>> WELCOME TO THE 266TH MEETING
OF THE NATIONAL ADVISORY MENTAL
HEALTH COUNCIL, I'M JOSH GORDON,
DIRECTOR OF NIMH, AND I WOULD
LIKE TO THANK YOU FOR JOIN US
TODAY BOTH MEMBERS OF THE
COUNCIL HERE AND NIMH STAFF, NIH
STAFF AS WELL AS MEMBERS OF THE
PUBLIC WHO ARE VIEWING THIS ON
VIDEOCAST. OUR COUNCIL MEETING
IS A TIME FOR INFORMATION
EXCHANGE BETWEEN THE INSTITUTE,
COUNCIL MEMBERS, MEMBERS OF THE
PUBLIC AND IT IS AN OPPORTUNITY
FOR US TO SHARE NEWS AND PLANS
FOR THE FUTURE AS WELL AS TO
PROVIDE FEEDBACK ON THOSE PLANS
AND ON OTHER ISSUES. AT OUR
MEETING TODAY WE WELCOME SEVEN
NEW MEMBERS TO OUR COUNCIL. TED
ABEL, PAMELA COLLINS, MARGUERITA
LIGHTFOOT, JOEL NIGG PATRICIA
CAPERO AND BRIAN ROTH. WELCOME.
WE HAD AN OPPORTUNITY AT CLOSED
SESSION YESTERDAY TO INTRODUCE
EACH OTHER SO WE WON'T GO
THROUGH IT TODAY BUT ENCOURAGE
COUNCIL MEMBERS THEY MAKE
COMMENT DURING THE OPEN COMMENT
SESSION WITH THEIR NAMES AND
INSTITUTIONS BEFORE THEY MAKE
THOSE COMMENTS OR ASK QUESTIONS.
WE HAVE FOUR MEMBERS RETIRING
FROM OUR COUNCIL. CHERYL KING,
YAEL NIV, KNEEL RISCH AND
BRANDON STAGLIN STAGLIN. CONGRATULATIONS
FOR YOUR RETIREMENT, THANK YOU
FOR YOUR SERVICE OVER THE YEARS
AND AS CUSTOMARY WE'LL GIVE YOU
THE OPPORTUNITY TO MAKE COMMENTS
GIVE US ADVICE, ADVICE TO NEW
MEMBERS OF THE COUNCIL, AND JUST
VARIOUS POINTS DURING THE
MEETING. BEFORE WE MOVE ON TO
THE BUSINESS OF THE MEETING I
WANT TO REMIND US ALL OF A FEW
LOGISTICAL ITEMS. FIRST AS I
MENTIONED THIS OPEN SESSION IS
BEING VIDEOCAST BROADLY TO THE
NIH COMMUNITY AND TO VIEWING
PUBLIC ALLOWING PEOPLE TO WATCH
AND LISTEN REMOTELY. THIS
MEETING IS ALSO BEING RECORDED
TO ALLOW VIEW ON DEMAND.
THEREFORE, WE WANT TO MAKE SURE
TO REMIND YOU OF A FEW
PROCEDURES WE DO ON ZOOM TO MAKE
SURE THAT PEOPLE OBSERVING CAN
HEAR YOU AND SEE YOU
APPROPRIATELY. WE ENCOURAGE
COUNCIL MEMBERS TO KEEP THEIR
VIDEO ON THROUGHOUT THE MEETING.
BUT ASK NIMH STAFF DIVISION
DIRECTOR ET CETERA TO USE VIDEO
ONLY WHEN PRESENTING. WE ASKNA
YOU PLEASE UNMUTE YOUR
MICROPHONE WHEN SPEAKING, MUTE
YOUR MICROPHONE WHEN NOT
SPEAKING. FOR ANY COUNCIL
MEMBERS OR OTHERS WHO ARE USING
PHONE AUDIO, PLEASE KNOW THAT
YOU CAN PRESS "*" 6 TO MUTE OR
UNMUTE. WE ALSO ASK COUNCIL
MEMBERS TO UNMUTE TO MAKE A
COMMENT OR ASK A QUESTION RATHER
THAN USE THE CHAT FUNCTION.
PLEASE RESERVE CHAT USE FOR
CONTACTING THE NIMH ZOOM HOST
FOR ANY TECHNICAL ISSUES,
ANYTHING ENTERED IN THE CHAT BOX
WILL BE IN THE PERMANENT RECORD
OF THE SESSION. WHEN WE CALL FOR
A VOTE WE WILL ASK COUNCIL
MEMBERS TO USE THE RAISE HAND
FUNCTION AT THE BOTTOM OF YOUR
WINDOW TO VOTE. IT COULD BE
LOCATED ACTUALLY AT THE BOTTOM
OF THE MENU OR IN THE ZOOM
PARTICIPANT MENU OR BOTH. VOTING
COUNCIL MEMBERS ON THE PHONE
UNMUTE BY PRESSING STAR 6 SO WE
CAN CAPTURE YOUR VOICE VOTE. IF
YOU EXPERIENCE CONNECTIVITY
ISSUES YOU NEED TO CALL IN,
PLEASE REFER TO YOUR PERSONAL
ZOOM ITINERARY FOR THE OPEN
SESSION DETAILS. WITH THAT, I'LL
PROCEED TO THE BUSINESS OF THE
MEETING. AND FIRST ORDER IS TO
ASK FOR COMMENTS OR CORRECTIONS
TO MINUTES FROM OUR SEPTEMBER
2021 MEETING, COPIES OF THOSE
MINUTES WERE PROVIDED IN ADVANCE
OF THE MEETING ANDLY ASK TRACY
TO TAKE OVER THAT FUNCTION AND
ASK FOR A VOTE TO APPROVE THEM.
TRACY.
>> ALL RIGHT. SO IF THERE ARE NO
CORRECTIONS I WOULD LIKE TO ASK
FOR A MOTION FOR APPROVAL OF THE
SEPTEMBER 2021 COUNCIL MINUTES.
I SEE MOTION AND SECOND, SO ALL
THOSE IN FAVOR OF ACCEPTING THE
MINUTES AS PROVIDED. .
ALL RIGHT. GREAT. LOOKS LIKE WE
HAVE JUST ABOUT EVERYONE. IF YOU
WANT TO PUT YOUR HANDS DOWN NOW
I'LL ASK IF ANYONE IS OPPOSED TO
ACCEPTING THE MINUTES AS
PROVIDED. ALL RIGHT. ANY
ABSTENTIONS? OKAY. PAMELA
ABSTAIN. THANK YOU. WE WILL
PROCEED WITH THOSE MINUTES.
THANK YOU. .
>> THE NEXT ORDER OF BUSINESS IS
THE NIMH DIRECTORS REPORT BY
YOURS TRULY. I'M GOING TO SHARE
MY POWERPOINT. AND I'M GOING TO
TRY TO PUT IN PRESENTER VIEW,
LET ME KNOW ARE YOU SEEING THE
CORRECT VIEW?
>> LOOKS GOOD, JOSH.
>> OKAY. GREAT. SO IT IS MY
PLEASURE TO WELCOME YOU ALL HERE
TO THIS FEBRUARY 2022 ADDITION
OF THE NHC. I'M AS USUAL GOING
TO TALK TO YOU ABOUT SOME OF THE
NEWS TO KNOW FROM THE NIMH, WE
WILL TALK ABOUT CONGRESSIONAL
AND OTHER INTERACTIONS WITH
NIMH, GIVE YOU AN UPDATE AS TO
THE BUDGET AND APPROPRIATIONS
PROCESS. SOME UPDATES FROM THE
NIH BROADLY, SOME NEWS FROM
WITHIN THE NIMH AND THEN END
WITH A FEW HIGHLIGHTS FROM THE
SCIENCE BEING CONDUCTED REALLY
AROUND THE GLOBE SUPPORTED BY
THE NATIONAL INSTITUTE OF MENTAL
HEALTH. TERMS OF CONGRESSIONAL
INTERACTIONS. WE HAVE HAD A
NUMBER OF INTERACTIONS, IT'S
BEEN VERY ACTIVE, MUCH OF IT
VIRTUAL AS YOU MIGHT IMAGINE IN
THE AGE OF COVID. ON NOVEMBER
2ND, 2021, NIMH STAFF REACHED
SENATOR BROWN'S STAFF ON
PARTICIPATION BY ADOLESCENCE IN
CLINICAL TRIALS, VERY IMPORTANT
ISSUE ESPECIALLY IN THIS STAGE
WHERE THERE IS A LOT OF CONCERN
ABOUT CHILD AND ADOLESCENT
MENTAL HEALTH IN THE CONTEXT OF
THE COVID PANDEMIC. ON DECEMBER
15, 2021, NIMH DEPUTY DIRECTOR
SHELLEY AND STAFF -- AND NIMHD
NATIONAL INSTITUTE OF MINORITY
HEALTH AND HEALTH DISPARITIES
DEPUTY DIRECTOR MONICA WEB
COOPER BRIEFED STAFF FROM THE
SENATE EDUCATIONS LABOR AND
PENSIONS COMMITTEE ON MENTAL
HEALTH DISORDER SEARCH INCLUDING
PEDIATRIC MENTAL HEALTH AND
HEALTH DISPARITIES. ON JANUARY
21ST OF THIS YEAR, JUST TEN DAYS
AGO, NIMH STAFF BRIEFED
REPRESENTATIVE BARE'S STAFF ON
RESEARCH INTO EARLY PSYCHOSIS,
IMPORTANT PRIORITY FOR NIMH AND
COMMUNITY AT LARGE. THESE
INTERACTION INFORM CONGRESS AS
THEY DECIDE HOW TO INFLUENCE
NIMH POLICY AND TO GIVE US THE
FUNDS NECESSARY TO CARRY OUT THE
RESEARCH THAT WE ARE ALL SO
EXCITED ABOUT. WHAT DO WE DO
WITH THOSE MONEYS? THE VAST
MAJORITY GOES AWAY TO OTHER
INSTITUTIONS IN THE FORM OF
RESEARCH GRANTS AND WHAT YOU CAN
SEE HERE IS THE SUCCESS RATES,
NUMBERS APPLICATIONS NUMBER OF
APPLICATIONS FUNDED AND OVERALL
SUCCESS RATES FOR NIMH OVER THE
PAST SIX YEARS WITH THE NUMBERS
FROM 2021 NOT QUITE YET FINAL,
IT TAKES A WHILE TO FINALIZE OUT
AND MAKE SURE WE HAVE ALL OUR
EYES DOTTED AND Ts CROSSED
FROM THE PREVIOUS FISCAL YEAR.
BUT WHAT YOU CAN SEE IS A UP AND
DOWN BUT OVERALL SLIGHT GROWTH
IN THE NUMBER OF APPLICATIONS TO
NIMH FOR RESEARCH GRANTS. AND
MODEST INCREASE IN THE NUMBER OF
GRANTS WE HAVE BEEN ABLE TO
FUND. OVER THESE PAST SIX YEARS
WE ARE KEEPING A RELATIVELY
FAIRLY CONSTANT SUCCESS RATE IN
THE LOW 20s. MEANING THAT IF
YOU APPLY FOR A GRANT YOU HAVE
ABOUT A 22% CHANCE OF GETTING
THAT GRANT AND THAT'S OBVIOUSLY
LOVE TO REACH MORE BUT THAT IS
WHAT OUR BUDGET ENABLED US TO
DO. AS MOST OF YOU KNOW, AT NIMH
THE GRANTS THAT PEER REVIEW AND
THOSE PEER REVIEW PANELS GIVE US
A SCORE THAT COMES TO NIMH
PROGRAM STAFF THAT MAKE
RECOMMENDATIONS TO ME AND WE
MAKE RECOMMENDATIONS -- REQUEST
FOR CONCURRENCE FROM THIS
COUNCIL. AND AS MANY OF YOU
KNOW, THE REVIEW SCORES, WE
DON'T HAVE A SPECIFIC CUT OFF,
WE TRY TO LOOK HOW GRANTS FIT IN
WITH OUR PRIORITIES WITH THE
NIMH STRATEGIC PLAN, AND WHAT --
ASPECT TO SUPPORT WORK FORCE
DIVERSITY AMONG OTHER
PRIORITIES. AND WE DECIDE
INDIVIDUALLY ON EACH AND EVERY
GRANT WHETHER TO -- WHETHER TO
SUPPLY -- WHETHER TO FUND THAT
GRANT OR NOT. THIS IS THE END
RESULT OF THAT PROCESS FOR THE
PREVIOUS FISCAL YEAR. 2021. WHAT
YOU CAN SEE IN LIGHT BLUE ARE
GRANTS FUNDED IN DARK BLUE AND
GRANTS THAT WERE NOT FUNDEDED. AND
YOU SEE ON THE BOTTOM THE
PERCENTILE SCORE FOR GRANTS THAT
RECEIVE PERCENTILE SCORE THAT IS
ASSIGNED BY REVIEW PANEL SO YOU
CAN SEE IF YOU ARE IN THE TOP
TEN PERCENT OF GRANTS EVALUATED
BY REVIEW PANELS, HAS HIGH RATE
OF SUCCESS IN TERMS OF ACHIEVEK
NIMH FUNDING. AND THERE IS A
GRAY ZONE AROUND 13 PERCENTILE
UP TO 30TH PERCENTILE WHERE WE
ARE MAKING A LOT OF
INDIVIDUALIZED DECISIONS ON
WHETHER TO OPPORTUNITY GRANTS OR
NOT BUT TEND TO FUND MOST GRANTS
THAT SCORE UNDERNEATH 20TH
PERCENTILE AND AS MANY AS WE CAN
IN THE 20TH TO 30TH RANGE. IN
TERMS OF THE BUDGET THESE ARE
DOLLARS THAT WE HAVE BEEN
APPROPRIATAPPROPRIATED BY CONGRESS IN
LIGHT BLUE AND ADJUST FOR
INFLATION IN DARK BLUE, WHAT WE
HAVE BEEN TALKING FOR SEVERAL
YEARS, CONGRESS HAS BEEN
CONSISTENTLY INCREASING THE NIH
BUDGET AND THE NIMH BUDGET SINCE
REALLY SINCE 2015. AND THOSE
CONSISTENT INCREASES HAVE
RESULTED IN AN INCREASE BUYING
POWER IN TERMS OF INFLATION
ADJUSTED DOLLARS SUCH THAT WE
ARE NOW ABLE TO FUND MORE
RESEARCH IN PLACE ADJUSTED
DOLLARS THAN WE WERE BACK IN
2010, WHICH IS A NICE RECOVERY
FROM A PERIOD OF STAGNATION THAT
PRECEDED THAT 2015. WE ARE VERY
PLEASE WITH THIS, ABLE TO REACH
DEEPER INTO OUR GRANT
APPLICATIONS THAN OTHERWISE. AND
WE HOPE TO RECEIVE ANOTHER
INCREASE THIS YEAR. IN TERMS OF
THE 2022 BUDGET, WE KNOW THAT IN
DECEMBER 3, PRESIDENT BIDEN
SIGNED THE FURTHER EXPANDING
GOVERNMENT FUNDING ACT, A
CONTINUING RESOLUTION THAT
EXTENDED THE FISCAL YEAR 2021
SPENDING LEVELS THROUGH FEBRUARY
18 OF THIS YEAR. AND WE ARE
HOPING THAT IN FEBRUARY WE WILL
RECEIVE OUR FULL YEAR
APPROPRIATIONS WITH REGARD TO
THAT, THE HOUSE PASSED A BUDGET
BILL SOMETIME AGO AND ON OCTOBER
18 SENATE APPROPRIATIONS
COMMITTEE RELEASED THE TEXT OF
THEIR VERSION OF THAT BUDGET
BILL. THAT TEXT INCLUDES A 12%
INCREASE FOR NIH AND 5.5%
INCREASE FOR NIMH INCLUDING $25
MILLION SPECIFICALLY TO EXPAND
RESEARCH ON MENTAL HEALTH IMPACT
OF THE COVID-19 PANDEMIC. SO WE
ARE HOPEFUL THAT SOME VERSION OF
THE HOUSE OR SENATE BILLS WILL
BE PASSED AND WOULD BE ABLE TO
REACH MORE GRANTS THIS YEAR THAN
WE WOULD OTHERWISE. THAT IS THE
NEWS IN TERMS OF LEGISLATIVE
OVERSIGHT BUDGET APPROPRIATIONS.
NOW LET'S TALK ABOUT THE NIH,
THE BIGGEST NEWS THAT HAPPENS
SINCE THE LAST COUNCIL SESSION
YOU KNOW ABOUT, ON DECEMBER 19,
2021, FRANCIS COLLINS STEPPED
DOWN FROM HIS ROLE AS DIRECTOR
OF THE NIH AND MORE PERSONALLY
FROM HIS ROLE AS MY BOSS. I
REALLY ENJOYED TREMENDOUSLY
WORKING WITH DR. COLLINS OVER
THE YEARS SINCE HE OFFERED ME
THIS POSITION IN 2016. AND HE
HAS BEEN INCREDIBLE MENTOR,
FRIEND AND WONDERFUL LEADER FOR
THE NIH. AMONG MANY
ACCOMPLISHMENTS INCLUDE
INITIATING THE BRAIN INITIATIVE
WHICH IS INSTRUMENTAL IN
REVOLUTIONIZING THE TECHNOLOGIES
WE BRING TO BARE TO ADDRESS
NEUROBIOLOGY UNDERLYING MENTAL
ILLNESS AND OTHER ILLNESSES OF
THE BRAIN. OTHER INITIATIVES CAN
UP INCLUDE THE ALL OF US PROGRAM
WHICH WE AT NIH WORK WITH TO TRY
TO EXPAND OUR UNDERSTANDING OF
THE BEHAVIORAL UNDERPINNINGS OF
MENTAL HEALTH. AS WELL AS THE
HEAL INITIATIVE MULTI-FACETED
INITIATIVE AIMING TO ESTABLISH A
RESEARCH BASE TO COUNTER THE
EFFECTS OF THE SEEMINGLY
UNRELENTING EFFECTS OF THE
ONGOING OPIOID EPIDEMIC. AND
THEN OF COURSE THE RESPONSE, THE
NIH WIDE RESPONSE WHICH NIMH
PROUDLY PARTICIPATED IN, TO THE
COVID PANDEMIC. DR. COLLINS ALSO
ADDRESSED POLICIES AND
ACTIVITIES TO REDUCE SEXUAL
HARASSMENT, TO MAKE NIH AND
WIDER SCIENTIFIC WORK FORCE A
INCLUSIVE ENVIRONMENT AND
ADDRESS ISSUES OF STRUCTURAL
RACISM WITHIN THE BIOMEDICAL
RESEARCH COMMUNITY ALL WHICH ARE
ONGOING ENTERPRISES AND SPEAKING
OF ONGOING I'M PLEASED THAT DR.
LARRY TABAK WHO HAS BEEN
PRINCIPLE DEPUTY DIRECTOR FOR AS
LONG AS I HAVE KNOWN HIM, AS
LONG AS I HAVE KNOWN THE NIH,
HAS BEEN THE DEPUTY DIRECTOR
ASSUMED THE ACTING DIRECTOR ON
DR. COLLINS DEPARTURE AND WILL
CONTINUE THAT ROLE UNTIL A
SUCCESSOR IS NAMED AN CONFIRMED
BY THE SENATE. OTHER NIH
LEADERSHIP NEWS, OF PARTICULAR
RELEVANCE THE NIMH IS BILL
RILEY, DIRECTOR OF NIH OFFICE OF
BEHAVIORAL AND SOCIAL SCIENCE
RESEARCH AND NIH ASSOCIATE
DIRECTOR FOR BEHAVIORAL SOCIAL
SCIENCE RESEARCH IS RETIRED AND
SINCE SEPTEMBER 30TH BUT IT WAS
AS OF DECEMBER 30TH, NOT
SEPTEMBER 30TH. BILL HAS BEEN A
COLLEAGUE, A REAL FRIEND AND
PARTNER IN MANY IMPORTANT
INITIATIVES THAT AIM TO ADDRESS
THE BEHAVIORAL SOCIAL SCIENCE
MANIFESTATIONS OF ILLNESSES
ACROSS THE SPECTRUM, OF COURSE
BUT ESPECIALLY TRUE FOR MENTAL
ILLNESS AND FOR OTHER AREAS
UNDER NIMH'S PURVIEW. HIS
DEPUTY, CHRISTINE HUNTER WILL BE
SERVING AS ACTING DIRECTOR OF
OBSSR WHILE SEARCH IS ONGOING.
I'M PROUD TO BE ABLE TO CO-LEAD
THE SEARCH FOR A NEW DIRECTOR OF
OBSSR, THAT SEARCH IS WELL
UNDERWAY SO IF YOU ARE
INTERESTED IN APPLYING FOR THE
JOB LET ME KNOW. ON DECEMBER 2,
2021 PRESIDENT BIDEN CAME TO NIH
IN DURING THAT VISIT HE
ANNOUNCED ADMINISTRATION ACTIONS
FOR BATTLING COVID-19 OVER THE
WINTER MONTHS. ACTIONS INCLUDING
EXPANDING TESTING, KEEPING
SCHOOLS OPEN, PROTECTING
ECONOMIC RECOVERY AND MORE.
THESE ACTS HAVE BECOME ALL MORE
IMPORTANT IN THE CONTEXT OF THE
WAVE WE HAVE BEEN EXPERIENCING
THE LAST SIX WEEKS OR SO WITH
OMICRON VARIANT. AND WE ARE
EXCITED TO HAVE -- TO HOST HIM
HERE AT NIH AND TO HAVE HIM
VISIT NOT HIS FIRST VISIT AS
PRESIDENT AND WE ARE PLEASED HE
IS ABLE TO MAKE ANOTHER ONE. OUR
SECRETARY HHS SECRETARY XAVIER
BECRRA IN ADDITION TO DEPUTY
SECRETARY ANDREA PALM ALSO
VISITED THE NIH SINCE THE LAST
COUNCIL MEETING, THEY SPOKE TO
PATIENTS SATISFY AND LEADERSHIP
FOCUSED ON NUMBER OF DIFFERENT
ISSUES INCLUDING VISITING THE
NIH CLINICAL CENTER, WHERE THEY
LEARNED ABOUT CUTTING EDGE
CANCER RESEARCH, AND TOURING THE
VACCINE RESEARCH CENTER WHICH
PLAYED SUCH AN IMPORTANT ROLE IN
CORONA VIRUS VACCINE
DEVELOPMENT. MOVING ON FROM
PEOPLE TO IDEAS. MANY OF YOU
KNOW NIMH IS WORKING FOR
FOUNDATION FOR NATIONAL
INSTITUTES OF HEALTH AND
ACCELERATED MEDICINES
PARTNERSHIP PROGRAM TO INITIATE
A PROGRAM CALLED AND
SCHIZOPHRENIA. NIH IS ENGAGE
WITH NUMBER OF INSTITUTES ACROSS
THE NATIONAL INSTITUTES OF
HEALTH WITH FOUNDATION ON
ANOTHER ACCELERATING MEDICINES
PARTNERSHIP WITH THE BESPOKE
GENE THERAPY CONSORTIUM TO
ACCELERATE GENE THERAPIES FOR
RARE DISEASE, INCLUDING
NEURODEVELOPMENTAL DISORDERS AND
OTHERS. NIH AND PARTNERS PLAN TO
CONTRIBUTE APPROXIMATELY $76
MILLION OVER FIVE YEARS TO
OPTIMIZE AND STREAMLINE GENE
THERAPY DEVELOPMENT PROCESS. IN
ORDER TO HELP BUILD UNMET
MEDICAL NEEDS OF PEOPLE WITH
RARE DISEASES. THIS IS REALLY
IMPORTANT INITIATIVE ADDRESSING
TECHNOLOGICAL INNOVATIONS THAT
CAN HELP PEOPLE BUT WHICH
BECAUSE THESE DISEASES ARE SO
RARE ARE OFTEN DIFFICULT TO
APPLY. SO WE HOPE TO BE ABLE TO
MAKE PROGRESS ACROSS A BROAD
RANGE OF MEDICAL NEEDS WITH THIS
COLLABORATIVE AND PARTNERSHIP.
AS YOU KNOW UNDER DR. COLLINS
LEADERSHIP AND CONTINUING UNDER
DR. TABAK, THE NIH HAS BEEN
SUPPORTING THE UNITE INITIATIVE
AN INITIATIVE THAT REALLY
MULTI-FACETED AND AIMES TO
INCREASE THE INCLUSIVITY AND
EQUITY AND DIVERSITY WITHIN THE
NIH WORK FORCE AS WELL AS WITHIN
THE WIDER SCIENTIFIC WORK FORCE.
ONE OF THE MORE COMPELLING
RECENT INITIATIVES LAUNCHED OUT
OF UNITE IS THE TOGETHER WE ARE
STRONGER INITIATIVE WITH POWER
OF INCLUSIVE WORKPLACE
RECOGNITION PROJECT. WHICH WILL
DIVERSIFY THE PORTRAITURE AND
ART WORK THROUGHOUT NIH
BUILDINGS AND DIGITAL SPACES SO
THAT ALL CAN SEE THEIR ROLE AND
THEIR POTENTIAL ROLE IN THE
BIOMEDICAL RESEARCH ENTERPRISE
AND IN A WAY THAT CELEBRATES THE
RICH DIVERSITY OF OUR NIH WORK
FORCE. ANOTHER NIH WIDE
INITIATIVE THAT NIMH HAS BEEN
PLAYING AN IMPORTANT ROLE IS IN
IS AN EFFORT ALSO INSPIRED BY
UNITE INITIATIVE TO ADVANCE THE
RESEARCH INTO HEALTH DISPARITIES
AND PROMOTE HEALTH EQUITY. THE
COMMON FUND WHICH IS A FUND
ADMINISTERD BY THE NIH DIRECTOR
HAS JUST AGREED LAST WEEK TO
FUND A LARGE MULTI-FACETED
INITIATIVE FOCUSED ON STRUCTURAL
DETERMINANTS OF HEALTH
INEQUALITIES CALLED COMPASS OR
COMMUNITY PARTNERS TODAY VANCE
SCIENCE FOR SOCIETY. I WITH
SEVERAL FELLOW INSTITUTE
DIRECTORS AND MANY FANTASTIC
SCIENTISTS FROM ACROSS THE
EXTRAMURAL SIDE OF THE VARIOUS
INSTITUTES INVOLVED, HAVE
DESIGNED A PROGRAM WE THINK IS
GOING TO TRANSFORM THE LANDSCAPE
FOR HEALTH EQUITY RESEARCH
THROUGHOUT NIH. THIS COMPASS
INITIATIVE WILL BE COMPRISED OF
COMMUNITY BASED PARTNERSHIPS,
THAT WILL STUDY INTERVENTIONS
THAT TARGET STRUCTURAL
DETERMINANTS OF HEALTH INEQUITY.
WHICH INVOLVE MORE THAN JUST
HEALTHCARE SYSTEM BUT RANGE OF
DIFFERENT CONDITIONS THAT SHAPE
THE WAY PEOPLE ARE BORN, WAY
THEY LIVE, WAY THEY LEARN, WORK,
PLAY, WORSHIP AND AGE. AND THESE
STRUCTURAL DETERMINANTS WILL BE
ADDRESSED THROUGH INTERVENTIONS
THAT ARE AIMED AT REDUCING THEIR
IMPACTS ON ADVERSE HEALTH
OUTCOMES. THE COMMUNITY BASED
PARTNERSHIPS WILL BE ORGANIZED
INTO A HUB AND SPOKE LIKE
STRUCTURES WITH THE HUBS BEING
ACADEMIC PARTNERSHIPS TO ENSURE
THE COMMUNITY BASED ORGANIZES
RUNNING THE INTERVENTIONS ARE
EQUIPPED AND TRAINED TO BE ABLE
TO CONDUCT THE RESEARCH AND THE
RIGOROUS REPRODUCIBLE WAY AND
SUPPORTED WITH ALL NECESSARY
SUPPORTSES THEY NEED TO BE ABLE
TO CONDUCT THAT RESEARCH.
MEANWHILE VARIOUS HUBS AND
SPOKES WILL BE CONTRIBUTING
THEIR DATA TO COORDINATE -- DATA
COORDINATION CENTER. IT WILL BE
DOING MORE THAN COORDINATING
DATA, THEY WILL BE SETTING
COMMON DATA ELEMENTS TO ENSURE
DATA FROM THE VARIOUS
INTERVENTIONS THAT ARE BEING
STUDIED CAN BE INTEGRATED INTO A
LARGER HOLE AND CAN BE USED TO
FOSTER IMPLEMENTATION OF THESE
INTERVENTIONS WHEN EFFICACIOUS
THROUGHOUT THE UNITED STATES.
THE COORDINATION CENTER WILL BE
PARTNERED WITH NATIONAL HEALTH
EQUITY RESEARCH ASSEMBLY,
ASSEMBLY OF COMMUNITY MEMBERS
ACADEMICS, POLICY MAKERS, THAT
WILL ENSURE THAT THE RESEARCH
BEING CONDUCTED THROUGHOUT THE
PROJECT MEETS THE NEEDS OF THE
WIDER COMMUNITIES AND STAKE
HOLDERS INVOLVED. THIS IS AN
EXCITING PARTNERSHIP, WE LOOK
FORWARD TO TELLING YOU MORE
ABOUT IT OVER THE COMING YEARS.
ANOTHER IMPORTANT NIH WIDE
ACTIVITY THAT NIMH IS EMBEDD IN
IS NIH RECOVERY INITIATIVE, AN
INITIATIVE THAT AIMS TO STUDY
LONG COVID SO CALLED LONG COVID
OR POST ACUTE SEQUELAE OF
COVID-19, NOT JUST STUDY BUT
DEVELOP AND TEST INTERVENTIONS
AIMED AT REDUCING THE ADVERSE
IMPACTS OF THAT SYNDROME. THE
NIH RECOVERY INITIATIVE
LAUNCHED, SPENT NEARLY $570
MILLION TO BUILD A NATIONAL
STUDY POPULATION OF DIVERSE
RESEARCH VOLUNTEERS AND SUPPORT
LARGE SCALE STUDIES BOTH ON THE
EFFECT AND OF INTERVENTION SO WE
ARE PLEASED TO HAVE BEEN ABLE TO
HELP LAUNCH THIS INITIATIVE
THAT'S BEING LED BY NUMBER OF MY
COLLEAGUES INCLUDING WALTER
KORESHETS OF NINDS. SPEAKING OF
PARTNERSHIPS WITH NINDS, AND
OTHER INSTITUTES, I WANTED TO
GIVE YOU A COUPLE OF UPDATES
FROM THE BRAIN RESEARCH
INITIATIVE, THE BRAIN RESEARCH
THROUGH ADVANCING INNOVATIVE
NEUROTECHNOLOGIES INITIATIVE.
THIS IS SUPPORTED BY
APPROPRIATIONS TO EACH OF NINE
DIFFERENT INSTITUTES ACROSS THE
NIH AND ALSO SEPARATE
APPROPRIATIONS THROUGH THE CURES
ACT. A COUPLE OF UPDATES FROM
THIS PROGRAM, SIX BRAIN
INITIATIVE FUNDED SCIENTISTS
SELECTED TO THE NIH HIGH RISK
HIGH REWARD RESEARCH PROGRAMS.
AND REALLY THE BRAIN HAS BECOME
A LEADER ENSURING EFFORTS TO
ENHANCE WORK FORCE DIVERSITY AS
BRAIN INITIATIVE APPLICANTS ARE
REQUIRED TO SUBMIT A PLAN FOR
ENHANCING DIVERSE PERSPECTIVES
ALONG WITH RESEARCH PLANS FOR
GRANT APPLICATIONS AND WE ARE
FOLLOWING CLOSELY THE EFFICACY
OF THIS PROCEDURE IN TERMS OF
ENHANCING DIVERSITY AND HOPE TO
DOCK THIS AT NIMH SOON. IN TERMS
OF SCIENCE NEWS COMING OUT OF
THE BRAIN, IN OCTOBER A REAL
BLOCKBUSTER EVENT HAPPENED, THE
NIH FUNDED BRAIN INITIATIVE CELL
CENSUS NETWORK PUBLISHED ATLAS
OF THE MOTOR CORTEX, THIS
COLLABORATIVE WORK ENGAGED MORE
THAN 250 SCIENTISTS AT NEARLY 50
INSTITUTIONS, RESULTED IN
SIMULTANEOUS PUBLICATION OF OVER
20 DIFFERENT DOCUMENTS. AND A
DROVE OF DATA DISSECTING THE
MANY DIFFERENT CELL TYPES THAT
MAKE UP THE MOTOR CORTEX. THIS
PILOT PROJECT SETS A PATH WHICH
WE CAN UNDERSTAND DIVERSITY OF
CELL TYPES UNDERLYING CORTICAL
REGIONS AND INDEED OTHER REGIONS
OF THE BRAIN. ACROSS MULTIPLE
SPECIES. AND LAYS FOUNDATION TO
UNDERSTAND THEIR FUNCTIONAL
IMPACT. WE ARE EXCITED ABOUT THE
FIRST EFFORT BY DICCN AND LOOK
FORWARD TO MORE IN THE FUTURE.
SO FROM THE NIH LET'S TURN TO
NIMH TO GIVE YOU SOME NIMH NEWS
TO KNOW. WE CONTINUE TO BE
INVOLVED IN MESSAGING AND
RESEARCH IN RESPONSE TO COVID-19
COVID-19. WE HAVE PUT OUT A
NUMBER OF DIFFERENT MESSAGES
WHETHER IT BE DIRECTORS MESSAGE
FROM MYSELF OR PUBLIC SERVICE
MESSAGING HELPING CHILDREN
ADOLESCENTS COPE WITH COVID-19
DIRECTING THE PUBLIC TO
RESOURCES THEY CAN USE. WE KNOW
THAT YOUTH MENTAL HEALTH IS
PARTICULARLY AT RISK IN THIS
PANDEMIC AND WE WANT TO HELP
PARTICIPATE IN WHATEVER EFFORTS
ARE NECESSARY TO COUNTER THAT
THREAT. WE HAVE ALSO RELEASED
TWO NOTICES WITH REGARD TO --
NOTICE OF SPECIAL INTEREST,
THREE, AND NOTICES CALLING FOR
RESEARCH ON COVID-19 MENTAL
HEALTH IMPACT, ENCOURAGE THOSE
OF YOU IN THE FIELD WHO ARE
INTERESTED IN THIS TO LOOK AT
THOSE NOTICES. AND TO APPLY FOR
FUNDS FOR -- TO UNDERSTAND AND
TO MITIGATE MENTAL HEALTH IMPACT
OF COVID-19. WE ARE NOT THE ONLY
ONES TO RECOGNIZE THE IMPORTANCE
OF YOUTH MENTAL HEALTH IN THIS
AGE, ONE OF THE MOST IMPORTANT
MEMBERS OF THE GOVERNMENT IN
TERMS OF SAFEGUARDING OUR HEALTH
IS THE SURGEON GENERAL AND DR.
VIVEK MURTHY AND OFFICE RELEASED
A U.S. SURGEON GENERAL'S
ADVISORY DESCRIBING THE IMPACT
OF THE PANDEMIC ON YOUTH MENTAL
HEALTH, THIS IS A DOCUMENT THAT
IS REALLY AN OUTSTANDING
DOCUMENT, I ENCOURAGE THOSE OF
YOU INTERESTED TO READ IT. FULLY
EXPLICATES THE THREATS TO YOUTH
MENTAL HEALTH POSED BY PANDEMIC. PANDEMIC.
AND IT WILL SERVE AS A GUIDE TO
TRYING TO REDUCE THOSE IMPACTS
THROUGH CARE AND RESEARCH
THROUGH THE FUTURE. BEFORE WE
TURN TO INDIVIDUAL NIH STAFF
NIMH STAFF ONE MORE PIECE OF
NEWS OF INTEREST TO THE
COMMUNITY, THE IACC HAS HELD TWO
VIRTUAL MEETINGS SINCE
REINSTANTIATED LAST SUMMER AND
OFFICE OF AUTISM RESEARCH
COORDINATION ISSUED REQUEST FOR
INFORMATION TO INFORM DEVELOP OF
THE THE NEXT VERSION OF THE IACC
STRATEGIC PLAN, ENCOURAGE YOU
VISIT THE IACC WEBSITE, TO TO
FIND OUT MORE INFORMATION ABOUT
THESE EFFORTS AND LOOK FORWARD
TO LEARNING MORE FROM OUR
VARIOUS STAKEHOLDER COMMUNITY
MEMBERS ON THE IACC. NOW LET'S
TURN TO NIMH STAFF. FIRST WE TRY
WHERE WE CAN TO CELEBRATE HONORS
AND AWARDS AND TWO MEMBERS
RECEIVED TWO OF THE MEMBERS OF
OUR INTRAMURAL RESEARCH PROGRAM
HAVE RECENTLY RECEIVED VERY HIGH
ACCOLADES INDEED. DR. ELIZABETH
MURRAY, CHIEF OF THE SECTION ON
NEUROBIOLOGY LEARNING AM MEMORY
AND LABORATORY OF
NEUROPSYCHOLOGY RESEARCH
PROGRAM, RECEIVED THE GOLDMAN
RAKIC PRIZE FOR OUTSTANDING
ACHIEVEMENT IN COGNITIVE
RESEARCH AND DR. LESLIE
UNGERLEIDER, CHIEF OF LABORATORY
BRAIN AND COGNITION AND NIMH IRP
RECEIVED A SITE FOR SOCIETY FOR
NEUROSCIENCE PATRICIA HALL HONOR
AWARD. OTHER NEWS INCLUDE
RECRUITMENTS YOU HEARD YESTERDAY
IN CLOSE SESSION FOR COUNCIL
MEMBER OF MANY DEVELOPMENTS OVER
THE LAST YEAR IN THE INTRAMURAL
RESEARCH PROGRAM, ONE OF THE
MOST RECENT DR. SYLVIA LOPED
GUZMAN JOINED THE PROGRAM AS A
TENURE TRACK INVESTIGATOR AND
CHIEF OF THE UNIT ON
COMPUTATIONAL DECISION ON
NEUROSCIENCE. REALLY EXCITED
PERSONALLY DR. GUZMAN JOINED US
BEEFING UP OUR CLINICAL AND OUR
COMPUTATIONAL EFFORTS WITHIN THE
INTRAMURAL RESEARCH PROGRAM. NOW
ON TO BITTERSWEET NEWS WE HAVE
RETIREMENTS TO TELL YOU ABOUT.
FIRST I WANT TO MENTION THE
FIRST PUBLIC ANNOUNCEN'T, DR.
ROBERT HEINSSEN DIRECTOR OF
DIVISION OF SERVICE AND
INTERVENTION RESEARCH SINCE 2009
WILL STEP DOWN FROM THAT ROLE IN
JUNE OF 2022. DR. HEINSSEN HAS
BEEN A REMARKABLE LEADER KNOWN
FAR AND WIDE FOR HIS EFFORTS ON
KEY INITIATIVES AIMED AT EARLY
PSYCHOSIS FIRST EPISODE
PSYCHOSIS, SUICIDE PREVENTION
AND PRAYD BY IMPLEMENTATION OF
EVIDENCE BASE SERVICES IN REAL
WORLD SETTINGS SETTINGS. HE WAS PRINCIPLE
ARCHITECT OF EARLY PSYCHOSIS IN
PREVENTION NETWORK OR EPI NET
FOR PEOPLE WITH SERIOUS MENTAL
ILLNESS. HIS LEADERSHIP PLAYED
AN IMPORTANT ROLE IN
TRANSFORMING THE CARE OF FIRST
PSYCHOSIS THROUGHOUT THE UNITED
STATES BY ENSURING THAT
COORDINATED SPECIALTY CARE IS
AVAILABLE TO THOUSANDS OF
INDIVIDUALS THROUGHOUT THE
COUNTRY. HIS LEADERSHIP
PROMOTING EVIDENCE BASED PERSON
CENTERED TREATMENT FOR SERIOUS
MENTAL ILLNESS IS REALLY
UNPARALLELED HE WON MANY
AREGARDS FOR SERVICE INCLUDING
THE 2019 DISTINGUISHED SERVICE
AWARD FOR NATIONAL ALLIANCE ON
MENTAL ILLNESS AND PERSONALLY I
HAVE TO SAY BOB HAS BEEN
TREMENDOUS MENTOR AN ADVISOR TO
ME TEACH ME AS MUCH AS I CAN
LEARN ABOUT INTERVENTION
RESEARCH, SERVICES RESEARCH,
IMPLEMENTATION RESEARCH, AND
MORE. AND HOW WE CAN DO OUR BEST
TO ENSURE NIMH RESEARCH HAS
PUBLIC HEALTH IMPACT SO I WANT
TO THANK BOB PERSONALLY FOR BOB,
YOU FOR YOUR SERVICE, IT IS
REMARKABLE WORKING WITH YOU, I
WILL ENJOY CONTINUING TO WORK
WITH YOU, AS YOU KNOW ALTHOUGH
HE'S STEPPING DOWN FROM HIS
DIRECTORSHIP OF THE DIVISION HE
WILL JOIN MY OFFICE OFFICE OF
DIRECTOR SERVING AS SENIOR
ADVISOR SPECIFICALLY IN THESE
AREAS ENSURING THE PUBLIC HEALTH
IMPACT OF NIMH RESEARCH. A
NATIONAL SEARCH FOR REPLACEMENT
WILL BEGIN SOON. IF YOU ARE
INTERESTED IN THAT, COME AND
TALK TO ME. THERE'S OTHER STAFF
TRANSITIONS, FOUR MEMBERS
RETIRED IN THE LAST SEVERAL
MONTHS INCLUDING BARBARA LIPSKA,
ROBERT COX. CHRISTIAN GRILLON
AND CAROLYN BEEBE SMITH. ALL
OUTSTANDING CONTRIBUTORS TO THE
PROGRAM IN A MYRIAD OF WAYS TO
SCIENCE THAT WE DO AND THEY WILL
BE MISSED. ALSO MISSED ARE TWO
NIMH LISTENING TERM STAFF WHO
PASSED AWAY IN THE LAST SEVERAL
MONTHS. MORT MISHKIN FORMER
CHIEF OF THE NIMH LABORATORY OF
NEUROPSYCHOLOGY AND GIANT IN
COGNITIVE NEUROSCIENCE PASSED
AWAY AFTER A LONG AND SUCCESSFUL
CAREER THAT INCLUDED ELECTION
NATIONAL ACADEMY OF SCIENCE,
ACADEMY OF MEDICINE AND NUMEROUS
OTHER ACCOLADES AND AWARDS.
