORE THAN YOU DO
THE IMPORTANCE OF STUDYING THE
VARIABILITY IN WHICH BEHAVIOR IS
IMPLEMENTED IN CIRCUITS IN
DIFFERENT CONTEXTS.
THERE'S A DANGER OF CREATING A
MACHINE-LIKE MODEL OF THE BRAIN
THAT MAY BE FAULTY, AND SO
ESSENTIALLY THE QUESTION IS, WHY
ARE THE EFFECTS VARIABLE?
WHY DID THE PRIOR PROMISE FAIL
IN A SENSE, YOU KNOW, THAT THAT
MAY BECOME A CENTRAL QUESTION
RATHER THAN NOISE IN THE SYSTEM,
THE VARIABILITY MAY BE LAWFUL.
AND SO I WOULD PUT MORE EMPHASIS
ON RECOGNIZING THAT THE SURGICAL
CONTEXT IS ONE CONTEXT, AND THEN
THE COMPLEX -- BEHAVIORAL
COMPLEX IS ANOTHER AND THE BRAIN
CAN -- THE SAME BEHAVIOR IN
DIFFERENT CIRCUITS.
SO TO HAVE THAT VARIABILITY
RESPONSE THAT YOU HEIGHT LIE
HERE, I'D PUT MORE EMPHASIS ON
THAT, WOULD BE MY ONLY
SUGGESTION.
I THINK OF THAT AS EENG LOGICAL
VALIDITY, IF YOU WILL.
>> I THINK IT'S ALSO REALLY
IMPORTANT FOR UNDERSTANDING
PRECISION MEDICINE APPROACHES,
BECAUSE WE'RE SEEING VARIABILITY
AT THE LEVEL OF INDIVIDUAL THAT
WE NEED TO UNDERSTAND IN ORDER
TO BUILD CLOSED LOOP MODELS THAT
CAN BE MORE WIDELY GENERALIZED.
>> THANK YOU FOR THAT
AMPLIFICATION.
AND I'LL ADD THE DEVELOPMENT,
ALL THE WAY UP TO THE THIRD
DECADE OF LIFE, SO HOW DOES
BRAIN MATURATION AND AGING
AFFECT IMPLEMENTATION?
OBVIOUSLY WITH THE TRANSCRANIAL
STIMULATIONS AND SO ON, WE HAVE
THE ISSUE OF WHAT HAPPENS IN
PEDIATRIC DEVELOPING BRAINS
BEING A CHALLENGE, SO I WOULD
ENCOURAGE A REFLECTION ON
DEVELOPMENT HERE TOO WITHOUT
MAKING THIS BE ALL THINGS TO ALL
PEOPLE TO STILL HAVE THAT AS
PART OF THE THOUGHT.
>> IF YOU ARE PREPARED TO MAKE A
COMMENT, YOU CAN.
NOW YOU CAN ALSO REVIEW THE
PROPOSAL AND GIVE US ADDITIONAL
COMMENTS.
>> WELL, I READ IT PREVIOUSLY,
SO I'M HAPPY TO COLLECT SOME OF
MY THOUGHTS.
THIS IS REALLY AN EXCITING AREA
FOR WHERE PSYCHOPATHOLOGY
RESEARCH IS GOING.
IN MY READING OF IT, I WAS
EXCITED, YOU KNOW, DEEP BRAIN
STIMULATION HAS HELD PROMISE FOR
SOME OF THE MOST INTRACTABLE
ASPECTS OF MENTAL ILLNESS OVER
THE PAST DECADE OR SO, AND IS
BECOMING INCREASINGLY USED IN A
NUMBER OF ADDITIONAL
CIRCUMSTANCES AND WHAT'S REALLY
BEEN INSPIRING THAT WILL I'VE
SEEN ACROSS A NUMBER OF
INSTITUTIONS IS HOW THIS
TECHNOLOGY HAS INCREASED
COMMUNICATION BETWEEN SURGERY
DEPARTMENTS AND PSYCHIATRY
DEPARTMENTS AND BRINGING IN
NEUROSCIENCE DEPARTMENTS AND SO
FORTH, SO I'M GLAD TO SEE THAT
THERE'S SUPPORT GOING ON HERE.
I'M WONDERING HOW NIMH IS
REACHING OUT TO PERHAPS SOME OF
THOSE OTHER INSTITUTES THAT
WOULD BE NATURAL ALLIES WITH
REGARDS TO THIS KIND OF WORK AS
IT'S GOING FORWARD.
>> YEAH, I LIKE THAT QUESTION
BECAUSE I THINK FOR A LOT OF
THESE PATIENT POPULATIONS, IT'S
A NATIONWIDE KIND OF RECRUITMENT
AREA, SO THERE ARE POCKETS OF
PEOPLE, RESEARCH TEAMS THAT ARE
IN THE UNITED STATES KIND OF
DOING THIS WORK, AND SO BY
NECESSITY, THEY NEED TO REACH
OUT TO EACH OTHER AND
INCORPORATE OTHER KIND OF
PERSPECTIVES.
SO I THINK THIS PARTICULAR
CONCEPT DOES FACILITATE ANY
INTERDISCIPLINARY SCIENCE KIND
OF AS YOU MENTIONED, BUT IT ALSO
NECESSITATES KIND OF
COMMUNICATION IN ORDER TO KIND
OF FACILITATE THE SCIENCE JUST
BECAUSE IT'S NOT UBIQUITOUS TO
EACH INSTITUTION.
SO I THINK THIS IS THE PERFECT
OPPORTUNITY FOR THAT.
>> THANK YOU.
ANY OTHER COMMENTS OR QUESTIONS?
TED.
>> THANK YOU.
I THINK THIS IS REALLY A
TERRIFIC OPPORTUNITY.
I THINK -- I WOULD ACTUALLY
THINK ABOUT PERHAPS WORDING IT
EVEN A LITTLE BIT BROADER.
