Psychiatr News April 21, 2006
Volume 41, Number 8, page 19
© 2006 American Psychiatric Association
Psychiatrists Warn Congress About Danger of Cutting Research Funds
Rich Daly
The start of the 2007 federal budget season is marked by psychiatrists'
push to get Congress to increase spending on medical research.
J. Raymond DePaulo, M.D., took time from his many obligations in March to
visit Capitol Hill and talk about the "little things" of life. In
his case, the little things are genomics and genetics, research that needs
additional funds at a time when Congress is considering leveling off or
cutting back medical research support.
"The research progress made in the last 30 years has changed the
nature of cancer treatment. We can make that kind of progress in
psychiatry—create options—if we progress in our understanding of
how the drugs we use do what they do," said DePaulo, chair of the
Department of Psychiatry and Behavioral Sciences at Johns Hopkins University
School of Medicine.
He talked to Psychiatric News while on the way to Capitol Hill in
early March as part of APA's 23rd Annual Academic Consortium, which brings
medical researchers to Washington, D.C., to learn about health policy and
contact members of Congress.
DePaulo urged members of Congress to help continue medical research that
has begun to delve into understanding how treatments affect patients on the
molecular level. A deeper understanding of mental illness through genetics and
genomics will allow researchers to understand why some drugs work in some
patients and not others.
The efforts of DePaulo and other researchers to raise the issue of mental
health research in Congress came as it began considering President Bush's
Fiscal 2007 budget request, which includes funding the National Institutes of
Health (NIH) at the Fiscal 2006 level, or $28.6 billion. Mental health
advocates consider this a reduction, in light of an expected 3.5 percent
increase in biomedical costs this year.
"We want a 5 percent increase in NIH funding in order to not lose the
momentum of the last decade and a half," said James H. Scully Jr., M.D.,
APA's medical director. "There's a huge commitment to it, so you can't
turn off medical research like a TV."
Scully said the aim of the Capitol Hill visits is to put a human face on
the research and those who make financial sacrifices to conduct publicly
funded research, which may otherwise appear only as a line item to
legislators.
Thomas Insel, M.D., director of the National Institute of Mental Health
(NIMH), told Academic Consortium attendees that the doubling of NIH's research
budget since 1998 has allowed the development of tools to identify which
patients will best benefit from psychotherapy and which require medication.
The feeling among policy-makers is that NIH's consistent budget increases in
recent years have given it a lead over other agencies and departments that now
lag by
comparison.
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As part of APA's 2006 Academic Consortium psychiatrists and government
officials attended a Capitol Hill reception to honor Rep. Jim Walsh (R-N.Y.)
for his efforts to enhance the mental health care of veterans through his
leadership as chair of the Appropriations Subcommittee on Military Quality of
Life and Veterans Affairs and Related Agencies.
Jeffrey Lieberman, M.D., Rep. Jim Walsh (R-N.Y.), and J. Raymond
DePaulo, M.D.
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As part of APA's 2006 Academic Consortium psychiatrists and government
officials attended a Capitol Hill reception to honor Rep. Jim Walsh (R-N.Y.)
for his efforts to enhance the mental health care of veterans through his
leadership as chair of the Appropriations Subcommittee on Military Quality of
Life and Veterans Affairs and Related Agencies.
Harold Pincus, M.D., APA Medical Director James Scully, M.D., APA
legislative assistant Andrea Uckele, and Walsh.
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As part of APA's 2006 Academic Consortium psychiatrists and government
officials attended a Capitol Hill reception to honor Rep. Jim Walsh (R-N.Y.)
for his efforts to enhance the mental health care of veterans through his
leadership as chair of the Appropriations Subcommittee on Military Quality of
Life and Veterans Affairs and Related Agencies.
APA Director of Advocacy Eugene Cassel, J.D. (center), with Bernard
Grocer, M.D., and Rachel Glick, M.D.
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As part of APA's 2006 Academic Consortium psychiatrists and government
officials attended a Capitol Hill reception to honor Rep. Jim Walsh (R-N.Y.)
for his efforts to enhance the mental health care of veterans through his
leadership as chair of the Appropriations Subcommittee on Military Quality of
Life and Veterans Affairs and Related Agencies.
John Nurnberger Jr., M.D., Ph.D. (left), a medical researcher at Indiana
University, talks with Paul Sirovatka, M.S., associate director for research
policy analysis at APA.
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Research over the last decade has given the NIMH a 10,000-patient dataset,
and now funding is needed to analyze how those data can inform mental health
care.
Insel suggested that psychiatrists approach lawmakers with specifics and
focus on topical issues, such as increased funding for veterans. Recent
studies report about 60,000 returning Gulf War veterans could have
posttraumatic stress disorder, and up to 5 percent of those may commit
suicide.
Cindy Miner, Ph.D., deputy director of the Office of Science Policy and
Communications at the National Institute on Drug Abuse (NIDA), told symposium
attendees that the surge in NIH research funding in recent years allowed solid
advances, such as the study and perfection of buprenorphine for office-based
treatment of opioid addiction. Such research and treatment are at least
partially responsible, she said, for a 19 percent drop in drug abuse by youth
since 2000.
NIDA's 2006 priorities include research on preventing drug abuse,
developing better methamphetamine treatment programs, and cutting the rise in
AIDS rates among adolescent girls stemming from intravenous drug use, Miner
said. NIDA also aims to better support young researchers, who have difficulty
obtaining funds when competing with established colleagues.
John Nurnberger Jr., M.D., Ph.D., a medical researcher at Indiana
University, said his work is heavily dependent on continued support from NIH
and NIDA. He visited members of Congress with the message that research on
treatments for mental illness is very cost-effective because it alleviates
substantial costs incurred by those left untreated. His research has
identified genes linked to bipolar disorder and substance abuse, but another
"funding push" is needed to clarify the association of those genes
with specific disorders.
"We're in serious danger of having investigators drop out of the
system because of the budget cuts," Nurnberger said.
James Harris, M.D., urged members of Congress to support the training of
more child psychiatrists through a federal loan-forgiveness program. The
shortage of such specialists, who number about 6,700, will grow worse since
four child psychiatry training programs have closed in the last 10 years.
The decline in numbers has coincided with a surge in prescriptions for
children and adolescents by pediatricians and general practitioners, who
sometimes lack a comprehensive understanding of potentially harmful side
effects of antipsychotics and antidepressants. 
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