DAVID SCHORR FORMER ACTING
DIRECTOR OF DSIR AND FORMER
ACTING DIRECTOR OF DIVISION AND
CLINICAL TREATMENT RESEARCH ALSO
PASSED RECENTLY. HE BEGAN AS A
RESEARCHER BUT LATER TOOK ON
NUMBER OF DIFFERENT ROLES
THROUGHOUT NIMH INCLUDING
ASSOCIATE DIRECTOR FOR CLINICAL
RESEARCH IN THE INTRAMURAL
RESEARCH PROGRAM. HIS
CONTRIBUTIONS TO NIMH RESEARCH
HAVE BEEN RECOGNIZED TO MANY
AWARDS INCLUDING NAMI EXEMPLARY
PSYCHIATRIST AWARD. HE WILL BE
REMEMBERED FOR LIFE LONG
COMMITMENT TO ADVANCING
BIOETHICS AND IMPROVING THE
ETHICS OF RESEARCH PARTICIPANTS.
NOW WE CAN TURN TO SCIENCE
HIGHLIGHTS, WHAT IS EXCITING
WHAT IS NEW IN TERMS OF WHAT
NIMH HAS BEEN SUPPORTING. FOR
COLOR YOU SHOULD KNOW DIVISIONS
EACH COMPETE WITH NUMBER OF
DIFFERENT NOMINATIONS AND
THERE'S ALWAYS TOO MUCH GOOD
SCIENCE TO HIGHLIGHT I DO MY
BEST TO TRY TO PROVIDE
REPRESENTATIVES SAMPLING OF WHAT
IS GOING ON SO I HAVE THREE
BRIEF STORIES TO TELL YOU ABOUT
TODAY THAT WE ARE EXCITED ABOUT.
IT IS UNFORTUNATE THAT I DON'T
HAVE ENOUGH TIME TO TELL YOU
ABOUT ALL THE MANY HUNDREDS OF
THE MORE NOMINATIONS. ONE OF
THE THINGS WE ARE DEEPLY
INTERESTED IN AT NIMH IS
UNDERSTANDING THE --
UNDERSTANDING BEHAVIOR, HOW IT
RATES TO MENTAL ILLNESS AND
IMPORTANTLY ONE ADVANCE IN OUR
ABILITY TO UNDERSTAND BEHAVIOR
HAS BEEN APPLICATION OF
COMPUTATIONAL TOOLS TO DISSECT
BEHAVIOR INTO COMPONENT PARTS
AND USE THAT DISSECTION TO MAP
THE COMPONENT PARTS OF BEHAVIOR
ON TO BRAIN FUNCTION. THIS PAPER
BY SOOJUMG NA AND MANY OTHER
COLLEAGUES IS REALLY A SHINING
EXAMPLE OF THAT EFFORT. ONE OF
THE MAIN THINGS WE NEED TO
UNDERSTAND IN -- IF WE ARE TO BE
ABLE TO HELP THOSE WITH MENTAL
ILLNESS IS SOCIAL FUNCTION. MANY
DIFFERENT MENTAL ILLNESSES
AFFECT OUR ABILITY TO FUNCTION
WITHIN THE COMPLEX SOCIAL
ENVIRONMENT IN WHICH WE LIVE AND
OF COURSE THOSE COMPLEX
ENVIRONMENTS ARE ALSO A SOURCE
OF STRESS AND RISK FACTORS FOR
MENTAL ILLNESS AND WE ALL KNOW
THIS BECAUSE OF OUR OWN
EMOTIONAL REACTIONS TO THE
DECREASES IN SOCIAL
CONNECTEDNESS WE HAVE ALL
EXPERIENCED IN THE CONTEXT OF
THE PANDEMIC. SO UNDERSTANDING
THE NEURAL MECHANISMS BY WHICH
WE NAVIGATE THIS COMPLEX SOCIAL
WORLD IS A KEY GOAL OF NIMH
RESEARCH, THIS PAPER TRIES TO DO
IT. THEY DO IT BY TAKING ONE
ASPECT OF THE SOCIAL
ENVIRONMENT, AND TRYING DODIE
SECOND IT DOWN. THAT AS SPECK
IS OUR ABILITY TO PREDICT PEOPLE
AROUND US ARE GOING TO DO IN
RESPONSE TO OUR OWN SOCIAL
ACTIONS. THEY DO THIS BY
STUDYING A TASK U CALLED THE
SOCIAL CONTROL ABILITY TASK. IN
THIS TASK, YOU ARE PLAYING A
GAME AND THE GAME THAT YOU PLAY
IS THAT YOU ARE WORKK WITH A
GROUP, A TEAM, TEAM A IN THIS
CASE IS SHOWN ON THE LEFT SIDE
OF THE GRAPH AND THAT TEAM
RECEIVES ON EACH OF MANY TRIALS,
40 TRIALS OR SO, RECEIVES A $20
REWARD. AND THAT TEAM THEN
PROPOSES TO SHARE SOME AMOUNT OF
THAT REWARD WITH YOU. IN THIS
CASE EXAMPLE, THE MEMBER SAYS I
GOT 20 BUCKS I WILL SHARE FIVE
WITH YOU. AND YOU CAN EITHER
ACCEPT THAT, 5 BECAUSE YOU FEEL
IT IS FAIR, YOU DESERVE THAT $5
OR REJECT IT BECAUSE YOU FEEL
LIKE YOU KNOW WHAT, I DON'T -- I
DESERVE MORE OF THE $5. WE WORK
TOGETHER TO GET THAT REWARD AND
YOU SHOULD GIVE ME MORE THAN $5.
IF YOU ACCEPT IT YOU RECEIVE IF
YOU REJECT YOU DON'T. AND THEN
YOU RATE HOW YOU FEEL AFTER THAT
WHATEVER YOU EXPERIENCE AND THEN
THE NEXT TRIAL HAPPENS. AND YOU
DO THIS FOR 40 TRIALS. THE
REASON THIS IS A SOCIAL GAME IS
BECAUSE MEMBERS OF THE TEAM A
THEY DON'T ACTUALLY GET THE
REWARD UNLESS YOU SHARE IT WITH
THEM. SO THEY HAVE AN INCENTIVE
TO TRY THE GIVE A FAIR AMOUNT OF
THE REWARD AND ENOUGH FOR YOU TO
ACCEPT IT, BUT NOT ENOUGH THAT
-- BUT AS LITTLE AS YOU WILL
ACCEPT SO THEY CAN KEEP AS MUCH
AS POSSIBLE SO IT IS A LITTLE
BIT OF A COMPETITIVE GAME, A
LITTLE BIT OF A COOPERATIVE
GAME, DEPENDENT AND COOPERATIVE
INSTINCTS SORT OF FACE OFF
AGAINST EACH OTHER, YOU CAN
COLLABORATE WITH THEM AND TAKE A
LOW AMOUNT BUT THAT MEANS YOU
WON'T GET MUCH OVER TIME.
THERE'S TWO VERSIONS OF THE GAME
THESE PEOPLE PLAY. FIRST THE
THING THAT THEY DON'T KNOW WHILE
PLAYING IT BUT YOU KNOW AS THE
EXPERIMENTER IS THAT TEAM A AND
TEAM B WILL EACH PLAY 40 TRIALS,
THEY ARE DIFFERENT. IN TEAM A
WHAT YOU DO WHETHER TO ACCEPT OR
REJECT EACH OFFER AFFECTS WHAT'S
GOING TO HAPPEN NEXT. AND IN
BLOCK 2 WHATEVER YOU DO IT
DOESN'T MATTER THE PLAYERS FROM
TEAM B ARE GOING TO IGNORE WHAT
YOU DO AND DECIDE TO ACCEPT OR
RE-- TO OFFER YOU $15 OR $12 OR
WHATEVER, REGARDLESS OF WHAT YOU
DO. OF COURSE, THERE IS NOT ANY
REAL TEAM A OR B, IT IS JUST A
COMPUTER PLAYING ON THE OTHER
SIDE. THAT'S THE OTHER THING YOU
DON'T KNOW WHEN PLAYING THIS
GAME. THAT ENABLES THE
EXPERIMENTERS TO SET UP A
CONTROLLABLE TASK WHERE THE
INDIVIDUAL PLAY IN THE GAME HAS
AN IMPACT ON THE OFFERS THAT
COME IN THE FUTURE. AS OPPOSED
TO AN UNCONTROLLABLE TASK WHERE
NO MATTER WHAT YOU'LL GET THE
SAME SET OF AWARDS. THE CONTROL
IS A VERY SIMPLE RULE, IF YOU
REJECT AN OFFER THEN THE NEXT
OFFER WILL BE A LITTLE HIGHER.
THAT MAKES SENSE, RIGHT? IF YOU
REJECT YOUR $5 OFFER THE TEAM
DOESN'T GET THE $15 SO THEY WILL
GIVE YOU A LITTLE BIT MORE NEXT
TIME SO THEY GET TO KEEP SOME OF
THE REWARD. IF YOU ACCEPT THE
OFFER THE TEAM WILL REDUCE
AMOUNT OF NEXT OFFER ON THE NEXT
TRIAL. THAT MAKES SENSE ALSO.
OH, YOU WERE WILLING TO TAKE $5?
SEE IF YOU WILL TAKE 4 BECAUSE
THAT ENABLES THEM TO KEEP MORE
OF THAT $20 REWARD. SO AGAIN
THERE'S TWO SETS OF TRIALS HERE,
ONE WHICH BEHAVIOR AS YOU AS
INDIVIDUAL PLAY IN THE GAME
EFFECTS WHAT HAPPENS NEXT AND
ANOTHER WHERE BEHAVIOR DOES NOT
AFFECT WHAT HAPPENS NEXT. SO
WHAT WILL THIS TELL US ABOUT
SOCIAL BEHAVIOR?
THESE INVESTIGATORS WERE TRYING
TO FIGURE OUT HOW WE AS HUMAN
BEINGS MAKE PREDICTIONS ABOUT
WHAT IS GOING TO HAPPEN NEXT IN
A SOCIAL SITUATION. WE DO THIS
ALL THE TIME. WE ARE TALKING
WITH SOMEONE WE CARE ABOUT, WE
ARE NEGOTIATING WHO IS GOING TO
COOK DINNER. WE SAY WELL IF I
COMPLIMENT THEM ON THEIR COOKING
MAYBE THAT WILL MAKE THEM MORE
LIKELY TO COOK DINNER FOR ME
TONIGHT. AND NEGOTIATING A
NUMBER OF DIFFERENT SOCIAL
SITUATIONS SO HOW DO WE DO THAT?
WHAT ARE THE NEURAL MECHANISMS
THAT UNDERLINE OUR ABILITY TO
WHAT'S GOING TO HAPPEN BASED
UPON OUR OWN SOCIAL ACTS. THAT
IS WHAT WE STUDY HERE T. FIRST
STEP IS DESIGN THE TASK THE
SECOND STEP IS TO MODEL THE TASK
WITH A MATHEMATICAL ALGORITHM
THAT BASICALLY SAYS OH, ME AS A
PERSON PLAYING THIS GAME HOW DO
I DECIDE WHAT TO DO? ONE IS THAT
I LOOK FORWARD TO THE VERY NEXT
TRIAL AND SAY IF I REJECT THEM,
WHAT HAPPENS ON THE NEXT TRIAL?
THAT WOULD BE A ONE STEP MODEL.
I AS AN ACTOR PLAYING THIS GAME
AM GOING TO THINK ONE STEP
AHEADS AND TRY TO FIGURE OUT
WHAT REWARD I MIGHT GET, ONE
STEP AHEAD AND THEN DECIDE WHAT
TO DO ON THE CURRENT TRIAL.
THERE'S OTHER MODELS, THERE'S
MODELS THAT SAY FORGET WHAT WILL
HAPPEN IN THE FUTURE, JUST
DECIDE IF YOU WANT THAT $5 OR
NOT. THAT WOULD BE A ZERO STEP
MODEL. OR YOU COULD LOOK FORWARD
THREE OR FOUR STEPS YOU CAN SAY
WELL WHAT HAPPENS ON THE NEXT
TRIAL AND THE NEXT TRIAL AFTER
THAT, AND NEXT TRIAL AFTER THAT.
THAT WOULD BE A TWO STEP OF
THREE STEP OR FOUR STEP MODEL.
SO THEN THE INVESTIGATORS ASKED
IF I MODEL INDIVIDUAL HUMANS
BEHAVIOR ON THIS TEST, ON THIS
TASK, AND MODEL LOOKS FORWARD
ONE STEP VERSUS LOOKS FORWARD
TWO STEPS, WHAT MODEL PERFORMS
WELL IN TERMS OF PREDICTK WHAT
HUMANS ACTUALLY DO. IN OTHER
WORDS, THE INVESTIGATORS ARE
TRYING TO FIGURE OUT BASED ON
COMPUTATIONAL MODEL HOW MANY
STEPS AHEAD THE AVERAGE PERSON
PLAYING THIS TASK THINKS TURNS
OUT IT IS TWO STEPS AHEAD. BEST
ANSWER, YOU GET THE BEST
PREDICTION WHEN THE COMPUTER
MODEL TRIES TO PREDICT OUT AHEAD
TWO STEPS IN ADVANCE, GET THE
BEST PREDICTION OF HUMAN
BEHAVIOR BY THINKING TWO STEPS
AHEAD. NOW, THAT IS
INTERESTING. SO THAT TELLS US
SOMETHING ABOUT THE
PSYCHOLOGICAL METHODOLOGY WE USE
TO TRY TO WITHIN THE CONFINES OF
THE TASK PREDICT MY SOCIAL
BEHAVIOR AFFECT IS GOING TO HAVE
ON OTHER PEOPLE'S SOCIAL
BEHAVIORS. NOW WE CAN ASK WELL,
WHAT IN THE BRAIN CON FIRMS OR
DENY THIS IS TWO STEP MODEL OR
WHERE IN THE BRAIN IS THIS TWO
STEP MODEL BEING INSTANTIATED?
ACTUALLY THESE INVESTIGATORS
CLEVERLY LOOK AT BOTH OF THOSE
THINGS AT THE SAME TIME. THEY
TOOK NEURAL ACTIVITY, SO THEY
PUT PEOPLE IN THIS TASK IN THE
SCANNER AND THEY ASKED WHERE IN
THE BRAIN CAN WE FIND EVIDENCE
OF MODELS OF DIFFERENT STEPS.
WHERE DOES NEURAL ACTIVITY LOOK
LIKE IT IS WORKING ON A ZERO
STEP MODEL, ONE STEP, TWO STEP
OR THREE STEP MODEL, ET CETERA.
WHAT THEY FOUND IS THAT THERE IS
ONE PLACE IN THE BRAIN THAT
APPEARS DOING ANY FORWARD
THINKING THAT APPEARS TO BE
CORRESPONDING WITH NEURAL
ACTIVITY WE EXPECT BASED UPON
ANY GIVEN MODEL. THAT IS THE
VENTRAL MEDIAL PREFRONTAL CORTEX
HERE IN THE FRONT OF THE BRAIN.
AND IMPORTANTLY THAT PART OF THE
BRAIN IS NOT ACTIVE WITH 0 STEP
MODEL 1 OR 3 STEP MODEL, IT IS
ACTIVE ONLY TWO TWO STEP MODEL.
SO INTERESTING EXPERIMENT, WE
ARE TRYING TO USE A MATHEMATICAL
MODEL TO PREDICT HOW HUMANS
BEHAVE THEN LOOK IN THE BRAIN
AND SEE DOES THE BRAIN BEEHIVE
LIKE THAT TWO STEP MODEL
PREDICTS LIKE THAT MODEL
PREDICTS AND THE ANSWER IS IT
DOES, IT ALSO PROVIDES
INFORMATION WHERE IN THE BRAIN
THOSE COMPUTATIONS ARE TAKING
PLACE. THIS IS FANTASTIC USE OF
COMPUTATIONAL NEUROSCIENCE TO
DISSECT PHENOTYPES AN
IMPORTANTLY, IT REQUEST HAVE
CLINICAL RELEVANCE, WE CAN TRY
TO UNDERSTAND WHETHER ASSESSMENT
OF PREDICTIONS OF FUTURE DURING
THE SOCIAL INTERACTIONS IS
IMPAIRED IN DISORDER WHERE
INDIVIDUALS HAVE CHALLENGES WITH
SOCIAL BEHAVIORS. AND THEN WE
CAN ALSO ASK WHETHER THIS PART
OF THE BRAIN IS IMPAIRED AS WELL
DURING THE THOSE MOMENTS. SO I
THINK IT IS AN EXCITING
DEVELOPMENT BASIC NEUROSCIENCE.
NEXT FROM BASIC NEUROSCIENCE WE
ARE GOING TO TURN TO DEPRESSION
CARE AND DEPRESSION CARE IN THE
GLOBAL SETTING DEPRESSION CARE
IN THE GLOBAL SETTING IN THE
SETTING OF HIV. LESSONS LEARNED
FROM GENERALIZABLE. THIS STUDY
BY STEVEN AND JOHN AND
COLLABORATORS IS SUPPORTED BY
OUR DIVISION OF AIDS RESEARCH,
ASKED A REALLY IMPORTANT
QUESTION. WE KNOW THERE IS A LOT
OF CO-MORBIDITY BETWEEN
INDIVIDUALS WHO HAVE HIV AND
DEPRESSION. AND THE QUESTION IS,
IF WE TREAT THAT DEPRESSION, AND
IF WE TREAT IT ACTUALLY IN A
SUSTAINABLE WAY THAT IS USING
PSYCHOTHERAPY, COGNITIVE
BEHAVIORAL THERAPY DELIVERED BY
CLINIC NURSES BECAUSE THAT IS
GENERAL CLINIC NURSES NOT
SPECIFIC MENTAL HEALTHCARE
PROVIDERS, CAN WE IMPROVE NOT
ONLY DEPRESSION BUT ALSO THE
ADHERENCE TO THEIR HIV
MEDICATIONS. SO THAT WE CAN
ENSURE THAT THEY WILL GET NOT
ONLY GET WELL FROM DEPRESSION
BUT ALSO THAT THEY WILL BE ABLE
TO ACHIEVE LOWER VIRAL LOAD AND
LONGER TERM PHYSICAL HEALTH. SO
THE ANSWER TO THIS QUESTION AS
YOU MIGHT GUESS BY FACT I'M
HIGHLIGHTING IS YES, INDEED YOU
CAN DO THAT. AND IN FACT YOU
HAVE TO DO IT. IN ORDER TO
LOWER YOUR HIV LOAD AND ENSURE
ADHERENCE TO HIV CARE. AND THE
EXPERIMENT IS SUCH THEY TOOK A
NUMBER OF INDIVIDUALS WHO HAD
BOTH DEPRESSION AND WERE HIV
POSITIVE. THEY ASSESS THEM WITH
NUMBER OF DIFFERENT MEASURES
INCLUDING -- AND VIRAL LOAD. AT
BASELINE AND THEN THEY RANDOMIZE
THEM TO EITHER TREATMENT AS
USUAL BY TYPICALLY INVOLVED AN
IMPRESSIVE MEDICATION OR
REFERRAL TO PSYCHIATRIC CARE,
BUT WHICH IS REALLY CHALLENGING
AND DIFFICULT TO ACHIEVE IN
THESE GLOBAL SETTINGS. OR
ADDITION A COGNITIVE BEHAVIORAL
THERAPY ADMINISTERED BY GENERAL
CLINIC NURSES. THE RESULTS WERE
PRETTY SUBSTANTIAL, THAT IS THAT
TREATMENT WITH COGNITIVE
BEHAVIORAL THERAPY LOWERED YOUR
HAMD SCORES, IMPROVED DEPRESSION
MUCH MORE ROBUSTLY THAN DID
TREATMENT AS USUAL. AND VIRAL
LOAD ALSO DROPPED. AND THIS WAS
TRUE BOTH AT FOUR MONTHS AND
EXTENDED OUT TO A YEAR. HERE IS
THE DATA GRAPHICALLY SO YOU CAN
SEE THAT PEOPLE IMPROVE THEIR
ADHERENCE, SORRY THAT'S THE
HAMD. HERE WE IMPROVED BY
PHYSICAL MONITORING PILL
DISPENSER. YOU CAN SEE ADHERENCE
IN THE COGNITIVE BEHAVIOR
THERAPY GROUP WAS BETTER THAN
TREATMENT AS USUAL. THAT IS TRUE
AT FOUR MONTHS AND ALSO TRUE OUT
AT ONE YEAR. THE END RESULT OF
VIRAL LOAD BETTER 4, 8, 12
MONTHS AFTER DELIVERY OF
COGNITIVE BEHAVIORAL THERAPY. SO
IMPORTANT FOR TWO REASONS, ONE
WITHIN THE SETTING AND IN THE
CONTEXT OF HIV TREATING THE
DEPRESSION IMPROVE MANAGEMENT OF
THIS CHRONIC HEALTH CONDITION
AND ALSO IT SHOWED THE PATHWAY
TO IMPLEMENTATION OF THIS
DELIVERY THROUGH NON-SPECIALIST
CARE WHICH COULD BE EXPANDED TO
MANY OTHER PLACES IN THE UNITED
STATES AS ELSEWHERE WHERE
SPECIALLY HEALTHCARE MENTAL
HEALTH CAN BE CHALLENGING TO
FIND. LET'S TURN BACK TO MENTAL
HEALTH, WORK FUNDED BY DIVISION
OF TRANSLATIONAL SCIENCE --
RESEARCH, AND LET'S TURN TO A
THERAPY ON THE CUTTING EDGE,
DEEP BRAIN THERAPY, DEEP BRAIN
STIMULATION FOR OBSESSIVE
COMPULSIVE DISORDER. THIS PAPER
IS NOT IS MUCH ABOUT THERAPY BUT
FIGURING WAYS TO ENHANCE IT, IT
COMES FROM NICOLE AND DAVID
WARTON AND COLLEAGUES. THEY ARE
TAKING INDIVIDUALS WHO HAVE DEEP
BRAIN STIMULATERS IMPLANTED TO
TREAT OBSESSIVE COMPULSIVE
DISORDER AND ASK THEM TO RELEARN
ANYTHING ABOUT ACTIVITY PATTERNS
IN THE BRAIN TO ENABLE US TO
IMPROVE ON OUR CURRENT ABILITY
TO TREAT THESE INDIVIDUALS. SO
THEY TOOK A NUMBER OF FOLKS WHO
HAD THESE STILL LAYS FOR IMPLANT
NOD THE BRAIN, ONLY STIMULATORS
IN BRAIN THROUGH VISUALATIONS
ESTABLISH WHERE IN THE BRAIN
ELECTRODES ARE. AND THESE
ELECTRODES NOT ONLY ALLOW
STIMULATION BUT ALSO ALLOW
REPORTING. SO THEY TOOK
MULTI-SIDE ELECTROPHYSIOLOGICAL
REPORTINGS FROM THESE DEEP BRAIN
REGIONS IN INDIVIDUALS WITH
OBSESSIVE COMPULSIVE DISORDER
AND THIS IS A TECHNIQUE PAPER TO
DESCRIBE WHAT THEY CAN DO AND IT
IS ASTOUNDING WHAT THEY CAN DO.
THEY COUPLE THE RECORDINGS NOT
JUST THE RECORDINGS THEMSELVES
BUT WITH VIDEO OBSERVATIONS OF
THE INDIVIDUALS AS THEY ARE
UNDERGOING DEEP BRAIN
STIMULATION EXPERIENCING VARIOUS
EXTERNAL STIMULI. THEY CAN
MONITOR THINGS LIKE THE VELOCITY
OF THE HEAD MOVEMENT, THE
AMPLITUDE OF THE STIMULATION,
THE ELECTRICAL ACTIVITY AT TIPS
OF THE ELECTRODES, AND ALSO THE
AFFECT EXPRESSED BY THEIR FACES
DETERMINED AUTOMATICALLY BY A
DEEP LEARNING ALGORITHM. THEN
THEY CAN MAP THESE VARIOUS
QUANTITIES THEY CAN
SIMULTANEOUSLY MEASURE ON TO
EACH OTHER SO THEY CAN LOOK AT
ALL THOSE THINGS BUT THEY CAN
ALSO LOOK AT SELF-REPORTED
INTENSITY OF OCD SYMPTOMS. THEY
CAN CORRELATE THESE VARIOUS
VARIOUSELECTRO PHYSIOLOGICAL
PARAMETERS AND LOOK AT THEIR
RELATIONSHIP BETWEEN THESE
DIFFERENT PARAMETERS YOU CAN
MEASURE LIKE AFFECT OR LIKE SELF
REPORTED SYMPTOMS, AND SHOW
CORRELATION. FOR EXAMPLE, THEY
ARE SHOWING RELATIONSHIP BETWEEN
ACTIVITY IN DIFFERENT FREQUENCY
RANKS HERE DELTA THETA ALPHA
THETA, THESE ARE FREQUENCY RANKS
IN LOCAL ACTIVITY GOING UP AND
DOWN AND UP AND DOWN IN
DIFFERENT SPEEDS OVER TIME. AND
THE INTENSITY OF THE OCD
SYMPTOMS. AND WHILE THESE ARE
TANTALIZING THERE IS NOT ENOUGH
DATA YET IN THIS PAPER TO MAKE
ANY FIRM CONCLUSIONS BUT THE
POWER OF THIS TECHNIQUE TO BE
ABLE TO MAP DEEP ACTIVITY IN THE
BRAIN SIMULTANEOUSLY WITH DEEP
UNDERSTANDING OF THE BEHAVIOR
AND AFFECTIVE STATE OF
INDIVIDUAL, GIVES HOPE FOR THE
FUTURE TO CUSTOMIZE TREATMENT
FOR FOLKS AND MAKE SURE
TREATMENT IS TARGETING SYMPTOMS
IN A PERSONALIZED WAY. SO THOSE
ARE THE HIGHLIGHTS I HAVE FOR
YOU. I WILL CLOSE WITH OUR
VISION, WE ENVISION A WORLD
MENTAL ILLNESS ARE PREVENT AND
CURE AND THE MISSION TO
TRANSFORM THE UNDERSTANDING AND
TREATMENT OF THOSE ILLNESSES TO
CLINICAL RESEARCH, PAVING THE
WAY FOR PREVENTION RECOVERY AND
CURE. AND OPEN IT UP WE DO HAVE
ABOUT TEN OR 15 MINUTES, SAY TEN
BECAUSE I WANT TO ENTER TUESDAY
A SPECIAL GUEST AT THE END. TEN
MINUTES FOR QUESTIONS.
BRANDONICS I THINK YOBRANDON, YOU ARE THE FIRST, GO
AHEAD.
>> THANKS, JOSH. GREAT
PRESENTATION. EXCITING SCIENCE
YOU SHOWED AND GREAT
DEVELOPMENTS ARE GREAT TO HEAR
ABOUT. I WANT TO CONGRATULATE
AND THANKS BOB HEISSMAN FOR HIS
SERVICE AS DEPUTY DIRECTOR.
GREAT TO WORK WITH YOU OVER E
THE YEARS, YOU ARE A HERO FOR ME
AND MANY I KNOW AND SERVICES
INTERVENTION RESEARCH. QUESTION
FOR YOU JOSH, OR BOB WHOEVER
WANTS TO ANSWER, NOW THAT BOB IS
STEPPING DOWN FROM THAT ROLE,
BEENING SEEN YOUR ADVISOR AS
DIRECTOR DO YOU ENVISION THIS
EARLY PSYCHOSIS AND CLINICAL
PROGRAMS THAT ARE UNDERWAY RIGHT
NOW SUCH AS THE EPI NET AND THE
ACCELERATED MEDICINES
PARTNERSHIP IN SCHIZOPHRENIA
WILL CONTINUE TO GROW SIMILAR
PROGRAMS THEY CONTINUE TO GROW
UNDER THE AGENDA OF NIMH IN
COMING YEARS?
>> GREAT QUESTION, THANKS,
BRANDON. THANKS FOR UNDERSCORING
WHAT IMPORTANT MEMBER OF OUR
COMMUNITY BOB HAS BEEN. THE
QUICK ANSWER TO YOUR QUESTION
IS, THERE'S NOT GOING TO BE ANY
CHANGE IN OUR -- FROM THE PRIOR
WHICH WE REPRESENT EPI NET AND
OTHER EFFORTS UNDERSTANDING AN
TREATING SERIOUS MENTAL ILLNESS.
IN FACT, BOB'S PURVIEW IS REALLY
GOING TO BE IN THIS SPECIAL
ADVISORY ROLE, WORKING ON
ENSURING THE SUSTAINABILITY OF
THESE PROGRAMS AND SPECIFICALLY
AROUND EPI NET. ENSURING THEIR
IMPACT BY HE'S GOING TO BE
WORKING HAND IN HAND WITH OTHER
FEDERAL AGENCIES TO MAKE SURE
THEY UNDERSTAND THE QUALITY OF
EVIDENCE COMING OUT OF THESE
PROGRAMS. AND THAT THAT EVIDENCE
IS USED TO EXPAND SERVICES AND
THE EFFICACY OF SERVICES OFFERED
THROUGHOUT THE UNITED STATES AND
PUBLIC MENTAL HEALTH. SO IT IS A
REALLY IMPORTANT ROLE THAT BOB
WILL TRANSITION TO AND LOOK
FORWARD TO TELLING YOU MORE
ABOUT IT AS THINGS MOVE ON.
THANKS, BRANDON.
>> THANKS FOR SHARING SUCH A
RICH UPDATE. --
>> YOU KNOW WHAT, LET ME
INTERRUPT. BRANDON WOULD YOU
TAKE A MOMENT TO INTRODUCE
YOURSELF FOR THE PUBLIC?
>> GOOD POINT. I'M BRANDON
STAGLIN PRESIDENT OF ONE MIND.
>> THANKS, CHERYL YOUR NAME AND
AFFILIATION.
>> CHERYL KING, PROFESSOR AT
MICHIGAN MEDICINE. THANKS AGAIN
FOR THE RICH UPDATE AND FOR THE
SCIENCE HIGHLIGHTS. I THINK
THAT'S ALWAYS A BONUS THAT WE
GET AT THESE MEETINGS. BRINGING
THOSE TO OUR ATTENTION. I ALSO
WANT TO HAVE A SHOUT OUT TO BOB,
BOB I THINK I, I THINK MANY OF
US HAVE REALLY APPRECIATED YOUR
STRATEGIC DIRECTION BUT ALSO
JUST YOUR POSITIVE ENERGY AND
YOUR POSITIVE SPIRIT ABOUT IT
ALL, IT IS JUST REALLY BEEN A
JOY TO HAVE SOME INTERACTIONS
AND KNOW YOU HAVE BEEN AT THE
HELM OF -- FOR THIS RESEARCH. T
MY QUESTION IS REALLY ABOUT
RESOURCES. AND I WANT YOUR
OPINION ON SOMETHING, JOSH.
BECAUSE WHEN WE CONSIDER OUR
ENGAGEMENT OF SCIENTISTS, WE ARE
REALLY A NATIONAL RESOURCE AND
OUR URGENCY TO MOVE SCIENCE
FORWARD, I'M WONDERING WHAT YOUR
THOUGHTS ARE, ON WHAT WOULD BE
AN IDEAL FUNDING LEVEL BECAUSE
THROUGH MY MANY YEARS OF
REVIEWING NIMH GRANTS, I THINK I
HAVE BEEN STRUCK THAT REALLY A
SUBSTANTIAL PROPORTION ARE QUITE
STRONG AND YES THEY MADE
BENEFITS FROM SOME MINOR TWEAKS
AND REVISIONS BUT THAT WOULDN'T
NECESSARILY REQUIRE THE
SCIENTISTS TIME, THE DELAYS TO
MOVING A SCIENCE FORWARD Z THAT
IT TAKES WHEN SOMEONE HAS TO
REVISE AN APPLICATION, MAJOR
EFFORT AND TIME FOR ENTIRE TEAM
AND RESUBMIT IT 8 TO 10 MONTHS
LATER. SO WHAT MIGHT BE IDEAL
FROM YOUR PERSPECTIVE OR YOUR
THOUGHTS ON THAT.
>> PUT ME IN A CHALLENGING
POSITION BUT I APPRECIATE THE
CHALLENGE. IT IS BECAUSE IT IS
NOT OUR JOB ESPECIALLY WHILE
APPROPRIATION PROCESS CONTINUES
TO REPRESENT WHAT WE CONSIDER AN
IDEAL FUNDING FOR OUR AGENCIES
TO CONGRESS. SO LET ME JUST
SLIGHTLY AMEND -- ANSWER IN A
WAY THAT IS PROBABLY NOT WHAT
YOU WANT ME TO SAY BUT LET ME
SAY THAT NO QUESTION IN MY MIND
WE CAN DOUBLE THE NUMBER OF
GRANTS WE FUND AND STILL FUND
OUTSTANDING SCIENCE. LET ME PUT
IT THAT WAY. WHEN WE FUND --
WHEN I SAY WE ARE FUNDING 22%
WHICH LAST YEAR THAT IS THE
NUMBER I THINK I SHOWED LAST
YEAR SUCCESS RATES, THAT DOESN'T
MEAN WE ARE FUNDING 22ERS
PERCENTILE, IT IS ACTUALLY LOWER
THAN THAT BECAUSE FUNDING COUNTS
MULTIPLE GRANTS AND DIFFERENT
THINGS FUNDED DIFFERENT WAYS. SO
WE CAN EASILY DOUBLE THE NUMBER
OF GRANTS WITHOUT AFFECTING THE
QUALITY. THERE ARE MANY IN THE
SCIENTIFIC COMMUNITY WHO POINT
OUT WHAT YOU JUST POINTED OUT
THERE, MANY EXCELLENT IDEAS AND
OF COURSE THE COST TO SCIENTISTS
HAVING TO REPEAT. I SEE THAT
COST ALL THE TIME. I SEE IT WHEN
I SAY YES TO ONE GRANT AND NO TO
ANOTHER BECAUSE WE CAN'T REACH
THAT NEXT GRANT AND THEN SEEING
THAT GRANT COME IN, THE NEXT
YEAR, AND IT DOES WELL AGAIN AND
THEN WHY DIDN'T WE JUST FUND IT
LAST YEAR? THIS IS A TREMENDOUS
COST TO SCIENCE, I WILL AGREE
WITH YOU AND I THINK I WILL
LEAVE IT AT THAT. AND LEAVE AT
THAT AND SOME OTHER TIME I MIGHT
GIVE YOU WHAT MY IDEAL WOULD BE.
THANKS, CHERYL.
>> THANKS SO MUCH, MY NAME IS
TEDDY ABEL, UNIVERSITY OF IOWA.
I APPRECIATE ALL THAT NIH HAS
DONE AND GRATEFUL FOR PREVIOUS
COUNCIL MEMBERS BRANDON STEPPING
OFF, I HAVE BEEN ON SOME PUBLIC
MEETINGS AND AS CHAIR OF BSCN
HEARD YOUR COMMENTS AND I
APPRECIATE THEM. I'M A PARENT OF
A 22-YEAR-OLD MAN ON AUTISM
SPECTRUM SO I DON'T HAVE THAT
PERSONAL EXPERIENCE BUT I HAVE
THAT AS FAMILY MEMBER SO I
APPRECIATE ALL YOU CONTRIBUTED
TO YOU ARE DISCONDUCT. GRATEFUL
FOR THAT. THE QUESTION I HAVE
FOR YOU, JOSH IS THINKING
ORIGINS OF MENTAL ILLNESS. IT
RELATES A LITTLE BIT TO THE
QUESTION BECAUSE THE OTHER ISSUE
WITH OUR GRANTS IS THEY ARE FIVE
YEARS LONG OR FOUR YEARS LONG OR
TRAINING GRANT IS TWO YEARS LONG
BUT MENTAL ILLNESS DEVELOPS
PRE-CLINICALLY IN SOME CASES
OVER DECADES. OR EVEN BACK IN
UTERO IN THE CASE OF AUTISM
SPECTRUM DISORDERS. I WONDER IF
YOU COULD HIGHLIGHT SOME OF WHAT
IS BEING DONE TO LOOK INK TO
THOSE PROCESSES A LOT 06 WHAT
YOU TALK ABOUT ARE OBVIOUSLY CUT
EDGE RESOURCES BUT PROBABLY NOT
GOING TO BE DOING THESE
IMPLANTATIONS IN MANY PATIENTS.
I CAN'T IMAGINE PATIENTS BEING
ABLE TO DO THIS TWO STEP SOCIAL
TASK TO FIGURE OUT WHAT IS GOING
ON AND WHAT IS ALTERED ABOUT
NEURAL CONNECTIONS. COULD YOU
UPDATE WHERE WE ARE ON DEVELOP
MN TALL ORIGINS OF MENTAL
ILLNESS?
>>
>> I FEEL LIKE IT'S SOFTBALL
QUESTION. LET ME FRAME THE
QUESTION -- THE RESPONSE IN
CONTEXT AND GIVE COUPLE OF EXAM.
LIKE YOU REQUESTED. WE DO OUR
BEST EFFORTS TO FUND LONG TYLED
IN STUDIES. AT THE SAME TIME WE
DON'T WANT TO HAVE SOMETHING
THAT WE START UM AND THEN END UP
HAVING TO SUPPORT IT JUST
BECAUSE IT IS A LONGITUDINAL
STUDY SO WE TRIED TO BE
STRATEGIC IN TERMS OF WHERE WE
MAKE LONGITUDINAL INVESTMENTS.
MANY ARE GIVEN IN FIVE YEAR
INCREMENTS AND MIGHT BE
SUPPORTED 5, 10, 15 YEARS AN HEN
NOT. WE CAN'T SUPPORT ANYTHING
LONGER THAN FIVE THOUGH MANY
THINGS WE SET UP WITH THE IDEA
OF GOING TO SUPPORT THEM FOR
LONGER. OUR MOST LONGITUDINAL
EFFORTS ARE FOCUSED IN THE
DEVELOPMENTAL SPACE. SO WE DON'T
HAVE A LOT OF FRAMINGHAM HART
STUDY WHERE WE FOLLOW AS ADULTS
50 YEARS BUT WE DO TRY TO SET UP
LONGITUDINAL STUDIES THAT SPAN
PERIODS OF HIGH RISK, PERIODS OF
TRANSITION, LIKE ADOLESCENCE,
EARLY CHILDHOOD, ET CETERA. AND
WE TRY TO INFUSE THEM WITH DATA
COLLECTING AND SHARING
REQUIREMENTS THAT ARE ENSURE
THAT THAT DATA CAN BE USED BY
OTHERS, CAN BE LINKED ACROSS
TIME, THAT PEOPLE CAN BE
RECONTACTED, ET CETERA. ONE OF
THE MORE AGONIZING DECISIONS WE
HAVE HAVE TO MAKE IS WHAT TO DO
WHEN LONGITUDINAL STUDY COMES
BACK IN FOR RENEWAL AND IT
DOESN'T ACHIEVE AN EXCELLENT
SCORE AND WE HAVE TO DECIDE DO
WE STOP THIS STUDY, DO WE
CONTINUE IT. AND WE OFTEN TRY TO
FUND CONTINUATION, LET THEM COME
BACK IN ET CETERA SO WE DON'T
LOSE THE LONGITUDINAL ASPECT.
THAT IS A LITTLE CONTEXT TO IT.
OBVIOUSLY TWO OF THE BIGGER
PROGRAMS THAT WE ARE ENGAGED
WITH IN THIS SPACE RIGHT NOW,
ARE THE ADOLESCENT BRAIN
COGNITIVE DEVELOPMENT STUDY OR
ABCD STUDY, AND ITS EARLIER
NEWER HEALTHY BRAIN AND
COGNITIVE STUDY. A B C D WILL
FLUE, STARTED FOUR YEARS AGO,
FOLLOWED CHILDREN FROM NINE TO
19. WITH SERIAL BRAIN SCANS,
BEHAVIORAL EVALUATION, CLINICAL
EVALUATION, PARENT EVALUATION.
EVALUATION OF SOCIAL
DETERMINANTS OF STRESS WITH
COVID-19 REALLY TRYING TO GET A
WRAP AROUND PICTURE OF THESE
KIDS AS BRAINS DEVELOP AND
IMPACT AND COUNCIL MEMBERS AND
OTHERS ENGAGED AND INVOLVED WITH
A THE B C D STUDY. THE SIZE IS
SIGNIFICANT, 12,000 CHILDREN.
AND WE SHOULD BE ABLE TO GET
SOME ANSWERS, IT IS NOT TARGETED
AT ILLNESS PER SE. I WILL
CAPTURE DEVELOPMENTAL ILLNESS
SUBSTANCE USE, ET CETERA. SO A
TREMENDOUS RESOURCE, ALL THAT
DATA IS PUBLISHED AS YOU ANOA
AVAILABLE FOR RESEARCHERS TO
USE. A SIMILAR STUDY WE ARE
JUST GETTING OFF THE GROUND, THE
PLANNING GRANTS WENT OUT, THE
NEW GRANTS ARE COMING IN FOR I
CAN'T REMEMBER IF THEY ARE
FUNDED YET BUT TO INITIATE
STUDY, THIS WILL TRACK CHILDREN
A FEW PRE-NATALLY BUT MOSTLY
POSTNATALLY FOR THE FIRST TEN
YEARS OF LIFE OVERLAPPING WITH
THE AGE RANGE A B C D STUDY. IT
IS A LITTLE SMALLER IN SCOPE,
SEVERAL THOUSAND CHILDREN BUT A
LITTLE BIT DENSER BECAUSE IN
CHILDREN THINGS ARE IN LITTLE
KIDS THINGS ARE HAPPENING FASTER
SO WE TRY TO SCAN THEM MORE
OFTEN, GET ASSESSMENTS MORE
OFTEN. SO BETWEEN THOSE WE WILL
GET GOOD UNDERSTANDING. THERE
ARE OTHER LONGITUDINAL STUDYS WE
SUPPORT ARE DISEASE SPECIFIC. WE
HAVE SOME IN THE ADHD AREA, SOME
IN ANXIETY AND STRESS AND
DEPRESSION. MOST ARE ADOLESCENT
AGE RANGE. WE TRY TO SUPPORT
LONGITUDINAL STUDIES WHERE WE
CAN, AND DESPITE LIMITATIONS OF
THE FIVE YEAR CYCLE.