ONE OF THE THINGS I GET A SENSE
OF, I HEAR THE DIALOGUE BETWEEN
PSYCHIATRISTS AND NEUROSURGEONS,
BUT NOT NECESSARILY THE CLINICAL
LEVEL, BECAUSE FOR EXAMPLE,
THERE ARE SOME LIMITATIONS TO
WHAT YOU CAN DO IN PATIENTS WHO
MAY NOT WANT TO BE DIAGNOSED
WITH SCHIZOPHRENIA OR IN
CHILDREN WITH AUTISM, SO YOU CAN
DO LIKE A SOCIAL RESPONSIVENESS
QUESTIONNAIRE, SEC, THERE ARE
THINGS CAN YOU DO, SO TO ME ONE
OF THE BIG QUESTIONS IS, HOW IS
WHAT YOU CAN UNDERSTAND IN A
NEUROSURGICAL SETTING, HOW DOES
THAT RELATE CLINICALLY?
I THINK THAT'S ONE OF THE
PIGGEST CHALLENGES.
BIGGEST CHALLENGES.
WE CAN UNDERSTAND HOW -- THERE'S
THIS GREAT EXPERIMENT NOW OF
LOOKING AT NAVIGATION IN
PATIENTS THAT ARE WALKING AROUND
WITH THE ELECTRODES IMPLANTED,
WHICH IS JUST REALLY INTERESTING
FROM A BASIC SCIENCE
PERSPECTIVE.
AND I WOULD REALLY THINK ABOUT
HOW IS IT YOU CAN ACTUALLY MAKE
A BETTER CONNECTION TO CLINICAL
AS BE SPECTS OF DISEASE AND
TREATMENT.
THIS IS STILL WORDED IN MANY
WAYS IN A BASIC WAY.
DOES THAT MAKE SENSE?
>> WE CAN THINK ABOUT THAT.
APPRECIATE THAT.
THANK YOU VERY MUCH.
APPRECIATE THE INPUT, AND WE'RE
GOING TO BRING UP OUR NEXT
PERSON AND WHILE DR. MIRI GITIK
COMES UP, I JUST WANT TO REMIND
ANY MEMBERS HERE FOR PUBLIC
COMMENT, WE KNOW WE'RE RUNNING
LATE.
WE'RE VERY SORRY.
MY GUESS IS WE'LL BE READY FOR
THE PUBLIC COMMENT AROUND
5:00 P.M., AND FOR THOSE MEMBERS
OF COUNCIL, IT MEANS WE ARE
GOING TO RUN A LITTLE BIT OVER.
I APOLOGIZE.
NEXT PRESENTER IS DR. MIRI GITIK
FROM THE DIVISION OF
NEUROSCIENCE AND BASIC
BEHAVIORAL SCIENCE.
SHE'S GOING TO PRESENT ON
GENETIC ARC AT THE TOUR OF
MENTAL DISORDERS IN ANCESTRALLY
DIVERSE POPULATIONS, THE SEQUEL.
>> THANK YOU.
GOOD AFTERNOON, AND THANK YOU
FOR THE OPPORTUNITY TO PRESENT
THIS NUMBER TWO CONCEPT.
SO BRIEFLY, TO DATE, MOST
PARTICIPANTS IN PSYCHIATRIC
GENETIC STUDIES ARE OF EUROPEAN
ANCESTRY AS YOU CAN SEE IN THE
FIGURE HERE.
[INAUDIBLE] RELATIVELY SMALL.
WHILE THIS FOCUS HAS LED TO
SUCCESSFUL GENETIC DISCOVERIES,
THE TRANSLATION OF THESE
FINDINGS TO -- REMAINS
PROBLEMATIC.
-- CREATES EVEN GREATER HEALTH
DISPARITIES.
TO ADDRESS THIS GAP, IN 2021,
NIMH HAS CREATED AN ANCESTRAL
POPULATIONS NETWORK, OR PAN,
WAPN WITHTHE IMPORTANT GOAL OF H
EQUITY, -- UNDERPOPULATIONS.
WITH OVER 100 INVESTIGATORS
WORKING OVER 25 SITES ACROSS THE
WORLD, AND FOCUSING ON
COLLECTING AND JOINTLY ANALYZING
DATA FROM OVER 200,000
PARTICIPANTS.
IN ADDITION TOLL THE FOCUS ON --
HAS ALSO ESTABLISHED ANOTHER
SCIENTIFIC FOCUS WORKING GROUPS.
WHICH ARE TRYING TO ADDRESS THE
QUESTIONS OF RELEVANCE TO
NATIONAL STUDIES.
WE THEN CLOSE -- CLINICAL AND
COGNITIVE PHENOTYPES ACROSS
DIFFERENT SETTINGS WORLDWIDE.
-- GLOBAL HUMAN RESEARCH AND
ETHICAL QUESTIONS IN UNDERSERVED
POPULATIONS WORLDWIDE, AND
CAPACITY BUILDING, OR RESEARCH
CAPACITY BUILDING IN PSYCHIATRIC
GENETICS.
IN WORLD POPULATIONS.
THE SECOND PHASE AIMS TO EXPAND
THE PREVIOUS SUPPORTED EFFORTS
IN THE FIELD BY SUPPORTING
STUDIES THAT WILL COLLECT LARGER
SAMPLES TO PUSH GENETIC
DISCOVERY AND PROVIDE
INVESTIGATION, AND STUDIES THAT
AIM TO -- IN WHICH PHENOTYPIC
FOCUS.
IN ADDITION THIS EFFORT IS
FOCUSED ON GENERATING RESOURCES
FOR COMMUNITY.
AND THE IDEA HERE IS TO
EXPAND -- AT FERVOR, HARMONIZE
THE ANALYSIS BETWEEN THE
DIFFERENT PROJECTS.
BEST PRACTICES WITH SPECIFIC
FOCUS ON PSYCHIATRIC GENETICS IN
VULNERABLE POPULATIONS.
