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Mental Health Research, 75 Years in the Making, a Discussion with NIMH’s Dr. Josh Gordon

For 75 years, NIMH has transformed the understanding and treatment of mental illnesses through basic and clinical research—bringing hope to millions of people.  Dr. Joshua Gordon, Director of the National Institute of Mental Health joined us share his thoughts on the Institutes’ evolution and its current work at a time when mental health is front and center among health concerns in the US and globally. Here are some of his thoughts on:

Mental health research and treatment advances at NIMH:

“[…] around the globe millions of people every year, who benefit from different versions of CBT (cognitive behavioral therapy) for different illnesses like depression, anxiety, obsessive compulsive disorder, all fundamentally lead back to early research done in the 1960s by NIMH funded investigators […] who figured out how these drugs worked. Enabling companies to take these early drugs which had significant side effects and were otherwise difficult to use and translate them into the safe, efficacious drugs that we know today like fluoxetine (Prozac). An antidepressant that works by blocking the various molecules in the brain that Dr. Julius Axelrod discovered in the labs of NIMH. More recent treatments like transcranial magnetic stimulation, therapies for postpartum depression also stem from fundamental research done at NIMH. Of course, the 75 years is just the beginning, we have a lot more work to do. We’re really excited about advances in genetics, in neuroscience, in understanding how illnesses arise through both biological and social determinants; using that understanding, to develop new approaches, preventative treatments, and importantly, current research that’s really aimed at understanding how best to apply the treatments.”

BRAIN Initiative’s impact on mental health research:

“[The BRAIN Initiative] is run collaboratively by ten NIH institutes and centers, including, of course, the NIMH. The Initiative was initially about developing new tools to approach understanding how the brain functions, how it produces behavior, and cognition. We can then use those tools to dramatically increase that understanding, and then apply those tools to illness. It’s been remarkably successful. We all know that the brain is a very complex organ and it’s comprised of billions of cells. Most of them are neurons, although there’s a whole host of other cells in the brain as well, and it’s not just one type of cell. We have various ways of figuring out the different cell types in a particular brain region. […] It was very slow making progress. Well, the molecular tools that the BRAIN Initiative sponsored to be able to study the molecules that are present in a single cell within the brain and do it with rapidity and accuracy. Instead of studying a single cell type we could study and develop thousands of cell types within a few days with this technology. So, the first five years that technology was developed, now we have a complete map of the cell types of a mouse brain, and we are working towards a complete map of all the cell types of the human brain as well.”

Addressing social determinants of mental health through community engagement:

“So, the one big question is, how can we get to mechanism from social determinants? We know that things like access to housing, to green space, to quality, mental health care, quality food, stress, adverse childhood experiences, these are all important social determinants of mental health. To be able to design treatments, we really need to understand the biological impacts of the social determinants of health. One way to do that is to mix in genetics. A number of our studies are now beginning to collect both social determinants and genetic information, so that we can, with some very simple maneuvers, begin to understand the mechanisms by which these social determinants are transduced into effects on the brain and the body. The promise of social determinants is less about treatments and more about prevention. That really requires us to look at our whole research program, which in the past has been really geared towards the endgame of things, when people have an illness, and understanding that illness, and treating it. Moving forward to what can we do to build resilience into people, so that they don’t succumb to the social determinants and or address those social determinants head on. We are pivoting many of our efforts in this space to encourage that community engagement piece, to really understand what communities perceive as their needs in the space. And to encourage people to develop interventions that really address those social determinants themselves, as opposed to the illnesses that developed from them years later.”

Watch the full discussion here.