>> THIS IS HONGKUI ZENG EYE
INSTITUTE FOR BRAIN SCIENCE. AS
A MEMBER OF THE BRAIN INITIATIVE
CELL CENSUS NETWORK BICCN WITH A
U 19 GRANT FROM NIHH I WANT TO
SAY THANK YOU FOR MENTIONING THE
LAND MARK PUBLICATION PACKAGE
FROM BICCN. BACK IN OCTOBER IN
NATURE ON THE ATLASES OF
MAMMALIAN MOTOR CORTEX. MY
QUESTION FOR YOU IS WHAT IS THE
LOCK TERM STRATEGY FOR NIH BRAIN
INITIATIVE OR JUST NIH IN
GENERAL, IN MAINTAINING THIS
TREMENDOUS RESOURCE FOR THE
COMMUNITY? AS YOU KNOW, WE ARE
ALREADY PROCEEDING AS YOU
MENTIONED, FROM MOTOR CORTEX TO
GENERATE CELL TYPE ATLAS FOR THE
ENTIRE BRAIN STARTING WITH MOUSE
AND HOPEFULLY VERY SOON IN HUMAN
BRAIN AS WELL. IT IS GOING TO BE
MULTI-DIMENSIONAL MULTI-MODEL OF
THE DIFFERENT NEURONAL AND
NON-NEURONAL CELL TYPES OF THE
BRAIN. WE THINK IT IS REALLY A
TREMENDOUS RESOURCE THAT WILL
ACCELERATE THE PROGRESS IN THE
NEUROSCIENCE FIELD. IN THE
FUNDING MECHANISMS WE SEE THAT
AND FUNDS GO TO GENERATING
CREATING THE DATABAS DATABASES WEB
PORTALS SUPPORTING MAINTAINING
THE DATA IS USUALLY
SIGNIFICANTLY LOWER THAN THE
DATA GENERATION PART. SO JUST
WONDER HOW WOULD YOUR
ORGANIZATION, NIMH AND OTHER
INSTITUTIONS, PUTTING EFFORT
MAINTAINING RESOURCES FOR THE
COMMUNITY LONG TERM?
>> GREAT QUESTION, WE DON'T HAVE
ALL THE ANSWERS FOR YET. THE
DATA RESOURCES ARE SUPPORTED BY
GRANTS FUNDING THAT DATA TO BE
COLLECTED AND SHARED
STANDARDIZED AN SHARED. WE ARE
CLEARLY GOING TO NEED TO FIND
LONG TERM SUSTAINABLE WAY OF
CONTINUING ACCESS TO THAT DATA
FAR INTO FUTURE. I WOULD LOVE
TO SAY WE HAVE EXAMPLES FROM
OTHER AREAS OF SCIENCE WHICH
WITH WE DO. PARTIALLY IN THE
SENSE WE HAVE WONDERFUL
DATABASES IN GENOMICS AND OTHER
AREAS THAT CARRY DATA FORWARD
INTO THE FUTURE, BUT WE ARE
STILL WORKING OUT HOW WE ARE
GOING TO BE ABLE TO SUSTAIN AS
THE DATA LEVELS INCREASE. JUST
ONE QUICK EXAMPLE I'M SURE YOU
ARE AWARE, WE ARE GOING TO BE
PIVOTING MANY OF OUR POSTMORTEM
DISEASE STUDIES TO INSIST OUR
INVESTIGATORS USE SINGLE CELL
TYPE ANALYSES BECAUSE WE THINK
THAT IS GOING TO BARE FRUIT. SO
WE CAN ENVISION A TIME WHERE THE
DATA COMING IN FROM BICCN WILL
BE DWARFED BY THE DATA THAT COME
FOR DISEASE STUDIES, TO TRY TO
UNDERSTAND THE MOLECULAR
CONSEQUENCES OF -- AND
CONTRIBUTORS TO DISEASE. SO HOW
ARE WE GOING TO SUSTAIN THE
EXISTING DATA AND BUILD LARGER
DATABASES, I THINK THERE IS A
COMMITMENT ON PART OF THE
INSTITUTES TO SUPPORT IT, THERE
IS A COMMITMENT ON PART OF
BUILDING ONE TO SUPPORT IT. THAT
IS THE CENTRAL NIH
ADMINISTRATION AND WE WILL
FIGURE HOW TO DO IT ALONG THE
WAY. BUT I CAN'T SAY WE HAVE A
MAP TOWARDS LONG TERM
SUSTAINABILITY AT THIS TIME,
UNDERSTANDING THE IMPORTANCE WE
DON'T HAVE THAT MAP YET. PAMELA
AND THEN WE'LL MOVE ON. I WANT
TO GIVE YOU A HEADS UP MY
THOUGHT IS BECAUSE I KNOW YOU
HAVE TO LEAVE EARLY THAT YOU
MIGHT AFTER THE CONCLUSION OF
THIS DISCUSSION GIVE US YOUR
ADVICE AND CONSENT RIGHT BEFORE
WE BREAK. SOUND GOOD? OKAY.
PAMELA, GO AHEAD.
>> I'M PAMELA COLLINS FROM THE
UNIVERSITY OF WASHINGTON. AND I
WANT TO ADD MY THANKS AND
CONGRATULATIONS TO BOB HEINSEN
WHOM I LEARNED A LOT AS
COLLEAGUE AND RESEARCHER IN THE
FIELD. CONGRATULATIONS, BOB. I
WAS REALLY EXCITED TO SEE THE
COMMON FUND COMPASS INITIATIVE,
THIS IS JUST A CRITICAL APPROACH
TO UNDERSTANDING COMMUNITY
NEEDS, STRUCTURAL AND SYSTEMIC
SOURCES OF INEQUITY, AND I THINK
ONE OF THE BEST WAYS TO DEVELOP
PERSON CENTERED INTERVENTIONS.
T SO IN ADDITION TO THE COMMON
FUND INVESTMENT, HOW CAN NIMH
LEAD THE SCIENCE AROUND
COMMUNITY PART ENTREPRENEUR
RESEARCH AND MENTAL HEALTH? AND
WHERE DOES THE INSTITUTE STAND
ON THESE APPROACHES RIGHT NOW IN
THIS BODY OF RESEARCH?
>> SO WE ARE ENTIRELY SUPPORTIVE
I WOULD SAY IS WHERE WE STAND AS
YOU KNOW PAMELA, WE ARE IN THE
PROCESS OF FINALIZING A
RECRUITMENT OF NEW DIRECTOR OF
OFFICE OF DISPARITIES RESEARCH
AND WORK FORCE DIVERSITY. AND WE
HAVE SOME FUNDS HELD ASIDE TO
SUPPORT INITIATIVES THAT THAT
NEW DIRECTOR WILL BRING MANY IN
THE COMING YEAR AND YEAR OR TWO.
AND BEYOND THAT. AND ONE OF THE
THINGS WE HAVE BEEN RECRUITING
FOR AS SOMEONE FAMILIAR WITH AND
ENGAGED IN COMMUNITY BASED
RESEARCH COMMUNITY PARTICIPATORY
RESEARCH IN THE AREA OF HEALTH
EQUITY. SO I THINK WE CAN LOOK
FOR AN EXPANSION OF THAT KIND OF
WORK AT NIMH. WE STILL AND
ACTUALLY THE COMPASSS INITIATIVE
IS IN VIEW WITH A FOCUS ON
MECHANISM. WE WANT TO UNDERSTAND
THE DETERMINANTS OF HEALTH
INEQUITIES AND TARGET THOSE
DETERMINANTS WITH INTERVENTIONS.
BUT WITH A BROADER WE ALSO SHARE
A FOCUS ON INTERVENTION. WE
DON'T THINK IT IS GOOD ENOUGH
THE LOOK AT THE PROBLEM, WE WANT
OUR INVESTIGATORS TO BE AT LEAST
MOVING TOWARDS THAT MECHANISTIC
DISSECTION WITH THE EYE OF
INTERVENTIONS IN MIND. WE
RECOGNIZE THAT THERE WILL BE
STAGE THAT -- AND THIS IS
BIGGEST CHALLENGE WE NEED TO
FIND WAYS TO SUPPORT PEOPLE WHO
ARE A DEVELOPING THOSE COMMUNITY
BASED RELATIONSHIPS AND THAT IS
AT THE HEART OF COMPASSS
INITIATIVE, THE FIRST TWO YEARS
ARE PLANNING PHASES THAT SUPPORT
COMMUNITY BASED ORGANIZATIONS TO
WORK WITH COMMUNITY MEMBERS TO
FIGURE OUT WHAT ARE THE PROBLEMS
THEY WANT TO ADDRESS, AND WHAT
ARE THE INTERVENTIONS THEY WANT
TO BRING TO BARE AND THEN AFTER
THAT TWO YEAR PERIOD, THEY WILL
BE APPLYING THOSE INTERVENTIONS
IN A STUDY. SO WE MAY CHOOSE A
MODEL LIKE THAT. BUT WE
DEFINITELY PLAN ON INCREASING
OUR INVESTMENT IN COMMUNITY
BASED INTERVENTIONS. NOT THAT
WE DON'T HAVE ANY NOW, WE
STARTED IN MANY IN THE GLOBAL
SETTING AND LOCAL HERE AT NIMH
AND WE WANT WHEN YOU ARE HERE
AND WE WANT TO EXPAND UPON THAT. THAT.
SO THANK YOU VERY MUCH FOR THE
QUESTIONS. AND WE ARE GOING TO
-- BEFORE WE TAKE A BREAK I WANT
TO GIVE THE OPPORTUNITY TO YAEL
NIV, ONE DEPARTING COUNCIL
MEMBERS TO GIVE US WORDS OF
WISDOM AND YAEL PLEASE INTRODUCE
YOURSELF BEFORE YOU DO SO.
>> THANK YOU SO MUCH. I'M GLAD I
WROTE THIS IN ADVANCE. SO I MANY
NAME IS YAEL NIV, I'M LEADING
COUNCIL MEMBER, AT PRINCETON
UNIVERSITY AND I'M GOING TO
LEAVE EARLY TODAY BECAUSE I
TEACH AT 3 P.M. SO HENCE
DEPARTING NOW BUT NOT LEAVING
NOW. SO I WANTED TO SAY THAT
IT'S BEEN SUCH A PLEA TOWER TO
SERVE ON THE NIMH COUNCIL, I'M
CONSTANTLY IN AWE OF THE DEPTH
AND THOUGHTFULNESS OF THE WORK
THAT'S BEING DONE HERE AT ALL
LEVELS. ONE ASPECT THAT I
LEARNED IF ONLY ON COUNCIL WAS
THE DEEP KNOWLEDGE AND
COMMITMENT THAT PROGRAM OFFICERS
HAVE TO THE PROJECTS IN THEIR
PORTFOLIOS. IT WAS REALLY A PLEA
SURE TO SEE HOW SERIOUSLY
CAREFULLY RESEARCH PROPOSALS ARE
CONSIDERED BY PROGRAM COUNCIL
AND LEADERSHIP. I THINK YOU
BROUGHT ME ON COUNCIL FOR MY
COMPUTATIONAL EXPERTISE BUT I
FEEL THAT ONE OF MY MOST
IMPORTANT ROLES ON COUNCIL WAS
TO ADD ADVOCATE BEHAVIORAL
RESEARCH AND RESEARCH ON
PSYCHOTHERAPY INTERVENTION AND
REMIND US OF NIMH ROLE IN
FIGHTING GENDER BIAS AND
SCIENCE. SO IN TERMS OF ADVICE
TO NEW COUNCIL MEMBERS I HOPE
SOMEONE WILL TAKE UP THIS ROLE.
YOU DON'T HAVE TO BE A WOMAN TO
DO IT. AND MORE BROADLY I'M
HEARTENED TO SEE NIMH TAKE A
MORE ACTIVE ROLE COMBATING
SEXISM AND RACISM; THESE EFFORTS
HAVE TO BE REAL EVER DEEPER AN
COME FROM THE TOP AND I'M GLAD
THEY DO. NIMH WITH LARGE BUDGET
AS WE SAW TODAY NOT AS LARGE AS
WE WAN BUT STILL LARGE, CAN
CONTINUE PER WAITING HISTORIC --
PERPETUATING HISTORIC BIAS OR
WORK TO RIGHT THE WRONGS. I SEE
IN CLOSE SESSIONS MORE
REFLECTION ON THIS ISSUE AND HOW
THESE ISSUES ARE IMPACTED BY
EVERYONE OF OUR DECISIONS. MOST
IMPORTANTLY, IN MY TIME ON
COUNCIL, WE HAVE CHANGED THE WAY
ADDITIONAL FUNDING TO VERY WELL
FUNDED LABS IS ASSESSED. I SEE
THIS AS A REALLY IMPORTANT STEP
AND WORKING AGAINST HORDING OF
RESOURCES. BECAUSE THE BOTTOM
LINE IS THAT IN ORDER TO LIFT UP
THOSE WHO HAVE BEEN
DISCRIMINATED AGAINST, THOSE WHO
HAVE BENEFITED FROM PRIVILEGE
NEED THE GIVE UP SOME OF THEIR
POWER. AND THIS IS NOT TRIVIAL
BECAUSE MANY OF US ON COUNCIL
HAVE SUCCESSFUL HIGHLY FUNDED
LABS. SO ALL THE MORE PROUD WE
CAN AS A GROUP COMMIT TO BETTER
SHARING OF RESOURCES. SO THANK
YOU, EVERYONE. IT WAS A REALLY
GREAT PRIVILEGE TO GET TO KNOW
ALL OF YOU AND TO WORK WITH YOU
AND GOOD LUCK WITH IMPORTANT
WORK THAT LIES AHEAD.
>> THANK YOU, YAEL FOR YOUR
ACTIVE ADVOCACY ON ALL THAT YOU
SAID AN MORE. AND FOR YOUR
ACTIVE PARTICIPATION IN THIS
COUNCIL THE LAST SEVERAL YEARS.
YOU ARE RIGHT, I BROUGHT YOU ON
FOR ONE REASON AND IT WAS VERY
PLEASED TO HAVE MULTIPLE REASONS
TO APPRECIATE YOUR
CONTRIBUTIONS. THANK YOU. OKAY.
WITH THAT WE ARE GOING TO TAKE A
BREAK WE ARE RUNNING A BIT
BEHIND SO WE WILL KEEP OUR BREAK
TO FIVE MINUTES INSTEAD OF TEN.
I APOLOGIZE. WE WILL COME BACK
AT 1:16. WE HAVE A WONDERFUL
GUEST TODAY. DR. ZENK FROM THE
NATIONAL INSTITUTE NURSING
RESEARCH. SEE YOU AT 1:16.
>> WELCOME BACK, EVERYONE FROM
OUR BREAK. BOTH MEMBERS OF
COUNCIL AS WELL AS THOSE OF YOU
IN THE VIDEOCAST. I WANT TO
WELCOME YOU BACK AND SAY HOW
HONORED WE ARE TO HAVE DR.
SHANNON ZENK WITH US TODAY,
DIRECTOR OF O NATIONAL INSTITUTE
OF NURSING RESEARCH. DR. ZENG'S
RESEARCH FOCUSES ON SOCIAL
INEQUITIES AN HEALTH WITH THE
GOAL OF IDENTIFYING EFFECTIVE
MULTI-LEVEL APPROACH TO IMPROVE
HEALTH AND ELIMINATE RACIAL
ETHNIC AND SOCIOECONOMIC HEALTH
DISPARITIES. AS NIMH CONTINUES
TO REEXAMINE OUR FOCUS ON SOCIAL
DETERMINANTS OF HEALTH, I
THOUGHT WE WOULD GREATLY BENEFIT
FROM HEARING HER INSIGHT AND
EXPLORE POTENTIAL FUTURE
PARTNERSHIPS BETWEEN NIMH AND
NINR, LET ME ADD WE ALREADY HAVE
ONE OF THOSE PARTNERSHIPS WE ARE
WORKING ON THAT INITIATIVE THAT
I JUST TOLD YOU ABOUT, COMPASSS
INITIATIVE HEALTH EQUITY THAT
JUST WAS AGREED TO BE FUNDED BY
THE COMMON FUND. AND DR. ZENK IS
A FANTASTIC LEADER AND FANTASTIC
COLLEAGUE SO TANK IT AWAY. THANK
YOU. -- TAKE IT AWAY.
>> THANK YOU SO MUCH, JOSH. IT
REALLY IS A PLEASURE TO BE WITH
ALL OF YOU TODAY AND GREAT TO
HAVE THE OPPORTUNITY TO TALK TO
YOUR COUNCIL SO THANK YOU. I'M
EXCITED TO HEAR HA THAT NIMH IS
CONSIDERING ADDITIONAL RESEARCH
AND SOCIAL DETERMINANTS OF
HEALTH AND SO JUST PLEASED TO BE
ABLE TO SHARE A NURSING RESEARCH
PERSPECTIVE ON THIS FIELD OF
RESEARCH. BEFORE WE GET STARTED
LET ME TELL YOU WHAT I'LL COVER
TODAY. FIRST MY CAREER PATH AND
IN ADDITION TO WHERE PEOPLE ARE
BORN PLAY LIVE WORK AND AGE. AND
I WILL SHARE THE WORK WE ARE
FUNDING WITH NINR AND SOME NIH
WIDE SOCIAL DETERMINANTS OF
HEALTH INITIATIVES. FINALLY I
WILL DISCUSS OUR UPCOMING
STRATEGIC PLAN AND WHERE WE ARE
HEADED UNDER MY LEADERSHIP AT
NINR. FIRST A LITTLE BIT ABOUT
ME. I BECAME INTERESTED IN
COMMUNITY ENVIRONMENTS AND
SPECIFICALLY HOW RESOURCES AND
RISKS WERE DISTRIBUTED ACROSS
COMMUNITIES AND IMPLICATION FOR
PEOPLE'S HEALTH WHILE PRACTICING
AS A NURSE IN HOME HEALTHCARE SO
SPENDING TIME IN PEOPLE'S HOMES
AND DIFFERENT COMMUNITIES I WAS
STRUCK BY THE TREMENDOUS
DIFFERENCES IN THE ENVIRONMENT
OF PATIENTS IN MY CASE LOAD IN
TERMS OF PRIVILEGE AS WELL AS
POVERTY. I FOUND IT DIFFICULT
TO TALK TO PATIENTS ABOUT HERBAL
THY EATING. WHAT THEY REALLY
NEED IS DECENT STABLE HOUSING,
SAFE ENVIRONMENT AND ACCESS TO
AFFORDABLE FOODS NEARBY. IN
RESPONSE TO THOSE CLINICAL
OBSERVATIONS I WENT
BACK-TO-SCHOOL TO LEARN WHAT I
COULD DO TO HELP ADDRESS THOSE
ISSUES. AND ACTUALLY I AM NOT
SURE IF YOU KNOW THIS JOSH BUT
I'M GRATEFUL TO NIMH FOR HELPING
SHAPE MY INTEREST IN SOCIAL
DETERMINANTS OF HEALTH.
SPECIFICALLY NIMH SUPPORTED
THREE YEARS OF MY PRE-DOCTORAL
TRAINING, THROUGH A T-32 ON
PSYCHOSOCIAL FACTORS ON MENTAL
HEALTH AND ILLNESS LED BY DR.
DAVID WILLIAMS THEN AT THE
UNIVERSITY OF MICHIGAN. SO I AM
VERY GRATEFUL TO NIM H. WITH
THAT SUPPORT I WAS ABLE TO
PARTICIPATE IN RESEARCH AS PART
OF THE DETROIT EPIDEMIC
COMMUNITY URBAN RESEARCH CENTER,
INCLUDING STUDIES USING STRESS
PROCESS MODELS TO UNDERSTAND AND
ADDRESS HEALTH DETERMINANTS AND
DISPARITIES AMONG RESIDENTS OF
DETROIT. SO ANOTHER CONNECTION
HERE IS I NOTICE THAT
COINCIDENTALLY YOUR NEXT SPEAKER
DR. ENRIQUE NEBLETT IS NOW
PROFESSOR AND MY FORMER
DEPARTMENT AT MICHIGAN, AND
ASSOCIATE DIRECTOR OF THE
DETROIT URC. SO ALL THESE
CONNECTIONS, JOSH. SO THROUGH
THE T 32 TRAINING AND OTHER
COURSE WORK I WAS EXPOSED TO
TROUBLING RESEARCH SHOWING
INEQUITIES BASED ON WHERE PEOPLE
LIVE. WHEN I WAS GOING TO SCHOOL
THERE WAS RELATIVELY NEW
RESEARCH COMING OUT BY DR.
ARLENE DOCUMENTING DISPARITIES
IN SURVIVAL AMONG AFRICAN
AMERICAN MEN LIVING IN DIFFERENT
U.S. COMMUNITIES. SHE FOUND FOR
EXAMPLE THE CHANCE OF SURVIVAL
TO AGE 65 WAS 60% NATIONWIDE, A
REALLY CONCERNING STATISTIC ON
ITS OWN,S BUT IT WAS ONLY 50% IN
CENTRAL CITY DETROIT AND 37% ON
CHICAGO SOUTH SIDE. TWO LOW
INCOME AFRICAN AMERICAN
COMMUNITIES. THERE IS ALSO NEW
RESEARCH COMING OUT THAT FOUND
LIVING IN A LOW INCOME
NEIGHBORHOOD WAS ASSOCIATED WITH
WORSE HEALTH EVEN WHEN YOU
CONTROL FOR INCOME AND WIDE
VARIETY OF OTHER FACTORS. THIS
WAS THE CASE ACROSS A WIDE
VARIETY OF HEALTH OUTCOMES.
AROUND THAT TIME DR. DAVID
WILLIAMS PROPOSED RACIAL
RESIDENTIAL SEGREGATION WAS A
FUNDAMENTAL CAUSE OF RACIAL
DISPARITIES IN HEALTH. SO ONE OF
THE QUESTIONS AT THIS TIME WAS
WHAT WERE THE MECHANISMS BY
WHICH SEGREGATION AND COMMUNITY
ECONOMIC CONDITIONS FOR EXAMPLE,
AFFECTED PEOPLE'S HEALTH HEALTH
AND REBUTTAL CKED TO
DISPARITIES. THAT LED TO FURTHER
OBSERVATIONS AN DISCUSSION AND I
HAD THE CHANCE TO SPEND TIME IN
DETROIT AS PART OF MY COURSE
WORK AND THROUGH MY WORK. I
HEARD PEOPLE TALK ABOUT LACK OF
HEALTHY FOODS IN THE LOCAL
COMMUNITIES AND SOME OF THE
OBSERVATIONS AT LOCAL STORE
CALLED EXTRA FOODS AT THE TIME
ARE DOCUMENTED IN THESE SLIDES.
SO THAT LAUNCHED MY RESEARCH
CAREER FIRST IN DETROIT LATER
CHICAGO AND NATIONWIDE MY
COLLEAGUES FOUND LOW INCOME AND
AFRICAN AMERICAN COMMUNITIES
HAVE LESS ACCESS TO HEALTHY
FOODS. FOR EXAMPLE, IN THE
DETROIT AREA, WE SHOWED THAT
SUPERMARKETS WHICH WE KNOW TEND
TO HAVE THE WIDEST SELECTION OF
HEALTHY FOODS, WERE LOCATED OVER
A MILE FURTHER FROM BLACK HIGH
POVERTY COMMUNITIES COMPARED TO
WHITE HIGH POVERTY COMMUNITIES.
THIS WAS ONE OF THE EARLY
STUDIES IN THE U.S. ON FOOD
DESERTS. WE ALSO FOUND MILLION
THY FOOD OPTIONS ARE LESS
AVAILABLE AT STORES AND
RESTAURANTS IN LOW INCOME AND
COMMUNITIES OF COLOR AND THAT
THE BALANCE OF HEALTHIER TO LESS
HEALTHY OPTIONS IS WORSE IN LOW
INCOME AFRICAN AMERICAN
COMMUNITIES. RECEIVE OUR
RESULTS ARE STUDIED ACROSS
COUNTRY, NOT ONLY HEALTHY FOOD
RESOURCES BUT WIDE VARIETY OF
OTHER RESOURCINGS ARE UNEQUALLY
DISTRIBUTED ACROSS COMMUNITIES,
INCLUDING JOBS THAT PAY A LIVING
WAGE, GOOD SCHOOLS, MUNICIPAL
SERVICES LIKE GARBAGE REMOVAL
AND PUBLIC TRANSIT, PHARMACIES,
ATTRACTIVE PARKS AND GREEN
SPACES, DESTINATIONS AN
INFRASTRUCTURE, FOR WALKING AND
BIKING. AS WELL AS CLEAN AIR AN
WATER. LIKEWISE LOW INCOME
COMMUNITIES ARE SUBJECTED TO
MORE RISESK SUCH AS GREATER
AVAILABLE AND MARKETING OF
TOBACCO, ALCOHOL AND JUNK FOOD.
Z ACCESSSIVE MONITORING BY
POLICE AND IMMIGRATION OFFICIALS
POLLUTION AND TOXIC SUBSTANCES.
SO MY TEAM AND I HAVE SINCE
GENERATED EVIDENCE ON HOW
VARIATIONS IN FOOD AND BUILT
ENVIRONMENT AFFECT INDIVIDUAL
DIET AND PHYSICAL ACTIVITY
BEHAVIORS AS WELL AS OBESITY
RISK, AND AFRICAN AMERICAN AND
MULTI-ETHNIC SAMPLES.
RECOGNIZING RESEARCH WAS STYMIED
BY LOCAL CROSS SECTIONAL STUDIES
WITH SAMPLE SIZES LAUNCHED AT
TIME OF INCEPTION WAS THE
LARGEST U.S. STUDY OF ITS KIND.
THIS STUDY INTEGRATED ELECTRONIC
HEALTH RECORD DATA AND
ADMINISTRATIVE DATA FROM THE
U.S. DEPARTMENT OF VETERANS
AFFAIRS, WITH MULTIPLE SOURCES
OF ENVIRONMENTAL DATA. IN OTHER
WORK WE EMPLOYED A CONCEPT FROM
BEHAVIORAL GEOGRAPHY CALLED
ACTIVITY SPACE TO ENRICH THE
CHARACTERIZATION OF
ENVIRONMENTAL EXPOSURES TO
INCLUDE PLACES WHERE PEOPLE
SPEND TIME NOT WHERE THEY LIVE.
WE HAVE EXTENDED THIS RESEARCH
WITH ADDITIONAL REAL TIME DATA
COLLECTION APPROACHES. TO
BETTER UNDERSTAND WHEN IT COMES
TO PEOPLE'S HEALTH, OR WHOM THE
ENVIRONMENT MATTERS, AND UNDER
WHAT CONDITIONS. WE ADDRESS
PROBLEMS IN BEHAVIORAL WEIGHT
LOSS INTERVENTION, TREMENDOUS
VARIABILITY IN INDIVIDUAL
RESPONSES AND SUSTAINED
BEHAVIORAL HEALTH IMPROVEMENTS.
EVALUATING WHETHER COMMUNITY
ENVIRONMENTS ALTER INTERVENTION
EFFECTIVENESS. SO GIVEN THEIR
IMPLICATIONS FOR PEOPLE'S HEALTH
AND HEALTH DISPARITIES AND
IMPORTANT QUESTION THEN IS HOW
CAN WE WRITE THE HISTORIC AND
CONTEMPORARY WRONGS OF RACISM
AND RACE BASED RESIDENTIAL
SEGREGATION THAT PRODUCE AND
PERPETUATE RACIAL INEQUITIES IN
ACCESS TO HEALTH RELEVANT
RESOURCES. THERE IS A CRITICAL
NEED HERE FOR SCIENTIFIC
EVIDENCE ON WHAT POLICIES AND
INVESTMENT ARE EFFECTIVE AND
INCREASING RESOURCES AND
REMOVING RISKS IN IMMUNITIES OF
COLOR AND ULTIMATELY IMPROVING
HEALTH BEHAVIORS AND HEALTH
OUTCOMES. THIS IS AN AREA OF
ACTIVE RESEARCH AND LET ME TELL
YOU ONE EXAMPLE OF RESERGE THAT
MY COLLEAGUES AND I CONDUCT --
RESEARCH WE CONDUCTED. THIS IS
POLICY RESEARCH. THE 2009 WIC
FOOD PACKAGE REVISION
DRAMATICALLY EXPANDED HEALTHY
FOODS SUCH AS FRUITS AND
VEGETABLES IN THE PACKAGE. THE
FIRST CHANGE IN THE PACKAGE IN
DECADES. NOW, THE REVISION WAS
DESIGNED TO IMPROVE THE KNEW
TRICKS OF WIC CLIENTS, YET THIS
COST NEUTRAL POLICY CHANGE WAS
ALSO ASSOCIATED WITH IMPROVEMENT
IN THE COMMUNITY ENVIRONMENT. IN
A STUDY OF NINE COUNTIES IN
NORTHERN ILLINOIS, WE FOUND
SMALL IMPROVEMENTS IN FRUIT AND
VEGETABLE AVAILABILITY AND
MODEST REDUCTION IN VEGETABLE
PRICES AT RETAILERS. STUDIES LED
BY OTHER TEAMS, GENERALLY FOUND
CONSISTENT RESULTS SO IT IS
STUDIES LIKE THESE THAT CAN HELP
US ACCUMULATE EVIDENCE ON THE
MOST PROMISING APPROACH TO
IMPROVE HEALTH AND COMMUNITIES
OF COLOR. SO SINCE JOINING NIH
ABOUT 16 MONTHS AGO I HAVE BEEN
WORKING TO SET UP MANY I
RESEARCH LAB AT THE NATIONAL
INSTITUTE ON MINORITY HEALTH AND
HEALTH DISPARITIES. I
APPRECIATE OUR NATION'S CAPITOL
STRUGGLES WITH PERSISTENT HEALTH
DISPARITIES AND I'M HOPEFUL OUR
RESEARCH WILL SERVE THESE
COMMUNITIES IN NIH BACKYARD. THE
FOCUS WILL REMAIN ON
UNDERSTANDING HOW COMMUNITY
ENVIRONMENTS AFFECT HEALTH
BEHAVIORS AN OUTCOMES IN AFRICAN
AMERICANS BUT ALSO IN THE
PROCESS OF DEVELOPING A NEW LINE
OF RESEARCH RELATED TO CLIMATE
CHANGE. INVESTIGATING
DETERMINANTS OF AND SECURITIES
IN -- DISPARITIES IN PERSONAL
HEAT EXPOSURE AND IMPLICATIONS
FOR INDIVIDUAL HEALTH. I'M
FORTUNATE TO WORK WITH REALLY
THREE TALENTED FELLOWS ALREADY.
AND WE ARE LOOKING FOR A STAFF
SCIENTIST SO IF YOU KNOW ANYONE
SEND THEM OUR WAY.
>> LET ME TRANSITION AND TALK
ABOUT NURSES ABOUT NURSING AND
HOW ALL THIS FITS IN. NURSES ARE
EVERYWHERE. WE ARE IN OUR
HOSPITALS AND CLINICS SCHOOLS
AND WORKPLACES IN HOMES AND
CLINICAL JUSTICE SETTINGS. AND
THROUGHOUT OUR COMMUNITIES.
NURSES APPROACH PREVENTION
TREATMENT AND CARE HOLISTICALLY,
OUR FOCUS IS ON THE PERSON IN
THE CONTEXT OF THEIR LIVES AND
THE CONDITIONS IN WHICH THEY ARE
BORN, LIVE, WORK, PLAY AND AGE.
IT IS NOT A PARTICULAR CONDITION
OR LIFE STAGE. A FOCUS EXTENDS
FROM IMPROVING THE HEALTH OF
INDIVIDUALS, TO THAT OF ENTIRE
POPULATIONS. IT IS THAT UNIQUE
PERSPECTIVE THAT FORMS THE
FOUNDATION OF NURSING SCIENCE
AND WHAT WE ARE DOING AT NINR.
THAT IS WHY OUR RESEARCH NEEDS
TO FOCUS ON THE WHOLE PICTURE OF
HEALTH, FROM THE BIOLOGY, OF A
PERSON CELLS AN GENES TO THEIR
WHOLE SELF FAMILY AND RESOURCES,
AND THE COMMUNITY AND SOCIETY IN
WHICH THEY LIVE. THAT
PERSPECTIVE INFORMS RESEARCH
PORTFOLIO AT N INR. CURRENTLY
MOST NINR RESEARCH DIRECTLY
INVOLVES PEOPLE. IN FACT OVER
75% FUNDING SUPPORTS RESERGE
THAT ENGAGES HUMAN PARTICIPANTS.
WE ARE AT THE CUTTING EDGE TO
MITIGATE DISPARITIES AND HEALTH
OUTCOMES. OVER 30% NURSE FUNDING
FOCUS ON RESEARCH TO ELIMINATE
DISPARITIES. WE ARE COMMITTED
TO FUNDING UNDER-REPRESENTED
MINORITY SCIENTISTSS. ACCORDING
TO A DATA FROM RECENT NIH STUDY,
OVER 75% APPLICATIONS SUBMITTED
TO NINR FOCUS ON TOPICS ON WHICH
AFRICAN AMERICAN INVESTIGATORS
DISPROPORTIONATELY APPLY. THIS
IS THE SECOND HIGHEST PERCENTAGE
AT NIH SECOND ONLY TO NEMHD.
MORE THAN A THIRD OF NINR BUDGET
SUPPORTS RESEARCH ON PREVENTING
CHRONIC CONDITION, HELPING
PEOPLE STAY HEALTHY AND REDUCING
THE RISK OF FUTURE ILLNESS. OVER
HALF OF OUR PREVENTION PORTFOLIO
INCLUDES A RANDOMIZED
INTERVENTION. Z A HIGHER
PROPORTION THAN NIH AS A WHOLE.
WE ARE COMMITTED TO INTERVENTION
RESEARCH. AND PREPARING THE
NEXT GENERATION OF NURSING
SCIENTISTS. AS A PERCENTAGE OF
OUR BUDGET NINR COMMITS FOR
SUPPORT TO TRAINING NEW EARLY
CAREER SCIENTISTS THAN NEARLY
ANY OTHER NIH INSTITUTE OR
CENTER. SO WITH WE ARE
SUPPORTING A NUMBER OF STUDIES
EXAMINING SOCIAL DETERMINANTS OF
HEALTH. LET' LOOK AT A FEW
EXAMINING CONDITIONS. ONE STUDY
EXAMINING COMMUNITY PROTECTIVE
FACTORS SPECIFICALLY GREEN
SPACE, RESIDENTIAL TREAT COVER
WAS ASSOCIATED WITH LOWER
PERCEIVED STRESS AN LOW INCOME
PREGNANT WOMEN AND URBAN
ENVIRONMENT WHO HAD HISTORY OF
DEPRESSION OR ANXIETY. FURTHER
EVIDENCE TO GRAIN SPACES FOR
HEALTH ANOTHER STUDY SHOWED
BRAIN BASED AN BRAIN MRI
MEASURES AND POTENTIAL
MODIFICATION BY SEX AND GENOTYPE
A RISK FACTOR ALZHEIMER'S
DISEASE. THE STUDY SHOWED
GREATER GREEN SPACE ASSOCIATED
WITH LESS VENTRICULAR
ENLARGEMENT. HOUSING ITSELF MAY
BE THE MOST IMPORTANT INDICATOR
OF ONE'S LIVING CONDITION. IN
THIS AREA ONE STUDY RECENTLY
FUNDED BY NINR IS EXAMINING THE
IMPACT OF HOUSING VOUCHERS ON
CHILDREN'S HEALTH CARE USAGE
AMONG LOW INCOME FAMILIES. THE
RESEARCH TEAM WILL USE UNIQUE
LINKAGE OF ADMINISTRATIVE
HOUSING DATA WITH MEDICAID
CLAIMS AND ENCOUNTER DATA. THE
STUDY WILL INVESTIGATE WHETHER
THE RECEIPT OF A HOUSING CHOICE
VOUCHER IS ASSOCIATED WITH
CHANGES IN MEDICAID ENROLLMENT
AND WHETHER CHILDREN WHOSE
FAMILIES RECEIVE A HOUSING
CHOICE VOUCHER HAVE DIFFERENT
PATTERNS OF HOSPITALIZATION,
EMERGENCY DEPARTMENTS VISITS,
WELL CHILD VISITS, AND HOUSING
SENSITIVE CONDITIONS ASTHMA,
OTHER RESPIRATORY CONDITIONS AND
MEMORY AND THOSE COMPARED ON THE
WEIGHT LIST. MANY EXAMINE EFFECT
OF INEQUITIES ON SPECIFIC
POPULATIONS AN LIFE STAGES FROM
CHILDHOOD, TO PREGNANCY, THROUGH
OLDER ADULTHOOD. AND THE AREA
OF CHILD HEALTH NINR SUPPORTED
SCIENTISTS ARE EXAMINING HEALTH
HEALTH IMPACTS OF EARLY LIFE AND
CHILDHOOD ADVERSITY. ONE
RECENTLY FUNDED STUDY IS
EXAMINING THE IMPACT OF
ADVERSITY ASSESSED BETWEEN 28
WEEKS GESTATION THROUGH THREE
YEARS OF AGE, ON ACCELERATED
BIOLOGICAL AGING INCLUDING
TELOMERE EROSION, AND EPIGENETIC
AGING CLOCKS ACROSS THE FIRST
THREE YEARS OF LIFE. A PATTERN
OF CHILDHOOD EVENS OCCURRING
ACROSS CHILDHOOD AND AD LESSENS
AND EFFECT ON BIOLOGICAL STRESS,
PSYCHOLOGICAL DISTRESS AND
TELOMERE LENGTH. IT SHOWS
STRESS AN IMMUNE BIOMARKERS SUCH
AS SALIVARY AND HAIR CORTISOL
CONCENTRATION ARE HIGHER IN
AFRICAN AMERICAN ADOLESCENTS
COMPARED TO WHITE ADOLESCENTS
BUT IN ONE STUDY THEY FOUND NO
EVIDENCE THAT ECONOMIC ADVERSITY
AT KEY DEVELOPMENTAL PERIODS OR
CUMULATIVELY EXPLAINED THOSE
DISPARITIES. IN THE AREA OF
MATERNAL HEALTH, WE ARE
SUPPORTING WORK FOCUSED ON
UNDERSTANDING FACTORS THAT
CONTRIBUTE TO DISPARITY IS IN
SEVERE MATERNAL MORBIDITY. ONE
STUDY FOUND THAT SEVERE MATERNAL
MORBIDITY HAS INCREASED ACROSS
ALL RACIAL AND ETHNIC GROUPS BUT
THAT CO-MORBIDITY CESAREAN BIRTH
AND OTHER FACTORS DIDN'T EXPLAIN
THOSE DISPARITIES. THAT STUDY
ALSO FOUND THAT RATES OF SEVERE
MATERNAL MORBIDITY WHICH ARE
HIGHEST AMONG AFRICAN AMERICAN
WOMEN MIGHT HAVE BEEN REDUCED
HAD AFRICAN AMERICAN MOTHERS
GIVEN BIRTH IN THE SAME
HOSPITALS AS WHITE MOTHERS.
THEIR PROJECT FOCUS HOW SOCIAL
DETERMINANTS ACROSS MULTIPLE
DOMAINS, STRUCTURAL INEQUALITY,
COMMUNITY RESOURCES, AND
HEALTHCARE ACCESS, CONTRIBUTE TO
RISK AND DISPARITIES.
INTERESTINGLY THERE ARE ALSO
TESTING THE IMPACT OF THREE
QUALITY COLLABORATIVES ON
MATERNAL MORBIDITY. WE ARE ALSO
SUPPORTING RESEARCH THAT
EXAMINES CHRONIC CONDITIONS IN
OLDER ADULTS. DEVELOPING
FEASIBLE EFFECTIVE AND SCALABLE
INTERVENTIONS TO IMPROVE HEALTH
AMONG PEOPLE WITH MULTIPLE
CHRONIC CONDITIONS, IS URGENT.
HOWEVER, RESEARCH GAPS HINDER
INTERVENTION DEVELOPMENT. MOST
INTERVENTIONS DO NOT CONSIDER
CO-OCCURRING FUNCTIONAL
LIMITATIONS. FAMILY CAREGIVERS
PERSPECTIVES. OR SOCIAL
DETERMINANTS OF HEALTH. MOREOVER
INTERVENTIONS COMMONLY FOCUS ON
DEFICITS RATHER THAN STRENGTH.
THESE LIMITATIONS ARE COMPOUNDED
BY LACK OF COMMUNICATION AMONG
PRACTICERS AND PEOPLE
EXPERIENCING MULTIPLE CHRONIC
CONDITIONS. ABOUT THEIR GOALS,
VALUES AND PREFERENCES. NINR
SUPPORTING THE HOSPITAL KINS
SENT B FOR RESILIENCE AN PERSONS
AND FAMILIES LIVING WITH
MULTIPLE CHRONIC CONDITIONS OR
PROMOTE CENTER WHICH IS POISED
TO ADDRESS THESE GAPS. AND LIKE
ALL NIH INSTITUTES RIGHT NOW,
COVID-19 IS ONE OF OUR HIGHEST
PRIORITIES. LAST YEAR NINR
JOINED NIMH AND SEVERAL OTHER
INSTITUTES IN AN NIH WIDE EFFORT
TO UNDERSTAND THE SOCIAL
BEHAVIORAL AND ECONOMIC HEALTH
IMPACT OF COVID-19 IN VULNERABLE
AND HEALTH DISPARITY
POPULATIONS. ONE NINR SUPPORTED
STUDY IS EXAMINING WHETHER AN
INTERVENTION IN SOUTH CAROLINA
FOR AFRICAN AMERICAN COVID-19
SURVIVORS, WITH UNDERLYING
CHRONIC ILLNESS AND THEIR
INFORMAL CAREGIVERS, IS A
EFFECTIVE IN IMPROVE HEALTH AND
CALL OF LIFE FOR BOTH PARTNERS
IN THE DYAD. THE INTERVENTION
WILL FOCUS ON OVERCOMING RACIAL
PANDEMIC RELATED STRESSORS IN
THE CONTEXT OF COMMUNITY SOCIAL
VULNERABILITY. ANOTHER STUDY IS
EXAMINING WHETHER INTENSIFIED
COMMUNITY REFERRALS TO ADDRESS
SOCIAL NEEDS OF PATIENTS, AS
PART OF THEIR DISCHARGE FROM AN
EMERGENCY DEPARTMENT SETTING,
IMPROVES GENERAL HEALTH IN
COVID-19 RELATED HEALTH OUTCOMES
WE ARE SUPPORTING A LONGITUDINAL
STUDY IN NEW YORK CITY FOCUSING
ON DISPARITIES THE STUDY
EXAMINES HEALTH AND EDUCATION
CHANGES AMONG CHILDREN AGE 2 TO
4, I'M SORRY, AMONG CHILDREN 2
TO 4 YEARS AFTER THE PANDEMIC
ONSET.ONSET. AND THE ROLE OF
NEIGHBORHOOD AND SCHOOL OF
RESOURCES IN EXACERBATING OR
MITIGATING THESE CHANGES. AND AS
MY LAST EXAMPLE WE ARE
SUPPORTING A COMMUNITY HEALTH
WORKER LED INTERVENTION TO
IMPROVE PHYSICAL AND
PSYCHOSOCIAL FUNCTIONING IN
OLDER PRIMARILY AFRICAN AMERICAN
ADULTS IN DETROIT. THE
INTERVENTION WILL TARGET
SELF-MANAGEMENT AND RESILIENCE
AT THE INDIVIDUAL LEVEL. SOCIAL
SUPPORT AT THE INTERPERSONAL
LEVEL AND ENHANCE HEALTH
DEPARTMENT CAPACITY AT THE
COMMUNITY LEVEL. TOO FURTHER
EXPAND THIS AREA OF RESEARCH
JUST LAST WEEK WE RELEASED AN
RFA ON EVALUATING THE IMPACT OF
PANDEMIC RELATED FOOD AND
HOUSING POLICIES AND PROGRAMS ON
HEALTH OUTCOMES OF INDIVIDUALS,
FAMILIES AND COMMUNITIES, FROM
HEALTH DISPARITY POPULATIONS.