RESEARCH CAPACITY BUILDING
ACTIVITIES, AND DEVELOP
PRACTICES FOR HOW WE ENGAGE
SOCIAL DETERMINANTS OF HEALTH IN
GENETIC STUDIES AT THIS LARGE
SCALE.
THANK YOU VERY MUCH AND HAPPY TO
ANSWER YOUR QUESTIONS.
>> THANK YOU.
FOR DISCUSSANTS WE'VE ASKED
DR. SCOTT AND COLLINS TO COVER.
WHO WOULD LIKE TO START?
>> THANK YOU.
THANK YOU FOR THE PRESENTATION
AND IT WAS GREAT TO SEE
ELABORATE PIECE OF THE CONCEPT
BECAUSE SOME OF THE THINGS YOU
LISTED ARE THINGS I HAD
QUESTIONED ABOUT.
FIRST OF ALL I'M REALLY
SUPPORTIVE OF THIS CONCEPT.
IT REALLY IS FOUNDATIONAL GLOBAL
MENTAL HEALTH RESEARCH, BECAUSE
IT EXTENDS THE OPPORTUNITY TO
EXTEND RESEARCH TO SO MANY
POPULATIONS.
MY QUESTIONS WERE ABOUT THE
STRATEGIES OF ENSURING
GEOGRAPHIC DIVERSITY AND
THINKING ABOUT WOULD YOU
ACTUALLY BUILD ON THE CENTERS
THAT YOU ALREADY HAVE OR IS THIS
ACTUALLY AN OPPORTUNITY TO
FIGURE OUT STRATEGIES FOR THOSE
CENTERS TO STRENGTHEN NEW
CENTERS TO DO SOME OF THIS WORK
BECAUSE I THINK THAT'S CERTAIN
LITTLE AN OPPORTUNITY.
AND MY OTHER QUESTION WAS
ACTUALLY GOING TO BE ABOUT THE
LC COMPONENT BUT I CAN SEE YOU
ALREADY HAVE THE ETHICS WORKING
GROUPS AND THE SOARM
DETERMINANTS OF CAPACITY
BUILDING.
SO WHEN YOU BUILD OUT THE -- ARE
THOSE COMPONENTS ALSO FUNDED, I
GUESS IS ONE OF MY QUESTIONS?
IS IT --
>> SO I GUESS TO ANSWER --
>> WORK GROUPS, BUT ARE THERE
QUESTIONS AROUND THOSE AS WELL?
>> TO ANSWER YOUR FIRST
QUESTION, WE WOULD LIKE TO
DIVERSIFY OUR POOL GOING BACK
TO -- YOU CAN SEE WE HAVE A
PRETTY NICE DIVERSITY ALREADY
BUT WE REALLY WOULD LIKE TO
DIVERSIFY.
THIS WAS MENTIONED PREVIOUSLY IN
COUNCIL DISCUSSIONS.
WE DO NEED LARGER SAMPLES AND
MAKE SIGNIFICANT DISCOVERIES SO
WE WOULD LIKE TO SUPPORT THAT AS
WELL, AND THE QUESTION OF HOW
DEEP DO WE GO, BOTH IN GENOMIC
AND PHENOTYPE SPACE, SO WE WOULD
LIKE TO SUPPORT ALL OF THESE
GOING FORWARD.
TO ANSWER YOUR SECOND QUESTION
ETHICS AND COMMUNITY ENGAGEMENT,
WE WOMAN LIKE THESE TO BE BUILT
INTO THE APPLICATION SO THE
APPLICATION WILL HAVE ASPECTS OF
THAT BUILT INTO THE RESEARCH
DESIGN.
GENOMICS IS MOVING SLOWLY
TOWARDS THAT SO THIS WILL
PROBABLY BE ONE OF THE FIRST
COORDINATED EFFORTS TOWARDS
THAT, AND INVESTIGATORS WILL BE
TASKED TO THINK ABOUT HOW WE DO
THAT IN A GENETICS --
>> THAT'S GREAT.
I REALLY LIKE THIS.
MY EXPERIENCE WITH THIS IS
THROUGH THE NEUROGAP INITIATIVE
THAT WILL DID A REALLY LOVELY
JOB OF INCORPORATING ETHICS AND
SOME OF THE SOCIAL IMPLICATION
OF THIS WORK AND THE -- IN SOME
OF THE AFRICAN SITES LISTED
THERE, SO BE GREAT TO SEE THAT
CONTINUE.
>> THANK YOU.
>> THANKS VERY MUCH FOR YOUR
PRESENTATION.
THAT WAS REALLY CLEAR.
SO I ALSO AGREE THAT THIS SHOULD
CONTINUE FOR A HOST OF REASONS.
THERE'S GREAT VALUE IN HAVING A
RANGE OF ANCESTRIES REPRESENTED
HERE.
I HAD A FEW RELATED QUESTIONS,
SO ONE THE SAME AS WE HAD BEF
BEFORE, ABOUT WHEN YOU CONTINUE
THE FUNDING, DO YOU ANTICIPATE
CONTINUING TO FUND THE SAME
PEOPLE THAT YOU HAVE BUT
EXPANDING THEIR STUDIES, MOST OF
THE PEOPLE OR ALL THE PEOPLE WHO
LEAD THOSE ARE VERY WELL
ESTABLISHED INVESTIGATORS.
ARE THERE PLANS TO ENCOURAGE
PEOPLE AT EARLIER STAIB STAGES N
THEIR CAREER TO LEAD THE WORK?
AND THEN ANOTHER ONE, THERE'S A
MIX OF ANCESTRIES REPRESENTED IN
THE -- I THINK IT'S SEVEN
STUDIES, HOWEVER MANY STUDIES
LISTED, LIKE THE PRESENTATION WE
HAD EARLIER ON EQUITY, I'M
CURIOUS ABOUT THE DIVERSITY IN
TERMS OF ANCESTRIES AND
BACKGROUNDS OF THE PEOPLE WURNT
CURRENTLY LEADING, MANAGING AND
ANALYZING THE DATA, AND HOW THAT
CAN BE EXPANDED OR WHAT PLANS
YOU MIGHT HAVE TO EXPAND THAT IN
THE NEXT ITERATION, AND THEN THE
THIRD THING IS ON DATA
DEPOSITION.
BECAUSE THAT REALLY ALLOWS A
MUCH BROADER GROUP OF PEOPLE TO
ASK QUESTIONS ABOUT THE DATA AND
YOU GET LARGER AND LARGER SAMPLE
SIZES WHICH ARE REALLY GOING TO
BE NECESSARY TO DO ANYTHING, SO
I'D BE CURIOUS ABOUT HOW MUCH OF
THE DATA HAS BEEN DEPOSITED, IF
YOU COULD HAVE A SCORECARD ON
THE WEBSITE THAT TELLS WHAT DATA
HAS BEEN DEPOSITED AND IN WHAT
FORM, THE GENOTYPES, THE
PHENOTYPE FILES THAT WOULD
EASILY FUNNEL SOMEBODY INTO
GOING TO FIND THIS, AND I
WONDERED ALSO IF YOU ARE GOING
TO FUND STUDIES THAT HAVE
ALREADY GOTTEN FUNDING, WHETHER
NEW FUNDING MIGHT BE CONTINGENT
ON DATA DEPOSITION FROM THE
FIRST ROUND OF FUNDING JUST TO
HELP PROVIDE ENCOURAGEMENT.
>> SO LAURA, I'M GOING TO ASK
TRACY WALDECK TO ANSWER YOUR
QUESTIONS BECAUSE THEY'RE REALLY
GRANTS POLICY QUESTIONS AS
OPPOSED TO PROGRAMMATIC
QUESTIONS.
TRACY.
>> SO JUST A COUPLE THINGS.
REMEMBER WE ARE DOING A CONCEPT
CLEARANCE OF THE SCIENCE, THE
AREA OF SCIENCE, WE'RE NOT
SPEAKING ABOUT FUNDING OR
APPLICATIONS, SO WE CAN'T WE
CAN'T SPEAK ABOUT WHO MIGHT BE
FUNDED OR WHO MIGHT APPLY.
SECONDLY, WE CANNOT TAKE INTO
ACCOUNT RACE, GENDER, ETHNICITY
IN TERMS OF WHO IS FUNDED, SO WE
DON'T HAVE THAT INFORMATION, WE
CAN'T SPEAK TO THAT INFORMATION
WHEN WE SELECT AN APPLICATION
FOR FUNDING SO WE WANT TO BE
REALLY CAREFUL ABOUT THAT.
IN TERMS OF DATA SHARING, NIH
HAS PRETTY CLEAR DATA SHARING
POLICIES SO THE DATA WILL BE
SHARED, THEY HAVE TO SUBMIT A
DATA SHARING AND MANAGEMENT
PLAN.
IN TERMS OF HOW IT'S REPRESENTED
ON THE NIMH WEBSITE, I THINK THE
TEAM CAN CERTAINLY TAKE YOUR
SUGGESTIONS INTO CONSIDERATION
FOR FUTURE POSTING.
>> THANKS.
>> THANK YOU, LAURA.
AND THANK YOU, MARIE.
ANY OTHER COMMENTS OR QUESTIONS
BEFORE HE WITH MOVE ON?
WE MOVE ON?
PLEASE, JYOTI.
>> AS YOU THINK ABOUT PHASE TWO,
ARE THERE OPPORTUNITIES TO
POTENTIAL PARTNER WITH FOGARTY?
>> YES.
YES.
>> THAT'S ALL.
THANK YOU.
>> OKAY.
THE FINAL CONCEPT CLEARANCE WILL
BE PRESENTED BY DR. YAEL
MANDELBLAT-CERF, NATIONAL
COOPERATIVE DRUG DISE VICE
DISCOVERY DEVELOPMENT GROUPS FOR
THE TREATMENT OF MENTAL
DISORDERS.
>> HELLO, EVERYONE.
THE DIVISION OF NEUROSCIENCE AND
BASIC BEHAVIOR SCIENCE IN THE
DIVISION OF TRANSLATIONAL
RESEARCH.
SO THERAPEUTICS DEVELOPMENT IS
HARD.
WE ALL KNOW.
IT'S LONG RISKY AND HIGHLY
EXPENSIVE PROCESS.
IT TAKES BETWEEN 10 TO 15 YEARS
TO BRING A NEW DRUG TO THE
MARKET, AND IT COSTS BETWEEN
1 TO 2 BI BILLION DOLLARS.
THE PROCESS INCLUDES MULTIPLE
STEPS ALL AIMED AND DE-RISKING
THE THERAPEUTICS DEVELOPMENT AND
INCREASING THE PROBABILITY OF
SUCCESS.
THAT INCLUDES TARGET
AUTHENTIFICATION AND VALIDATION,
COMPOUND SCREENING LIKE
HIGH-THROUGHPUT SCREENING,
OPTIMIZATION OF PROPERTIES AND
ACTIVITY, PRE-CLINICAL TESTING,
BIOMARKER DEVELOPMENT, AND OF
COURSE EVENTUALLY OPTIMAL DESIGN
OF CLINICAL TRIAL.
STILL WITH ALL THESE EFFORTS,
EVENTUALLY FOR THOSE COMPOUNDS
THAT SUCCEED TO GET TO THE
CLINICAL PHASE, 90% OF THEM FAIL
BETWEEN PHASE ONE TO PHASE THREE
AND LEAVING PATIENTS EAGERLY
AWAITING FOR EFFECTIVE
THERAPEUTICS.
SO FOR THIS CONCEPT, THE AIM IS
TO ACCELERATE THE INNOVATIVE --
FROM DISCOVERY AND PRE-CLINICAL
DEVELOPMENT UNTIL THE CLINICAL
EARLY TRIALS FOR NEW CANDIDATES
TO TREAT MENTAL DISORDERS.