DELIGHTED THIS IS ANOTHER
EXAMPLE WHERE NIMH IS
COLLABORATING. NOW TURN TO NINR
MORE AND SCIENTIFIC PERSPECTIVE
AND NATION'S HEALTH NEEDS
INFORMING INSTITUTES FUTURE
THROUGH OUR SOON TO BE RELEASED
STRATEGIC PLAN. AS PART OF OUR
STRATEGIC PLANNING EFFORT WE
UPDATED INSTITUTES MISSION
STATEMENT. AND AS YOU CAN SEE
HERE, WE ARE COMMITTED TO
SOLVING PRESSING HEALTH
CHALLENGE AN INFORMING PRACTICE
AN POLICY TO OPTIMIZE HEALTH AND
ADVANCE HEALTH EQUITY. A BIG
PART OF THE MISSION WILL INVOLVE
ADDRESSING SOCIAL DETERMINANTS
OF HEALTH. A RECENT REPORT FROM
NATIONAL ACADEMY OF MEDICINE
MAKES A COMPELLING CASE FOR
NURSING TO ASSUME A LEADING ROLE
IN ELIMINATING PERSISTENT HEALTH
DISPARITIES AND WE ABSOLUTELY
AGREE. MOVING FORWARD NURSING
SCIENCE CAN AND MUST HAVE AN
EVEN BIGGER IMPACT IN
IDENTIFYING SOLUTIONS TO END
HEALTH DISPARITIES. INCLUDING
DISPARITIES OF PANDEMIC HAS
EXPOSED, AND CONTINUES TO
COMPASS BATED. THAT IS WHY WE
ARE BUILDING ON OUR --
EXACERBATE. WE ARE WORKING TO
STRENGTHEN NIH SUPPORTED
RESEARCH AND HEALTH EQUITY
THROUGH OUR UPCOMING STRATEGIC
PLAN. AND I'M EXCITED TO SHARE A
LITTLE BIT ABOUT THIS BOLD NEW
STRATEGIC DIRECTION WHICH WILL
PROVIDE A BIG PICTURE VIEW OF
THE DIRECTIONS THAT WE'LL BE
HEADING NEXT. THE PLAN WILL
INCLUDES A SET OF GUIDEK
PRINCIPLES THAT WE BELIEVE
SHOULD DRIVE ALL ASPECTS OF NINR
SUPPORTED SCIENCE. FIVE
RESEARCH LENSES THAT PRESCRIBE
BROAD PERSPECTIVE FOR HEALTH
CHALLENGES, IT WILL DESCRIBE OUR
INTENTION TO DEVELOP STRATEGIC
IMPERATIVES, AS NEW HEALTH
CHALLENGES AND NEW OPPORTUNITIES
ARE IDENTIFIED. THOUGH THE PLAN
HASN'T BEEN RELEASED YET I CAN
SHARE SOME INFORMATION AND
FRAMEWORK WHICH IT WILL BE
BUILT. SO FIRST I WANT TO SHARE
SOME OF THE WAYS WE ENGAGE OUR
RESEARCH COMMUNITY IN DEVELOPING
STRATEGIC PLAN FRAMEWORK. I DO
THIS BECAUSE THE FEEDBACK WE
RECEIVE INDICATES BROAD SUPPORT
FOR OUR FRAMEWORK. WHICH
INCLUDES A FOCUS ON SOCIAL
DETERMINANTS OF HEALTH. 20
EXTERNAL EXPERTS IN A WORKING
GROUP THAT PROVIDED
RECOMMENDATIONS THROUGH OUR
ADVISORY COUNCIL. WE RECEIVED
385 ONLINE RESPONSES TO OUR TELL
US WHAT NURSING RESEARCH MEANS
TO YOU CAMPAIGN. OVER 100 EMAILS
RECEIVED IN RESPONSE WHEN OPEN
CALL FOR INPUT ON THE
DEVELOPMENT OF THE STRATEGIC
PLAN. I WORK PARTICIPATED IN 80
MEETINGS AND PRESENTATIONS, WITH
EXTERNAL GROUPS AND REQUEST FOR
INFORMATION ON THE DRAFT
STRATEGIC PLAN FRAMEWORK
GENERATED 130 PUBLIC COMMENTS.
SO WE STUDIED IMPACT AND
FEEDBACK WE RECEIVED. THE
MAJORITY OF RESPONDENTS FOR YOU
WILL DA FOR INPUT ON DEVELOPMENT
OF STRATEGIC PLAN EXPLICITLY
SUPPORTED A STRATEGIC DIRECTION
AND RESEARCH TOPICS ALIGNED WITH
SOCIAL DETERMINANTS OF HEALTH
HEALTH EQUITY AND COMMUNITY AND
POPULATION HEALTH. REGARDING THE
REQUEST FOR INFORMATION ON THE
DRAFT FRAMEWORK, NEARLY
TWO-THIRDS OF RESPONDENTS
SUPPORTED THE STRATEGIC PLAN
FRAMEWORK. SO I WILL DESCRIBE
GUIDING PRINCIPLES, NINR
DESCRIED IMPORTANT CALLS WE
BELIEVE ALL SUPPORTED WORK
SHOULD HAVE AS WE MOVE TO THE
FUTURE. INNER CANNING AWARDS
FOR FUNDING THE EXTEND WHICH
STUDIES REFLECT PRINCIPLES BEEN
A FACTOR IN OUR DECISIONS. SO WE
NEED TO SUPPORT RESEARCH THAT IS
HAS POTENTIAL FOR IMPACT ON
HEALTH AND WELL BEING, ADVANCES
EQUITY DIVERSITY AND INCLUSION.
ADDRESSES TODAY'S HEALTH
CHALLENGES AND HELPS US BE
PREPARED FOR THOSE OF THE FUTURE
AND PROVIDE SOLUTIONS TO
OPTIMIZE HEALTH ACROSS CLINICAL
COMMUNITY AND POLICY SETTINGS.
SO NOW LET ME EXPLAIN WHAT WE
MEAN BY RESEARCH LENS. SIMPLY
WHETHER WE ARE CALLING RESEARCH
LENS IS A PERSPECTIVE. BY WHICH
TO EXAMINE AND IDENTIFY HEALTH
CHALLENGE. AS WE KNOW, YOU MAY
NOT KNOW BUT THE FIELD OF
NURSING SCIENCE IS REALLY
COMPRISED OF MANY DIFFERENT
PERSPECTIVES WHAT TOPICS NURSING
SCIENCE SHOULD ADDRESS AND HOW
WE SHOULD DO SO. AND DEVELOPING
THE STRATEGIC PLAN NINR
IDENTIFIED FIVE LENSES THAT WE
THINK BEST LEVERAGE THE STRENGTH
OF NURSING SCIENCE, AND POSITION
THE FIELD TO INNOVATE AND THINK
BIGGER THAN IN THE PAST TO
INCREASE OUR IMPACT. SO LET'S
TAKE A CLOSER LOOK AT THE
LENSES. HEALTH EQUITY INCLUDES
STUDIES AIMED AT PRODUCING
EVIDENCE NEEDED TO REDUCE AND
ULTIMATELY ELIMINATE THE
SYSTEMIC AND STRUCTURAL
INEQUITIES -- INEQUALS THAT
PLACE SOME POPULATION GROUPS AT
A DISADVANTAGE IN ATTAINING
THEIR FULL HEALTH POTENTIAL.
POPULATION AND COMMUNITY HEALTH
INCLUDES STUDIES THAT I DRESS
CRITICAL HEALTH CHALLENGES AT
THE MACRO LEVEL BY FOCUSING ON
INTERVENTIONS THAT AFFECT GROUPS
OF PEOPLE WITH SHARED
CHARACTERISTICS OR THOSE WHO
LIVE WITHIN A SHARED AREA.
PREVENTION HEALTH PROMOTION
INCLUDE HOW TO PREVENT DISEASE
AND PROMOTE HEALTH THROUGH
CONTINUUM OF PREVENTION, FROM
PRIMORDIAL PREVENTION THAT
TARGETS THE UNDERLYING FACTORS
THAT INCREASE RISK OF ILLNESS,
TO TERTIARY PREVENTION THAT
AIMES TO REDUCE DISEASE
SEVERITY, SYMPTOMS AND
PROGRESSION. WITH PARTICULAR
EMPHASIS ON ELIMINATING HEALTH
DISPARITIES. SYSTEMS AND MODELS
OF CARE INCLUDE VERGE THAT
ADDRESSES CLINICAL
ORGANIZATIONAL AND POLICY
CHALLENGES THROUGH THE
DEVELOPMENT DISSEMINATION AND
IMPLEMENTATION OF NEW SYSTEMS
AND MODELS OF CARE. INCLUDING
THOSE THAT BRIDGE CLINICAL
COMMUNITY CARE WITH SOCIAL
FACTORS AND SOCIAL NEEDS.
FINALLY SOCIAL DETERMINANTS OF
HEALTH. AS DESCRIBED EARLIER
SOCIAL DETERMINANTS INCLUDE THE
CONDITIONS IN WHICH PEOPLE ARE
BORN, LIVE, WORK, PLAY AND AGE.
AND BECAUSE THESE DETERMINANTS
IMPACT SO MANY FACETS OF HEALTH
AND WELL BEING IT IS VITAL TO
SUPPORT RESEARCH TO EXAMINE THEM
AND IDENTIFY EFFECTIVE
APPROACHES TO ADDRESS SOCIAL
FACTORS POSITIVE AND NEGATIVE
AND SOCIAL NEEDS TO IMPROVE
HEALTH OUTCOMES. SO WE KNOW
MENTAL HEALTH NOT JUST PHYSICAL
HEALTH IS IMPACTED BY SOCIAL
DETERMINANTS AND AS YOU KNOW
NIMH ALREADY IS EXPLORING THESE
CONNECTIONS. FROM EXAMINING THE
ECONOMIC IMPACT OF STRESS ON
CHILDREN'S MENTAL HEALTH, TO THE
IMPACT OF SOCIAL DETERMINANTS ON
HIV CARE, TO PREVENTK SUICIDE IN
-- PREVENTING SUICIDE IN
AMERICAN INDIAN AND ALASKA
NATIVE COMMUNITY, IT IS CLEAR
NIMH LEADERSHIP AND RESEARCHERS
UNDERSTAND THE IMPACT OF SOCIAL
DETERMINANTS ON MENTAL HEALTH.
SO I WANT TO RECOGNIZE NIMH WORK
IN THIS AREA, AS WELL AS YOUR
COMMITMENT TO EXPANDING YOUR
WORK HERE. I CERTAINLY HOPE THIS
IS AN AREA WHERE WE CAN EXPAND
COLLABORATIONS AS WE MOVE
FORWARD. WE ARE DOING THAT, IT
SOUNDS LIKE DR. GORDON TALKED
ABOUT A COMPASS AND WE ARE
EXCITED TO BE COLLABORATING WITH
NIMH IN THIS EFFORT ALONG WITH
OTHER COLLEAGUES ACROSS NIH IN
THIS TEN YEAR PROGRAM. IN
ADDITION NINR AND NIMH ARE NOT
ALONE UNDERSTANDING THE
IMPORTANCE OF SOCIAL
DETERMINANTS OF HEALTH. IN
ITSELF RECENTLY RELEASED
STRATEGIC PLAN NIH IDENTIFIED
UNDERSTANDING BIOLOGICAL
BEHAVIORAL AND SOCIAL
DETERMINANTS OF POPULATION
HEALTH AS A KEY PART OF OUR
FOUNDATIONAL SCIENCE, WE ARE
GRATEFUL FOR NIH LEADERSHIP IN
THIS AREA OF RESEARCH. BEFORE I
FINISH I WILL TAKE A MOMENT TO
INVITE YOU TO JOIN US AT THE
2022 NATIONAL NURSING RESEARCH
ROUND TABLE HELD MARCH 3 AND 4.
THIS VIRTUAL MEETING WILL KISS
CUSS HOW EMERGENCY DEPARTMENTS
APPROPRIATELY IDENTIFY AND
ADDRESS SOCIAL NEEDS AND
UNDERSTAND THE ROLE OF SOCIAL
PROBLEMS AND RISK IN CREATING
DEMAND FOR EMERGENCY HEALTHCARE
SERVICES. EMERGENCY DEPARTMENTS
ARE NO STRANGER TO TREATING
MENTAL HEALTH CONDITIONS AS
WELL, ONE STUDY FROM 2020 FOUND
THAT OVER 8% OF EMERGENCY
DEPARTMENT VISITS WERE RELATED
TO MENTAL HEALTH. THESE
RESEARCHERS ALSO FOUND THAT THAT
PERCENTAGE WAS INCREASING. SO
YOU CAN FIND MORE INFORMATION
ABOUT THE ROUND TABLE ON OUR
WEBSITE. THANK YOU AGAIN FOR
INVITING ME TO JOIN TODAY. I
CERTAINLY HOPE THAT DURING
DISCUSSION WE CAN IDENTIFY AREAS
TO EXPAND COLLABORATION, FEEL
FREE TO REACH TO ME OR ANYONE AT
NINR FOR MORE INFORMATION ABOUT
RESEARCH AND ACTIVITIES IN THIS
AREA. THANK YOU, JOSH.
>> THANK YOU, SO MUCH FOR A
WONDERFUL TALK AND FOR OPENING
THE DIALOGUE. WE ALREADY HAVE A
FEW QUESTIONS LINED UP. PLEASE
MEMBERS OF THE COUNCIL IF YOU
WOULD LIKE TO ASK QUESTIONS OR
MAKE COMMENTS PLEASE TO RAISE
YOUR HAND, I SEE A NUMBER OF
HANDS ALREADY RAISED. JOSEPH YOU
WERE FIRST OUT THE GATE.
>> THANK YOU VERY MUCH. SO MY
NAME IS JOSEPH TELFAIR, I AM AN AN
ASSOCIATE DEAN OF RESEARCH
PRACTICES PUBLIC HEALTH HERE IN
THE SOUTH SOUTH. SO THANK YOU VERY
MUCH FOR THAT WORK AND SUPPORT
YOU GIVE OUR REGION HAS
BENEFITED A LOT FROM THE SUPPORT
THERE. SO I HAVE A COUPLE OF
QUESTIONS, I HAVE THREE ON THIS
ONE. MY FIRST ONE IS, THE NURSES
PLAY UNIQUE ROLE I UNDERSTAND
THAT, HOW WOULD YOU -- DATA
DISTINGUISH YOU -- YOU WOULD
DISTINGUISH THE WORK THAT THEY
-- OF A NURSE APPLYING FOR A LOT
OF THE WORK BECAUSE A LOT OF
WORK YOU ARE TALKING ABOUT IS
COVERED BY MULTIPLE
INSTITUTIONS, MOSTLY INSTITUTES
AND -- WHAT WOULD DISTINGUISH
NURSES ROLE IN THAT? AND NURSE
AND RELATED OTHER WHOSE DO
SIMILAR WORK LIKE PA AND THAT
SORT OF THING. THAT'S THE FIRST
QUESTION. THE SECOND QUESTION IS
THAT YOU FOCUS ON CRITICAL ISSUE
US RELATED TO INEQUITIES MOSTLY
SOCIAL INEQUITIES. WHAT ABOUT
STRUCTURAL INEQUITIES AND
STRUCTURAL ISSUES? YOU MENTION
IT BRIEFLY HOWEVER AROUND THE
AREAS THAT THIS COUNCIL LOOKS
AT, IS THE NEED TO HAVE SYSTEMS
LEVEL CHANGE IN ORDER TO BE ABLE
TO BE EFFECTIVE AND ADDRESSING A
LOT OF THE CONCERNS THAT ARE
HERE FROM THAT AND AGAIN I'M A
PUBLIC HEALTH PERSON SO I'M
TALKING ABOUT THE POPULATION
LEVEL THINGS ON THAT END. THE
OTHER LAST QUESTION THAT I HAVE
HAS MORE TO DO WITH BREADTH OF
THE WAY YOU ARE DEFINING
DIVERSITY. MY UNDERSTANDING IS
THAT SOME OF THE WORK YOU ARE
LOOKING AT HAS A LOT OF THE WAY
GOVERNMENT FOR DIVERSITY WHICH
IS RACE BASED. HOWEVER YOU KNOW
WHEN WE TALK ABOUT THE COVID
SITUATION A LOT OF DIVERSITY IS
BROADER THAN THAT, MANY INVOLVES
GEOGRAPHY, INVOLVES OTHER
THINGS. AND ALSO THE FOCUS ON
PERSON MENTAL HEALTH IN GENERAL
TO BE FOR THE OLDER POPULATION,
WHICH I APPRECIATE YACHT Y'ALL
ARE SUPPORTING BUT MY OTHER
CONCERN IS WORK FORCE ISSUES.
NONE OF YOUR EXAMPLES COVERED
WORK FORCE, HOWEVER WE KNOW THAT
PARTICULARLY FROM WHERE WE SIT,
WE HAVE FOUND THAT A LOT OF THE
WORK OUT OF THE CONCERNS IN WORK
FORCE IS THUS COVERED AND ALSO
LOOKS AT MULTIPLE CONCERNS
RELATED TO MENTAL HEALTH
BEHAVIORAL ISSUES, THAT ARE
LINKED TO BOTH SOCIAL AND
STRUCTURAL ISSUES. SO THOSE ARE
MY QUESTIONS. T AND HOPEFULLY
THEY ARE CLEAR, IF NOT HAPPY TO
EXPAND AND EXPLAIN. THANK YOU
VERY MUCH FOR YOUR TIME AND I
APPRECIATE PRESENTATION.
>> THANK YOU. YES. SO MANY
IMPORTANT QUESTIONS, I AGREE.
LET ME TRY AND YOU CAN LET ME
KNOW IF I DON'T COVER ALL THE
POINTS YOU RAISE. I THINK A
STRENGTH OF NURSING IS OUR FOCUS
ON PEOPLE SO WE REALLY NURSES
DON'T FOCUS ON A DISEASE OR A
CERTAIN HEALTH CONDITION, WE ARE
REALLY FOCUSED ON PEOPLE NEED TO
BE HEALTHY AND RESTORE THEIR
HEALTH. AND I THINK THAT'S A
REALLY IMPORTANT PERSPECTIVE AND
OF NURSING. AND I THINK IT IS A
REALLY IMPORTANT PERSPECTIVE
THAT NURSING SCIENCE BRINGS TO
NIH. I REALLY SEE OUR STRENGTH
IN OUR PERSPECTIVE IN OUR SCOPE
OF HOW WE THINK HEALTH
DETERMINANTS RANGING FROM
BIOLOGICAL TO SOCIETAL AND HOW
TO BRING THAT ALL TOGETHER. IN
TERMS OF RESEARCH PICTURE. I'M
CERTAINLY INTERESTED IN -- WE
ALL ARE AT NINR COLLABORATING
ACROSS NIH IN TERMS OF BRINGING
THESE PERSPECTIVES INCLUDING
WITH NIMH. WHEN I TALK ABOUT
SOCIAL DETERMINANTS AND THINKING
AT THE INSTITUTE IN TERMS OF OUR
WAY FORWARD, WE AGREE STRUCTURAL
FACTORS ARE IMPORTANT THE
ADDRESS SO WE SEE THAT BEING
PART OF OUR DIRECTIONS MOVING
FORWARD SOCIAL FACTORS FROM THE
INDIVIDUAL LEVEL TO STRUCTURAL
LEVEL. I AGREE, WE CAN'T MAKE
SUFFICIENT PROGRESS IN
ELIMINATING HEALTH INEQUITIES
UNLESS WE GENERATE THE EVIDENCE
WE NEED TO INFORM POLICY TO
ADDRESS THOSE STRUCTURAL
FACTORS. IN TERMS OF DIVERSITY,
MY OWN RESEARCH REALLY HAS
FOCUSED ON DIFFERENCES IN HEALTH
OUTCOMES BY RACE AND ETHNICITY
BUT THAT IS NOT THE SOLE FOCUS
OF THE INSTITUTE. WE ARE TAKING
A VERY BROAD PERSPECTIVE ON
DIFFERENT HELP DISPARITIES AND
THE IMPLICATIONS FOR ADVANCING
HEALTH EQUITY. OUR WORK FORCE IS
EXTREMELY IMPORTANT TO US IN
TERMS OF PREPARING THE NEXT
GENERATION OF NURSING
SCIENTISTS, WE NEED TO DO BETTER
IN TERMS OF PREPARING A DIVERSE
SCIENTIFIC WORK FORCE, ONE
EXAMPLE OF STEPS WE ARE TAKING
IS OUR COUNCIL IS KICKING OFF
WORKING GROUPS, ONE FOCUSED ON
RECOMMENDATIONS TO THE COUNCIL
AND HOW WE CAN IMPROVE DIVERSITY
OF OUR WORK FORCE AND THE OTHER
FOCUSED ON STRENGTHENING
INCLUSION IN OUR STUDIES. I
AGREE, THOSE ARE ALL REALLY
IMPORTANT ISSUES. HOW DID I DO
TOUCHING ON YOUR QUESTIONS?
>> ON SCALE OF ONE TO TEN ABOUT
AN EIGHT. THANK YOU.
>> JOEL, PLEASE INTRODUCE
YOURSELF AND GO AHEAD AND ASK
YOUR QUESTION.
>> JOEL NIGG NEW COUNCIL MEMBER
UNIVERSITY OF PORTLAND, OREGON.
INTERESTING THANK YOU SO MUCH
FOR I'M SUPER INTERESTED IN BOTH
YOUR PRESENTATION AND THE ONE
THAT WILL COME NEXT FROM DR.
NEBLETT ON RACISM. AS SOMEONE
WHO LIVES SEVERAL YEARS IN
CENTRAL CITY DETROIT AND WORKED
WITH YOUTH THERE SEEING THE
DEVASTATION OF NEIGHBORHOODS AND
HAS SPENT TIME THINKING HOW ALL
OF O OUR FANCY MODELS WHAT THEY
MEAN AND THAT CONTEXT SO MANY
PRESSURES ON PEOPLE, I FOUND
YOUR WORK VERY INTERESTING, I
APPRECIATE THE DETROIT MICHIGAN
CONNECTIONS THERE, OLD STOMPING
GROUNDS FOR ME. COUPLE OF THINGS
THAT I WANTED TO HIGHLIGHT THAT
I THINK THIS IS SO INTERESTING,
I HAVE TEN QUESTIONS LIKE DR.
TELFAIR, MANY, MANY QUESTIONS, I
WILL TRY TO NARROW DOWN, LOTS OF
QUESTIONS. I SEE SEVERAL WAYS
STRONGER COLLABORATION WITH NIMH
AND APPRECIATE HIGHLIGHTING THE
IMPORTANCE OF THAT. THREE THAT
POP OUT ARE COMPUTATION,
COMPLEXITY OF THESE EXPOSURE
RISK FOR APPROPRIATE MODELING
THAT LITERATURE RECENTLY IS
REALLY DIFFICULT THAT IT IS
SIMILAR TO TRY TO MODEL NEURAL
SYSTEMS. THERE'S SO MANY
INTERSECTING NODES OF RISK
THERE, THAT HAVE TO BE BROUGHT
TOGETHER. THAT IS ONE. A SECOND
ONE IS THE OVERLAP OF MENTAL
PHYSICAL HEALTH. AS YOU KNOW THE
OVERLAP A LOT AND PEOPLE WITH
MENTAL HEALTH HAVE GREATER
PHYSICAL HEALTH PROBLEMS AS
WELL. AND VICE VERSA. THIRD IS
INDIVIDUAL DIFFERENCES THIS IS
COMING FROM THE OTHER SIDE FROM
WHAT DR. TELFAIR BROUGHT UP, NOT
EVERYBODY NEEDS CONDITIONS HAS
BAD OUTCOMES YOU MENTION
RESILIENCE IN PASSING AND
DIFFERENCES IN RESPONSE SEEMS A
CRITICAL AREA FOR MENTAL HEALTH
PLUS LINKAGE YOU DIDN'T
HIGHLIGHT MUCH THAT I WOULD
THINK WOULD BE VERY IMPORTANT IN
ADDITION TO THE CRITICAL
STRUCTURAL ISSUES THAT HAVE BEEN
TALKED ABOUT AND I AGREE ARE
IMPORTANT. I WANT TO RAISE ONE
QUESTION -- TWO CONCEPTUAL
QUESTIONS SO YOU CAN ANSWER ONE
OR NEITHER DEPENDING ON WHAT YOU
WANT TO SAY, BUT WHAT IS THE
CONCENTRATION OF RISK FACTORS
SUGGEST THAT MAYBE LESS
IMPORTANT AS INDIVIDUAL RISK
FACTORS IN STUDYING
ACCUMULATION? AND THIS IS A
CONCEPTUAL QUESTION, WONDER HOW
YOU -- WHEN YOU DIVVY UP FOOD OR
HOUSING AND VERSUS EFFECTIVE
CORRELATE. DIFFERENTIATION OF
RACIAL ETHNIC DIVERSITY. WHEN I
LIVED IN DETROIT I WAS IN A
MIXED NEIGHBORHOOD WITH HALF
BLACK HALF WHITE, IT WAS
SEGREGATED UNONE SET OF THE
AVENUE WAS BLACK AND ONE WAS
WHITE. I WORKED HEAVILY WITH
KIDS ON BOTH SIDES BUT THE
ADVERSITY WAS SIMILAR, HOUSING
VACANT LOTS, VIOLENCE, ET CETERA
WERE SAME. AND THE WAYS WE
HANDLING IT SEEM SIMILAR, BUT
YET OF COURSE DETROIT WHEN I WAS
THERE IT WAS MAJORITY BLACK
CITY. YOU GET ON THE BUS, BLACK
AND WHITE AT LEAST SOME PARTS OF
THE CITY, RACISM IS CLEARLY A
STORE -- A FACTOR, DIFFERENT
FROM BLACKS AND WHITES AS THEY
MOVE ABOUT THE CITY, MOVE ABOUT
SYSTEMS. WHAT IS YOUR THINKING
AS AN INSTITUTE DIRECTOR AS YOU
THINK ABOUT DIFFERENTIATING
RACISMS, STEREOTYPING THE MANY
FACTORS THERE THAT WORK AGAINST
RACIAL MINORITY INDIVIDUALS IN
-- AFRICAN AMERICANS AND LATINOS
HISPANICS ALSO A BIG GROUP IN
DETROIT AS WELL AS MANY OTHER
GROUPS THAT ARE IN THAT DIVERSE
CITY. WHEN YOU HAVE SUCH
WIDESPREAD ECONOMIC ADVERSITY
WHAT IS YOUR THINKING OR TALK
THE SATE OF SCIENCE TO EDUCATE
US AS MENTAL HEALTH RESEARCHERS.
SEEMS LIKE EXTREMELY IMPORTANT
TIMELY ELEMENT THAT YOU TOUCHED
ON IN PASSING. THANK YOU.
>> WOW. SO MANY GREAT POINTS
THERE AS WELL. ONE, I LOVED THAT
WAS QUICK TO COME UP WITH THREE
WAYS THAT WE COULD COLLABORATE
AND THAT THERE'S SO MANY WAYS
OUR WORK CAN BE SYNERGISTIC IN
TERMS OF THE COMPUTATIONAL
COMPLEXITY, THE INTERSECTION OF
MENTAL PHYSICAL HEALTH, AND I
THINK THAT IS VERY ALIGNED WITH
NURSING PERSPECTIVE THAT WE
CAN'T SEPARATE THE TWO THERE
VERY INNER RELATED AS YOU POINT
OUT. I COULDN'T AGREE MORE. WE
DO NEED TO UNDERSTAND THE
STRUCTURAL AND I THINK THAT THAT
HAS RECEIVED LESS ATTENTION AT
NIH THAN OTHER TYPES OF SCIENCE.
CERTAINLY UNDERSTANDING
INDIVIDUAL RESPONSES OR
DIFFERENCES IN RESPONSES, IS
IMPORTANT. I KNOW IN OUR OWN
WORK THAT IS REALLY TRYING TO
UNDERSTAND THE CONTEXT OF
BEHAVIORAL INTERVENTIONS, WHO
RESPONDS AND SUCCEEDS AND WHO
LESS SO. ANOTHER THING I TOOK
FROM YOUR COMMENTS IS REALLY
THINKING ABOUT STRENGTHS AND TO
UNDERSTAND THOSE DIFFERENCES. I
THINK THAT IS THE CASE IN A LOT
OF RESPECTS. I THINK YOU ARE
RIGHT. SO MANY OF THESE RISK
FACTORS PART OF THE ISSUE IS
THEY DO CLUSTER AND GROUP
TOGETHER, THEY BUILD ON ONE
ANOTHER, TO EXACERBATE
DISPARITIES AND I THINK
UNDERSTANDING WHAT ARE IMPORTANT
PIVOT POINTS INTERVENTION POINTS
THAT ARE GOING TO PRODUCE THE
BIGGEST DIFFERENCE IN CHANGE IS
IMPORTANT BUT ALSO UNDERSTANDING
HOW ALL THESE FACTORS INTERACT
TO AFFECT HEALTH OUTCOMES AND
CONTRIBUTE TO DISPARITIES. I
THINK IN TERMS OF -- THE
LITERATURE IS LARGE SO TO
SUMMARIZE, BUT I THINK WE DO
KNOW, SOCIOECONOMICS IS
CERTAINLY AN IMPORTANT PART OF
THE PICTURE FOR UNDERSTANDING
RACIALIZED DIFFERENCES IN
HEALTH. BUT WE KNOW THERE IS
ALSO AN ADDED EFFECT OF RACISM
AND REALLY BEING CLEAR ABOUT
THAT AND SEEKING TO UNDERSTAND
THE MULTIPLE WAYS BY WHICH
RACISM PLAYS OUT IN PEOPLE'S
LIVES AND AFFECTS HEALTH AND
CONTRIBUTES TO THE INEQUITIES WE
SEE. I THINK IS REALLY CRITICAL.
I THINK WE DO KNOW THERE IS
ADDED EFFECT OF RACISM AND IT IS
OUR RESPONSIBILITY TO IDENTIFY
HOW THAT AFFECTS PEOPLE'S HEALTH
AND TO INFORM POLICY CHANGES. SO
I'M NOT EVEN GOING TO ASK HOW I
DID ON THAT ONE BECAUSE THAT WAS
A BIG QUESTION. SO I'LL JUST
TAKE IT LIKE HOPEFULLY POINT FOR
EFFORT.
>> THE COMMENT -- I APPRECIATE
ITISM I'M A BELIEVER OF RACISM
EFFECTS BUT IT IS REALLY
IMPORTANT THAT IT BE SPECIFIED
VERY CLEARLY MECHANISTICALLY.
>> WE ARE ALMOST OUT OF TIME,
TWO MORE QUESTIONS, SO
APPRECIATE MARJORIE AND BRANDON
IF YOU CAN KEEP THE QUESTIONS
SHORT AND SHANNON DO YOUR BEST
TO ANSWER QUICKLY TOO.
>> YES. REALLY SHORT.
>> DOING GREAT JOB.
>> SHANNON, THANK YOU FOR YOUR
PRESENTATION. I'M MARJORIE
BALDWIN -- I THINK SOMEONE IS
UNMUTED. IF EVERYONE WHO IS NOT
SPEAKING WITH MUTE THEMSELVES.
GO AHEAD.
>> I'M A HEALTH ECONOMIST FROM
ARIZONA STATE UNIVERSITY, I JUST
HAVE A COMMENT AND ONE QUESTION.
THE COMMENT IS AS A HEALTH
ECONOMIST I AM CONSTANTLY
BOMBARDED WITH STATISTICS ON HOW
POORLY THE U.S. HEALTHCARE
SYSTEM PERFORMS RELATIVE TO
OTHER COUNTRIES. AND THAT'S
SPECIALLY INCLUDES A MATERNAL
MORTALITY, MATERNAL MORBIDITY,
INFANT MORTALITY CHILD MORTALITY
RATES. THESE ARE USED TO
CONDEMN THE HEALTHCARE IN A
WHOLE WHEN REALLY LOOK AT THE
NUMBERS, THEY ARE LARGELY DRIVEN
BY DISPARITIES BOTH RACIAL
ETHNIC RURAL URBAN HEALTH
DISPARITIES SO THANK YOU FOR
SHINING A LIGHT ON THAT IN YOUR
TALK. AND THEN MY QUESTION, AS
ABOUT ECONOMIST, GOES BACK TO
THE BEGINNING OF YOUR TALK,
WHERE YOU TALKED ABOUT YOUR WORK
ON FOOD DESERTS AND HOW HEALTHY
FOODS WERE STORES THAT SOLD
HEALTHY FOODS WERE FURTHER
DISTANT FROM FOR CERTAIN
NEIGHBORHOODS THAT ARE
CLASSIFIED FOOD DESERTS. AS AN
ECONOMIST IF THEY ARE NOT THERE,
WHY AREN'T THEY THERE? IF THERE
WERE PROFITS IN BEING THERE,
ECONOMICS, SAYS THAT THE STORES
WOULD MOVE THERE SO WHY AREN'T
THERE PROFITS? ONE REASON IS WHY
IS THE DEMAND FOR THOSE FOODS
LOWER? AND ONE REASON YOU
HIGHLIGHTED MIGHT COST. AND WIC
RESULTS SHOW THAT. WHEN IT WAS
EASIER TO PAY FOR THOSE FOODS
STORES RESPOND AND STOCKED THE
FOODS. BUT THE OTHER THING I'M
THINKING OF IS PREFERENCES. AND
IF YOU ARE RAISED WITH ONLY
ACCESS TO LESS HEALTHY FOODS,
THOSE ARE THE FOODS THAT YOU
GOING TO PREFER. SO MY QUESTION
WAS QUICKLY ARE YOU ALSO WORKING
ON EDUCATION AND WAYS TO CHANGE
PEOPLE'S PREFERENCES SO THAT
THEY DEMAND THOSE HEALTHIER
FOODS COME TO THEIR COMMUNITIES?
>> THAT IS ALSO A REALLY BIG
QUESTION. SO I'M GOING TO TRY TO
BE SHORT AND SAY I MEAN THE
PROBLEM WITH FOOD DESERTS IS
ROOTED IN DISINVESTMENT IN
GENERAL FROM COMMUNITIES OF
COLOR THAT HAPPEN AND CONTINUES
OVER TIME AND I COULDN'T AGREE
MORE THAT'S WHERE I WAS GOING TO
GO, IT IS A CHICKEN OR THE EGG
ARGUMENT, IF YOU GROW UP IN A
COMMUNITY WITHOUT ACCESS AND
THAT'S HOW YOUR PREFERENCE IS
DEVELOPED IT WAS HARD TO MAKE
THAT CHANGE. SO I THINK A LIFE
COURSE PERSPECTIVE IS ESSENTIAL
TO UNDERSTANDING THAT SITUATION
AND ULTIMATELY ADDRESSING IT AND
I AGREE, ESPECIALLY GIVEN THAT
MULTI-LEVEL STRATEGIES ARE GOING
TO BE REQUIRED TO MAKE A
DIFFERENCE, THAT IS MY SHORT
ANSWER.
>> YOU CAN SEE HOW WELL OUR
COUNCIL FOLLOWS DIRECTION.
BRANDON, SHORT QUESTION FOR
SHANNON?
>> SHAN NOW RIVETING
PRESENTATION. YOUR WORK IS SO
IMPORTANT FOR SOCIETY RIGHT NOW.
I SUPPORT ALL WHAT YOU ARE
DOING. I HAVE ONE QUESTION THAT
IS TANGENTIAL RELATES TO WHAT
DR. TELFAIR MENTIONED THE WORK
FORCE. HEALTHCARE PROFESSIONALS
INCLUDING NURSES ARE REALLY
CHALLENGED RIGHT NOW WITH HEALTH
SERVICES INCLUDING MENTAL HEALTH
DUE TO THE CHALLENGE OF THE
PANDEMIC AND OTHER CONTRIBUTORS
IN OUR WORLD. THERE IS A GOOD
DEAL OF BURN OUT IN AND STRESS
AN MENTAL HEALTH CHALLENGES
AMONG NURSES AND HEALTH
PRACTITIONERS. IT SEEMS MORE
MENTALLY HEALTHY NURSES CAN BE
THE BETTER THE CARE THEY CAN
DELIVER AND BETTER OUTCOME OF
PATIENTS THEY TREAT. DO YOU SEE
THAT AS A TOPIC THAT CAN BE
STUDIED OR INVESTIGATED BY NINR
OR ADDRESSED IN I WAY CURRENTLY?
WE LEARN HOW IMPORTANT THE WORK
FORCE IS TO THE HEALTH OF OUR
NATION AND FUNCTIONING HEALTH
SYSTEMS. THAT COUNCIL LAST WEEK
WE PRESENTED A CONCEPT TO FOCUS
ON HEALTH OF NURSES, IT WAS
FRAMED IN TERMS OF BURN OUT BUT
REALLY WE TALKED ABOUT REALLY
TALKING ABOUT A MORE POSITIVE
FRAME WHICH HAS COME UP TODAY.
SPECIFICALLY THINKING
INTERVENTIONS THAT ADDRESS AT
SYSTEMS LEVEL AS OPPOSED TO
NURSES NEED TO COPE BETTER BUT
CHANGE THE SYSTEM TO SUPPORT
THEIR HEALTH AND KEEP THEM IN
THE WORK FORCE WHERE THEY ARE
NEEDED. SO WE AGREE IT IS AN
IMPORTANT ISSUE AND WE ARE
COMMITTED TO ADDRESSING THAT.
>> THANKS FOR THE QUESTIONS AND
COMMENT ALONG THE WAY,
APPRECIATE THE TALK, IT WAS
WONDERFUL AND THANKS FOR JOINING
US. WE ARE MOVE TON NEXT NOT
COMPLETELY UP RELATED TOPIC
STRUCTURAL RACISM AND BLACK
MENTAL HEALTH. MY PLEASURE TO
WELCOME DR. ENRIQUE NEBLETT. HE
HAS BEEN AN IMPORTANT
CONTRIBUTOR TO THIS FIELD FOR A
LONG TIME HE IS PROFESSOR OF
HEALTH BEHAVIOR UNIVERSITY OF
MICHIGAN SCHOOL OF PUBLIC HEALTH
AND WAS THIS PAST YEAR THE FIRST
RECIPIENT OF THE NIMH JAMES
JACKSON MEMORIAL AWARD WHICH
HONORS OUTSTANDING RESEARCHERS
WHO DEMONSTRATE EXCEPTIONAL
ACHIEVEMENT IN LEADERSHIP IN
MENTAL HEALTH DISPARITIES
RESEARCH. HE JOINS COUNCIL
MEETING TODAY TO PRESENT
STRUCTURAL RACISM IN BLACK YOUTH
MEN DATA MOVING BEYOND THE CLOWN
AT THE CIRCUS.
>> I AM HERE. I'M TRYING TO GET
MY SCREEN SITUATED HERE. ARE YOU
ABLE TO SEE THE SLIDES?
>> YES.
>> FANTASTIC. THANKS FOR THE
INTRODUCTION, GREAT TO BE BACK,
I'M HONORED TO HAVE THE
OPPORTUNITY TO SPEAK BEFORE THE
COUNCIL THIS AFTERNOON. OUR TIME
IS SHORT BUT I DO HAVE A QUICK
ROADMAP HERE. IN TERMS OF WHAT I
WOULD LIKE TO DO TODAY. I WANT
THE SHARE THE MOTIVATION, TALK
ABOUT THE MODELS THAT INFORMED
MY WORK OVER THE YEARS. I WANT
TO SHARE WITH YOU RESEARCH SNAP
SHOTS RELATED TO THIS BROAD
TOPIC OF RACISM AND MENTAL
HEALTH THEN TALK NEW CONCEPTUAL
IDEAS I AND COLLEAGUES SRI HING
THINKING ABOUT IN REGARDS TO
STRUCTURAL RACISM AND MOVING
BEYOND THE CLOUD SO TO SPEAK SO
LOOKING FORWARD TO HAVING THIS
OPPORTUNITY. LET ME START WITH
MOTIVATION FOR THIS TALK. MANY
YEARS AGO AS A STUDENT PROBABLY
GRADUATE SCHOOL, I READ A BOOK
BY PERELL AT HOWARD UNIVERSITY,
IT'S TITLED MENARCHE AND
PSYCHOLOGY. WILL IS A QUOTE THAT
STAND OUT FROM HIS BOOK BOOK. THE
QUOTE READS AS FOLLOWS. RACE
RELATIONINGS AND INTERPERSONAL
DYNAMICS THAT TAKE PLACE IN A
MODERN RACIST SYSTEM ARE BUT A
SMALL CORNER OF THE TOTAL
PICTURE. THEY ACT LIKE A CLOWN
AT THE CIRCUS. THEY ARE NOT
TOTALLY UNIMPORTANT. BUT THEY
SHOULD NEVER COMMAND OUR FULL
ATTENTION. WE SHOULD NOT SEE
THEM AS PRIMARY CAUSAL AGENTS.
HE SAYS I THINK IT IS WISE TO
TAKE VERY SERIOUSLY THE
DISTINCTIONS JONES REFERRING TO
JAMES JONES HERE, MAKES BETWEEN
RACISM AND PREJUDICE ALONG WITH
HIS TAXONOMY OF THE TYPES OF
RACISM. IN SO DOING WE MAY AVOID
FOCUSING ON THE CLOWN WHILE
NEGLECTING MORE IMPORTANT
ACTIVITIES TAKES PLACE IN THE
CENTER RING. THIS IS A QUOTE
FROM 1999 THAT HARELL WROTE AND
I THINK IT IS INTERESTING TO SEE
WHERE THE ARC OF THE FIELD HAS
BEEN WITH REGARD TO RACISM AND
WHERE IT HAS BEEN THE LAST
SEVERAL YEARS WITH RECENT
ATTENTION TO STRUCTURAL RACISM
SO TALK ABOUT THAT, OVER THE
NEXT TEN TO 15 MINUTES OR SO.
WHEN I THINK CONCEPTUAL MODELS
OF RACISM AND HEALTH OVER THE
YEARS, THERE'S BEEN A PROGREG
THAT IS OUT OF SYNC WITH HIS
COMMENT ABOUT THE CIRCUS BUT
MAYBE WE ARE STARTING TO CATCH
UP, I DON'T KNOW. HERE IS ONE OF
THE ORIGINAL MODELS OF RACISM
AND HEALTH RODNEY CLARK AN
COLLEAGUES AROUND THE SAME TIME
THAT HE WAS WRITING THIS BOOK
ACTUALLY, SO THIS IS AMERICAN
PSYCHOLOGIST AND RODNEY CLARK
AND COLLEAGUES SAID IN THIS
PAPER THAT RACISM OCCURS WHEN
THE INDIVIDUAL PERCEIVES RACISM,
THE INDIVIDUAL PERCEPTIONS OF
RACISM LEAD TO EXAGGERATED
PSYCHOLOGICAL OR PHYSIOLOGICAL
RESPONSES AND THAT OVER TIME
THOSE IN TURN YIELD NEGATIVE
HEALTH OUTCOMES. THAT WAS ONE
OF THE FIRST MODELS NOT THAT
LONG AGO. IN 20, 25 YEARS.
SUGGESTING THAT RACISM WAS AN
INDIVIDUAL EXPERIENCE. ABOUT TEN
YEARS LATER DAVID WILLIAMS WROTE
THIS FANTASTIC PAPER ON RACE
DISCRIMINATION AND HEALTH
MOHAMMED. THE EMPHASIS GAVE US A
LITTLE BIT MORE IN TERMS OF
MECHANISMS BUT LARGELY HAD AN
INDIVIDUAL FOCUS SO IF YOU THINK
ABOUT CONCEPTUALIZATION OF
RACISM DISCRIMINATION IS THOUGHT
INDIVIDUAL LEVEL OF RACISM,
THERE IS NOTHING ABOUT
INSTITUTIONAL OR CULTURAL RACISM
HERE. AND THEY ARGUED OKAY
INDIVIDUALS NEGATIVE EMOTIONAL
STATE MEDIATES MENTAL HEALTH,
HEALTH BEHAVIORS ARE IMPORTANT
TO CONSIDER, LESS EXERCISE MORE
SMOKING LESS HEALTH PROMOTING
BEHAVIOR AND PHYSIOLOGICAL
SYSTEMS MIGHT PLAY A MEDIATING
ROLE. AGAIN, WHEN THIS PAPER WAS
WRITTEN IN 2009 THERE WAS A
STRONG EMPHASIS ON INDIVIDUAL
RACIAL DISCRIMINATION. WILLIAMS
AN MOHAMMED COME BACK FOUR YEARS
LATER AND NOW GET A LITTLE
CLOSER TO WHERE WE ARE IF YOU
LOOK HERE LOTS OF BOXES AND
CIRCLES AND ARROWS BUT NOTICE IN
TERM OF THINKING ABOUT BASIC
FUNDAMENTAL CAUSES, THERE'S THIS
RED CIRCLE HERE WHERE WILLIAMS
AND MOHAMMED SAY RACIAL
DISCRIMINATION WE ARE TALKING
ABOUT IS NOW MIDDLE OF THE
MODEL, WE THINK IF WE ARE REALLY
GOING TO GET AT THIS THING WE
HAVE TO PAY ATTENTION TO THE
FUNDAMENTAL CAUSES, THE
INSTITUTIONAL RACISM AND
CULTURAL RACISM WHICH WE REALLY
DON'T PAY ATTENTION TO, AND I
WILL TALK MORE ABOUT IN A
SECOND. BUT AS YOU CAN SEE HERE
FROM THE ARC OF HE IS MODEL, WE
SORT OF HAVE BEEN TALKING A LONG
TIME ABOUT MOVING FROM
INDIVIDUAL TO MORE SYSTEMIC OR
STRUCTURAL LEVELS OF RACISM, HOW
WE DO EMPIRICAL LITERATURE WE
WILL SEE IN A SHORT -- IT IS
STILL A DEVELOPING ENTERPRISE.
HERE IS ANOTHER MODEL NANCY
CREIGER AROUND SAME TIME TALKING
ABOUT A LOT OF SAME SORTS OF
THINGS LOOKING HERE IN TERMS OF
TOXINS HAZARDS AND PATHOGENS
GETTING BEYOND THE INDIVIDUAL
LEVEL MARKETING MEDICAL CARE, ET
CETERA. SO SOME OF THE THINGS
WE THINK ABOUT SOCIAL
DETERMINANTS OF HEALTH. SO
PRESIDENT LET ME SHARE A COUPLE
OF RESEARCH SNAP SHOTS RECENT
RESEARCH WE HAVE BEEN DOING WITH
COLLABORATORS. LET ME SHOW YOU
MY BROAD RESERGE PROGRAM FOCUSED
ON RACISM AND HEALTH. BUT TRUE
TO WHAT MUCH OF THE LITERATURE
HAS DONE, HAS BEEN AT THE
INDIVIDUAL LEVEL SO I'M TRAINED
AS A CLINICAL PSYCHOLOGIST, MUCH
OF THE WORK THAT WE HAVE DONE
HAS LOOKED AT INDIVIDUAL
EXPERIENCES OF RACIAL
DISCRIMINATION, HOW THEY RELATE
TO MENTAL HEALTH OUTCOMES I DID
A POST DOC IN CARDIOVASCULAR
PSYCHOPHYSIOLOGY WITH DR.
HARRELL AND HAVE EXPANDED MY
THINKING ABOUT HEALTH BEYOND
MENTAL HEALTH OUTCOMES THOUGH
THAT'S KIND OF MY PRIMARY FOCUS
ONE THING I CAN INTERD IN A LONG
TIME IS NOT JUST HOW RACISM
LEADS TO POOR HEALTH, BUT WHAT
WHAT FACTORS MITIGATE RACISM AND
MEN AL HEALTH. I HAVE BEEN
PARTICULARLY INTERESTED IN IN
RACIAL IDENTITY, HOW INDIVIDUALS
AGAIN DEFINE SIGNIFICANCE AND
MEANING OF BEING AFRICAN
AMERICAN HOW THE PARENTS TALK TO
THEIR KIDS ABOUT RACE, YOUTH IN
PARTICULAR, WE KNOW THERE ARE
SPECIFIC MESSAGES THAT MITIGATE
NEGATIVE EFFECTS OF
DISCRIMINATION ON MENTAL HEALTH,
IN AFRICAN CULTURAL VALUES IS
ANOTHER SORT OF THING THAT AGAIN
HAS BEEN LOOKED AT PRIMARILY AT
AN INDIVIDUAL LEVEL, ONE OF THE
THINGS I'M INCREASINGLY THINKING
ABOUT IS HOW WE THINK ABOUT
IDENTITY AS A COMMUNAL OR
COLLECTIVE LEVEL HOW DO WE THINK
ABOUT AFRICAN CULTURAL VALUES,
HOW CAN WE MEASURE THAT IN
UNDERSTANDING RESILIENCE IN
CONTEXT OF NOT ONLY INDIVIDUAL
BUT STRUCTURAL RACISM. SO COUPLE
OF SNAP SHOTS. THIS IS A PAPER
PUBLISHED THIS YEAR, IN J CAP
LOOKING AT THE LINK BETWEEN
RACIAL DISCRIMINATION, THERE IT
IS AGAIN AND SUICIDAL IDEATION.
THESE ARE HIGH SCHOOL STUDENTS,
I WILL CALL YOUR ATTENTION TO
THE MICROAGGRESSIONS COLUMN
HERE, WE ARE LOOKING AT THE
RELATIONSHIP BETWEEN
MICROAGGRESSIONS AS WELL AS MORE
OVERT FORMS OF DISCRIMINATION
AND SUICIDAL IDEATION.LY CUT TO
THE CHASE. WHAT WE FOUND IS
THAT THE SUBTLE FORMS OR
MICROAGGRESSIONS BEING WORRIED
ABOUT THE THREAT YOU MIGHT
EXPERIENCE, THAT WAS PREDICTIVE
CONCURRENTLY AND PERSPECTIVELY
OF SUICIDAL IDEATION ABOVE AND
BEYOND DEPRESSIVE SYMPTOMS. THIS
WAS NOT A STUDY OF STRUCTURAL
RACISM, BUT ONE THING I'M
THINKING ABOUT A LOT IS HOW DO
THE DAY TO DAY EXPERIENCES OF
SOCIAL DETERMINANTS OF HEALTH
STRUCTURED BY RACISM INFLUENCE
MENTAL HEALTH? SO WHAT IS THE
IMPACT OSTEOID TO DAY FOOD
EXPERIENCE INSECURITY AND DAY TO
DAY EXPERIENCE IN THE WAY SUBTLE
EXPERIENCES ARE NOT RACIAL
EPITHET PER SE BUT WE BELIEVE
THEY HAVE IMPLICATIONS FOR
PHYSIOLOGY, HOW DOES THE DAY TO
DAY EXPERIENCE OF HOUSING
INSECURITY, SOME OF THE HORRIBLE
STORIES WE HAVE SEEN THE LAST
MONTH OR SO AROUND HOUSING
CONDITIONS, RELATE TO MENTAL
HEALTH AND WHAT ARE THE
MECHANISMS. SO THAT IS ONE SNAP
SHOT STUDY THAT I THINK IS
RELATED TO LOW GRADE CHRONIC
EXPOSURE TO STRUCTURAL RACISM.
ANOTHER STUDY LOOK AT
INTERNALIZED RACISM. GO BACK TO
THE MODEL THAT I SHOWED YOU FOR
DAVID WILLIAMS YOU SAW NOT ONLY
FOCUSING ON INSTITUTIONAL RACISM
BUT CURL CHURL RACISM. THERE'S
VERY LITTLE RESEARCH IN THOSE
AREAS. CULTURAL RACISM REFERS TO
THE REPRESENTATIONS OF IMAGES
AND SYMBOLS LANGUAGE PROMINENT
IN MEDIA, THAT ARE BELIEVED TO
SUGGEST SUPERIORITY OF ONE GROUP
OVER ANOTHER. THIS PARTICULAR
FORM OF RACISM THOUGH
SCIENTIFICALLY WE ARE STILL
FIGURING HOW TO MEASURE IS
IMPORTANT BECAUSE IT HAS CLEAR
LINKS TO THINGS LIKE IMPLICIT
BIAS, AND IT ALSO HAS LINKS TO
AS SEEN HERE ON THE SLIDE
INTERNALIZED RACISM. SO THE IDEA
IS THESE NEGATIVE
REPRESENTATIONS AND NEGATIVE
SYMBOLS ARE INTERNALIZED BY
FOLKS AND LEAD TO PEOPLE FEELING
PRETTY BADLY ABOUT THEMSELVES SO
PEOPLE SORT OF COME TO BELIEVE
IN NEGATIVE REPRESENTATIONS OF
THEIR CULTURE, INTERNALIZED
RACISM BY THE WAY IS LINKED WITH
MORE PHYSICAL HEALTH OUTCOMES
THAN PSYCHOLOGICAL OUTCOMES. BUT
CARD YES VASCULAR OUTCOMES AND A
NUMBER OF OTHER STRESS RELATED
OUTCOMES. IN THIS STUDY THAT WE
DID A COUPLE OF YEARS AGO, WE
ACTUALLY FOUND THAT THE MORE
PEOPLE WERE AFFECTED BY THESE
INTERNALIZED RACISM ATTITUDES,
SO IF THEY FELT NEGATIVELY ABOUT
BEING AFRICAN AMERICAN, IF THEY
SAID THINGS LIKE PEOPLE SHOULD
CHANGE THEIR HAIR SO THAT THEY
FIT IN TO THE PLACES WHERE THEY
WORK, THAT THE VULNERABILITY TO
DISCRIMINATION ON INCREASES IN
ANXIETY WAS GREATER THAN IF YOU
DIDN'T ESPOUSE THOSE
INTERNALIZED RACISM ATTITUDES.
SO THERE SEEMS TO BE A GROWING
INTEREST IN UNDERSTANDING HOW
THESE NEGATIVE VIEWS THAT COME
FROM CULTURAL REPRESENTATIONS
MIGHT EXACERBATE IMPACT OF
INDIVIDUAL EXPERIENCES OF
RACISM, THIS IS QUITE IMPORTANT
BECAUSE MEDIA REPRESENTATION, WE
KNOW AFRICAN AMERICANS AND OTHER
GROUPS ARE NEGATIVELY
REPRESENTED AND WE NEED TO PAY
MORE ATTENTION TO HOW THESE
THINGS AFFECT HOW PEOPLE FEEL,
AND PLAY OUT IN DAY TO DAY
EXPERIENCES. THIS LAST STUDY
HERE IS ANOTHER RECENT
COLLABORATION. IT IS NOT MENTAL
HEALTH BUT IT IS LOOKING AT HOW
WE MIGHT MEASURE STRUCTURAL
RACISM AND DISCRIMINATION, IN
THE CONTEXT OF HEALTH OUTCOMES.
SO THIS PARTICULAR STUDY WE LOOK
AT COVID-19 CASES AND PAY
TALLTIES AND THE WAY WE
CONCEPTUALIZE WE DIDN'T CALL IT
RACISM BUT LOOK AT BLACK WHITE
SEGREGATION WHICH IS THOUGHT TO
BE A REPRESENTATION OF
INSTITUTIONAL RACISM, WE LOOK AT
ECONOMIC INEQUALITY AND WHAT WE
FOUND IS THAT NOT SURPRISINGLY
INTERACTION OF INCOME INEQUALITY
AND RESIDENTIAL SEGREGATION, THE
GREATER THE BLACK WHITE
SEGREGATION YOU SAW THE RATES OF
COVID-19 FATALITIES TAKE OVER.
THIS IS THE EARLIER STAGES OF
THE PANDEMIC AND THIS WAS
OBVIOUSLY NOT OBVIOUSLY BUT
THESE WERE NOT JUST BLACK
INDIVIDUALS BUT LOOKING AT
LARGER CITIES AND HOW THEY WERE
AFFECTED BY THIS SORT OF
INSTITUTIONAL LEVEL RACISM. BEGS
THE QUESTION OF HOW THIS IS
LOOKED AT IN CONTEXT OF MENTAL
HEALTH AND THE ANSWER IS WHEN
YOU DO A SIMPLE SEARCH OF
STRUCTURAL RACISM AND MENTAL
HEALTH YOU ACTUALLY UNLESS
THERE'S BEEN A SORT OF NEW
ADDITION SINCE MY LAST REVIEW A
FEW MONTHS AGO YOU ARE NOT GOING
TO FIND A WHOLE LOT. SO ONE
QUESTION THAT THEY GIVE OUT IS
HOW TO TAKE THIS SORT OF LOOK AT
SEGREGATION AND INCOME
INEQUALITY AND MAP IT ON TO
MENTAL HEALTH. SO THAT IS WHERE
I WANT TO SPEND THE NEXT SET OF
SLIDES. HOW DO WE GET BEYOND THE
CLOWN. , WE ARE HOPEFUL AND
TRYING TO MOVE TOWARDS A
PARADIGM SHIFT IN BRINGING THE
STRUCTURAL RACISM LITERATURE TO
LOOK SPECIFICALLY AT MENTAL
HEALTH IN ADDITION TO USUAL
SUSPECT SEGREGATION ONE OF THE
WAYS THAT PEOPLE HAVE TENDED TO
LOOK AT THIS, ALTHOUGH AGAIN
THIS IS MOSTLY BEEN PHYSICAL
HEALTH OUTCOMES, HAVE BEEN
LOOKING AT BLACK WHITE
DISPARITIES IN A NUMBER OF
PLACES THAT WE KNOW THERE ARE
DISPARITIES SO EMPLOYMENT,
EDUCATION, HOUSEHOLD INCOME, ET
CETERA. SO WHAT A LOT OF STUDIES
DO IS LINK, SORT OF MEASURE
STATE LEVEL COUNTY LEVEL THE
EXTENT TO WHICH THERE ARE BLACK
WHITE DISPARITIES AND HOW THEY
MAP ON TO HEALTH. AGAIN USUAL
SUSPECTS RACIAL SEGREGATION LOOK
AT DISPARITIES IN TERMS OF WHO
IS INCARCERATED. AND
INCREASINGLY WHAT I HAVE ARGUED
IS IMPORTANT TO DO IS TO ALSO
EXPAND OUR DEFINITION OF
STRUCTURAL RACISM TO INCLUDE
CULTURAL RACISM. SO WITH SOME
COLLEAGUES, HERE AT MICHIGAN,
ONE OF THE THINGS WE HAVE BEEN
THINKING ABOUT IS HOW MIGHT WE
REPRESENT OR MEASURE EXPOSURE TO
FOLKS EXPOTIONED O YOU WILL EXPOSURE TO CU LTURAL
RACISM, WE HAVE A DATA SET WITH
GEOCODED DATA WITH REGARD TO
CONFEDERATE STATUTES AND OTHER
REPRESENTATIONS OF CULTURAL
SYMBOLS ACROSS THE COUNTRY SO WE
HAVE BEEN THINKING ABOUT HOW THE
MEANING OF HIGHWAYS -- NAMING OF
HIGHWAY, NAMING OF DIFFERENT
STATUTES IN PARTICULAR WILL
HOUSE IN PROXIMITY TO THOSE
MARKERS MAY HAVE LOCATIONS FOR
HEALTH THE SAME WAY THAT SOME
SCHOLARS LOOKED AT SORT OF
INTERNET DATA, TO WHAT EXTENT
ARE PEOPLE LOOKING UP THE N WORD
ON THEIR COMPUTER, WITH DISEASE
AND MORTALITY OUTCOMES. SO THAT
IS ONE THING WE HAVE BEEN
THINKING ABOUT. SOME OF THE
STRENGTH THAT FOLKS HAVE BEEN
PAYING ATTENTION TO ARE LOOKING
BEYOND JUST THE NEIGHBORHOOD
LEVEL AND CENSUS TRACK, THIS IS
A REALLY GREAT NEW DIRECTION
BECAUSE IT ALLOWS US TO THINK
ABOUT POLICY LEVEL, ALLOWED THE
CHANGES IN POLICY AND OUR
ABILITY TO UNDERSTAND HOW
POLICIES MATTER. HAPPEN AT THE
STATE LEVEL WHICH IS DIFFERENT
FROM LOOKING AT THINGS LIKE
CENSUS TRACK. VERY FEW STUDIES
DONE FROM MENTAL HEALTH ARENA
BUT TRYING TO LOOK AT HOW THESE
DISPARITIES PLAY A ROLE IN
MENTAL HEALTH IS A NEW
DIRECTION. LIMITATIONS HERE I
HAVE ALLUDED TO THEM ALREADY SO
I WILL KEEP IT MOVING HERE.
EMPHASIS ON SINGULAR DOMAIN,
RACISM IS COMPLEX, IT HAS
MULTIPLE LEVELS, THAT'S WHAT
HARRELL IS GETTING AT, WE TENDED
TO JUST LOOK AT SINGULAR LEVELS
OF RACE. U OR ONE SPECIFIC
EXEMPLAR SEGREGATION
INCARCERATION UNDERSTANDING HOW
THESE THINGS FIT TOGETHER I
THINK WILL BE A CHALLENGE GOING
FORWARD. ANOTHER AREA WE ARE
INTERESTED IN BECAUSE OF THE
MODEL I SHOWED EARLIER IS THE
BIOLOGICAL EMBEDDED THE
STRUCTURAL RACISM SO STRESS A
KEY PATHWAY IS NOT NEW FIRST
MODEL I SHOWED YOU BUT HOW DO
SOME OF THE THINGS I TALKED
ABOUT IN TERMS OF CURL CHURL
EXPOSURES -- CULTURAL EXPOSURE,
MEDIA REPRESENTATIONS, EXPOSURE
TO CONFEDERATE STATUTES IS THE
LINK BETWEEN THOSE EXPOSURES AND
MENTAL HEALTH MEDIATED BY
PHYSIOLOGIC SYSTEMS. MY AREA OF
EXPERTISE IS IN A AUTONOMIC
NERVOUS SYSTEM, CARDIOVASCULAR
REACTIVITY IN PARTICULAR AND I
STARTED THE PAIR UP WITH
SCIENTISTS AND THERE'S NEW WORK
LOOKING AT NEURAL MECHANISMS TO
UNDERPIN LINKS BETWEEN NOT JUST
SUPPRESS STRESS IN GENERAL BUT
RACISM AND DISCRIMINATION IN
HEALTH OUTCOMES. WE KNOW THAT
CENTRAL NERVOUS SYSTEM IS IN
CONTROL IN TERMS OF NETWORKS
DICTATING STRESS RESPONSE,
ESSENTIAL NERVOUS SYSTEM
CONTROLS, INFLAMMATORY MARKERS
AND INFLAMMATORY RESPONSE, SO TO
THE EXTENT WE PAY MORE ATTENTION
TO NEURAL MECHANISMS AND FIZZ
OWE LOGICAL MECHANISMS MIGHT
HELP US TO GET A BETTER READ ON
THESE OTHER PHYSIOLOGICAL
SYSTEMS THAT HAVE BEEN LINKED
WITH PTSD LINKED WITH DEPRESSION
AN ANXIETY. I AM NOT A
NEUROSCIENTIST BY ANY STRETCH OF
THE IMAGINATION BUT CERTAINLY
THERE IS WORK LOOKING AT
SALIENCE NETWORKS AND LIMB BIC
FUNCTION THAT SORT OF HAVE LINKS
TO NEUROTRANSMITTER FUNCTION AND
HOW THESE BREAKDOWN AND LEAD TO
INCREASE VULNERABILITY TO MENTAL
HEALTH DIFFICULTIES. SO THAT IS
AN AREA THAT WE ARE THINKING
ABOUT AS WELL. A LOT OF STUDY
IN THIS AREA NOT SURPRISINGLY
CONTINUE TO BE EXPERIMENTAL
STUDIES, THAT ARE FOCUS AT
INDIVIDUAL LEVEL AND SMALL
SAMPLE SO HOW CAN WE KIND OF GET
AT MECHANISMS PAYING ATTENTION
TO UPSTREAM FACTORS. I OLD YOU
I'M INTERESTED IN RESILIENCE. WE
KNOW EXPOSURE TO RACISM DOESN'T
IMPACT EVERYONE EQUALLY. SO HOW
DO WE BRING STRUCTURAL FACTORS
INTO OUR UNDERSTANDING OF
RESILIENCE MANY THE FACE OF
RACISM HERE ARE NUMBER OF
FACTORS, GENERAL FACTORS THAT
FOLKS HAVE BEEN INTERESTED IN,
SOCIAL SUPPORT, PARENTAL AND NET
MONITORING FOR YOUTH OUTCOMES.
NEIGHBORHOOD FOR SELECTED
EFFICACY, ET CETERA. SO MY
COLLEAGUES ARE INTERESTED IN MY
WORK HAS BEEN INTERESTED IN
UNDERSTANDING RACE RELATED
CULTURAL PROTECTIVE OR
RESILIENCE FACTORS SO WE HAVE
DONE WORK LOOKING AT RACIAL
SOCIALIZATION HOW PARENTS TALK
TO THEIR KIDS ABOUT RATES AND
ALSO SOME STUDIES WITH RELIGIOUS
INVOLVEMENT AND CORTISOL DHEA
INVOLVEMENT WHICH IS MEDIATED BY
DEPRESSIVE SYMPTOMS. LOOKING AT
INDIVIDUAL DISCRIMINATION. ONE
THING YOU WILL SEE IN A
CONCEPTUAL MODEL NEXT SLIDE IS
BEGINNING TO THINK ABOUT, I WILL
GO THERE NOW, HOW DO THESE
DIFFERENT FORMS OF STRUCTURAL
RACISM RELATE TO MENTAL HEALTH
THROUGH PHYSIOLOGICAL SYMPTOMS
AND HOW MIGHT RESILIENCE FACTORS
MODERATE THIS MEDIATIONAL PATH.
THERE IS A LOT HERE, MORE THAN
ANY ONE STUDY COULD TACKLE, BUT
THE CHALLENGE WHERE WE ARE
HOPING TO GO WITH THIS IS TO
KIND OF BILL SO THAT A THERE ARE
STUDIES THAT CLEARLY LINK
EXEMPLARS IN TO MENTAL HEALTH
EMPIRICAL WORK AND WELCOME LOOK
AT MULTIPLE LEVELS OF RACISM. SO
HOW DOES EXPOSURE TO CULTURAL
MANIFEST STATIONS AND MEDIA LINK
WITH PEOPLE'S FIZZ YOU LOGICAL
RESPONSES, OVER TIME, OVER LIFE
COURSE PERSPECTIVE WHICH WE ARE
LACKING CURRENTLY. HOWICS AND
MENTAL HEALTH CONCEPTUALIZATION
BEYOND USUAL SUSPECTS BUT ALSO
INCLUDE THINGS LIKE SATISFACTION
WELL BEING AND POSITIVE MENTAL
HEALTH. BEFORE I WRAP UP I WOULD
BE REMISSISSIPPI IF I DID NOT
ONLY TALK STRUCTURAL RACISM AND
SOCIAL DETERMINANTS OF HEALTH IN
CONTEXT OF MENTAL HEALTH BUT
ALSO IN OUR FIELD AT LARGE. I
IMAGINE YOU SAW THIS INTERESTING
PAPER THAT CAME OUT ACTUALLY NOT
A PAPER, IT WAS KIND OF AN OP ED
LAST FALL I THINK IN STAT EWE
WHERE WILL IS THIS QUESTION OUR
WHITE SCHOLARS PROVOCATIVE
COLONIZING RESEARCH ON HEALTH
DISPARITIES. RELEVANT IN
CONTEXT OF UNITE INITIATIVE AND
SOME OF THE THINGS WE HAVE BEEN
TALKING ABOUT BUT COUPLE OF
BULLET POINTS, WE HAVE SPECIAL
ISSUES THAT ARE SUPPOSEDLY FOCUS
FOCUSED ON STRUCTURAL AND
SYSTEMIC RACISM BUT LEAD
INVESTIGATORS ON THE PAPERS ARE
BLACK SCHOLARS OR RACIAL ETHNIC
MINORITY SCHOLARS. REALLY
EXCITED ABOUT THE POTENTIAL TO
ENGAGE IN COLLABORATION IN
STUDYING MARGINALIZED
POPULATIONS. I WONDERER IF
THERE IS A WAY TO INCENTIVIZE
COLLABORATION BETWEEN SCHOLARS
LIKE MYSELF WHO HAVE EXPERTISE
NOT ONLY IN LIVED EXPERIENCE BUT
IN THE RACISM TO ENCOURAGE
COLLABORATION WITH INVESTIGATORS
WHO ARE NOT BIPOC SCIENTISTS SO
THATVATIONS THAT WE DO HAVE
TEAMS NOT JUST TEAM SCIENCE BUT
THAT ARE RACIALLY AN ETHNICALLY
DIVERSE. THAT'S SOMETHING I HAVE
BEEN THINKING ABOUT. THE HEALTH
EQUITY TOURISM TALKED ABOUT PEER
REVIEW PROCESSES AND HOW I HAVE
THIS EXPERIENCE UNFORTUNATELY
WHERE MY EXPERTISE ON A PAPER IS
IGNORED. NUMBER OF PEER REVIEWS
OR PEER REVIEWERS WHO HAVE
EXPERIENCES IS LIMITED, FOLKS
ARE STRETCHED THIN, HOW DO WE
RECTIFY, I HAVE SOME IDEAS
THERE, THIS SHORTAGE OF -- AND
MAKE SURE THOSE WHO HAVE
EXPERTISE ARE AT THE TABLE SO TO
SPEAK PROVERBIAL TABLE. THERE
ARE COUPLE OF OTHER THINGS HERE,
THINKING ABOUT ETHNICITY AND
DIVERSITY, WE ARE STILL
COMMUNITY PARTNERS HERE IN
DETROIT ARE TALKING ABOUT HOW
CAN'T EVEN GET ETHNIC DATA IN
TERMS OF LATINX POPULATIONS,
WITH REGARD TO COVID-19 AND
MENTAL HEALTH EXPERIENCE IN
TERMS OF THE DATA THAT DETROIT
HEALTH DEPARTMENT HAS. SO THE WE
DON'T PAY ATTENTION TO
ETHNICITY, DON'T PAY ATTENTION
TO DIFFERENCES BETWEEN ASIAN
AMERICAN GROUPS FOR EXAMPLE AND
WE USE THE PAN ETHNIC LABELS
THAT'S ANOTHER DIMENSION OR
ELEMENT THAT HAS TO BE BROUGHT
INTO SCIENCE. ONE THING I LAMENT
WITH MY STUDENTS EVEN IN 2022 IS
WHEN YOU LOOK AT HEALTHY PEOPLE
2030, MAINSTREAM TEXT BOOKS ON
SOCIAL DETERMINANTS OF HEALTH
AND I ACTUALLY USE A SOCIAL
DETERMINANTS OF MENTAL HEALTH
TEXTBOOK, RACISM IS HARDLY
MENTIONED IN THE BOOK. STUDENTS
HAVE BEEN SAYING DR. NEBLETT
BONDER GIVEN YOU SAY RACISM IS
THE FUNDAMENTAL CAUSE WHY DON'T
WE SEE IT EXPLICITLY IN HEALTHY
PEOPLE 2030, WHY IS IT THAT IN
THE TEXTBOOK ON SOCIAL
DETERMINANTS OF MENTAL HEALTH WE
TALK DISCRIMINATION BUT NOT
STRUCTURAL DETERMINANTS DETERMINANTS. ALL OF
THESE THINGS I THINK ARE
IMPORTANT TO CONSIDER, WHO ARE
THE PIs WHAT ROLES ARE THEY
PLAYING, DECISION MAKING PROCESS
AND I'M SURE ONE WE HEARD IN
TERMS OF SHORT TURN AROUND TIME
FOR FUNDING, ARE THE PEOPLE WHO
MIGHT BE ABLE TO DO SOME REALLY
INNOVATIVE AND CREATIVE SCIENCE,
REPRESENTED AND HAVE RESOURCES
GIVEN SHORT TURN AROUND TIMES
REQUIRED TO PUT TOGETHER GRANTS
FOR NIH. IN CONCLUSION NOTHING
SURPRISING HERE, BUT RACISM
EXTENDS BEYOND BEHAVIOR OF THE
INDIVIDUAL AND IS EMBEDDED IN
HISTORICAL CULTURAL
INSTITUTIONAL ORGANIZATIONAL
GOVERNMENTAL STRUCTURE AND
PROCESSES THAT LIMIT
OPPORTUNITIES AND RESOURCES.
STRUCTURAL RACISM IS A
FUNDAMENTAL CAUSE AND SO HOW DO
WE BEGIN TO REFLECT THIS
COMPLEXITY IN OUR STUDIES OF
MENTAL TRY TO UNDERSTAND
PATHWAYS AND MECHANISMS. I LIKE
THIS SORT OF QUOTE HERE,
PARAPHRASING FRED WILLIAMS AND
MOHAMMED AND STRUCTURAL RACISM
RFA A FEW MONTHS BACK WHICH SAID
CHANGES IN FUNDAMENTAL CAUSES
LEAD TO CHANGES IN OUTCOMES.
INTERVENTIONS IN INTERMEDIATE
PATHWAYS WITHOUT CORRESPONDING
CHANGES IN FUNDAMENTAL CAUSES
ARE UNLIKELY TO PRODUCE
IMPROVEMENTS IN POPULATION
HEALTH ELIMINATE DISPARITIES AND
PROMOTE HEALTH EQUITY. SO THE
QUESTION I LEAVE YOU WITH, IS AS
WE THINK ABOUT THE DISMANTLING
RACISM BUT DOING SO IN
SCIENTIFICALLY INFORMED WAYS IF
THE INTERVENTIONS CONTINUE TO BE
AT THE INDIVIDUAL LEVEL HOW WE
WILL BE ABLE TO IMPROVE OUR
SCIENCE TO INFORM STRUCTURAL
INTERVENTIONS THAT CAN BEGIN TO
ADDRESS WHAT DR. HARRELL
MENTIONED WHEN HE SAID WE NEED
TO MOVE BEYOND THE CLOWN, TO THE
ISSUES AT THE CENTER OF THE
RING. THANK YOU VERY MUCH.
>> THANK YOU, DR. NEBLETT,
WONDERFUL TALK AND CHALLENGE TO
NIMH ALONG LINES OF WHAT DR.
ZENG TALKED ABOUT THE COMPASS
INITIATIVE IN TRYING TO DEAL
WITH THE STRUCTURAL DETERMINANTS
OF INEQUITIES, THIS TIME
SPECIFICALLY IN EFFECT OF
RACISM. I'M SURE THERE IS LOTS
OF COMMENTS AND QUESTIONS, I
WANT TO REMIND COUNCIL MEMBERS
TO PLEASE RAISE YOUR VIRTUAL
HANDS AND SET UP THOSE QUESTIONS
AND I'M HAPPY TO CALL ON YOU. IF
YOU HAVEN'T INTRODUCED YOURSELF
ALREADY TODAY TO OUR PUBLIC YOU
MAY DO SO, YOU MIGHT AS WELL DO
SO EVEN IF YOU HAVE SO DR.
NEBLETT KNOW WHOSE THE
QUESTIONER IS. TED YOUR FIRST
UP.
>> THANKS FOR THERY IF I CAN
TALK. MY NAME IS TEDDY ABEL
UNIVERSITY OF IOWA. I HAD A
BROADER QUESTION. YOU TALKED
STRUCTURAL RACISM AND IMPACT ON
HEALTH DISPARITIES AND HOW WE
UNDERSTAND AND THINK ABOUT
LESSENING THAT. BUT I WONDER IF
YOU CAN COMMENT OR INTERESTING
TO THINK ABOUT IMPACT OF
STRUCTURAL RACISM ON THE
(INAUDIBLE). STRUCK BY
PERSPECTIVE ON THOMAS COULDN'T
WHO TALKED PARADIGMS AND HOW
THOSE PARADIGMS RESTRICT THE
QUESTIONS THAT WE ASK AS
RESEARCHERS. I WONDER HOW MUCH
STRUCTURAL RACISM EVICTS THOSE
QUESTIONS. AND LIMITS
CREATIVITY AND IMPACT OF THE
SCIENCE THAT WE FUND AT NIMH AND
WE DO AS INVESTIGATORS.
>> LET ME TAKE A STAB. YOU WENT
YOU WANT AT A KEY MOMENT WHERE
YOU SAID STRUCTURAL RACISM AND
SOMETHING BUT I THINK I WAS ABLE
TO --
>> BASIC -- SCIENTIFIC RESEARCH
ESSENTIALLY, RATHER THAN
THINKING ABOUT A CLINICAL IMPACT
WHAT ABOUT ITS IMPACT ON THE
RESEARCH WE DO AND QUESTIONS WE
ASK.
>> YEAH. I MEAN, I THINK THAT'S
SOME OF WHAT I START TO GET AND
PART OF THE REASON I INCLUDED
THAT LAST SLIDE IN TERMS OF THE
-- I THINK IT IMPACTS THE
INNOVATION OF THE SCIENCE AND
QUESTIONS WE ARE ABLE TO ASK. I
THINK SOME OF THE PEOPLE WHO
HAVE EXPERTISE ARE -- I HAVE HAD
SOME REALLY -- I DON'T WANT TO
GET TOO PERSONAL BUT INTERESTING
EXPERIENCES IN TERMS OF BEING
BROUGHT IN FOR EXPERTISE ON
RACISM AND PEOPLE KIND OF BEING
SURPRISED THAT I KNEW WHAT I WAS
TALKING ABOUT WITH REGARD TO
RACISM AND SO IF FOLKS WHO HAVE
KNOWLEDGE AND EXPERTISE WHO HAVE
DONE THE WORK WITH THESE
POPULATIONS, ARE NOT PART OF THE
TEAMS THAT WILL AFFECT THE TYPES
OF QUESTIONS THAT ARE ASKED AND
OUR ABILITY TO ANSWER THEM AND
CREATIVITY WHICH WE ANSWER THEM.
SO THAT IS ONE WAY. I DON'T WANT
TO BE REPETITIVE HERE BUT
THINKING ABOUT WHO THE FOLKS ARE
WHO DO HAVE THE MONEY THE LOOK
AT SOME OF THESE THINGS, I THINK
WE HAVE TO BE INNOVATIVE IN THAT
THE FOLKS WHO MAY BE ABLE TO ADD
SOME INNOVATION MAY NOT BE ABLE
TO TURN THINGS AROUND QUICKLY
ENOUGH AND APPLY FOR NIH GRANT
IN A SHORT TIME. IF YOU ARE --
SO WE KNOW THAT STRUCTURAL
RACISM SHAPES WHO HAS ACCESS TO
BEING ABLE TO PRODUCE THE
SCIENCE SO THAT IS CRITERION FOR
EVALUATING THE SCIENCE YOU ARE
PERPETUATING THE INEQUITIES. OF
COURSE THERE ARE LOTS OF OTHER
WAYS BUT I WILL STOP THERE.
>> THANK YOU.
>> THANK YOU, DR. NEBLETT. YAEL.
>> I THINK YOU ARE MUTED. OR I
CAN'T HEAR YOU.
>> YOU ARE STILL MUTED. .
>> OKAY. IS IT BETTER? SORRY.
I'M SORRY. SO YAEL NIV FROM
PRINCETON UNIVERSITY I'M GOING
TO HAVE TO THREE IN THREE
MINUTES BECAUSE I'M GOING TO
TEACH SO I WILL JUST QUICKLY I
WAS WONDERING WITH RESPECT TO
THE LAST QUESTION AND YOUR
ANSWER NOW, I WAS THINKING, WHAT
DO YOU RECOMMEND FOR NIMH AND
BIGGER FOR ALL OF NIH AND THINKK
HOW STRUCTURAL RACISM IS
BASEICALLY RAREFIED IN WHAT WE
VALUE, WHEN GRANTS ARE REVIEWED
AND INSTITUTION OR THE
RESEARCHER ARE EVALUATED IN SOME
PARTS OF THE EVALUATION THERE,
WE VALUE PAPERS, WE VALUE DATA
SETS, THESE ARE A SMALL SUBSET
OF CONTRIBUTIONS OF SCIENTIFIC
AND COMMUNITY CONTRIBUTIONS AND
THE WAY RESEARCH CONTRIBUTE TO
SOCIETY. I THINK PART OF THAT IS
PART OF STRUCTURAL RACISM AND
THIS IDEA OF LIKE WORSHIP OF THE
THE WRITTEN WORD VERSUS OTHER
CONTRIBUTIONS THINGS EASILY
ASSIGNED TO ONE PERSON VERSUS
MORE COLLECTIVE CONTRIBUTIONS.
AND THIS IS -- YEAH, A BIG
QUESTION I REALIZE.
>> IT IS TOUGH BUT EMBEDDED IN
WHAT WE DO. WE HAVE TO EXPAND
HOW WE THINK ABOUT WHAT
CONSTITUTES SUCCESS AND THESE
METRICS ARE IMPORTANT. BUT AGAIN
THE EXTENT WE CAN BUILD TEAMS
THAT MAYBE HAVE FOLKS WHO HAVE
SOME OF THOSE RESOURCES
EXPERTISE, BUT THERE IS ALSO
INNOVATION TEAMS THAT MAY HAVE
FOLKS WHO DON'T HAVE AS LONG
STANDING HISTORY ARE THE SAME
SORT OF I DON'T KNOW WHAT TO
CALL IT NOT SURE WHAT WORD TO
USE, BEING PART OF A TEAM
PUTTING THOSE TOGETHER HAVING TO
WORK TOGETHER IS IMPORTANT. AS
YOU ASK YOUR QUESTION, I THINK
ABOUT MYSELF. WHEN I STARTED AT
UMC AT ASSISTANT PROFESSOR I HAD
TWO OR THREE PUBLICATIONS, THIS
WAS IN PART SHAPED BY NUMBER OF
FACTORS. I WOULD SAY STRUCTURAL
RACISM PLAYED A ROLE. USC TOOK A
RISK WITH ME, I DIDN'T HAVE THE
SAME PEDIGREE THAT YOU WOULD
EXPECT TO SEE BUT I HAD AN NSF
FUNDED GRANT, I HAD A
POST-DOCTORAL AWARD, AND I THINK
THEY SAW POTENTIAL OR I HOPE
THEY DID. SO SOMETIMES YOU HAVE
GOT TO LOOK BEYOND TRADITIONAL
MARKERS AN USUAL SUSPECTS AND
EXPAND HOW YOU THINK ABOUT
POTENTIAL CONTRIBUTIONS BECAUSE
THE FOLKS WHO MAY BE ABLE TO
MAKE CONTRIBUTIONS ARE NOT
ALWAYS LOOK THE WAY ON PAPER AND
SO WE CAN'T THROW THOSE OUT
COMPLETELY BUT HOW WE CAN
INCENTIVIZE INNOVATION WITH SOME
TRADITIONAL MARKERS, EXPANDING
HOW WE THINK ABOUT THIS, ET
CETERA.
>> THANK YOU.
>> THANK YOU FOR THE
PRESENTATION. I HAVE A SLIGHT
TWEAK OF DR. NEBLETT'S QUESTION.