THE
INITIATIVE GOALS, ADVANCE THE
DISCOVERY, DEVELOPMENT AND PLOOF
OF CONCEPT TESTING OF NEW
EVIDENCE-BASED CANDIDATE AGENTS
AND NEUROSTIMULATION APPROACHES
TO TREAT MENTAL DISORDERS, TO
DEVELOP PHARMACOLOGIC AND
NEUROMODULATORY TOOLS FOR BASIC
AND CLINICAL RESEARCH IN SUPPORT
OF EXPERIMENTAL THERAPEUTIC
STUDIES.
TO FOSTER COLLABORATIVE
PARTNERSHIPS BETWEEN ACADEMIC
AND INDUSTRY RESEARCHERS AND
MULTIDISCIPLINARY TEAMS OF
SCIENTISTS.
WE EXPECT TO GENERATE PROJECTS
THAT PROPOSE TRANSLATABLE NEW
THERAPEUTICS ACROSS DIFFERENT
MODALITIES.
WHETHAT CAN BE SMALL MOLECULES,
ASO, GENE THERAPY, AND ALSO
NOVEL NEUROSTIMULATION
TECHNOLOGIES INCLUDING FOR
EXAMPLE CLOSED LOOP STIMULATIONS
THAT WAS MENTIONED BEFORE AS
WELL.
WE ALSO EXPECT TO GENERATE
PROJECTS THAT PROPOSE NOVEL
PHARMACOLOGIC RESEARCH TOOLS FOR
BASIC AND CLINICAL RESEARCH TO
FURTHER CHARACTERIZE EXISTING
DRUG TARGETS OR TO VALIDATE NEW
ONES.
NEW CLINICAL MEASURES OR
BIOMARKERS FOR HUMAN PROOF OF
CONCEPT TRIALS OR NEW NOVEL
THERAPEUTICS FOR MENTAL HEALTH
DISORDERS.
ASSESS THE SAFETY, TOLERABILITY
AND EFFICACY FOR PROMISING NOVEL
THERAPEUTIC DRUGS AND DEVICES IN
EARLY CLINICAL TRIALS.
THAT'S ALL.
THANK YOU FOR LISTENING.
>> THANK YOU.
AND FOR OUR DISCUSSANTS, WE'VE
ASKED DRS. ABEL AND MACDONALD TO
COMMENT.
WHO'S GOING TO START?
>> I'M HAPPY TO GO.
>> I GOT A PASS LAST TIME.
>> GO AHEAD.
>> I'LL JUMP IN THIS TIME.
SO THIS IS HEADY STUFF, HOW DO
WE GET THE THERAPEUTICS PIPELINE
GOING.
I THINK A LOT OF US WILL FIND
THAT THERE'S AN ECHO BETWEEN
THIS AND THE FIRST CONCEPT
CLEARANCE.
SO MY FIRST COMMENT WAS IS THIS
AN OVERLAPPING VENN DIAGRAM IN
TERMS OF THE STIMULATION
DEVICES?
THIS OF COURSE ALSO INCLUDES
OTHER KINDS OF NEUROTHERAPEUTICS
AS WELL, BUT ARE THERE
CONVERSATIONS THERE THAT WOULD
BE USEFUL TO HAVE SO THAT YOU
GUYS CAN EITHER BE SURE TO KEEP
THESE CONCEPTS SEPARATE OR MERGE
THEM AS MAY BE APPROPRIATE?
AND I THINK ANOTHER ASPECT OF
THIS IS THAT THIS IS -- THIS
ALSO HAS AN HE C AN ECHO TO THET
CAME OUT IN 2022, WAS IT, A FEW
YEARS BACK THAT WAS THIS PLUS
ALCOHOL, AND NOW ALCOHOL, YOU
GUYS -- THERE ARE FOLKS FOR
THAT, SO IT SEEMS LIKE THERE
WOULD BE A TRACK RECORD FOR THIS
KIND OF PRIMING OF THE PUMP, AND
IT WOULD BE USEFUL TO -- I WAS
WONDERING WHAT HAD BEEN LEARNED
FROM THAT PROCESS.
FOR EXAMPLE, ARE THERE WAYS IN
WHICH THE FDA HAS BROUGHT IN TO
SOME PROJECTS VERSUS OTHER
PROJECTS OR HAS BEEN BROUGHT
IN -- THAT CAN BE BROUGHT IN
EARLY TO REDUCE REDUNDANT
EFFORT, TO REDUCE TO STREAMLINE
THAT INTEGRATION BECAUSE THESE
ARE ULTIMATELY CONVERSATIONS
THAT WILL COME BEFORE THE FDA.
SO THAT WAS THE SECOND QUESTION
I HAD.
AND THEN I ALSO WANTED TO
CHANNEL DR. BEIDAS A LITTLE BIT,
RINAD WOULD PROBABLY ASK YOU IS
THERE A WAY TO -- ABOUT
SCALABILITY, ABOUT
IMPLEMENTABILITY INTO THESE
APPLICATIONS SO THAT WE CAN BE
ASKING INVESTIGATORS BEFOREHAND,
WHAT DO THINGS LOOK LIKE GOING
FORWARD IN TERMS OF THE
IMPLEMENTABILITY OF THESE?
TWO COMPOUNDS THAT ARE OTHERWISE
INDISTINGUISHABLE, THE ONE
THAT'S MORE IMPLEMENTABLE IS THE
ONE THAT WE'RE GOING TO WANT TO
PUT MORE BEHIND.
AND THOSE ARE MY THREE THOUGHTS.
>> OKAY.
SO WHILE START WITH THE FIRST
ONE.
THE BIG DIFFERENCE IS THAT IN
THIS PROCESS, IN THIS CONCEPT,
WE ARE FOCUSING FROM THE EARLY
DEVELOPMENT OF DRUG/DEVICE AND
TAKING IT ALL THE WAY TO THE
FIRST IN HUMAN, WHILE TO MY
UNDERSTANDING, THE OTHER CONCEPT
WAR MORE ABOUT EXISTING DEVICES
AND OPTIMIZING THEM AND MAYBE
THOSE THAT ARE MORE LATE TO THE
DEVELOPMENT, SO IN THAT SENSE I
SEE THAT DOES NOT OVERLAP, BUT
WE CAN DEFINITELY MAKE SURE THAT
IT'S DEFINITELY SEPARATED.
THE SECOND QUESTION ABOUT THE --
FROM TWO YEARS AGO, YES, IT IS A
CONTINUATION OF THAT, THEY
DECIDED NOT TO JOIN THIS NEW
CONCEPT.
AND LACKING BACK FOR THE LAST 10
YEARS, THERE WERE OVER 10
PROJECTS THAT WE AWARDED IN THIS
CONCEPT, DIFFERENT DEVELOPMENTS
OF IT, AND YES, IT'S HARD TO
FIND THOSE PROJECTS, IT'S HARD
TO GET THEM AND IT'S NOT -- I
WISH THERE WERE MORE -- A REASON
TO CONTINUE IT AND MAYBE GET
MORE, THINKING OTHER WAYS HOW TO
ENGAGE SI SCIENTISTS TO ATTRACT
THEM AND DEVELOP THOSE PROJECT,
BUT IN THAT SENSE, I'M NOT SURE
WHAT ELSE I'M --
>> THE QUESTION, IF YOU'VE GOT A
POPULATION OF 10 STUDIES, WHICH
OF THOSE WERE SUCCESSFUL, WHICH
OF THOSE WEREN'T SUCCESSFUL, ARE
THERE LESSONS TO BE LEARNED FROM
THOSE SUCCESSES AND NOT
SUCCESSES, AND ALSO
CONSULTATIONS TO BE HAD WITH
PERHAPS SOME OF BOTH THE
SUCCESSFUL APPLICANTS AND THE
UNSUCCESSFUL APPLICANTS AS TO
HOW THAT RFA COULD BE TWEAKED
FURTHER TO OPTIMIZE IT FOR THEIR
CIRCUMSTANCES.
>> LINDA, IF YOU WANT TO CHIME
IN?
>> I THINK WE'LL MOVE TO TED'S
QUESTION.
>> THANK YOU.
FIRST A COMMENT, I THINK THIS IS
REALLY TERRIFIC AND I THINK IT
BUILDS ON A LOT OF THE FOCUS ON
PRECISION PSYCHIATRY AND
UNDERSTANDING TARGET ENGAGEMENT,
AND IT REQUIRES A LOT OF THESE
TESTS, WHICH IS MAYBE WHY
THERE'S SO FEW OF THEM, BECAUSE
YOU REALLY NEED TO HAVE
SOMETHING YOU ACTUALLY KNOW WHAT
IT'S GOING TO DO AND BE ABLE TO
FOLLOW IT, WHICH IS A PRETTY
HIGH BAR.
THE OTHER BAR IS A BAR THAT
COMPANIES MAY SET, WHERE THEY
MAY NOT WANT TO HAVE COMPOUNDS
TESTED IN THIS WAY, SO THAT'S
SOMETHING TO CONSIDER ABOUT
WHAT'S GOING TO BE KIND OF
ALLOWED AND WHAT'S GOING TO
HAPPEN.
I ALSO THINK ONCE YOU CONSIDER
THE FOLLOW YUN OF INDIVIDUALS IN
THESE STUDY, GRANTS THAT ARE
GOING TO BE FUNDED BY NIH ARE
GOING TO HAVE A DURATION BUT
THESE INDIVIDUALS HAVE A
LIFETIME THAT THEY LIVE.
AND IT WOULD BE IMPORTANT, I
THINK, TO HAVE SOME WAY TO KEEP
TRACK OF THEM.
IT'S A LITTLE BIT ABOUT WHAT
ANGUS WAS SAYING, WHAT WOULD
HAPPEN WITH THESE STUDIES.
HAVE YOU THOUGHT ABOUT HOW
ETHICAL CONCERNS WILL BE
INCORPORATED INTO THIS CONCEPT
CLEARANCE AND INTO THIS PROGRAM?
>> I HAVE NOT.
FROM MY POINT OF VIEW, MOST OF
THE WORK HERE IS ON THE
PRE-CLINICAL UNTIL GETTING TO
THE FIRST IN HUMAN, BUT I'LL BE
HAPPY TO HEAR THOUGHTS THAT YOU
WANT TO ADD.
SOMETHING THAT OTHERWISE --
>> SO I WOULD MAKE A VERY
SPECIFIC SURGS A VERYSPECIFIC SU
THINK ABOUT IT, THAT YOU TALK TO
THE BRAIN INITIATIVE ABOUT IT.
ACTUALLY THIS APPLIES TO ALMOST
ALL OF THE CONCEPT CLEARANCES
WE'VE DONE TODAY, ESPECIALLY THE
HUMAN STUDY ONES.
SO NONE OF THE GRANTS THAT GO
INTO THE BRAIN INITIATIVE, THE
LARGE GRANTS, KIND OF WHAT --
THE HUMAN BRAIN GRANTS, MANY OF
WHICH ARE NOT FAR FROM THE EARLY
CONCEPT CLEARANCES THAT LIZZY
DESCRIBED, THEY ALL HAVE A
NEUROETHICIST INVOLVED, ALL OF
THEM.
IN THE TEAM.
NOT THAT THEY TALK TO EVERY TWO
YEARS.
ON THE TEAM.
THAT'S SOMETHING -- AND THERE'S
A WHOLE NEUROETHICS WORK GROUP
WITH THE BRAIN NICHE TV.
INITIATIVE.