SO THE CHAL LENG THAT HAS BEEN
BROUGHT UP AND I THINK WE
DISCUSSED ON COUNCIL, GEORGIA
SOUTHERN BY THE WAY IN PUBLIC
HEALTH. SO THE QUESTION WE HAVE
CONSISTENTLY STRUGGLE WITH IS
THE POINT ABOUT DECISION MAKING
AND WHO MAKES THE DECISION AN
THINGS YOU BROUGHT UP RELATED
TOO THAT. HOWEVER INDEPENDENT OF
THAT, THIS IS CONSISTENTLY AS
YOU KNOW STUDIED THE LITERATURE
SO YOU KNOW DECADES THAT WE ASK
THE SAME QUESTIONS AND LOOK AT
THE SAME TYPES OF THINGS. YOU
WORK IN DETROIT SO BASED UPON
ORIGINS OF YOUR CENTER CAME OUT
OF THAT. SO MY QUESTION HAS MORE
TO DO WITH THE MOVING NEEDLE
SITUATION. SIMILAR TO WHAT I
ASKED PREVIOUS SPEAKER, YOU TALK
STRUCTURAL RACISM, I TALK ABOUT
STRUCTURE IN GENERAL AND WHO
MAKES A DECISION RELATED TO
THAT. WHILE MANY EFFORTS WE
RECOGNIZE THIS HAS BEEN THERE,
IT REALLY IS A MIND SET THAT WE
STUDY AND WE STUDIED OVER AND
OVER AGAIN, THE QUESTION OF WHY
DOES RACISM EXIST MANY THE FIRST
PLACE. GOES BACK HISTORICALLY
AND YOU MENTIONED SEVERAL PEOPLE
WHO LOOK AT THE SOCIAL
EPIDEMIOLOGY OFNA IN THEIR WORK
SO MY QUESTION IS MORE TO DO
WITH IF WE ARE GOING TO MAKE THE
CHANGE, WHAT RECOMMENDATIONS
THAT ARE ACTIONABLE INTERVENTION
BASED, THAT CAN BE POINTED TO
THAT REALLY WOULD MOVE THE
NEEDLE? WE STUDY -- LOOK AT
RACE, HOW WE DEFINE SOCIAL
LOGICALLY AND WE LOOK AT FROM A
SOCIAL CONTEXT OF THEIR -- THE
PLACE IN TIME,REAL TIME
DISCUSSIONS OF THIS, BUT WE ARE
STILL VEXED EVEN IN ALL THE
STUDIES THAT ARE BEING DONE, OF
HOW TO REALLY DESIGN
INTERVENTIONS PARTICULARLY
EFFECTIVE INTERVENTIONS THAT
DEAL WITH THE SOCIAL MENTAL
HEALTH BEHAVIOR TYPES OF THINGS
THAT CREATE THE ENVIRONMENT FOR
RACISM TO EXIST AND DRIVE IN THE
FIRST PLACE AND THEN CHANGE
THOSE ENVIRONMENTS BY
INFLUENCING THOSE WHO MAKE
DECISIONS TO ALLOW THOSE
ENVIRONMENTS TO EXIST. AND
DESPITE THE HARD WORK THERE, IT
IS STILL SOMETHING THAT WE
REALLY NEED TO DO. SO I BRING
THAT QUESTION UP BECAUSE WORK
YOU ARE LOOKING AT IS TRYING TO
GET AT BUT I STILL THINK --
LOOKING AT A LOT OF WORK BEING
DONE AND FINDING LOT OF WORK
DONE IN OTHER TYPES OF THINGS,
NOT REALLY GETTING AT THE ROOT
ISSUES, THAT WILL INFLUENCE THE
KIND OF CHANGE THAT NEEDED TO BE
DONE AND THAT WE HAVE EVIDENCE
TO SUPPORT THAT, THAT WE CAN
USE. SORRY IF -- I AM RAMBLING
BUT THAT IS MY QUESTION, I HEAR
WHAT YOU ARE SAYING AND THERE IS
AGREEMENT ABOUT WHAT YOU SAY BUT
IT IS STILL FALLS SHORTS OF IT,
IN TERMS OF HOW DO WE MAKE
RECOMMENDATIONS PARTICULARLY
COUNCIL LIKE THIS WHO LOOKS AT
THESE ISSUES FIRST DOMESTICALLY
BUT ALSO THE BIGGER QUESTION
WHICH YOU DON'T HAVE TO ANSWER
BUT I WANT TO BRING UP FOR THE
RECORD, IS THAT GLOBALLY WHAT
YOU ARE TALKING ABOUT EXISTS BUT
THE LEVEL OF WORK ON THAT ISSUE
GLOBALLY FALLS SIGNIFICANTLY
SHORT. THANK YOU FOR YOUR TIME.
>> THANKS FOR THE QUESTION. I
WISH I HAD AN ANSWER TO IT. I
THINK IF I DID HAVE AN ANSWER TO
IT YOU WOULDN'T BE ASKING THE
QUESTION BUT THE FACT IS WE HAVE
BEEN TALKING ABOUT THIS FOR A
VERY LONG TIME. AS YOU WELL
KNOW, AT THE ROOT OF STRUCTURAL
RACISM ARE ISSUES OF POWER AND
INEQUITY AND UNTIL WE FIND WAYS
TO DISRUPT THAT POWER DYNAMIC
AND SHARE THE POWER AND CHANGE
THE EXISTING STRUCTURE, WE ARE
GOING TO CONTINUE TO SEE THE
SAME PATTERNS. SOME MAY SAY OKAY
THAT SOUNDS NICE, HOW DO YOU
DISRUPT POWER? THERE'S PEOPLE
THAT REALLY HAVE BEEN PUSHING
FOR REPRESENTATION OF COMMUNITY
PARTNERS AND PEOPLE WHO ARE
LIVING THIS EVERY DAY TO BE AT
THE TABLE AND TO BE PART OF THE
DECISION MAKING PROCESS AND TO
WEIGH IN ON REVIEW PANELS AND
THINGS OF THAT NATURE. WE HAVE
LISTENING SESSIONS AND WE BRING
IN FOLKS AND ASK THEM THEIR
OPINIONS HOW WE CAN MAKE CHANGES
BUT THAT IS NOT THE CHANGE TO
LEAD THE STRUCTURAL CHANGE. SO
HOW CAN WE BE SERIOUS, ASSUMING
IT WAS A RHETORICAL QUESTION,
ABOUT THINGS THAT ARE REALLY
GOING TO CHANGE THE PEOPLE WHO
ARE AT THE TABLE AND NOT JUST
FOR A ONE OFF LISTENING SESSION
BUT WILL BECOME PART OF THE
STRUCTURE, ABILITY TO CHANGE
POLICIES, THAT CAN REALLY MAKE A
DIFFERENCE, I THINK WHEN WE
START THE TRY TO DO THAT THEN
MAYBE WE CAN -- WE HAVE A CHANCE
BUT WHEN YOU TALK ABOUT LONG
TERM POWER STRUCTURE EMBEDDED
HISTORICALLY, IT IS GOING TO
TAKE SOME CREATIVITY AND
INNOVATION.
>> THANK YOU. FOR THAT COMMENT.
>> I WANT TO THANK YOU DR.
NEBLETT AND ALL THE COUNCIL AND
QUESTIONS AND LISTENING THE
CONSIDERATION OF WHAT WE HEARD
FROM DR. NEBLETT AND DR. ZENG.
APPRECIATE YOU ENRIQUE COMING BY
AGAIN. PLEASURE AS ALWAYS.
>> THANKS FOR HAVING ME. TAKE
CARE.
>> SO WE ARE AT 2:50. WHICH IS
APPROXIMATELY FIVE MINUTES LATE.
WE WILL TAKE A FULL TEN MINUTE
BREAK THEN START THE NEXT
SESSION A LIT LATE A THREE
O'CLOCK WHEN WE WILL HEAR TRY
ANNUAL REPORT ON INCLUSION WOMEN
AND MINORITIES AND LA RESEARCH
AT NIMHH. TAKE CARE AND WE'LL BE
BACK AT THREE O'CLOCK. SEE YOU
SOON. NAMHC
WE ARE GOING TO LAUNCH
INTO THE NEXT COMPONENT OF OPEN
SESSION. WE ARE OBLIGATED TO
REPORT TO YOU INCLUSION OF
MINORITIES ON NIMH RESEARCH.
TIME TO DO THAT AGAIN.
PRESENTING IS ASHLEY KENNEDY
CLINICAL TRIALS PROGRAM
COORDINATOR OFFICE OF CLINICAL
RESEARCH WHICH OVERSEES
COMPLIANCE WITH CLINICAL
RESEARCH REALLY ACROSS THE
INSTITUTE. DR. KENNEDY.
>> THANK YOU FOR THAT
INTRODUCTION. MY NAME IS ASHLEY
KENNEDY, I REPRESENT THE
INCLUSION DATA FOR NIMH FUNDED
CLINICAL RESEARCH FOR FISCAL
YEARS 2019 TO 2021. THE NIH
MANDATES TO MAKE SURE WOMEN AND
MINORITIES IN CLINICAL RESEARCH
IN MANNER APPROPRIATE TO
SCIENTIFIC QUESTION UNDER STUDY
AND RESEARCH IS GENERALIZABLE TO
THE ENTIRE POPULATION. IN LINE
WITH THAT GOAL, NIH DEFINED
PHASE 3 CLINICAL TRIALS SHOULD
BE DESIGNED IN A MANNER
SUFFICIENT TO PROVIDE VALID
ANALYSIS OF WHETHER THE
VARIABLES BEING STUDIED AFFECT
WOMEN OR MEMBERS OF RACIAL
ETHNIC MINORITY GROUPS OTHER
TRIAL PARTICIPANTS. NEXT SLIDE.
THE MINIMUM STANDARDS FOR RACE
ETHNICITY ARE SET BY OFFICE OF
MANAGEMENT AND BUDGET, CURRENTLY
THERE ARE FIVE RACIAL CATEGORIES
AND TWO ETHNIC CATEGORIES. NEXT
SLIDE. RATION AND ETHNICITY ARE
DISTINCT CONCEPTS. MANY MAY
IDENTIFY WITH RACIAL ANDETH IN I
CAN CATEGORY. INDIVIDUALS HAVE
OPTION WITH MORE THAN ONE RACIAL
CATEGORY. WITH A RESEARCH
PARTICIPANT IDENTIFIES MORE THAN
ONE RACIAL CATEGORY THEY REPORT
AS MORE THAN ONE RACE. WHENEVER
POSSIBLE SELECTION OF RACIAL
ETHNIC CATEGORIES SHOULD BE
COMPLETE BY INDIVIDUAL
PARTICIPATING IN RESEARCH STUDY.
INDIVIDUALS ALSO HAVE OPTION TO
NOT PROVIDE THIS INFORMATION. IF
A RESEARCH PARTICIPANT ELECTS TO
NOT PROVIDE THIS INFORMATION,
THEY ARE REPORTED AS UNKNOWN NOT
REPORTED. TODAY I WILL PRESENT
DATA ON ALL NIMH EXTRAMURAL
INTRAMURAL CLINICAL RESEARCH AND
NIH DEFINED PHASE 3 CLINICAL
TRIALS. I ARE START ARE DATA
FROM NIMH EXTRAMURAL CLINICAL
VERGE. OVERALL ENROLLMENT TO
EXTRAMURAL CLINICAL RESEARCH BY
SEX GENDER REMAIN CONSISTENT
FROM 2019 TO 2021, ON AVERAGE
54% PARTICIPANTS WERE FEMALE,
44% MALE AND 2% UNKNOWN. IN
TERMS OF NIMH ENROLLMENT
EXTRAMURAL RESERGE BY RACE, THIS
FIRST SLIDE DEPICTS THE COUNTS
FOR EACH RACE GIVEN FISCAL YEAR
AND IN THE NEXT SLIDE YOU WILL
SEE RACE PRESENTED BY
PERCENTAGES. THIS WAS DONE THE
EXPLAIN THE TRAINING AFRICAN
AMERICAN ENROLLMENT IN
EXTRAMURAL CLINICAL RESEARCH.
THE LARGEST RACIAL MINORITY
GROUPS WERE AFRICAN AMERICAN AND
ASIAN. AFRICAN AMERICAN
ENROLLMENT INCREASED FROM 2019
TO 2020 AND 2021 AFRICAN
AMERICAN ENROLLMENT SLIGHTLY
DECREASED. WHITE ENROLLMENT
CONSISTENTLY INCREASED ACROSS
FISCAL YEARS. THE INCREASE FROM
2019 TO 2020 FOR UNKNOWN RACE
MAYBE ACCOUNTED FOR BY
EXTRAMURAL PROJECT THAT IS
BUILDING A GENETIC BANK IN
UNDER-REPRESENTED POPULATIONS
AND LARGE TRIAL IMPLEMENTING
COLLABORATIVE CARE FOR PERINATAL
DEPRESSION. THIS SLIDE DEPICTS
PERCENTAGE FOR EACH RACE
FORGIVEN FISCAL YEAR. SO
ALTHOUGH AFRICAN AMERICAN
ENROLLMENT INCREASED FROM 2019
TO 2020 DEPICTED IN PREVIOUS
SLIDE, DUE TO THE OVERALL
PERCENT -- PARTICIPANT
ENROLLMENT INCREASE TO BETWEEN
2019 AND 2020 THE PERCENTAGE FOR
AFRICAN AMERICAN ENROLLMENT
DECREASED IN 2021 AFRICAN
AMERICAN ENROLLMENT DECREASED
WHICH FURTHER ACCOUNTS FOR
REDUCTION IN THIS GROUP
ENROLLMENT PERCENTAGE.
ENROLLMENT BY ETHNICITY ON
AVERAGE 10% PARTICIPANTS WERE
HISPANIC OR LATINO. NOW PIVOT TO
DATA FROM NIMH INTRAMURAL
CLINICAL RESEARCH. ACROSS THE
FISCAL YEARS FOR ENROLLMENT TO
INTRAMURAL RESEARCH 48%
PARTICIPANTS WERE FEMALE, 42%
MALE AND 10% WERE UNKNOWN. IF
RACIAL DISTRIBUTION OF
PARTICIPANTS IN INTRAMURAL
RESEARCH WAS SIMILAR ACROSS THE
FISCAL YEARS. MAJORITY OF
PARTICIPANTS IDENTIFIED AS WHITE
ON AVERAGE 64%. OWN KNOWN RACE
WAS ON AVERAGE 16% WHICH IS
MOSTLY ACCOUNTED FOR BY FOUR
LARGE INTRAMURAL STUDIES. THE
LARGEST RACIAL ETHNIC MINORITY
GROUPS WERE AFRICAN AMERICAN, ON
AVERAGE 11% AND ASIAN ON AVERAGE
6%. MENTION SLIDE. ENROLLMENT
INTO INTRAMURAL CLINICAL
RESEARCH BY ETHNICITY, 5%
PARTICIPANTS WERE HISPANIC OR
LATINO. LASTLY I WILL BE
DISCUSSING DATA ON NIMH PHASE 3
CLINICAL TRIALS. ON AVERAGE 67%
OF PARTICIPANTS WERE FEMALE
SLIGHT FLUCTUATIONS IN FEMA
REPRESENTATION ACROSS FISCAL
YEARS. THE LARGE INCREASE IN
ENROLLMENT FROM 2020 TO 2021
MAYBE ACCOUNTED FOR BY TWO
EXTRAMURAL RESEARCH STUDIES.
ONE LARGE SCALE TRIAL UTILIZING
MOBILE TECHNOLOGY AND COLLEGE
POPULATIONS WITH MENTAL
DISORDERS, AND PRAGMATIC TRIAL
EVALUATING STRATEGIES FOR THE
IMPLEMENTATION eHEALTH HIV
PREVENTION PROGRAM. IN TERMS OF
NIMH ENROLLMENT IN PHASE 3
CLINICAL TRIALS BY RACE, THIS
FIRST SLIDE DEPICTS COUNTS FOR
EACH RACE FORGIVEN FISCAL YEAR
AND THE NEXT SLIDE YOU WILL SEE
RACE PRESENTED BY PERCENTAGES.
THIS WAS DONE TO EXPLAIN
TRAINING AFRICAN AMERICAN
ENROLLMENT IN PHASE 3 CLINICAL
TRIALS. THE LARGEST RACIAL GROUP
IN PHASE 3 CLINICAL TRIALS IS
AFRICAN AMERICAN. IN 2019 THE
LARGE AFRICAN AMERICAN
ENROLLMENT IN PHASE 3 CLINICAL
TRIALS MAYBE ACCOUNTED FOR BY
EXTRAMURAL TRIAL EVALUATING
COMMUNITY SUPPORT WORKER
INTERVENTION FOR HIV WHICH
COMPLETED ENROLLMENT THAT
YEARMENT AFRICAN AMERICAN
ENROLLMENT REMAINED CONSISTENT
IN 2020 AND 2021 AFRICAN
AMERICAN ENROLLMENT
SIGNIFICANTLY INCREASED. NEXT
SLIDE. THIS SLIDE DEPICTS THE
PERCENTAGE FOR RACE FORGIVEN
FISCAL YEAR. SO ALTHOUGH AFRICAN
AMERICAN ENROLLMENT REMAINED
RELATIVELY CONSISTENT IN 2019
AND 2020, AS DEPICTED PREVIOUS
SLIDE DUE TO OVERALL PHASE 3
CLINICAL TRIALS PARTICIPANT
ENROLLMENT INCREASE FROM 2019 TO
2020 THE PERCENTAGE FOR AFRICAN
AMERICAN ENROLLMENT DECREASED.
IN 2021, AFRICAN AMERICAN
ENROLLMENT SIGNIFICANTLY
INCREASED HOWEVER THE OVERALL
PHASE 3 CLINICAL TRIAL
PARTICIPANTS ENROLLMENT
INCREASED WHICH ACCOUNTS FOR THE
REDUCTION IN THIS GROUP
ENROLLMENT PERCENTAGE. ON
AVERAGE 6.8% PARTICIPANTS
IDENTIFY ETHNICITY AS HISPANIC
WITH INCREASE IN HISPANIC
PARTICIPATION ACROSS THE FISCAL
YEAR. THE LARGE INCREASE IN
ENROLLMENT AMONG INDIVIDUALS WHO
REPORTED HISPANIC ETHNICITY FROM
2020 TO 2021, MAYBE ACCOUNTED
FOR BY THREE EXTRAMURAL
PROJECTSS. A LARGE SCALE TRIAL
UTILIZING MOBILE TECHNOLOGY AND
COLLEGE POPULATIONS WITH MENTAL
DISORDERS, A PRAGMATIC TRIAL
EVALUATING STRATEGIES FOR
IMPLEMENTATION OF E HEALTH HIV
PREVENTION PROGRAM. AND TRIAL
EVALUATING THE EFFECT OF
INTERNET BASED COGNITIVE
BEHAVIORAL THERAPY IN COLLEGE
STUDENTS WITH MENTAL DISORDERS.
THANK YOU FOR YOUR TIME. .
>> THANK YOU VERY MUCH, ASHLEY
FOR THE CLEAR PRESENTATION. ANY
QUESTIONS FROM COUNCIL? ASHLEY,
IF I MIGHT IN APPRECIATE THE
ATTEMPT TO TRY -- LET ME TURN IT
OVER TO LAURA ACTUALLY. ALMASY.
>> LAURA ALMASY FROM CHILDREN
HOSPITAL PHILADELPHIA,
UNIVERSITY OF PENNSYLVANIA. CAN
YOU SAY A LITTLE BIT ABOUT THE
NUMBERS OF STUDIES IN EACH OF
THESE CATEGORIES? IT SEEMS LIKE
THE NUMBERS FROM YEAR-TO-YEAR
ARE INFLUENCED A GREAT DEAL BY
PARTICULAR STUDIES COMING ON OR
OFFLINE.
>> SO YOU WOULD LIKE TO KNOW THE
NUMBER OF GRANTS ASSOCIATED
INCLUSION ENROLLMENT REPORTS FOR
THE GIVEN FISCAL YEARS?
>> YES. SO HOW MANY NIH FUNDED
NIMH FUNDED PHASE 3 CLINICAL
TRIALS ARE THERE? SEEMS LIKE ONE
OR TWO STUDIES COMING IN AND
OUT. OUT. IS REALLY DRIVING THE
YEAR-TO-YEAR TRENDS.
>> I DON'T HAVE EXACT NUMBERS OF
STUDIES BECAUSE IT -- IT IS A
LOT OF GRANTS THAT MAKE UP THE
DATA. . I'M HAPPY TO GET THAT
DATA FOR YOU THOUGH. I WOULD
HAVE TO TAKE A DEEPER DIVE AND
LOOK AT NUMBER OF STUDIES.
>> THERE IS A LOT OF STUDIES BUT
A FEW ARE SO LARGE THAT THEY --
THEY DOMINATE THINGS.
>> YES. THAT IS CORRECT. OR
THEY ACCOUNT FOR INCREASES
ACROSS FISCAL YEARS.
>> LAURA, WHAT MY QUESTION WAS
GOING TO GET AT IS THE LEVEL OF
-- DEGREE WHICH THESE LARGE
STUDIES IMPACT OVERALL
PERCENTAGES. SUGGESTING WE NEED
WAY TO CLARIFY, DIVIDE BY
CATEGORIES THAT NIH ASKS TO
REPORT OUT LIKE PHASE 3 CLINICAL
TRIALS BUT IMPORTANT TO GET AT
ONE ENCOURAGING FACTORS ABLE TO
ACHIEVE PREPRETTY SUBSTANTIAL
DEGREE PARTICIPATION AMONG
AFRICAN AMERICANS, AND MAYBE
PROPORTIONAL REPRESENTATION OF
HISPANICS OVERALL THOUGH TRICKY
TO DO THAT. BUT I THINK THERE
ARE -- IT IS UNCLEAR TO WHAT
KINDS OF STUDIES WE ARE REACHING
ON THESE VARIOUS MINORS AND
WHETHER OVERALL PORTFOLIO IS
BALANCED IN TERMS OF
REPRESENTATION THAT IS EFFECTIVE
SO PARSING THAT OUT WOULD BE
HELPFUL.
>> THE REPORT DOES DETAIL THE
TOTAL NUMBER OF INCLUSION ENROLL
ENROLLMENT REPORTS FOR EACH
FISCAL YERKES, THAT GOES IN LINE
WITH NUMBER OF GRANTS. I PULLED
THAT UP IF YOU WANT ME TO GO
THROUGH THIS.
>> LET ME SEE. SORRY. YOU DON'T
HAVE A SHOWING RIGHT NOW.
>> I PULLED IT UP IN THE REPORT.
>> THANK YOU VERY MUCH. ANY
OTHER QUESTIONS OR COMMENTS FROM
COUNCIL? APPRECIATE THE REPORT
OUT, THANK YOU VERY MUCH. THANKS
TO ALL THE COLLEAGUES AT OCR
OFFICE OF CLINICAL RESEARCH
WHICH HELPS PREPARE THIS AND
MORE IMPORTANTLY HELPS MONITOR
CLINICAL PROGRAMS SOME OF THE
REPORT OUT IN THE PAST IN TERMS
OF WHAT WE DO, THEY DON'T COME
UP IN CLOSE SESSION, THEY DON'T
REVIEW GRANTS, THEY HELP US
ENSURE THAT OUR OUR CLINICAL
TRIALS AND OTHER STUDIES
ENGAGING CLINICAL SUBJECTS ARE
DONE ETHICALLY, RESPONSIBLY, THE
DATA IS SAFEGUARDED, MAJOR
OPERATION AND APPRECIATE IN THE
DIRECTOR OF OCR WAS JUST
APPOINTED THIS YEAR AND ORONES
RUNS A GREAT SHOT SO THANKS TO
EVERYONE THERE FOR THIS
PRESENTATION. I THINK THIS PUTS
US A LITTLE BIT AHEAD OF TIME.
>> JUST HAVE TO TAKE A VOTE ON
THAT REPORT.
>> HE CAN O.
>> I ACTUALLY HAVE A QUESTION.
>> GO AHEAD BRIAN.
>> IT IS INTERESTING TO ME
FEMALES ARE GENERALLY
OVERREPRESENTED VERSUS MALES IN
THE CLINICAL TRIALS. WE DON'T
NEED THIS INFORMATION NOW BUT IS
THERE A BREAK DOWN IN TERMS OF
BASICALLY DIAGNOSIS? BECAUSE
JOSH IS NODDING HERM IT IS WELL
KNOWN THERE ARE DIFFERENCES IN
PREVALENCE RATES AMONG SEXES FOR
SCHIZOPHRENIA, DEPRESSION AND SO
ON. DOES THIS SORT OF OVER -- I
WOULD SAY OVERREPRESENTATION BUT
LARGER NUMBER OF FEMALES THAN
MALES BECAUSE THERE ARE MORE
DISEASE ENTITIES BEING
INVESTIGATED THAT ARE -- HAVE A
PREVALENCE IN FEMALES MORE THAN
MALES. IS THAT YOUR SENSE OR
WAS THERE SOMETHING ELSE?
>> THAT IS AN ASSUMPTION WHICH I
DON'T THINK WE HAVE THE DATA TO
ANSWER. I DON'T KNOW IF YOU CAN
ANSWER HA QUESTION AT ALL.
>> THE REPORT DOES NOTE TOTAL
NUMBER OF PARTICIPANTS ENROLLED
IN PROJECTS ASSOCIATED WITH
RESEARCH CONDITION, OR DISEASE
CATEGORY CAN BE DISPLAYED BY SEX
GENDER RACE ETHNICITY. AND THAT
WILL BE PUBLISHED MARCH 1 THIS
YEAR. IT HAS TO DO WITH RCDC
>> GREAT, THANK YOU. THANKS. WE
WILL GO AHEAD AND HAND OFF TO
TRACY TO CONDUCT THE VOTE.
>> OKAY. SURE. SO WE ARE SEEKING
A MOTION FOR APPROVAL OF THE
NIMH TRIENNIAL REPORT WHICH
PROVIDED INFORMATION HOW NIH
COMPLIED WITH REQUIREMENT TO
REPORT INCLUSION DATA DATA. SO IS
THERE A MOTION TO APPROVE? I SEE
IT AND A SECOND. SO ALL THOSE IN
FAVOR OF APPROVING THIS REPORT
YOU CAN RAISE YOUR HAND. ALL
RIGHT. 13 YOU CAN TAKE YOUR
HANDS DOWN NOW. ANY VOTES TO NOT
APPROVE THE REPORT? ANY
ABSTENTIONS? WE ARE ALL SET
THEN, THANK YOU SO MUCH.
>> TRACY YOU SHOULD INTRODUCE
YOURSELF FOR THE VIDEOCAST
AUDIENCE, NOT SURE YOU HAVE DONE
THAT TODAY.
>> I APOLOGIZE. I'M TRACY --
EXECUTIVE SECRETARY FOR THE
COUNCIL AND DIRECTOR OF THE
DIVISION OF EXTRAMURAL
ACTIVITIES HERE AT NIMH.
>> THANK YOU.
>> I THINK WE SHOULD GO AHEAD
AND MOVE ON, WE ARE A LITTLE
AHEAD OF SCHEDULE, SO THAT MIGHT
ALLOW US TO TAKE A BREAK LATER
IF WE NEED TO. KNOWING HOW MUCH
WE LIKE TO DISCUSS THINGS HERE
COUNCIL WE SHOULD TRY TO APPLY
THOSE TO THE DISCUSSION NOW. SO
WE CAN START WITH CONCEPT
CLEARANCES? OKAY. SO AS YOU ALL
KNOW, EACH YEAR, EACH COUNCIL
ROUND WE TAKE THE OPPORTUNITY TO
PRESENT TO YOU SEVERAL
SCIENTIFIC CONCEPTS FOR INPUT
FROM THE COUNCIL. THE PURPOSE OF
THESE CLEARANCES IS FIRST AND
FOREMOST, THE NIMH STAFF AND
LEADERSHIP THAT IS DEVELOPING
CONCEPTS FOR FUTURE RESEARCH
DIRECTIONS TO HEAR YOUR FEEDBACK
INCLUDING SUGGESTIONS TO SHAPE
INITIATIVES. SECOND IS SO WE
MAKE SURE IN PUBLIC SETTING TO
LET THE COMMUNITY KNOW WHAT WE
ARE PLANNING FUTURE, THAT
ENSURES A FAIR PLAYING FIELD FOR
ALL SCIENTISTS. AND ALSO IN
TERMS OF OPPORTUNITY FOR PUBLIC
FEEDBACK AS WELL. A BRIEF
DESCRIPTION OF CONCEPTS
AVAILABLE TO YOU VIA THE
ELECTRONIC BOOKLET, THE ASR WITH
YOUR FEEDBACK WE AIM TO FROM
SEED WITH EACH RESEARCH --
PROCEED WITH RESEARCH
ACTIVITIES. I WANT TO LET YOU
KNOW THAT THE PUBLICATION OF
RESEARCH OPPORTUNITIES AND THE
TIMING OF THOSE RESEARCH
OPPORTUNITIES IS NOT CERTAIN.
THEIR EXISTENCE WILL DEPEND UPON
APPROVAL OF SUFFICIENT FUND TO
COVER COST OF THESE IN THE
FUTURE. WE ARE PRESENTING THEM
TO YOU FOR THAT INPUT AND SO
THAT EVERYBODY KNOWS OUR PLANS
BUT THESE ARE NOT GUARANTEES OF
LAUNCHING INITIATIVINGS. ONCE
PRESENTED PUBLIC HERE, THE
CONCEPTS WILL BE POSTED ON THE
NIMH WEBSITE AVAILABLE FOR
FURTHER COMMENT. AND FINALLY FOR
PURPOSES OF TODAY'S DISCUSSION
WE HAVE ASSIGNED TWO COUNCIL
MEMBERS TO EACH CONCEPT THOUGH
WE WELCOME FROM FEEDBACK FROM
EVERYBODY. SO FIRST UP WE HAVE
DR. ERIC MURPHY FROM DIVISION OF
TRANSLATIONAL RESEARCH WHO WILL
BE PRESENTING THE CONCEPT OF
UNDERSTANDING DEVELOPMENTAL
PROCESSES IN YOUTH SUICIDE.
ERIC. WELCOME.
>> THANKS, DR. GORDON. SO THANKS
FOR INVITING ME TO SPEAK ABOUT
THIS CONCEPT. AS DR. GORDON
SAID, UNDERSTANDING
DEVELOPMENTAL PROCESSES AND
YOUTH SUICIDE AND THE GOAL OF
THIS CONCEPT IS TO ENCOURAGE
RESEARCH ON THE PROCESSES THAT
CONTRIBUTE TO SUICIDE RISK IN
YOUTH IN THE UNITED STATES. WE
KNOW THE RANKS OF YOUTH
PSEUDOSIDE -- RATES HAVE BEEN
RISE MANAGE THE UNITED STATES
AND INCREASES HAVE BEEN
PARTICULARLY PRONOUNCED IN
CERTAIN RACIAL ETHNIC MINORITY
GROUPS.
HOWEVER THERE'S FUNDAMENTAL
BARRIERS TO IMPROVING OUR
UNDERSTANDING OF RISK AND
SUICIDE IN YOUTH WE HOPE TO
ADDRESS. BASIC QUESTIONS WE ARE
STILL ASKING INCLUDE WHAT SHOULD
WE BE MEASURING, SHOULD MEASURES
BE SIMILAR ACROSS AGES OR
DEVELOPMENTALLY SPECIFIC? WHO IS
AT RISK AND WHAT STAGE OF
DEVELOPMENT. THERE IS A LACK OF
VALIDATED DEVELOPMENTALLY
APPROPRIATE MEASURES OF
SUICIDALITY ACROSS CHILDHOOD AND
ADOLESCENTS. THIS MAKES IT
PARTICULARLY DIFFICULT TO
DETERMINE WHAT SUICIDAL THOUGHTS
AND BEHAVIORS OR THEIR PRIER
CURSORS LOOK LIKE AT DIFFERENT
AGE AND HOW THEY DEVELOP. TO
IDENTIFY WHETHER CONSTRUCTS THAT
CONTRIBUTE TO SUICIDALITY ARE
CONSERVED ACROSS DEVELOPMENT OR
MAYBE AGE SPECIFIC. AND TO
ASSESS RISK AND PROTECTIVE
FACTORS EXCEPT FOR
RETROSPECTIVELY AND THE REASON
WE NEED THIS BETTER
UNDERSTANDING OF THIS
PHENOMENOLOGY AND ETIOLOGY OF
CHILD ADOLESCENT SUICIDE IS ALSO
TO IMPROVE PERSONALIZED
TREATMENT BY TARGETING THE RISK
FACTORS AND MECHANISMS MOST
RELEVANT FORGIVEN YOUNG PERSON.
NEXT SLIDE PLEASE. NOW AS I
MENTIONED EARLIER THE PICTURE OF
SUICIDE RISK IN YOUTH IS NOT
MONOLITHIC AND WE NEED TO ENSURE
THAT OUR APPROACH TO EVALUATING
SUICIDE RISK RECOGNIZES
IMPORTANT DIFFERENCES BETWEEN
GROUPS. FOR EXAMPLE, WHILE
SUICIDE RISK DIFFERS BETWEEN
DIFFERENT GROUPS, THERE IS
EMERGENT EVIDENCE THAT ALSO
SUGGESTS THAT THE TIMING OF HIGH
RISK PERIODS MAY DIFFER ACROSS
GROUPS, THIS IS SOMETHING WE
WOULD WANT TO CONSIDER. WE ALSO
NEED TO CONSIDER INTERSECTIONAL
FRAMEWORKS AS WELL AS GATHERING
INTEGRATING ASSESSMENT DATA FROM
MULTIPLE SOURCES TO GET A CLEAR
PICTURE OF RISK AND RESILIENCE
FACTORS. THIS ALSO INCLUDES
CONSIDERING KEY CONTEXTUAL
FACTORS WHEN EVALUATING
ASSESSMENT RESPONSES IN
DIFFERENT SETTINGS. AS FAR AS
ANTICIPATED OUTCOMES OF THIS
CONCEPT, WE HOPE THIS CONCEPT
CLEARANCE WILL ALLOW US TO
ADDRESS GAP AREAS THAT HAVE BEEN
BARRIERS TO PROGRESS IN YOUTH
SUICIDE RESEARCH. AND FURTHER WE
HOPE IT WILL IMPROVE
IDENTIFICATION OF RISK FACTORS
AND POTENTIAL TARGETS FOR
PREVENTION INTERVENTION
DEVELOPMENTALLY APPROPRIATE AND
MAY CONTRIBUTE TO THE
DEVELOPMENT OF PERSONALIZED
TREATMENT. LIKE TO HEAR FROM
THE COUNCIL MEMBERS WHO HAVE
AGREED TO GIVE FEEDBACK ON THIS.
>> THANK YOU ERIC THANK YOU ERIC. JOSEPH A ND
AMY ARE DISCUSSANTS -- I'M
SORRY, CHERYL AND MATTHEW
DISCUSSANTS FOR IN PARTICULAR
CONCEPT, I DON'T KNOW IF YOU
HAVE A PREFERENCE BUT LET'S
START. CHERYL.
>> THANK YOU FOR BY BRINGING
THIS FORWARD. I STRONGLY SUPPORT
THE PROPOSAL PARTICIPATED THE
NIH ROUND TABLE ON THIS YOUTH
SUICIDE AND ALL OF US WHO
PARTICIPATED WERE STRUCK BY THE
SUBSTANTIAL RESEARCH GAPS. THERE
IS AN EAGERNESS IN THE FIELD TO
MOVE FORWARD DEVELOP PREVENTION
AND INTERVENTION STRATEGIES BUT
THERE SO MUCH WE DON'T KNOW YET.
AND WE REALLY NEED TO FOCUS ON
UNDERSTANDING PROCESSES
TRAJECTORIES HOW WE MEASURE RISK
FOR SUICIDE, SELF-HARM
CONSTRUCTS RELATED PHENOMENA AND
THEN WE ARE IN A BETTER POSITION
TO DEVELOP MORE EFFECTIVE
PREVENTION INTERVENTION
STRATEGIES. COMMUNITY APPROACH.
SOME OF THE THINGS RISK ACROSS
DIFFERENT GROUPS. I'M NOT
POSITIVE WHAT YOU MEANT BUT
PROBABLY BROADLY MEANT IT
BROADLY DEFINED SOCIO
DEMOGRAPHIC ROOTS BUT IMPORTANT
WE EMPHASIZE THE IMPORTANCE OF
UNDERSTANDING DIFFERENT PROFILES
OF DEVELOPMENTAL TRAJECTORIES.
YOU NOTICE -- YOU MENTIONED THAT
IT IS NOT HOMOGENOUS, IF WE WERE
TO LOOK AT YOUTH, YOUNG CHILDREN
WHO ARE SUICIDAL, THEY ARE
HETEROGENOUS IN TERMS OF
CHARACTERISTICS OF MANY
DIFFERENT LEVELS. FOR INSTANCE
THERE MAYBE ONE DEVELOPMENTAL
TRAJECTORY FOR CHILDREN WITH
SEVERE BEHAVIORAL DISINHIBITION.
THAT IS A GROUP WE TALKED ABOUT
QUITE A BIT AT THAT SUMMIT. A
THERE MAYBE ONE O OR MORE FOR
THAT BUT MAYBE ONE OR MORE FOR
OTHER GROUPS WHO HAVE NO
BEHAVIORAL DISINHIBITION BUT
OTHER CHARACTERISTICS. SO ONE
THING THAT IS REALLY IMPORTANT
AND WHAT COMES FORWARD IS TO BE
SURE INVESTIGATORS ARE
ADDRESSING HETEROGENEITY AND NOT
TRYING TO COME UP WITH AN
EQUATION TO UNDERSTAND RISK. I
ALSO REALLY WANT TO HIGHLIGHT
THE INTERSECTIONAL FRAMEWORK OF
THE CONCEPT CONSIDERING SOCIAL
FACTORS SYSTEMS AND
INTERDEPENDENCE. THERE'S SUCH
MARKED DIFFERENCES IN SUICIDE
RISK FOR SUP GROUPS OF PEOPLE
ACROSS THE LIFE SPAN. AND MENTAL
ILLNESS MENTAL HEALTH ARE
CRITICALLY IMPORTANT AND YET IT
GOES BEYOND THAT, WHY WE HAVE
SUCH DIFFERENCES IN SUICIDE
RATES ACROSS STATES IN THE U.S.?
FOR OUR AMERICAN INDIAN
ADOLESCENTS. FOR YOUNG PEOPLE
WHO SELF-IDENTIFY AS A GENDER
MINORITY. SO WE NEED TO BE SURE
WHEN PEOPLE COME FORWARDS, THEY
ARE THINKING ABOUT THE MENTAL
ILLNESS MENTAL HEALTH ASPECT,
NEARLY DEFINED, I KNOW THEY CAN
BE BROADLY DEFINED TO INCLUDE
ALL OF THIS. BUT THAT WE REALLY
DO GET TO SOME OF THOSE OTHER
LEVELS OF RISK RISK. THANK YOU SO
MUCH FOR BRINGING IT FORWARD AND
I DEFINITELY SUPPORT IT.
>> THANKS, CHERYL. MATTHEW.
>> I'M NEW TO THE COUNCIL,
PSYCHOLOGIST AT HARVARD
UNIVERSITY. SO I WANT TO START
BY SAYING THANKS SO MUCH TO ERIC
AND COLLEAGUES AT NIMH PUTTING
TOGETHER A REALLY COMPELLING
CONCEPT CLEARANCE AND REALLY
WELL DONE EXCELLENT WORKSHOP
LIKE CHERYL I PARTICIPATED IN
PART OF THE WORKSHOP, I THOUGHT
IT WAS IMPORTANT AND NICELY
IMPLEMENTED. I STRONGLY SUPPORT
THIS CONCEPT CLEARANCE, I WON'T
REPEAT THE GREAT POINTS CHERYL
MADE TO DRAW OUT A FEW ERIC
MENTION THERE HAD IS A HUGE NEED
TO IMPROVE ASSESSMENT IN KIDS
AND ADOLESCENTS. IF WE ASK
ADULTS HAVE YOU THOUGHT ABOUT
SUICIDE THERE'S SO MUCH
HETEROGENEITY IN THAT GROUP. SO
COMING UP WITH ANY BIOLOGICAL
MARKERS BEHAVIORAL MARKERS FOR
THIS OUTCOME WHEN SO BROAD WE
NEED TO DO A BETTER JOB AND IT
GETS MORE COMPLICATED TO KIDS
AND ADOLESCENTS. RECENT META
ANALYSES, WE ARE NOT GOOD AT
PREDICTION OR SUICIDE
INTERVENTION. WE NEED TO DO
BETTER THAN WE ARE SO REALLY
IMPORTANT TOPIC. VERY TIMELY,
ALSO BECAUSE OF THE CURRENT
COVID SITUATION. THERE IS A HUGE
BOARDING CRISIS IN OUR EMERGENCY
DEPARTMENTS, JUST AN ARTICLE OUT
IN BOSTON LAST WEEK SAYING THAT
FOR KIDS AN ADOLESCENTS THE
AVERAGE TIME FOR THOSE WHO STAY
OVER NIGHT IS ONE WEEK. A LOT
NEEDS TO BE DONE IN THE SHORT
TERM SO GREAT THIS IS FOCUS.
ERIC ALSO MENTIONED IMPORTANCE
FOCUSING ON BLACK YOUTH, KIDS,
BLACK YOUTH BETWEEN AGE 5 AND 12
HAVE TWICE SUICIDE RATE AS DO
WHITE PEOPLE AND THE SUICIDE
RATE MUCH HIGHER AMONG THOSE
GOVERNMENT CALLS WHITE FOR MANY
YEARS. SO THIS IS REALLY SPECIAL
NEED. I KNOW THERE WAS NIMH
NOTICE OF SPECIAL INTEREST BUT
SUGGEST THIS CONTINUE TO BE A
FOCUS. MY ONE CAUTION IS THE
SUICIDE RATE IS PRETTY LOW IN
YOUNGER PEOPLE. THERE'S ONLY A
FEW DOZEN SUICIDES EACH YEAR --
DEATH AMONG THOSE UNDER AGE 12.
SOMETHING IMPORTANT TO KEEP IN
MIND FOR THOSE WHO ARE TO
FOCUSING ON THE EARLIER PERIOD
WE HAVE TO MAKE SURE WE ARE
FOCUSING ON TRACTABLE PROBLEMS
AND QUESTIONS BUT OVERALL NICELY
DONE EXCELLENT JOB AND I
STRONGLY SUPPORT THE CONCEPT
CLEARANCE.
>> ARE THERE QUESTIONS OR
COMMENTS FROM OTHER MEMBERS OF
THE COUNCIL?
>> GO RIGHT AHEAD. I GOT TO
CHANGE MY VIEW HERE.
>> I'M DR. (INAUDIBLE) SAMHSA,
WE ARE VERY -- GREAT INTEREST TO
ASK AND I APPRECIATE THE
OPPORTUNITY TO HEAR ABOUT THIS.
I DID HAVE A COUPLE OF THINGS I
WANTED TO THROW OUT THERE
CONSISTENT WITH COUPLE OF
COMMENTS. ONE IS LUMPING USING
THE WORD SUICIDALITY IS KIND OF
A LUMP, LUMPING TOGETHER SEVERAL
IMPORTANT CONCEPTS YOU MIGHT
WANT TO SEPARATE INTO ELEMENTS.
WE -- SAMHSA YOU THINKING
PLANNING ATTEMPTING AT LEAST
THOSE THREE. AND THE OTHER USE
OF THE WORD PERSONALIZED
TREATMENT ASSOCIATED WITH
GENETICS, INDIVIDUAL GENETIC SO
YOU MAY WANT TO CONSIDER
SOMETHING ALONG THE LINES OF
INDIVIDUALITY OR PERSON CENTERED
TREATMENT, THINGS THAT RESONATE
WITH THE INDIVIDUALS. WE FOLLOW
THAT OUR NSDA DATA FOLLOWS OVER
TIME SEVERAL YEARS OF DATA IN
TERMS OF THINKING PLANNING AND
ATTEMPTING SUICIDE ATTEMPTS THAT
CAN BE MADE ANY WAY PARTNER ON
USE OF THAT DATA WE WELCOME THAT
WITH GRANTEES. THANK YOU.
>> THANKS, ANITA, WE APPRECIATE
THOSE COMMENTS. ACCORDING TO THE
NEW PROCEDURES WE ADOPTED
YESTERDAY, TRACY WE DO NOT HAVE
TO VOTE ON THE CONCEPT CLEARANCE
ANY MORE BUT WE APPRECIATE THE
FEEDBACK, MUCH POSITIVE BUT VERY
CONSTRUCTIVE SUGGESTIONS AS
WELL, INCORPORATE AS WE MOVE ON.
THE NEXT CONCEPT TO BE PRESENTED
IS BY DR. SUZY POLLARD DIVISION
OF AIDS RESEARCH, EXPANDING
COLLABORATIVE IMPLEMENTATION
SCIENCE WITHIN THE HIV EPIDEMIC
NATIONAL PLAN. YESTERDAY DAN
ROUSCH DIVISION DIRECTOR
PRE-STAGED THIS INITIATIVE BY
TALKING TO US A LITTLE BIT ABOUT
THE HIV PLAN. SUZY PLEASE TAKE
IT AWAY.
>> THANKS, DR. GORDON. HI,
EVERYONE. THANK YOU FOR THAT
OPPORTUNITY TO PRESENT TODAY. MY
NAME IS SUZY POLLARD, PROGRAM
OFFICER DIVISION OF AIDS
RESEARCH AND AREA OF
IMPLEMENTATION SCIENCE. I WILL
PRESENT OUR CONCEPT DR. GORDON
MENTIONED EXPANDING
COLLABORATIVE IMPLEMENTATION
SCIENCE WITHIN THE HIV EPIDEMIC
NATIONAL PLAN. SO WE KNOW THERE
ARE HIGHLY EFFICACIOUS TREATMENT
AND STRATEGIES TO PREVENT AND
TREAT HIV. YET INEQUITIES IN
ACCESS TO TREATMENTS AND IN HIV
HEALTH OUTCOMES PERSIST. HIV
CONTINUES TO DISPROPORTIONATELY
AFFECT RACIAL ETHNIC GROUPS SUCH
AS BLACK AND HISPANIC
INDIVIDUALS YOU CAN SEE CLEARLY
IN THIS FIGURE. AS WELL AS
SEXUAL GENDER MINORITIES,
ECONOMICALLY DISADVANTAGED AND
RURAL COMMUNITIES, INCREASINGLY
RECOGNIZED THAT SOCIAL
STRUCTURAL TERMS OF HEALTH SUCH
AS POVERTY STIGMA HOMELESSNESS
AND STRUCTURAL RACISM ARE ROOT
CAUSES OF HIV INEQUITIES ANSWER
MUST BE URGENTLY ADDRESSED. IN
2019 DEPARTMENT OF HEALTH AND
HUMAN SERVICES LAUNCHED THE
ENDING THE HIV EPIDEMIC MANY THE
U.S. INITIATIVE. WHICH AIMS TO
REDUCE HIV INFECTIONS IN THE
U.S. BY 90% BY 2030 BY SCALING
UP KEY HIV PREVENTION AND
TREATMENT INTERVENTIONS.
DEVELOPING INTERVENTIONS THAT
ADDRESS SOCIAL STRUCTURAL
DETERMINANTS OF HEALTH IS
CRITICAL TO END THE EPIDEMIC AS
WELL AS BROADER NIH MISSION TO
PROMOTE HEALTH EQUITY. THERE ARE
CURRENTLY SOME EVIDENCE BASED
STRUCTURAL INTERVENTIONS THAT
TARGET CERTAIN SOCIAL
DETERMINANTS OF HEALTH AND SHOWN
TO IMPROVE HIV OUTCOMES BUT NOT
YET ADAPTED TO DIFFERENT CONTEXT
OR SCALED UP. THERE IS ALSO NEED
TO DEVELOP NEW INNOVATIVE
INTERVENTIONS THAT ADDRESS OTHER
SOCIAL STRUCTURAL DETERMINANTS
OF HEALTH AIMING TO UNDERSTAND
FACTORS THAT AFFECT THE
IMPLEMENTATION. SO
IMPLEMENTATION SCIENCE METHODS
ARE DESIGNED PRECISELY TO ANSWER
THESE TYPES OF QUESTIONS. SO
THE OVERALL GOAL IS TO SUPPORT
COLLABORATIVE IMPLEMENTATION
SCIENCE RESEARCH, FOCUSED ON
STRENGTHENING EVIDENCE FOR HIV
INTERVENTION THAT TARGET SOCIAL
STRUCTURAL DETERMINANTS OF
HEALTH AND TESTING STRATEGIES
THAT FACILITATE THE UPTAKE AND
ADAPTATION. WE WILL AIM TO
SUPPORT DIVERSE RESEARCH
PROJECTS THAT HAVE A COMMON
FOCUS ON PRE-EXPOSURE
PROPHYLAXIS AND VIRAL
SUPPRESSION TO ENABLE
COMPARISONS ACROSS CONTEXT AND
DIFFERENT STRATEGIES. THE
PROJECT WILL BE EXPECTED TO BE
CARRIED OUT IN PARTNERSHIP WITH
COMMUNITY AND IMPLEMENTING
PARTNERS, AIM TO SUPPORT A
COORDINATION CENTER WHICH WILL
FACILITATE COLLABORATION DATA
HARMONIZATION AND CROSS SITE
LEARNING. IN TERMS OF EXPECTED
OUTCOMES IN ADDITION TO
GENERATING NEW DATA, REGARDING
THESE INTERVENTIONS AND
UNDERSTANDING BETTER HOW TO
IMPLEMENT THEM THE FORMATION OF
GENERALIZABLE KNOWLEDGE BASE AND
SET OF GUIDING PRINCIPLES FOR
IMPLEMENTATION FACILITATE
ADAPTATION AND SKILL, THIS WILL
BE A TRANS-NIH EFFORT TO
INCORPORATE PRIORITIES FROM A
NUMBER OF ICs AND DEMONSTRATE
COLLECTIVE DEDICATION TO
ADDRESSING HIV HEALTH
INEQUITIES. AND ALSO STRONGLY
ENCOURAGE RESEARCHERS FROM
HBCUs AND OTHER MINORITY
SERVING INSTITUTIONS TO APPLY.
THANK YOU.
>> THANK YOU VERY MUCH, SUZY. WE
HAVE TWO DISCUSSANTS ASSIGNED
JOSEPH TELFAIR AND AMY KILGORE.
AMY
>> DO YOU WANT TO GO FIRST?
>> CAN YOU HEAR ME?
>> YES.
>> SO I'M AMY (INAUDIBLE)
DIRECTOR OF VA QUALITY
ENHANCEMENT RESERGE INITIATIVE
AT U.S. DEPARTMENT OF VETERANS
AFFAIRS AND PROFESSOR OF
LEARNING HEALTH SCIENCES AT
MICHIGAN. I APPRECIATE YOUR
PRESENTATION DR. POLLARD. THIS
IS AN IMPORTANT AREA TO PROMOTE
REALLY THE NEXT GENERATION OF
IMPLEMENTATION RESEARCH THAT
INVOLVES COMMUNITY ENGAGEMENT
AND ANTI-RACISM AND COMBATING
STRUCTURAL RACISM. I STRONGLY
SUPPORT THIS INITIATIVE. I THINK
IN MANY RESPECTS IT ALSO COMES
IN ON THE REALLY KEY AREAS THAT
WE NEED MORE RESEARCH IN TERMS
OF IMPLEMENTATION SCIENCE THOSE
ARE THE STRUCTURAL AND POLICY
LEVEL TYPES OF IMPLEMENTATION
STRATEGIES. ALSO AT THE PERSONAL
LEVEL TO REALLY UNDERSTAND AND
SEE WHAT COMMUNITIES FIND
BENEFICIAL FOR HIV PREVENTION SO
FORTH. SO STRONGLY ENCOURAGE
THOSE FOCUS AREAS. IN ADDITION
TO THAT JUST AFTER HEARING
TODAY'S TALK FROM DR. NEBLETT
AND ZENG THERE IS A ALSO AN
OPPORTUNITY TO GROW THE PIPELINE
OF INTERDISCIPLINARY RESEARCH IN
IMPLEMENTATION SCIENCE, NIH IS
LEAD IN THIS TO BEGIN WITH, I
THINK A GENERATION AGO I FEEL
LIKE EARLY FIRST GENERATION
IMPLEMENTATION SCIENCE CAME FROM
NIMH AND INVOLVED SOCIAL SCIENCE
ANTHROPOLOGY AND OTHER AREAS WE
TYPICALLY DON'T THINK OF BUT IS
TYPICAL INVESTIGATOR
DIVERSIFYING WHICH IS GREAT SO I
ENCOURAGE NOT ONLY REACHING OUT
TO THE USUAL PLACES LIKE MEDICAL
ACADEMIC HEALTH SYSTEMS AND
THINGS THAT -- GOING TO THE
HBCUs BUT ALSO TO ALLIED
HEALTH PROFESSIONAL SCHOOLS AS
WELL AS OTHER SCHOOLS THAT MIGHT
DO REALLY GREAT INNOVATIVE AND
CREATIVE FIRST RESEARCH WITH
COMMUNITY PARTNERSHIPS AS WELL.
AND TO THINK CREATIVELY ABOUT
COMMUNITY ORGANIZATIONS LIKE
CITY BLOCK, NOT MAKING ANY SORT
OF ENDORSEMENT HERE BUT THAT IS
ONE EXAMPLE OF COMMUNITY BASED
ORGANIZATION THAT PROVIDE
INFRASTRUCTURE, A LOT OF THAT
TYPE OF INFRASTRUCTURE DR.
GORDON TALKED WITH COMPASS
INITIATIVE AS WELL. THOSE ARE
SOME IDEAS BUT I'M EXCITED ABOUT
THIS, LOOKING FORWARD TO SEEING
HOW IT COMES TO FRUITION.
>> CONCRETE SUGGESTIONS. JOSEPH.
>> THANK YOU VERY MUCH, JOSEPH
TELFAIR PUBLIC HEALTH PRACTICE
RESEARCH GEORGIA SOUTHERN. SO I
WOULD CONCUR WITH MUCH OF WHAT
MY COLLEAGUE PRESENTED, THEY ARE
GREAT IDEAS, ALSO THINK DR.
GORDON FOR THE ACTUAL PREAMBLE
TO ALL THIS WITH THE
PRESENTATIONS WE JUST HAD FROM
COLLEAGUES AND OTHERS BECAUSE IT
SETS THE STAGE FOR WHAT IT IS
THAT YOU ARE DISCUSSING. SO MY
COMMENTS I WILL -- I HAD A FEW
OF THE SAME BUT I WILL AVOID
THOSE AND JUST MAKE A COMMENT.
FIRST OF ALL, I DO HAVE -- I
THINK IT MAKES SENSE, IN TERMS
OF OVERALL, I WOULD HIGHLY
SUPPORT THE WORK THAT'S DONE
HERE. . . WITH SOME UNDERSTANDING.
SO IN YOUR OPENING STATEMENT YOU
TALK ABOUT SOCIAL AND STRUCTURAL
DETERMINANTS. I AGREE NEED TO BE
ADDED TO THE ELEMENTS OF THE
WORK ITSELF. THE CHALLENGE OF
IT THOUGH, IMPLEMENTATION
RESEARCH, IS THAT WHEN YOU BEGIN
TO SORT OF LOOK AT AND TRY TO
UNDERSTAND MORE STRUCTURAL
ISSUES, YOU RUN INTO THE USUAL
BARRIERS THAT OF THE COMPLEXITY
OF OPERATIONAL DEFINITIONS WAYS
TO MEASURE THOSE THINGS, SO
FORTH. SO STRONG RECOMMENDATION
WOULD BE IN WHATEVER WAY YOU
ROLE THIS OUT YOU MAKE CLEAR TO
THE INVESTIGATORS WHAT IT IS
THAT YOU ARE TALKING ABOUT. WHAT
IS IT THAT SOME REALLY GOOD
CONCRETE EXAMPLES LIKE POLICIES
RELATED TO THE WORK, ALLOWS FOR
LAWS AN POLICIES, IF YOU ARE
GOING TO DO ACADEMIC
RELATIONSHIP THERE ARE
INTERVENTIONS THAT IN AND OF
THEMSELVES HAVE LAWS THAT
PROHIBIT THEM THOUGH THEY ARE
EFFECTIVE LIKE NEEDLE EXCHANGE,
SO FORTH. ALSO THERE'S STILL
SODOMY LAWS ON THE BOOKS. SO YOU
HAVE A WHOLE BUNCH OF THOSE
THINGS. THERE'S STILL WAYS THAT
STIGMATIZATION IS NOT
ELIMINATED. PARTICULARLY AT
POLICY LEVEL, PARTICULARLY IN
INSTITUTIONS. MANY OF THEM EVEN
HEALTHCARE INSTITUTIONS. OR
EVEN SOME POLICIES SO STRONG
RECOMMENDATION WOULD BE THAT IN
THE COLLABORATION WITH OTHER
INSTITUTES, THAT YOU REALLY MAKE
CLEAR THE STRUCTURAL AS WELL AS
SOCIAL DETERMINANTS YOU HAVE.
THAT'S MY FIRST STATEMENT. THE
SECOND PART IS I THINK SOCIAL
CULTURAL RISKS AND INFLUENCES
WHICH ARE NOT DISCUSSED HERE,
BUT CLEARLY BASED UPON THE
IMPETUS OF WHAT YOU ARE TRYING
TO DO NEED TO BE CONSIDERED
BECAUSE YOU ARE TALKING ABOUT
GROUPS WHILE WE HAVE THESE
RACIAL DEMARCATIONS, AND WE HAVE
THESE ETHNICITY DEMARCATION, A
LOT OF THE LEVEL OF INVOLVEMENT
PARTICULARLY INVOLVEMENT WHERE
YOU HAVE CARE SEEKING AND OTHER
THINGS HAVE A STRONG CULTURAL
COMPONENT TO THAT. SO IN THAT
CASE THOSE ARE SOCIAL STRUCTURAL
ISSUES SO I SUGGEST KIERING
THOSE ADD THAT BECAUSE EVEN
THOUGH THEY ADD COMPLEXITY OF
STUDY THEY ALSO ADD TO WHAT THE
KIND OF OUTCOMES THAT YOU ARE
TALKING ABOUT BUT THAT YOU MIGHT
HAVE SO THAT WOULD BE SOMETHING
TO HAVE. I WAS GLAD TO SEE THAT
YOU HAVE -- LOOK AT HISTORY AND
YOU TALK ABOUT HISTORY, AND THE
EVIDENCE THAT IS THERE. BUT
HOWEVER, MAKING DEMARCATIONS
BETWEEN SHORT AND MEDIAN AND
LONG TERM OUTCOMES IS GOING TO
BE IMPORTANT BECAUSE
IMPLEMENTATION SCIENCE ALLOWS
YOU TO DO MULTIPLE LEVELS OF
THAT, THAT WOULD BE WORTH IT.
THE OTHER PART THOUGH IS THAT
YOU TALK ABOUT NEW CONTEXT YOU
WANT TO BRING TO SCALE THAT, IS
IN YOUR PART. I WASN'T CLEAR
WHAT YOU MEANT BY THAT.
>> SO I THINK A LOT OF THESE --
THERE IS A SPECTRUM IN TERMS OF
EVIDENCE FOR THESE DIFFERENT
INTERVENTIONS BUT THERE ARE
INTERVENTIONS THAT FOCUS ON
SOCIAL DETERMINANTS OF HEALTH
CARRIED OUT IN ONE CONTEXT, IN
ONE SMALL AREA. SO THE IDEA IS
THAT IS BEAUTY OF IMPLEMENTATION
SCIENCE, AS BEING ABEL THE LOOK
AT BOTH EFFECT AND PLEA
AGREEMENT MENNATION, DEPENDING
WHERE THAT EVIDENCE IS, BEING
ABLE TO HAVE FOCUS ON
EFFECTIVENESS AND IMPLEMENTATION
BUT LOOKING AT A CONTEXT BESIDES
THE ONE THAT WHERE THERE IS
ALREADY SOME PRELIMINARY
EVIDENCE.
>> THANK YOU, THAT IS REALLY
HELPFUL. I HI IT IS IMPORTANT IN
YOUR DISCUSSION DISCUSS THE FACT
YOU TRAY TO GROW THE PARADIGM IF
YOU WILL BEYOND WHAT TRADITIONAL
WAYS THAT THAT'S DONE BECAUSE IF
YOU EXPAND BEYOND CONTEXT YOU
HAVE TALK HOW THEY INTEGRATE AS
WELL. IN TERMS OF HOW THEY
WORK. THAT IS THE OTHER THING.
MY LAST COMMENT IS I FULLY AGREE
WITH THE IDEA YOU WILL
SIMULTANEOUSLY STRENGTHEN
EVIDENCE FOR MULTI-LEVEL HIV
INTERVENTION THAT ADDRESS THESE
WHILE DEVELOPING THESE
IMPLEMENTATION STRATEGIES. SO
THAT PAIRING IS DEFINITELY --
THAT TO ME THE STRONGEST
ARGUMENT FOR THIS INTERVENTION
IS YOU LOOK AT EVIDENCE AND HAVE
EVIDENCE DRIVEN INTERVENTIONS
THAT IN AND OF THEMSELVES
CHALLENGE TRADITIONAL PARADIGMS
IN THE WAY WE DO WORK. THAT IS
MY LAST COMMENT. THANK YOU FOR
ASKING ME TO LOOK AT THIS. I
FULLY CONCUR WITH MY COLLEAGUE,
THIS WILL BE A GREAT IDEA.
>> THANK YOU VERY MUCH. ANY
COMMENTS FROM OTHER MEMBERS OF
THE COUNCIL?
>> I HAVE ONE COMMENT.
MARGUERITA LIGHTFOOT. OHU
SCHOOL OF PUBLIC HEALTH
UNDERSCORING SOMETHING IMPLIED
BY MY COLLEAGUES AND THAT IS
WHILE THERE IS ALSO -- THE NEED
TO FOCUS ON INTERVENTIONS THAT
LOOK AT THESE SOCIAL STRUCTURAL
DETERMINANTS OF HEALTH, THE
THING TO ALSO KEEP IN MIND IS
THAT OUR IMPLEMENTATION SCIENCE
FRAME WORKS BY WHICH WE
UNDERSTAND AND STUDY HOW
INTERVENTIONS ARE UPTAKE OF
INTERVENTIONS ARE OFTEN VERY
SILENT TO RACISM AND
INSTITUTIONAL RACISM AND THESE
ISSUES THAT WE ARE TALKING
ABOUT. SO INHERENT IN YOUR CALL
FOR THESE THINGS IS ALSO HAVING
FOLKS BE ATTUNE TO THE FACT THAT
OUR FRAME WORKS -- THEY NEED TO
ADAPT FRAME WORKS, BE ABLE TO
LOOK AND UNDERSTAND THE
INSTITUTIONAL STRUCTURAL
BARRIERS TO IMPLEMENTATION OF
THESE KINDS OF INTERVENTIONS AS
WELL.
>> THANK YOU THANK YOU. GREAT POINT.
>> THANK YOU, MARGUERITA. IN THE
INTEREST OF TIME I'M GOING TO
MOVE ON, AS A BLANKET STATEMENT
I WILL ASK THAT THE COMMENT OR
DISCUSSANTS BECAUSE WE ARE
RAPIDLY RUNNING OUT OF TIME, WE
HAVE FOUR MORE CONCEPTS TO GO
THROUGH. EACH OF THE
DISCUSSANTS KEEP YOUR REMARKS
BRIEF AND IF YOU COULD TAKE
ADDITIONAL E DETAIL SUGGESTIONS
AND SEND THEM IN WRITING TO US
WE'LL MAKE SURE THEY GET O THE
CORRECT PROGRAM OFFICERS TO
INCORPORATE THEM. THE NEXT UP
WE HAVE DR. ISHMAEL AM R AMARREH.
OFFICE OF WORK FORCE DIVERSITY.
IT'S WRITTEN WRONG ON MY
PROGRAM. WHO IS GOING TO TALK
ABOUT NIMH FACULTY DEVELOPMENT
AWARD TO PROMOTE DIVERSITY MANY
MENTAL HEALTH RESEARCH. ISHMAEL
TAKE IT AWAY.
>> THANKS, DR. GORDON. MY NAME
IS ISHMAEL AMARREH FROM OFFICE
FOR DISPARITY RESEARCH ON WORK
FORCE DIVERSITY, PRESENTING THIS
CONCEPT FOR NIMH DEVELOPMENT
AWARD TO PROMOTE DIVERSITY IN
MENTAL HEALTH. THE GOAL IS TO
ENHANCE MENTAL HEALTH BY
SUPPORTING EARLY RESEARCH
FACULTY RESEARCHERS FROM
UNDEREPIREPRESENTED GROUPS AND
BIOMEDICAL VERGE. THE CONCEPT
PROPOSES A PROGRAM TO SUPPORT
EARLY CAREER FACULTY
INVESTIGATOR WHOSE HAVE EARNED
Ph.D. OR M.D. Ph.D. AND NOT
CURRENTLY OR FORMER INDEPENDENT
PROGRAM DIRECTOR PRINCIPLE
INVESTIGATORS AND NIH AWARDS.
THE PROGRAM WILL PROVIDE
RESEARCH SUPPORT FOR PERIOD OF
CAREER DEVELOPMENT INCORPORATION
FOR LAUNCHING RESEARCH CAREER.
NEXT SLIDE. THIS DATA HAS BEEN
SHARED WITH YOU PREVIOUSLY I
PRESENT IT HERE REMINDER THAT
THE GAP IN FUNDING AWARDS IS
LARGEST AT INVESTIGATOR LEVEL.
THE CONCEPT PROPOSES PROGRAM
THAT WILL EXPAND PERIOD OF HE
WILL JILT FOR CAREER DEVELOPMENT
PROGRAMS BEYOND EXISTING NIMH
SUPPORTED PROGRAMS. THIS CONCEPT
AIMES TO ENHANCE MENTAL HEALTH
RESEARCH WORK FORCE DIVERSITY BY
SUPPORTING SUCH INDIVIDUALS WHO
ARE CONDUCTING NIMH RELEVANT
RESEARCH AT A CRUCIAL
POTENTIALLY VULNERABLE FACE OF
THEIR -- PHASE OF THEIR CAREER.
RESEARCH CAREER. AND THAT
TRANSITION TO BECOMING
INVESTIGATOR. WE EXPECT THE
OUTCOMES WE EXPECT FROM THIS AND
CONCEPT WILL BE TO FILL A
PROGRAM GAP THAT EXISTS IN THE
NIMH PORTFOLIO WE HOPE THIS WILL
INCREASE THE NUMBER OF
APPLICANTS FROM EARLY CAREER
FACULTY AND THE GROUPS WE ARE
TARGETING. WE HOPE THAT THIS
WILL ALSO ENHANCE POOL OF THE
WELL TRAINED INVESTIGATORS WE
CURRENTLY TRAIN AND OVERALL
DIVERSIFY POOL OF MENTAL HEALTH
RESEARCH INVESTIGATORS. I WANT
TO THANK IN ADVANCE THE COUNCIL
MEMBERS WHO REVIEWED THIS FOR US
AND BACK TO YOU JOSH.
>> THANKS. REVIEWING THESE ARE
CHERYL KING AND MARGUERITA
LIGHTFOOT. CHERYL START US OFF
AGAIN?
>> SURE, IF I'M UNDERSTANDING
THIS I DO SUPPORT IT, IT CAN
HAVE A POSITIVE IMPACT.
DIVERSITY OF OUR RESEARCH WORK
FORCE IF I'M UNDERSTANDING IT IT
IS EXPANDING PRIMARILY THE
PERIOD OF ELIGIBILITY FOR
MENTORED CAREER DEVELOPMENT
PROGRAMS, I THINK THAT COULD
MAKE A REALLY IMPORTANT
DIFFERENCE BECAUSE OF THE PRESS
THAT IS ON EARLY INVESTIGATORS
ACROSS THEIR DUTIES AT THE
UNIVERSITY CERTAINLY IN THE
HEALTH SYSTEMS SO I SUPPORT IT.
MY COMMENTS OR SUGGESTIONS MORE
ABOUT COULD BE EXPANDED. MAYBE
THIS MEANS CONTINUING TO GROW
THE SUITE OF SUCH CONCEPTS OR
TAKING A MULTI-PRONGED APPROACH
IN THIS ONE, I DON'T KNOW WHICH
WAY THIS WOULD GO. BUT IT
STRIKES ME MORE TIME IS ONE
IMPORTANT ISSUE BUT NOT THE ONLY
ONE, MAY NOT EVEN BE THE PRIMARY
DRIVER I WAS THINKING THE ROBERT
WOOD JOHNSON PROGRAMS AND HOW
SOME WORKED ALSO TO GROW THE
NETWORK DURING THIS PERIOD OF
TIME. TO HELP INDIVIDUAL
DEVELOP A NATIONAL NETWORK OF
SCIENTISTS WHO SUPPORT THEM AND
GIVING INPUT INTO THEIR
RESEARCH. SO SOME EXTENT K
AWARDS DO THIS BUT NETWORK IS
EXPAND AND COULD MAKE
DIFFERENCE. ANOTHER ONE THAT
CAME TO MIND IS ALSO SOMETHING
THAT DR. NEBLETT MENTIONED THAT
WE FOCUS ALMOST SOLELY ON THE
PI, I THINK OF ALL THE TEAMS
DIVERSE TEAMS I WORK WITH OVER
THE YEARS AND THE PI POOL IS
RELATIVELY SMALL, THIS WILL MAKE
A DIFFERENCE BUT IT IS GOING TO
BE SLOW AND TAKE TIME. IT IS
IMPORTANT BUT WHAT ABOUT ALSO
GROWING THE DIVERSITY OF
LEADERSHIP TEAM WHETHER OR NOT
PI AND COULD WE PUT IN PLACE
SOME INCENTIVES FOR RESEARCH
THAT COMES IN REALLY RELEVANT
AND ACROSS THE BOARD WITH MORE
DIVERSE LEADERSHIP TEAMS. THANK
YOU. I SUPPORT IT AND I
APPRECIATE THAT YOU BROUGHT IT
FORWARD.
>>
>> QUICK COMMENT ABOUT THE FIRST
POINT. THE PLAN IS MEMBERS OF
THIS AWARDEES OF THIS MECHANISM
WOULD BE ELIGIBLE TO PARTICIPATE
IN A COHORT PROGRAM THAT WE
PARTICIPATE IN THROUGH NIGMS TO
SUPPORT K AWARD RECIPIENTS FROM
THIS CONTRIBUTING INSTITUTE SO
THAT COULD BE PART OF THIS
PARTICULAR MECHANISM. DEPENDING
UPON THE INDIVIDUAL. MARGUERITA.
>> I WILL KEEP MY COMMENTS
BRIEF. I ALSO AM VERY MUCH IN
SUPPORT OF THIS CONCEPT. THE
THING THAT CAME TO MY MIND AS MY
COLLEAGUES OTHER KIND OF THINGS
COULD BE DONE I WON'T GO INTO
ALL OF THAT. EXCEPT TO SAY I
THINK IT'S IMPORTANT FOR US TO
GIVE FOLKS MORE TIME FOR
ELIGIBILITY. FOLKS COME LATE
SOMETIMES TO RESEARCH AND TAKE
MORE TIME BUT ALSO GIVEN THE
NUMBER OF TIMES OFTEN SOMEONE
HAS RESUBMIT A GRANTNA GIVING
MORE TEAM ELIGIBILITY MAKES
SENSE. IF I I'LL PLUG ONE THING
WE CAN DO IN TERMS OF EXTENDING
TIME IS GETTING THAT KO 1 BACK
UP TO FIVE YEARS OPPOSED TO
FOUR.
>> THANKS, MARGUERITA. ANY OTHER
COMMENTS OR QUESTIONS FROM
MEMBERS OF THE COUNCIL? TED.
>> QUICK COMMENT TO REINFORCE
WHAT CHERYL SAID AND MARGUERITA
SAID. I THINK EVEN HAVING THIS
EXFEND BEYOND ITS THOUGHT ABOUT
EARLY CAREER MENTORED AWARDS, WE
REALLY ARE NOT DOING ENOUGH BUT
DOING EVEN LESS MID CAREER
INVESTIGATORS WE ARE NOT DOING
ENOUGH FOR YOUNG INVESTIGATOR
BUT WE HAVE TO THINK HOW WE ARE
GOING TO HELP THEM PROGRESS
THROUGH AWARDS, ADDITIONAL
MECHANISM AFTER K MECHANISM, I
WOULD BE SUPPORTIVE OF -- VERY
SUPPORTIVE OF THIS BUT
SUPPORTIVE HAVING IT BE LONGER
DURATION OR OTHER MECHANISMS.
>> THANKS. PAMELA.
>> THANK YOU THIS SOUNDS GREAT I
ALSO FULLY SUPPORT AND AGREE
WITH COMMENTS OF MY COLLEAGUES.
JUST WANTED TO ASK ABOUT THE
TRANSITION AT END OF AWARD TO
NEXT ONE. THAT'S WHERE PEOPLE
OFTEN GET TRIPPED UP IS
TRANSITIONING TO INDEPENDENCE.
THINKING ABOUT THIS, HOW WILL
THIS PERHAPSES IS THERE A WAY
THIS CAN EASE THAT, WILL THE
COHORT GROUP BE ABLE TO ADDRESS
THOSE ISSUES NOT SURE BUT
SOMETHING TO THINK ABOUT AS YOU
DEVELOP FURTHER CONCEPT.
>> THANKS, ISHMAEL RESPONSE TO
THAT PARTICULAR COMMENT?
>> I AGREE WITH ALL THOSE AND WE
ARE THINKING OF A LOT DIFFERENT
THINGS AND THE BIGGEST WE WANT
TO HAVE IN THIS PROGRAM OR
CONCEPT IS FLEXIBILITY SO WE ARE
BUILDING A LOT OF FLEXIBILITY IN
THE WAY THAT WE DO THINGS TO
HELP PEOPLE TRANSITION AND HELP
PEOPLE TRANSITION ESPECIALLY IN
THAT PERIOD WHERE WE KNOW THEY
NEED AND HAVE LOT OF COHORT
MENTORING AND ELIGIBILITY AND
WINDOWS ALL THESE THINGS SO
HOPEFULLY WE WILL BE -- YOU WILL
SEE THOSE COMMENTS AND
SUGGESTIONS IN WHAT WE BRING UP.
>> THANK YOU MEMBERS FOR YOUR
CONTRIBUTIONS. NEXT UP WE HAVE
CONCEPT FOR CENTER FOR GLOBAL
MENTAL HEALTH, DR. HOLLY
CAMPBELL ROSEN IMPROVING MENTAL
HEALTH OF MOBILE POPULATIONS
THROUGH DIAGNOSIS PREVENTION AND
TREATMENT THROUGH IMPLEMENTATION
STRATEGIES. HOLLY.
>> THANK YOU, DR. GORDON. AS HE
JUST SAID I WILL BE PRESENTING
THIS CONCEPT, I WON'T REREAD THE
TITLE. MY NAME IS HOLLY CAMPBELL
ROSEN FROM CENTER FOR GLOBAL
MENTAL HEALTH RESEARCH. THANK
YOU. ONE IN EVERY 95 PEOPLE ON
EARTH HAS FLED THEIR HOME
BECAUSE OF CONFLICT OR
PERSECUTION. GLOBAL MENTAL
HEALTH IS ROOTED IN HUMAN RIGHTS
AND ADDRESSES INEQUITIES
SELF-ING FROM POVERTY THIS
CONCEPT WILL ALLOW EXAMINATION
OF SUCH FACTORS AN MENTAL
ILLNESS IN MOBILE POPULATIONS
EXPERIENCING EMERGENCY CRISIS.
SO EMERGENCY CRISIS SUCH AS ARM
CONFLICTS AND DISASTERS
FREQUENTLY OCCUR IN LOW AND
MIDDLE INCOME COUNTRIES AND ARE
ASSOCIATED WITH CONSIDERABLE
PSYCHOLOGICAL SUFFERING. AS OF
MID-YEAR 2020 THERE WERE 281
MILLION INTERNATIONAL IMMIGRANTS
INCLUDING OF WHICH 48% WERE
WOMEN. HERE IS THE RATIONALE YOU
CAN SEE IT IS FAIRLY STRAIGHT
FORWARD. PEOPLE WHO FLEE DO SO
AND END UP IN UNSAFE UNLIVABLE
CONDITIONS. THEY OFTEN LIVE IN
CHAOTIC CONDITIONS WHERE THEY
CANNOT ACCESS FOOD OR WATER
INITIALLY OR BASIC RESOURCES.
MANY AS I MENTION MANY PEOPLE
AFFECTED BY CONFLICT EXPERIENCE
PSYCHOLOGICAL DISTRESS AND
DEVELOPMENTAL DISORDERS AND
RESEARCH INTO THE MENTAL HEALTH
OF THESE POPULATIONS IS NEEDED
GIVEN ALL TIME HIGH NUMBERS OF
MOBILE POPULATIONS GLOBALLY.
NEXT SLIDE PLEASE. THE RESEARCH
AREAS ARE VERY BROAD, THE
CONCEPT IS BROAD INTENTIONALLY
AND THEY ARE LISTED HERE. IN
GENERAL THERE ARE -- I WOULD
LIKE TO SOLICIT STUDIES OF THE
GENERAL POPULATION AS WELL AS
FOCUS ON SPECIFIC KEY POPULATION
OF WOMEN SEPARATED FAMILIES
PEOPLE LIVING WITH SERIOUS
MENTAL ILLNESS, CHILDREN AND
ADOLESCENTS PEOPLE WITH
DISABILITIES AND SEXUAL GENDER
MINORITIES. THEN I FOLLOW
NATURAL PROGRESSION OF
DEVELOPMENT AND ADAPTATION OF
INTERVENTIONS BOTH PREVENTIVE
INTERVENTION AND TREATMENT
INTERVENTIONS TAKING INTO
ACCOUNT THE SOCIO CULTURAL
CONTEXT. THEN IMPLEMENTATION
STUDIES, IN THIS CASE IN THE
CONTEXT OF HUMANITARIAN OR
EMERGENCY SETTING, IN WHICH
HUMANITARIAN RELIEF AGENCIES AND
GOVERNMENTS WORK. SO IT IS A
COMPLICATED ENVIRONMENT, PI
WORKING IN HERE WILL NEED TO
WORK CLOSE WITH THE MENTORING
ACTORS. TOO WELL WITH CERTAIN
CULTURES ASSESSMENT APPROACHES
WILL NEED TO BE ADAPTED FOR
LANGUAGE, IDIOMS OF DISTRESS AND
SOCIO CULTURAL CONTEXT. ED FROM
ANTICIPATED OUTCOMES ARE NEW
KNOWLEDGE OF PREVALENCE AND
CHARACTERISTICS OF MENTAL
DISORDERS IN MOBILE POPULATIONS
WITH INTERVENTIONAL DEVELOPMENT
AND CULTURALLY ADAPTED MENTAL
HEALTH ASSESSMENT THAT I
MENTIONED AND WE ARE INTERESTED
IN EFFECTIVENESS STUDIES ON BOTH
TREATMENT INTERVENTIONS DEVELOP
ALREADY DEVELOPEDDER ADAPTED TO
FIT NEEDS OF MOBILE POPULATIONS
AS WELL AS IMPLEMENTATION
STRATEGIES IN THE EMERGENCY
SETTINGS. THANK YOU. HAPPY TO
TAKE QUESTIONS.
>> THANK YOU, HOLLY, FOR
DISCUSSANTS TODAY WE HAVE JOSEPH
TELFAIR AND PAMELA COLLINS. JOE
START US OFF.
>> THANK YOU VERY MUCH I WILL
TRAY TO BE BRIEF. I LOOK AT LONG
-- I WAS A LITTLE LONG LAST
TIME. SO THE -- I THINK IT IS
VERY AMBITIOUS, AGREE YOU THAT
IT IS A BIT VAGUE ON THAT END
HOWEVER IT IS DEFINITELY
SOMETHING THAT IS IMPORTANT.
BUT I HAVE A FEW CARRY OUTS AND
I WILL SAY THEM BRIEFLY. IDEA
GREE THIS WORK IS IMPORTANT IN
TERMS OF DEVELOPING FOR MOBILE
POPULATION. AND I'M GLAD YOU
DEFINED WHAT THOSE WERE. SO THE
CONCEPT IS BROAD BUT UNCLEAR HOW
THIS WORKS BASED ON THIS
DOCUMENT IN PARTICULAR. THEN
WHAT YOU JUST ADDED IN TERMS OF
WHAT YOU ARE LOOKING FOR, I
AGREE THE INTENT IS MUST DO
HOVER GIVEN REALITIES OF THE
SOCIAL CULTURAL ECONOMIC
CONDITIONS LOW INCOME COUNTRIES
THEMSELVES DOES NOT ALLOW LEVELS
OF MITIGATION YOU WORK WITH AND
VEXES HUMANITARIAN GROUPS, HOW
YOU PUT THAT TOGETHER PRECARIOUS
IT MAY BE STABILITY ISSUE AND
BEING ABLE TO ACTUALLY DO
SYSTEMIC EVIDENCE BASE AIDE
LEVERAGE IS A BIT -- IS A
CHALLENGE AND I GUESS YOU
PROBABLY THOUGHT ABOUT THAT. SO
WITHOUT REAL CONCRETE AND
SPECIFIC TARGETED CONFIRMED
COLLABORATIONS, THAT MAY OR MAY
NOT EXIST, THAT MAY EXIST OR
NEED TO EXIST REALIZING GOALS IS
EXTREMELY DIFFICULT. ONE OTHER
THING I WANT TO ADD IS I WANTED
TO SAY THE -- IT WASN'T CLEAR IF
YOU HAD AN INSTRUCTIONAL RUBRIC
OF TYPE OR ANOTHER THAT WILL
ALLOW YOU TO ASSESS QUALITY AND
FEASIBILITY OF WHAT IT IS YOU
ARE SEEKING AND PARTICULARLY IN
TERMS OF LEVELS OF ENGAGEMENT,
ABILITY FOR GROUPS TO DO WORK
AND SO FORTH. LEAVE IT AT THAT.
THANK YOU.
>> THANK YOU, JOSEPH. PAMELA.
>> THANK YOU FOR THE DEVELOPMENT
OF THIS CONCEPT, IT IS A REALLY
IMPORTANT PIECE OF WORK FOR
POPULATION SIGNIFICANT RISK FOR
MENTAL DISORDERS AND THERE'S
SEQUELAE, I WILL MENTION FEW
BULLETS. THIS IS A GREAT
OPPORTUNITY TO INCORPORATE
RESEARCH PRIORITIES RELATED TO
SOCIAL INTERVENTIONS. A FOCUS ON
PRE-MIGRATION AS WELL AS POST
MIGRATION EXPOSURE MAKING THAT
EXPLICIT YOU ALLUDED TO THAT. AS
PREDICTORS OF DISTRESS. AND
AGAIN ENCOURAGING SOCIAL
INTERVENTIONS THAT ADDRESS THOSE
DETERMINANTS IN PRE-OR POST
MIGRATION CONTEXT COULD BE VERY
IMPORTANT FOR THIS PAYING
ATTENTION TO GENDER SPECIFIC
INTERVENTIONS ESPECIALLY
INCLUDING FOR MEN. SECOND
SOMETHING YOU HIGHLIGHTED, IS
THAT INTERSECTION COLLABORATION
IS CRITICAL FOR RESPONDING TO
NEEDS OF MOBILE POPULATION AND I
WONDER IF WHEN THINKING ABOUT
THE IMPLEMENTATION SCIENCE
QUESTIONS, THIS IS A REAL
OPPORTUNITY TO LEARN HOW DO WE
EFFECTIVELY WORK ACROSS SECTORS
WHAT ARE MOST EFFECTIVE MODELS
THIS KIND OF CROSS SECTOR
COLLABORATION THAT DO FACILITATE
DELIVERY OF MENTAL HEALTH
PROMOTION OR TREATMENT
INTERVENTION. FINALLY REALLY
GLAD TO SEE YOU REFER TO THEM IN
CONTEXTUAL SITUATIONS FOR
DEVELOPING ADAPTING
INTERVENTIONS, IDIOMS OF
DISTRESS, OTHER ASPECT OF
CULTURE, SO I THINK THIS ALSO IS
WAY TO EXPLICITLY ENCOURAGE MIX
METHOD AND PARTICIPATORY
RESEARCH METHODS. FINALLY I KNOW
THIS IS FOR LOW AND MIDDLE
INCOME COUNTRIES. I ALSO WONDER
IF IT IS AN OPPORTUNITY TO THINK
ABOUT ARE THERE WAYS TO DO
COMPARISONS BETWEEN DIFFERENT
KINDS OF REFUGEE RECEIVING
COUNTRIES INCLUDING I THINK THE
REFUGEE POPULATION IN THE U.S.
AS WELL AS WHO MAY HAVE A LARGER
COMMUNITY INTERNALLY DISPLACED
IN ANOTHER CONTEXT. CONSIDER
PERMITTING COMPARISONS WITH U.S.
COMMUNITIES. AND FINALLY MY
LAST POINT IS THAT IT IS SO
IMPORTANT THE WORK WE HAVE --
THAT WE DO AND PEOPLE HAVE BEEN
DOING FOR DECADES ON DEVELOPMENT
AND VALIDATION OF CULTURALLY
ADAPTED FEASIBLE MENTAL HEALTH
ASSESSMENT APPROACHES. AND THIS
IS ONGOING WORK IN GLOBAL MENTAL
HEALTH, ALSO ONGOING WORK WITH
DIVERSE ETHNIC AND CULTURAL
POPULATIONS IN THE U.S..
AND I JUST WONDER THIS IS
OUTSIDE THIS CONCEPT BUT WOULD
BEING ARE HOW YOU CAN NIMH CAN
FACILITATE CROSS TALK BETWEEN
THESE DIFFERENT GROUPS AND
KNOWLEDGE BASE AROUND THESE LONG
STANDING QUESTIONS, IT DOES
BRIDGE THE MANY GROUPS WORKING
ON THIS ISSUE CULTURAL
ADAPTATION. THANKS SO UP MANY. SO MUCH.