IT REALLY NEEDS TO BE -- THERE
ARE PLENTY OF EXAMPLES WHERE
FIRST IN HUMAN TRIALS WERE
ETHICALLY CHALLENGING.
SO IT'S VERY IMPORTANT.
>> THANK YOU.
ANY OTHER COMMENTS, QUESTIONS
FROM MEMBERS?
GO AHEAD.
>> I'LL BE BRIEF.
DR. MACDONALD WAS RIGHT, I DID
WANT TO SAY SOMETHING ABOUT
IMPLEMENTATION AND ACTUALLY IT'S
TRUE FOR ALL THESE CONCEPT
CLEARANCES.
I REALLY ENCOURAGE YOU ALL TO
THINK ABOUT DESIGNING FOR
IMPLEMENTATION EVEN THOUGH IT'S
EARLY TRANSLATIONAL RESEARCH, TO
OPTIMIZE FOR ACCEPTABILITY AND
INCLUDE END USERS LIKE
CLINICIANS AND HUMANS WHO WILL
BE RECEIVING THE DEVICES IN THE
FUTURE AND TO INCLUDE AN
IMPLEMENTATION SCIENTIST ON THE
TEAM IF POSSIBLE AS PART OF THE
KIND OF MULTIDISCIPLINARY TEAM.
>> I WOULD LIKE TO ADD TO THAT
THIS WHEN YOU START THE PROCESS
OF THERAPEUTIC DEVELOPMENT, YOU
START WITH A PATIENT AND YOU
THICK WHTHINK WHAT'S THE NEEDS N
YOU GO AND START THE DEVELOP
DEVELOPMENT.
THIS IS BASICALLY SAYING -- YOU
START WITH THAT AND YOU GO TO
THE TARGET AND DEVELOP --
>> THANK YOU VERY MUCH,
EVERYONE.
THANK YOU VERY MUCH.
WE'LL MOVE ON TO THE FINAL ITEM
ON THE AGENDA, WHICH IS THE
PUBLIC COMMENT SESSION FOR
TODAY'S MEETING, WE RECEIVED TWO
REQUESTS FOR COMMENT.
WHEN I CALL YOUR NAME S PLEASE
, PLEASECOME TO THE MICROPHONE D
COMPUTER THAT'S DIRECTLY ACROSS
FROM ME.
THE COMPUTER IS GOING TO HAVE A
CAMERA SO YOU CAN BE SITTING BY
THE VIRTUAL AUDIENCE.
PLEASE LIMIT YOUR COMMENTS TO
THREE MINUTES.
THE FULL TEXT OF YOUR SUBMITTED
COMMENTS HAVE BEEN PROVIDED TO
OUR COUNCILMEMBERS IN ADVANCE OF
TODAY'S MEETING, AND WILL BE
APPENDED TO OUR MEETING MINUTES
WHEN THEY ARE POSTED PUBLICLY.
SO I'D LIKE TO THANK BOTH OF THE
INDIVIDUALS WHO'VE REQUESTED TO
GIVE COMMENT TODAY.
AND THE FIRST ONE IS JAMES
CROMWELL.
MR. CROMWELL, PLEASE COME AGAIN
AND SIT IN THE CHAIR, AND MAKE
SURE YOU PRESS THE BUTTON ON THE
MICROPHONE UNTIL THE BUTTON
TURNS GREEN.
AND GO AHEAD AND MAKE YOUR
REMARKS WHEN YOU'RE READY.
>> GOOD AFTERNOON.
MY NAME IS JAMES CROMWELL.
FIRST OF ALL, I'D LIKE TO THANK
THE ADVISORY COUNCIL OF THE
NATIONAL INSTITUTE OF MENTAL
HEALTH FOR THE WORK YOU DO TO
IMPROVE THE LIVES OF INDIVIDUALS
SUFFERING WITH MENTAL ILLNESS.
I AM HERE AS PGH >> TRUSTEE
CROSBAN ANIMAL ADVOCATEAND ON BK
THAT YOU STOP WASTING MILLIONS
OF TAXPAYER DOLLARS ON EAR RIL
VANT EXPERIMENTS ON ANIMALS.
I AM ALSO HERE ON BEHALF OF THE
PEOPLE IN THIS COUNTRY WHO ARE
IN STRUGGLE TO RECOVER THEIR
MENTAL HEALTH.
I AM SURE YOU FEEL THE WEIGHT OF
YOUR RESPONSIBILITY, MILLIONS
LOOK TO YOUR AGENCY HOPING FOR
RELIEF FROM THE RAVAGES OF
MENTAL ILLNESS.
WE NEED YOU TO DO BETTER.
UNFORTUNATELY, I KNOW FROM
PERSONAL EXPERIENCE HOW
DEVASTATING IT IS TO WATCH A
LOVED ONE GRAPPLE WITH
DEBILITATING MENTAL ILLNESS.
A GREAT MANY PEOPLE ARE UNABLE
TO ACCESS TREATMENT OR EVEN FIND
A TREATMENT PLAN THAT ALLEVIATES
THEIR SYMPTOMS.
MANY OTHERS HAVE GIVEN UP TRYING
TO FIND HELP BECAUSE PAST
TREATMENTS HAVE FAILED THEM.
AS THIS COMMITTEE IS WELL AWARE,
MOST TREATMENTS FOR MENTAL
ILLNESS WERE FIRST DEVELOPED 50
YEARS AGO, AND THEY HAVEN'T
IMPROVED SINCE.
MANY HAVE GROSSLY UNPLEASANT
SIDE EFFECTS, AND THEY MOSTLY
ASSUREDLY DO NOT WORK FOR THE
VAST MAJORITY OF PEOPLE WHO ARE
DESPERATELY SEEKING RELIEF.
YOU MAY ALSO BE AWARE THAT MUCH
OF THE ANIMAL-BASED
EXPERIMENTATION YOU ARE
CURRENTLY FUNDING HAS LITTLE TO
NO RELEVANCE TO HUMAN MENTAL
ILLNESS AND WILL ASSUREDLY NEVER
LEAD TO NEW TREATMENTS AND CURES
FOR HUMANS.