>> THANKS, PAMELA, ARE THERE
OTHER COMMENTS OR QUESTIONS FROM
ANY OTHER MEMBERS OF COUNCIL?
>> ALL RIGHT THANK YOU. MOVE ON
TO THE NEXT CONCEPT CLEARANCE
WHICH COMES TO US FROM THE
DIVISION OF SERVICES AND
INTERVENTION RESEARCH. CHRISTINE
ULBRICHT WILL PRESENT ON
INNOVATIVE MENTAL HEALTH
SERVICES RESEARCHES NOT
INVOLVING CLINICAL TRIALS.
>> THANK YOU FOR THE OPPORTUNITY
TO PRESENT TODAY. AS DR. GORDON
MENTIONED I'M PROGRAM OFFICER IN
THE SERVICES RESEARCH AND
CLINICAL EPIDEMIOLOGY BRANCH OF
THE DIVISION OF SERVICES AND
INTERVENTION RESEARCH, WE
OVERSEE THE METHOD LOGICAL
RESEARCH PORTFOLIO. NEXT SLIDE
PLEASE. SO WHY IS THIS CONCEPT
NECESSARY? THERE CONTINUES TO BE
SUBSTANTIAL UNMET NEED FOR
MENTAL HEALTH SERVICES IN THE
UNITED STATES. FOR EXAMPLE, WE
KNOW THAT ONLY ABOUT HALF WHO
NEED MENTAL HEALTH SERVICE ALSO
RECEIVE SUCH SERVICES IN ANY
GIVEN YEAR. SO IN ORDER TO
ADDRESS CHALLENGES IN THE
DELIVERY OF HIGH QUALITY MENTAL
HEALTH CARE INNOVATIVE MENTAL
HEALTH SERVICES RESEARCH IS
REQUIRED. SPECIFICALLY RESEARCH
IS NEEDED TO IMPROVE ACCESS
CONTINUE MITY QUALITY VALUE AND
EQUITY OF MENTAL HEALTHCARE AND
ALSO THE ADOPTION SCALING AND
SUSTAINMENT OF EFFECTIVE
STRATEGIES TO MAXIMIZE THE
PUBLIC HEALTH IMPACT OF SUCH
CARE. SO ACCORDINGLY GOAL OF
THIS CONCEPT IS FOSTER
NON-CLINICAL TRIAL MENTAL HEALTH
SERVICES RESEARCH THAT ALIGNS
WITH GOAL NUMBER FOUR OF THE
NIMH STRATEGIC PLAN FOR RESEARCH
WHICH IS STRENGTHEN THE PUBLIC
HEALTH IMPACT OF NIMH RESEARCH.
SO WE ARE INTERESTED IN IP B
INVESTIGATIVE RESEARCH THAT WILL
INFORM SUPPORT AND IMPROVE
ADOPTION SUSTAINED
IMPLEMENTATION AND CONTINUOUS
IMPROVEMENT OF HIGH QUALITY
MENTAL HEALTH SERVICES ACROSS
DIVERSE SETTINGS. NEXT SLIDE.
SO WITH THIS CONCEPT WE ARE
INTERESTED IN SUPPORTING
RESEARCH ON IMPROVING THE
EFFICIENCY REACH AND CLINICAL
IMPACT OF EXISTING MENTAL HEALTH
SERVICES, EXPEDITING ADOPTION
SCALING SUSTAINED IMPLEMENTATION
AN CONTINUOUS QUALITY
IMPROVEMENT OF EVIDENCE BASED
MENTAL HEALTH OR AUTISM SERVICES
AND LEARNING HEALTHCARE SYSTEMS.
REDUCING OR ELIMINATING HEALTH
DISPARITIES AND ENSURING THAT
HIGH VALUE MENTAL HEALTH
SERVICES ARE RETIEDLY ACCESSIBLE
TO THOSE IN NEED THROUGH
INNOVATIVE SERVICE DELIVERY
MODELS AND EVALUATING THE IMPACT
OF INNOVATIONS IN MENTAL HEALTH
USING LARGE REPRESENTATIVE DATA
SETS AND NOVEL RESEARCH METHODS.
NEXT SLIDE. SO WRAP UP WE ANIS
PATE OUTCOMES OF SUCH RESEARCH
MAY INCLUDE THE IDENTIFICATION
OF FACTORS THAT IMPACT SERVICE
ACCESS, CONTINUITY, QUALITY,
EQUITY AND VALUE AND ANY SERVICE
TARGETS FOR FUTURE
INTERVENTIONS. THE DEVELOPMENT
AND TESTING OF NEW RESEARCH
TOOLS TECHNOLOGIES, MEASURES OR
METHODS TO STUDY SERVICE ISSUES,
LEVERAGING OF LARGE DATA SETS IN
ORDER TO UNDERSTAND FACTORS THAT
AFFECT SERVICES AND OUTCOMES.
STUDIES THAT ARE CONDUCTED IN
COMMUNITY OR PRACTICE BASED
SETTINGS WITH PARTICIPANTS WHO
FULLY REPRESENT TARGET
POPULATIONS. AND UTILIZATION OF
RESEARCH AND PRACTICE
PARTNERSHIPS WITH END USERS
PAYERS AND OTHER STAKEHOLDERS
THAT WILL MAXIMIZE THE
LIKELIHOOD THE RESEARCH FINDINGS
WILL INFORM PRACTICE AT THE
PATIENT CLINIC SYSTEM AND/OR
POLICY LEVEL. I WILL END THERE.
THANK YOU FOR YOUR TIME. LOOK
FORWARD TO DISCUSSION.
>> THANK YOU, CHRISTINE.
DISCUSSANTS FOR THIS CONCEPT
CLEARANCE ARE AMY AND CAMILLA
JACKSON. AMY START US OFF AGAIN.
>> SURE I WILL BE BRIEF. I
REALLY ENJOYED THIS CONCEPT
CLEARANCE, THANKS AGAIN FOR
SHARING IT. I ALSO FOUND IT TO
BE QUITE CHALLENGING TOO BECAUSE
IT IS VERY BROAD, IT COULD BE
VERY BROAD AND I REALLY
APPRECIATED THE RESEARCH
PRIORITIES THAT WERE LISTED HERE
ON THIS LAST SLIDE, ITS HELPED
TO SORT OF FRAME WHAT YOU ARE
LOOKING FOR. COUPLE OF THOUGHTS
JUST TO THINK ABOUT THIS, ONE IS
THAT MANY OF THE INNOVATIONS I
THINK ARE ESPECIALLY CHALLENGING
TO STUDY IN MENTAL HEALTH
SERVICES RESEARCH BECAUSE IT
OFTEN JUST TAKES MORE
INFRASTRUCTURE AND MONEY TO
BUILD PARTNERSHIPS WITH
DIFFERENT ORGANIZATIONS AND TO
ACTUALLY GET DATA WHERE P YOU DO
WORK IN OTHER AREAS, THAT
SOMETIMES JUST REGULAR ACCESS TO
DATA ON THE HEALTH SYSTEMS AND
WHAT IS GOING ON IN HEALTH
SERVICES ARE MUCH MORE EASILY
ACCESSIBLE THAN IF YOU TRYING TO
MEASURE MENTAL HEALTH OUTCOMES.
I MOW WE TRIED I KNOW WE HAVE
METHODS OF MEASURING MENTAL
HEALTH OUTCOMES BUT IT IS
SOMETHING TO CONSIDER IN TERMS
OF THINKING ABOUT THE RIGHT
MECHANISMS FOR THESE, ONE
EXAMPLE JUST FROM MY PERSONAL
EXPERIENCES INVOLVE BEING
INVOLVED IN THE NHLBI DECIPHER
INITIATIVE IS THAT IT IS A UG 3
UH 3 PHASED AWARD WHERE THERE IS
A LOT OF WORK HAPPENING ON THE
GROUND TO BUILD CAPACITY TO DO
REALLY COMPLICATED COMMUNITY
BASED IMPLEMENTATION STUDIES IN
HEART DISEASE IN MARGINALIZED AT
RISK POPULATIONS AND IT TAKES A
LOT OF THESE METHODS AROUND DATA
STRUCTURE BUILDING AND SO FORTH.
SO I REALLY WELCOME THE ACTUAL
FOCUS ON EMPIRICAL METHODS OF
ESSENTIALLY VALIDATING DATA
SOURCES, METHODS, VALIDATING THE
WAYS IN WHICH WE PROVIDE
CONNECTIONS WITH COMMUNITY
PARTNERS AND SO FORTH. I ALSO
WANT TO HIGHLIGHT SOMETHING DR.
LIGHTFOOT SAID ABOUT
IMPLEMENTATION RESEARCH AND
LEARNING HEALTH SYSTEMS
RESEARCH, THERE REALLY IS A NEED
TO MAKE IT MORE FOCUSED ON
SYSTEMIC RACISM AND HEALTH
EQUITY FOCUSED AREAS. I THINK
THAT MANY RISK FACTORS PRIMARILY
FOCUS ON GETTING THE
INTERVENTION RIGHT, FIDELITY BUT
MANY CASES SOME OF THE BEST
IDEAS COME FROM THE END USERS
THE PEOPLE WHO WE DELIVER MENTAL
HEALTH SERVICES TO. T SO THERE'S
A WAY OF HAVING A MORE END USER
FOCUS OR COMMUNITY FOCUS ON THE
IMPLEMENTATION THAT WOULD BE
GREAT. ESPECIALLY ON LEARNING
HEALTH SYSTEM THINKING AS WELL
SO THAT WAS IT THANKS FOR THE
DONE TO PROVIDE COMMENTS.
>> THANK YOU, AMY. NEXT
>> MEDICAL DIRECTOR IN NEW
JERSEY, WANTED TO THANK YOU FOR
THE OPPORTUNITY TO COMMENT. I
DON'T HAVE MAJOR ADDITIONAL
POINTS, I WAS VERY MUCH IN
SUPPORT OF THE CONCEPT, SOMEONE
SPOKE EARLIER ABOUT THE URGENCY
RIGHT NOW IN TERMS OF SERVICES
AND GETTING SERVICES TO PEOPLE,
THERE MAYBE AN OPPORTUNITY WE
SPOKE EARLIER ABOUT THE YOUTH
MENTAL HEALTH ADVISORY FROM THE
SURGEON GENERAL AND I WONDER
THERE'S AN OPPORTUNITY TO ALIGN
SOME OF THE EFFORTS HERE NEEDS
VERSUS HIGHLIGHT ON THAT
POPULATION AS WELL. THAT IS MY
ONLY ADDITIONAL COMMENT. THANK
YOU.
>> THANK YOU. MARJORIE YOU HAVE
A COMMENT OR QUESTION?
>> COUPLE OF COMMENTS. I'M SORRY
BECAUSE AMY SAYS THAT SCOPE IS
BROAD BUT MY COMMENTS ARE
ACTUALLY A LITTLE BIT ABOUT HOW
TO BROADEN THE SCOPE. CHRISTINE,
I WEAR TWO HATS HERE IN THE
COUNCIL, I AM HEALTH ECONOMIST,
STUDY EMPLOYMENT ISSUES FOR
PEOPLE WITH SERIOUS MENTAL
ILLNESS AND ALSO MOTHER OF A
YOUNG MAN WHO IS DIAGNOSED WITH
SCHIZOPHRENIA WHEN HE WAS IN
COLLEGE. SO I'M GOING TO PULL
FROM BOTH OF THESE AS A COMMENT.
ONE I WAS PLEASED THAT YOU SAID
THAT YOU WANT TO FOCUS ON
UNDERSTUDIED AREAS WITH HIGH
PUBLIC HEALTH IMPACT. I
ENCOURAGE YOU THINK ABOUT
SERVICES PROVIDED ALONG THE
CONTINUUM, OF RECOVERY OF A
PERSON WITH MENTAL ILLNESS. MANY
PEOPLE SAY THE NUMBER ONE
RECOVERY GOAL IS A JOB. AND SO I
THINK THERE IS MUCH THAT CAN BE
DONE REGARDING EMPLOYMENT
SERVICES, AND I THINK NOW
OUTSIDE THE BOX SUPPORTED
EMPLOYMENT BUT TO PEOPLE WHO CAN
RECOVER SUFFICIENTLY TO HOLD
MAINSTREAM JOBS AND GET OFF
SOCIAL SECURITY DISABILITY
PAYMENTS. AND I KNOW THEY ARE
OUT WILL BECAUSE I'M JUST
COLLECTED DATA ON HUNDREDS OF
PEOPLE WHO ARE WORKING IN
MAINSTREAM COMPETITIVE JOBS WHO
HAVE SERIOUS MENTAL ILLNESS
BIPOLAR SKITS PRESENTIA, MAJOR
DEPRESSION AND THEY ARE WORKING
IN A FULL SPECTRUM OF JOBS. I
DON'T THINK OUR MENTAL HEALTH
SERVICES SYSTEM NOW TAKES
ACCOUNT OF THAT, I KNOW WHEN I
TOOK MY SON TO THE EMPLOYMENT
SERVICES HERE IN PHOENIX AND I
WAS EXCITED THAT HE HAD AN
EMPLOYMENT COUNSELOR IN MENTAL
HEALTH SERVICES, HER SUGGESTION
WAS THAT HE COULD COLLECT COINS
FROM A VENDING MACHINE AND HE
HAD COMPLETED HIS COLLEGE
DEGREE. I ALSO READ STORY OF
YOUNG MAN WHO TOLD HIS SERVICE
PROVIDER THAT HE WANTED TO WORK
IN COMPUTER APPLICATIONS AND HIS
PROVIDER TOTAL HIM YOU WILL
NEVER BE ABLE TO DO THAT. SO OUR
MENTAL HEALTH SERVICES SYSTEM
NEEDS TO BE OPENING UP
OPPORTUNITIES FOR PEOPLE WITH
MENTAL ILLNESS AND EMPLOYMENT
NOT SHUTTING THEM DOWN. AND NOT
SURPRISINGLY I ALSO WANT TO
ENCOURAGE YOU TO SAY SOMETHING
ABOUT SERVICES TO THE FAMILIES.
WITH THE OUTPATIENT -- MOST CARE
FOR PERSONS WITH MENTAL ILLNESS
EVEN SERIOUS MENTAL ILLNESS IS
ON OUTPATIENT BASIS AND IT IS
FAMILIES THAT ARE PROVIDING A
LOT OF THAT CARE. I KNOW FROM MY
OWN EXPERIENCE I HAD STUDIED
DISABILITY ISSUES, I HAD
CONTEXT, I HAD GOOD INCOME THAT
I COULD PAY FOR A LOT OF THINGS
THAT WERE NEEDED FOR MY SON. I
HAD A FLEXIBLE JOB AND I COULD
STAY HOME WITH HIM. BUT FOR
PEOPLE WHO DON'T HAVE THAT
KNOWLEDGE DON'T HAVE THAT INCOME
I DON'T KNOW HOW THEY SURVIVE
THE TRAUMA OF HAVING A FAMILY
MEMBER WITH MENTAL ILLNESS. SO I
THINK THAT THAT'S ONE HUGE AREA
YOU CAN THINK ABOUT THE
DISPARITIES. DISPARITIES IN
OUTCOMES ARE GOING TO BE
INTRINSIC WHEN YOU HAVE
DISPARITIES IN ABILITY OF THE
FAMILY TO SUPPORT THE PERSON
WITH SERIOUS MENTAL ILLNESS. SO
I WOULD ENCOURAGE YOU TO THINK
ABOUT BOTH'S THEIR AREAS. AND
I'M EXCITED TO HAVE A CONCEPT
FOCUSING ON MENTAL HEALTH
SERVICES THANK YOU.
>> THANK YOU MARGE YES, ANY
OTHER COMMENTS OR QUESTIONS FROM
MEMBERS -- MARJORIE, ANY OTHER
COMMENTS? THANK YOU FOR FEEDBACK
ON THIS CONCEPT, MOVE TO NEXT
ONE. THE FINAL CONCEPT FOR TODAY
WILL BE PRESENTED BY DR. SUE
KOESTER, DIVISION OF
NEUROSCIENCE BASIC BEHAVIORAL
SCIENCE ON NOVEL ASSAYS TO
ADDRESS TRANSLATIONAL GAPS AN
TREATMENT DEVELOPMENT. THIS IS
REISSUE OF PRIOR CONCEPT. SUE.
>> THANK YOU, JOSH. AS JOSH
MENTIONED I'M SUSAN KOESTER
DEPUTY DIRECTOR DIVISION OF
NEUROSCIENCE AND I'M PRESENTING
THIS CONCEPT REISSUE ON BEHALF
OF A TEAM FROM ACROSS THE
DIVISION. SO AS YOU KNOW DRUG
DEVELOPMENT IS A RISKY PROCESS
AND THE SUCCESS RATE IS
PARTICULARLY DISAPPOINTING FOR
CNS DRUG CANDIDATES WITH 8%
RECEIVING FDA APPROVAL. TON'T
OMIZE THE VALUE OF INVESTMENTS
IN EARLY PHASE CLINICAL TRIALS,
THE NIMH IS TAKING AN
EXPERIMENTAL MEDICINE APPROACH
TO FOCUS EFFORTS ON EVALUATING
THE LINKS TEEN TARGETS CIRCUITS
AND KEY FUNCTIONAL DOMAINS IN
RELATION TOLL CLINICAL
IMPROVEMENT. HOWEVER, THE VALUE
OF DRUG CANDIDATES ENTERING INTO
TRIALS IS LIMITED BY THE
PRE-CLINICAL ASSAYS THAT OFTEN
SERVE AS GATE KEEPERS IN
DETERMINING WHICH CANDIDATES GO
FORWARD FOR DEVELOPMENT.
PRE-CLINICAL ASSAY MEASURES ARE
RARELY RELATED TO THE MEASURES
INCLUDED IN EARLY CLINICAL
TRIALS. SO THAT MANY OF OUR MOST
HEAVILY USED PRE-CLINICAL ASSAYS
ARE HISTORICALLY POOR PREDICTORS
OF CLINICAL EFFICACY FOR
PSYCHIATRIC DISORDERS. THE GOAL
OF THIS CONCEPT IS TO BETTER
ALIGN THE TYPES OF DATA
COLLECTED ACROSS LATE STAGE
PRE-CLINICAL DEVELOPMENT, EARLY
STAGE CLINICAL TRIALS TO IMPROVE
EFFICIENCY AND POTENTIAL FOR
SUCCESS OF THE DRUG DEVELOPMENT
PIPELINE. SPECIFICALLY THE GOAL
IS TO SUPPORT DEVELOPMENT AND
EVALUATION OF ASSAYS
QUANTITATIVE ROBUST AND RELIABLE
MEASURES AND THAT TAP INTO
SPECIFIC PHYSIOLOGICAL SYSTEMS
AND DOMAINS OF FUNCTION THAT ARE
IMPACTED IN MENTAL DISORDER. WE
WANT TO FOSTER RESEARCH
PARTNERSHIPS TO IDENTIFY
EVALUATED MANIPULATED ACROSS
NON-HUMAN PRE-CLINICAL SPECIES
AND HUMANS AND WANT TO TEST
CONSERVATION OF MECHANISM AND
SYSTEMS WE ARE LOOKING FOR
ASSAYS THAT ALLOW PERTURBATIONS
OF THE SAME TARGET CIRCUIT OR
SYSTEM IN ANIMALS AND HUMANS.
AND THAT ARE DESIGNED SO THAT
THE DATA WILL BE REGARD --
USEFUL REGARDING OF OUTCOME. WE
EXPECT TO GENERATE PROJECTS WITH
MORE POTENTIALLY TRANSLATABLE
ASSAYS AS ALTERNATIVES TO THE
CURRENT INEFFICIENT PRE-CLINICAL
ASSAYS AND EVALUATE THE UTILITY
OF THESE NOVEL MEASURES FOR BOTH
PRE-CLINICAL TESTING AND EARLY
PHASE CLINICAL TRIALS. OUR GOAL
IS TO ESTABLISH A SCIENTIFIC
RATIONALE FOR LIMITING
SPECULATIVE EXTRAPOLATION FROM
PRE-CLINICAL FINDINGS. WE
ANTICIPATE THAT THESE EFFORTS
WILL ENABLE US TO BETTER MANAGE
EXPECTATIONS OF EFFECT FROM
NOVEL THERAPEUTIC CANDIDATES
FROM THE PRE-CLINICAL PIPELINE
GOING INTO CLINICAL TRIALS.
THANK YOU, HAPPY TO HEAR YOUR
FEEDBACK.
>> THANK YOU, SUE. FOR
DISCUSSANTS WE HAVE SOFIA AND
BRANDON.
>> THANK YOU. SO I AM IN FULL
SUPPORT OF THIS CONCEPT
CLEARANCE, IT IS EXTREMELY
IMPORTANT TO ENHANCE EFFICACY
AND EFFICIENCY OF PRE-CLINICAL
STAGES OF DRUG DEVELOPMENT
AROUND THE USE OF ANIMAL MODELS.
SO MANY AS DR. KOESTER SO WELL
STATED, SO MANY TRIALS FAIL AND
WE ARE SACRIFICING THOUSANDS AND
THOUSANDS OF ANIMALS IN THE
PROCESS IS TO -- MOST WHICH ARE
WASTED IN THE PROCESS. WHEN --
IF WE HAD BETTER MEASURES THAT
WERE MORE ALIGNED BETWEEN ANIMAL
AND HUMANS, IT WOULD BE MUCH
MORE EFFICIENT IN TERMS OF
ANIMAL -- BUT MOREOVER IN TERMS
OF THE MONEY SPENT AND EFFORTS
SPENT IN PRODUCING NEW
MEDICATIONS FOR PEOPLE WHO NEED
THEM, WE NEED THESE MEDICATIONS
IN OTHER TREATMENTS AS FAST AS
POSSIBLE, PEOPLE ARE STRUGGLING
IN DESPERATE AT THIS STAGE. AND
SO I FULLY SUPPORT THIS. CONCEPT
CLEARANCE TO MAKE IT MUCH MORE
EFFICIENT TO DEVELOP NEW
TREATMENTS FOR PEOPLE WHO NEED
THEM. THANK YOU.
>> THANK YOU, BRANDON. SOPHIA.
>> THE ONLY THING I HAVE TO ADD
HERE BESIDES BEING IN SUPPORT OF
THIS CONCEPT IS THIS KIND OF
BEING ABLE TO FUND THESE STUDIES
WILL SUPPORT REALLY INTERESTING
PROPOSALS FOCUSING ON WHAT YOU
HIGHLIGHTED FOR US TODAY JOSH
LOOKING AT COMPUTATIONAL MODELS
OF BEHAVIOR THAT CAN BE STUDIED
IN HUMANS BUT ALSO STUDIED
ANALOGOUS BEHAVIOR STUDIED IN
ANIMALS. THIS ALLOWS US TO PROBE
THE INFORMATION PROCESSING
PATHOLOGY THAT IS UNDERLYING
BEHAVIORS THAT OCCUR IN MENTAL
ILLNESS. IT ALSO ALLOWS US TO
START PROBING VARIATIONS,
PARAMETER VARIATIONS THAT MIGHT
BE RESPONSIBLE FOR HETEROGENEITY
UNDERLYING PATHOPHYSIOLOGIC
HETEROGENEITY IN MENTAL ILLNESS
NOT REVEALED BY SYMPTOM CLUSTERS
BECAUSE SYMPTOM CLUSTERS MAY
RESULT FROM A RANGE OF
UNDERLYING PATHOPHYSIOLOGIC
MECHANISMS SO THIS WILL BRING US
CLOSER PERHAPS, SUCCESSFUL TO
IDENTIFY THE TARGET POPULATIONS
NOT JUST FOR THE PRE-CLINICAL
WORK BUT CLINICAL WORK AS WELL.
>> THANK YOU. I SEE TWO
QUESTIONS FROM MEMBERS OF
COUNCIL.
BRIAN.
>> THIS INTERESTING. I DIDN'T
READ THE WHOLE THING. BUT I
GUESS A QUESTION I HAVE IS SO
WHEN THE FDA EVALUATES
MEDICATIONS, FOR PSYCHIATRY THEY
ARE EVALUATED BASED ON TREATMENT
OF DISEASE, NOT SYMPTOM LIKE AND
ANHEDONIA. I APPRECIATE THE
SPIRIT WITH WHICH THIS IS
OFFERED BUT I AM NOT ENTIRELY
CONVINCED IT WILL ELIMINATE THE
PROBLEM SEEING DRUG DISCOVERY
ANHEDONIA FOR INSTANCE AS FAR AS
I KNOW IS NOT FDA APPROVED
INDICATION FOR MEDICATION.
COGNITION AND SCHIZOPHRENIA SO
YEARS AGO THERE WAS A BIG NIMH
INITIATIVE TO DEVELOP NEW
MEDICATION TO IMPROVE COGNITION
AND SCHIZOPHRENIA AND I REMEMBER
AT THE TIME THERE WAS SOME PUSH
BACK FROM THE FDA ABOUT WHETHER
THAT WAS AN APPROVABLE
INDICATION. JUST SOMETHING TO
THINK ABOUT. I DON'T HAVE A
SOLUTION OR ANSWER BUT A
CONCERN.
>> LINDA BRADY DIRECTOR OF
NEUROSCIENCE BEHAVIORAL STUDIES
SCIENCE WHO MIGHT HAVE A
RESPONSE TO THAT PARTICULAR
POINT LINDA.
>> YOU ARE MUTED. WE CAN'T HEAR
YOU. I CAN TRY TO RESPOND FOR
YOU.
>> THANK YOU, VERY MUCH FOR THAT
COMMENT, BRIAN. I THINK THAT
OVER THE YEARS AS OUR INSTITUTE
HAS INTERACTED WITH COLLEAGUES
AT FDA AND THE PSYCHIATRY
DIVISION AND THROUGH NUMBER OF
EFFORTS THAT DR. HOLLY LISENBY
HAS BEEN LEADING THERE IS A LOT
OF INTEREST IN CONSIDERING
SYMPTOM DOMAINS FOR TARGETING
THERAPEUTICS. WE HAVE LEARNED A
LOT THROUGH AMP SCHIZOPHRENIA
PROGRAM ABOUT THAT AND THROUGH
OTHER MEETINGS LIKE YOU
DISCUSSED IN TERMS OF COGNITION
AND DEPRESSION. AND WE ARE ALSO
EXPLORING OTHER SYMPTOM DOMAINS
THAT CAN BE TARGETED FOR
TREATMENT DEVELOPMENT SO I THINK
THEY ARE OPEN AS LONG AS THERE'S
CLEAR BIOLOGICAL QUANTITATIVE
MEASURES. IN ADDITION TO THIS
SYMPTOM DOMAINS AS AN OUTCOME.
>> I GUESS THE POINT IS THAT IT
IS THE ASSUMPTION IS THAT IF WE
HAVE QUANTITATIVE MEASURE OF AND
ANHEDONIA THAT IS TRANSLATABLE,
THAT ULTIMATELY THIS WOULD LEAD
TO FDA APPROVED INDICATION FOR
TARGETING THAT SYMPTOM DOMAIN. I
GUESS IT MAY OR MAY NOT. SOUNDS
LIKE THE FDA IS AT LEAST OPEN TO
IT BUT IT WOULD BE SOMETHING NEW
AND UNPRECEDENTED WHICH WOULD BE
GOOD. IT IS JUST A CONCERN.
>> BRIAN I WANT TO POINT OUT
THAT IS ONE POSSIBLE OUTCOME OF
WORK. THERE IS ANOTHER ONE AS
WELL. THAT IS THAT BY STUDYING
BIOLOGY UNDERLYING SPECIFIC
DOMAINS OF FUNCTION IDENTIFIED
THROUGH THIS OR OTHER MEANS, WE
WILL IDENTIFY PATHOPHYSIOLOGICAL
PROCESSES THAT MIGHT EXIST IN
SOME SETS OF INDIVIDUALS THAT
WOULD RESPOND MORE GENERALLY TO
TARGETING THOSE MECHANISMS,
MEANING MAYBE SOME INDIVIDUALS
SAY WITH SCHIZOPHRENIA MIGHT
HAVE HALLUCINATIONS BECAUSE OF A
PARTICULAR DEFICIT IN SENSORY
PATHWAYS, THAT WOULD BE
AMELIORATE WITH A DRUG TARGETING
SOME FOR OF SENSORY PERCEPTION
MECHANISM AND THAT DRUG WOULD
NOT JUST HELP WITH SENSORY
SYMPTOMS BUT ALSO MIGHT HELP
WITH HALLUCINATIONS. FOR
EXAMPLE. SO I THINK BOTH ARE
POTENTIAL OUTCOMES OF THIS. BUT
YOU ARE RIGHT, IT IS UNPROVEN.
UNTIL WE GET AN EXAMPLE OF
SOMETHING THAT WORKS. JOEL.
>> THANKS, INTERESTING IDEA,
VERY IMPORTANT. ONE ISSUE U YOU
DIDN'T MENTION THAT I KNOW HAS
BEEN RAISED BY OTHERS, AND I
DON'T HAVE THE EXPERTISE BUT THE
FAILURE OF DRUGS TO TRANSLATE
FROM ANIMALS TO HUMANS IS ONE
POINT WHICH YOU RAISE THE ISSUE
HEREHERE. AND WE SPENT THE REST OF
THE DAY HEARING THE IMPORTANCE
OF EPIDEEM LOGICAL CONTEXT
VARIOUS KINDS AND HOW THEY ALTER
NEUROBIOLOGY RESPONSE SO IF THE
ASSUMPTION IS NEUROBIOLOGY IS --
REGARDLESS OF INPUTS IS THAT ONE
ISSUE LOOK AT MORE CLOSELY TO
FIGURE WHY THESE DON'T TRANSLATE
AS WELL AS WE LIKE OR
FREQUENTLY. AND MAYBE THAT
SHOULD BE ADDED HERE SOMETHING
TO CONSIDER. IS WHETHER THERE
SHOULD BE MORE STUDY OF
VARIATION IN ANIMAL ENVIRONMENTS
THAT MIGHT BETTER REPRODUCE
HUMAN RESPONSE IN DIFFERENT
HUMAN ENVIRONMENTS TO INCREASE
THAT THROUGH PUT. THIS IS OUT OF
MY AREA BUT CONVERSATION THAT'S
GONE ON IN SOME AREAS OF THE
FIELD. MORE EXPERIENCING THIS
PART.
>> THANK YOU, JOEL. THANK YOU
VERY MUCH FOR THE COMMENTS ON
THESE CONCEPTS. AND WE WILL MOVE
TO THE FINAL SEGMENT OF THE OPEN
SESSION AND I WILL BEG YOUR
FORGIVENESS FOR US GOING OVER.
WE DO HAVE COMMENTS FROM
RETIRING MEMBERS. TO CLOSE OUT
THE DAY'S EVENTS. WE HAVE FOUR
COUNCIL MEMBERS WHO SERVICE ON
COUNCIL ENDING MARCH 30TH ONE OF
THEM YOU HEARD FROM YAEL NIV AND
UNFORTUNATELY DR. KNEEL RISCH
COULDN'T JOIN US TODAY BECAUSE
OF A FAMILY EMERGENCY. SO WE DO
HAVE TWO COUNSEL MEMBERS WHO
WILL BE RETIRING FROM SERVICE ON
THE COUNCIL FOR NOW, I WANT TO
THANK CHERYL KING AND BRANDON
STAGLIN IN ADDITION TO YAEL AND
NEIL FOR THEIR REALLY WONDERFUL
CONTRIBUTIONS TO THIS COUNCIL
OVER THE LAST SEVERAL YEARS.
YOUR INPUT HAS REALLY HELPED
SHAPE THE SCIENTIFIC PRIORITIES
OF NIMH. I APPRECIATE THE CANDOR
YOU BRING, THE COURAGE YOU BRING
TO EXPRESS THAT CANDOR. AND THE
WAY EWE CHALLENGE ME OVER THESE
YEARS AND CHALLENGE THE REST OF
US HERE AT NIMH TO DO BETTER.
AND WITH THAT I WILL OFFER THE
OPPORTUNITY, WE WILL START WITH
CHERYL KING TO OFFER SOME WORDS
OF WISDOM FOR YOUR FELLOW
COUNCIL MEMBERS OR ANYTHING ELSE
YOU WOULD LIKE THE SAY. CHERYL.
>> THANK YOU, JOSH. THIS HAS
BEEN SUCH A RICH EXPERIENCE AND
I REALLY APPRECIATED THE
OPPORTUNITY TO SERVE OUR FIELD
IN THIS WAY AND REALLY TO DO IT
WITH SUCH A SAVVY INVESTED JUST
SMART GROUP OF COLLEAGUES, IT
HAS BEEN A GREAT EXPERIENCE AND
I HOPE ALL OF YOU GET TO MEET IN
PERSON AGAIN SOMETIME TOO. I
THINK WHAT STRIKES ME ABOUT THIS
EXPERIENCE IS THAT AFTER SO MANY
YEARS LITERALLY DECADES, WORKING
AS A CLINICAL SCIENTIST WITH A
LASER FOCUS THAT TAKES, FOCUSING
ON PROBLEM, POTENTIAL SOLUTIONS
METHODOLOGIES RESEARCH
CHALLENGES, IT HAS BEEN A
PRIVILEGE, A GIFT AT THIS POINT
IN MY CAREER TO HAVE THE
COUNCIL'S UP CLOSE VIEW WITH
KIND OF A WIDE ANGLE LENS AT
EVERYTHING GOING ON IN OUR FIELD
IN TERMS OF RESEARCH ACROSS
AGES, ACROSS PROBLEMS LEVELS OF
ANALYSIS, SOCIO DEMOGRAPHIC
COMMUNITY CON DETECTION. FROM
EFFORTS TO IMPROVING OUR
UNDERSTANDING OF ILLNESS TO
PREVENTION AND TREATMENT AND
ALSO RESEARCH TRIED TO COME UP
WITH NEAR TERM SOLUTIONS. AND
RESEARCH THAT IS FOCUSED ON THE
POSSIBILITIES OF NEW WAYS TO
PREVENT AND EVEN BETTER
SOLUTIONS IN THE FUTURE. IT IS
REALLY BREATHTAKING IN A SENSE
THE SIGNIFICANCE AND THE
COMPLEXITY AND JUST THE BREADTH
OF WHAT ALL FALLS UNDER NIMH. I
THINK ALL OF US WE HAVE SURELY
SERVED ON MANY COMMITTEES, AND
COUNCILS BUT FEW WITH THIS KIND
OF GROUP OF COLLEAGUES AND WITH
THIS MUCH SIGNIFICANCE SO THAT
HAS BEEN SO RICH. REFLECTING MY
PERSONAL EXPERIENCE ON COUNCIL
MY RESEARCH AND EXPERTISE
RELATES TO UNDERSTANDING
TRAJECTORIES ARE OF SUICIDE RISK
AND TRYING TO IMPROVE SUICIDE
RISK SCREENING ASSESSMENT AND
INTERVENTION STRATEGIES. THAT
ALIGNS WITH ONE OF THE KEY NIMH
PRIORITIES WHICH IS SUE SAID
PREVENTION RESEARCH SO EVE MANY
OPPORTUNITIES TO GIVE INPUT ON
PRIORITIES. IT'S MEANINGFUL AND
MADE COUNCIL ENGAGING. ONE
THING I APPRECIATED IS ATTENTION
GIVEN TO DIVERSITY AND EQUITY
ISSUES AS IT RELATES TO
SOMETHING NEAR AND DEAR WHICH IS
MENTOR SHIP AND DEVELOPMENT OF
EARLY CAREER RESEARCHERS. DURING
PAST SEVERAL YEARS ON COUNCIL WE
FACE A NUMBER OF THESE ISSUES
HEAD ON AND WITH A LOT OF
TRANSPARENCY. IT IS GREAT TO
HAVE BEEN PART OF THAT. I KNOW
IT WILL CONTINUE. WHILE IT IS
REALLY GOOD TO SEE SO MUCH
TRANSPARENCY OF DATA, AND FRANK
DISCUSSION WHAT WE CAN DO.
FINALLY I WANT TO SHARE I HAVE
WORKED IN DIFFERENT WAYS WITH
NIMH FOR REALLY MORE THAN A
COUPLE OF DECADES BUT WHAT I
KEEP LEARNING AND REINFORCED ALL
THE TIME IS NIMH IS A MODEL
ORGANIZATION AND I SAY THIS
SINCERELY. FROM DIRECTOR JOSH,
DIVISION DIRECTORS PROGRAM
OFFICERS ALL THE ADMINISTRATIVE
STAFF WHAT IMPRESSIVE GROUP.
THERE IS A SHARED MISSION. CORE
VALUES ARE CLEAR, WITH
EXCELLENCE COMMUNICATION
CIVILITY. I HAVE BEEN
CONTINUALLY IMPRESS WITH THE
KNOWLEDGE AND LEVEL OF
PREPARATION ARE EVERYONE AT NIMH
WHO PARTICIPATES IN THESE
MEETINGS. SO WOW TO ALL OF YOU.
MY HAT'S OFF TO YOU AND WHAT A
GREAT GROUP. FINALLY JUST TO THE
NEW MEMBERS, ENJOY AND KNOW YOUR
INPUT WILL BE VALUED AND YOU CAN
MAKE A DIFFERENCE. THANKS VERY
MUCH.
>> THANK YOU, CHERYL. WONDERFUL
THANK YOU AGAIN FOR YOUR SERVICE
ON THIS GROUP AND YOUR SERVICE
TO COME. BRANDON.
>> THANK YOU, JOSH AND THANKS TO
ALL THE NIMH FOR ENABLING ME TO
PARTICIPATE IN IN COUNCIL. I
LEARNED ABOUT THE NIH WHEN I WAS
ABOUT MID 20s RECOVERY FROM
VERY SEVERE SECOND EPISODE
SCHIZOPHRENIA, AND IT GAVE ME
HOPE TO LEARN ABOUT WHAT THE
NIMH WAS DOING, TO DEVELOP
RESEARCH TO HELP PEOPLE LIKE ME,
THOUSANDS AN MILLIONS ACROSS THE
COUNTRY AND BEYOND, SIMILAR
CONDITIONS, BY INVESTIGATING
COMPLEXITY OF THE BRAIN AND THE
MIND AND NOW THE ENVIRONMENT SO
MANY OTHER DIMENSIONS OF
SOCIETY. THAT GO INTO MENTAL
HEALTH, I WAS ENTHRALLED
LEARNING ABOUT THESE THINGS AND
MY PARTICIPATION ON THE COUNCIL
NOW IS THE ONE OF THE HIGHEST
HONORS I HAVE BEEN ABLE TO
EXPERIENCE IN MY LIFE TO
CONTRIBUTE TO THE PUBLIC GOOD,
AS WELL AS WORK ALONGSIDE
AMAZING SCIENCE LIKE FELLOW
COUNCIL MEMBERS, AN HONOR TO
WORK WITH YOU AS WELL SIMILAR TO
CHERYL, EXTREMELY IMPRESS WITH
THE CARING AND FOCUS OF THE NIMH
TEAM AND I WORDS OF ADVICE I
MIGHT SAY THAT I THINK ONE OF
THE GREATEST STRENGTH I HAVE IS
MY LIVED EXPERIENCE WITH SERIOUS
MENTAL ILLNESS AND THE
PERSPECTIVE THAT FROM SLIDES. SO
I URGE THE NIMH AND OTHER
RESEARCH ENTITIES TO CONTINUE TO
INVOLVE LIVED EXPERIENCE AS A
CORE COMPONENT OF GUIDING THE
RESEARCH THAT IS DONE SIMILAR TO
WHAT AMY WAS SAYING EARLIER.
UNDERSTANDING THE NEEDS AND THE
INTERESTS AND THE PERSPECTIVE OF
THE END USER OF THE SERVICES
THAT WE ARE AIMING TO IMPROVE
THROUGH RESEARCH WE DO THROUGH
NIMH IS CRITICAL TO MAKING THAT
RESEARCH COUNT. AND I THINK NOT
ONLY BY INVOLVING PEOPLE LIVED
EXPERIENCE ON COUNCIL OR WORK
GROUPS THINGS LIKE THAT THAT ARE
IMPORTANT BUT I KNOW SCIENTISTS
WHO HAVE LIVED EXPERIENCE WITH
SERIOUS MENTAL ILLNESS AS WELL.
AND IF THEY CAN BE ABLE TO GUIDE
RESEARCH AS WELL HARNESSING BOTH
LIVED EXPERIENCE AND SCIENTIFIC
EXPERTISE, THEIR LEADERSHIP CAN
BE VERY EFFECTIVE AND GUIDING
RESEARCH TO REALLY MAKE A BIG
DIFFERENCE ALONG THE NEEDS OF
PEOPLE WITH MENTAL HEALTH
CHALLENGES. SO THAT IS WHAT I
HAD TO SAY. THANK YOU AGAIN FOR
THE OPPORTUNITY TO BE ON THE
COUNCIL.
>> BRANDON, THANK YOU VERY MUCH
FOR YOUR CONTRIBUTIONS OVER THE
YEARSYEARS. AS WE HAVE GOTTEN TO KNOW
EACH OTHER MORE AND MORE, I
APPRECIATE ALL THE MORE THE
PERSPECTIVE YOU BRING, NOT JUST
AS INDIVIDUAL WITH LIVED
EXPERIENCE BUT AS AN INDIVIDUAL
AS BRIGHT AND INTELLIGENT AND
INSIDESIVE PERSON WHO REALLY
CARIS. SO THANK YOU, VERY MUCH.
THANK YOU ALL FOR A WONDERFUL
MEETING, I WANT TO ESPECIALLY
THANK DIVISION OF EXTRAMURAL
ACTIVITIES WHO PUTS THIS
TOGETHER, DEB DABNEY, KAREN
EVAN, TRACY AND ALEX DUNKER WHO
HAS BEEN SHEPHERDING THROUGH ON
THE TECHNICAL THING. I MIGHT
HAVE FORGOTTEN A FEW SO I WILL
TURN IT TO TRACY TO SEE IF SHE
WANTS TO ADD ANY NAMES AND THEN
WE WILL ADJOURN.
>> I WOULD LIKE TO ADD --
MANAGEMENT ACTIVITIES AND WANDA
HARRIS.
>> YES THANK YOU FOR REMINDING
ME. ONE QUICK NOTE UNFORTUNATELY
NIH MADE DECISION FOR JUNE
BETTER OR WORSE WE WILL BE
VIRTUAL IN JUNE. SO I HOPE TO
GET TO MEET YOU PERHAPS IN THE
FALL IN PERSON AT THE FALL
MEETING BUT WE WILL SEE YOU ON
ZOOM IN JUNE. BYE-BYE FOR NOW.