DESPITE THIS, THE NIMH CONTINUES
TO FUNNEL MILLIONS OF DOLLARS
EACH YEAR INTO EXPERIMENTS THAT
HAVE NO HOPE OF BRINGING RELIEF
TO PEOPLE STRUGGLING WITH MENTAL
ILLNESS.
BY THAT, I MEAN EXPERIMENTS SUCH
AS DELIBERATELY BRAIN DAMAGING A
MONKEY.
THIS MONKEY IS NAMED SAM SMITH
AND I URGE YOU ALL TO READ
WHAT'S ON THE BACK.
A DESCRIPTION OF HIS LIFE.
FORCING MICE TO FIGHT EACH OTHER
AND SLEEP-DEPRIVING PRAIRIE
BULLS, NONE OF WHICH HAVE LED TO
HUMAN-RELEVANT TREATMENTS.
THE NIMH ALSO CONTINUES TO FUND
PROJECTS THAT USE THE
DISCREDITED FORCED SWIM TEST
THAT USES SMALL ANIMALS THAT ARE
NEARLY DROWNED IN INESCAPABLE
BEAKERS OF WATER IN ORDER TO
REPLICATE HUMAN DEPREPTION.
DEPRESSION.
WHAT SENSE DOES THAT MAKE?
THESE EXPERIMENTS HARM AND KILL
TENS OF THOUSANDS OF ANIMALS
EACH YEAR, AND THEY ULTIMATELY
COME AT THE EXPENSE OF IMMEDIATE
COMMUNITY AND PATIENT NEEDS.
THERE ARE MILLIONS OF PEOPLE IN
THE U.S. SUFFERING WITH MENTAL
ILLNESS RIGHT NOW WHO NEED THE
NIMH TO HELP THEM.
RATHER THAN TO CONTINUE TO WASTE
PRECIOUS RESOURCES ON
EXPERIMENTS THAT WILL NOT
TRANSLATE TO HUMANS.
THIS MISAPPLICATION OF FUNDING
IS IRRESPONSIBLE.
IT IS IN DIRECT CONFLICT WITH
THE INSTITUTE'S MISSION TO PAVE
THE WAY FOR PREVENTION, RECOVERY
AND ULTIMATELY CURES.
TO ADDRESS THE MENTAL HEALTH
CRISIS OUR NATION IS FACING, WE
ARE ASKING THE ADVISORY COUNCIL
TO TAKE IMMEDIATE STEPS TO
REDIRECT THE RESOURCES BEING
WASTED ON USELESS ANIMAL-BASED
RESEARCH AT THE EXPENSE OF MORE
HUMAN -- OF MORE HUMAN RELEVANT
AND RESEARCH METHODS.
I AM NOT ALONE.
I HAVE HERE A LETTER SIGNED BY
NEARLY 400 PHYSICIANS,
SCIENTISTS AND MENTAL HEALTH
PROFESSIONALS, AS WELL AS A
PETITION SIGNED BY MORE THAN
50,000 MEMBERS OF THE GENERAL
PUBLIC, ALL OF WHOM IMPLORE NIMH
TO STOP FUNDING CRUEL AND
FRUITLESS EXPERIMENTS ON ANIMALS
AND START FUNDING RESEARCH THAT
CAN TRULY HELP THE PEOPLE
STRICKEN WITH THESE DEBILITATING
ILLNESSES.
IN CONCLUSION, WE URGE THE NIMH
TO DO THE FOLLOWING: REALLOCATE
NIMH INTRAMURAL AND EXTRAMURAL
RESEARCH FUNDING TO ANIMAL-FREE
HUMAN-RELEVANT MODELS.
TWO, PROVIDE REGULATORS AND
RESEARCHERS WITH TRAINING IN THE
USE OF HUMAN-RELEVANT MODELS.
AND THREE, INCREASE THE AMOUNT
OF FEDERAL FUNDING ALLOCATED TO
PREVENTIVE MEASURES, IMPROVING
ACCESS TO CARE.
THANK YOU FOR YOUR
CONSIDERATION.
>> THANK YOU FOR YOUR COMMENTS,
AND THANK YOU FOR MAKING THE
TRIP AND YOUR HEARTFELT ADVOCACY
FOR INDIVIDUALS WITH -- BEARING
THE BURDEN OF MENTAL ILLNESS.
OUR NEXT SPEAKER IS STEVEN
FARGOLI.
I HOPE I'M PRONOUNCING THAT
CORRECTLY.
PLEASE COME TO THE SAME
LOCATION.
>> WHEN CAN I SUBMIT THE
DOCUMENTS?
>> PLEASE, YOU CAN BRING IT
RIGHT HERE.
>> IS IT MR. FARGOLI?
ARE YOU HERE?
WELL, I NOTE WE HAVE
MR. FARGOLI'S WRITTEN COMMENTS.
THEY WILL BE, AGAIN, APPENDED TO
THE MINUTES AND PUBLICLY POSTED.
THANK YOU VERY MUCH.
THAT BRINGS US TO THE CONCLUSION
OF THIS OPEN SESSION OF COUNCIL.
I VERY MUCH APPRECIATE THE
OPPORTUNITY TO WORK WITH YOU
ALL, MEMBERS OF COUNCIL, FOR THE
PAST SEVERAL YEARS.
MEMBERS OF THE NIMH COMMUNITY
FOR MUCH LONGER.
AND IT'S BEEN A PLEASURE.
WE MEET TOMORROW AT --
>> 9:00 A.M.
>> -- 9:00 A.M. IN THIS ROOM
FOR THE CLOSED SESSION, IN WHICH
WE WILL CONSIDER THE NEXT ROUND
OF GRANTS FOR FUNDING.
THANK YOU VERY, VERY MUCH.
[APPLAUSE]