Why brain research is vital: Column

To those whose loved ones struggle with mental illnesses and to researchers who know how close we are to new discoveries, the National Institutes of Health's recent budget proposal is particularly urgent. The agency has requested $4.5 billion over the next dozen years to meet the critical goals of President Obama's BRAIN Initiative. The project, to map the circuitry of the brain, would not only help us to better understand complex human behavior, but could spark profound new advancements in treating brain disorders.

Fifty years ago, President John F. Kennedy's administration helped release thousands of mentally ill and disabled from institutions into community care settings. Too many had been warehoused, treated with neither dignity or respect. Yet resources to care for them never met the need. When President Bill Clinton held the first-ever White House Conference on Mental Health 15 years ago, an estimated one in five Americans experienced a mental disorder every year. Today, it is one in four — and of the quarter of the American population who experience mental illness, 60% receive no treatment.

That's why the BRAIN Initiative is so critical. For one, the price tag pales in comparison to what mental illness costs America and the world each year. They are the world's most expensive group of diseases. They have a greater negative impact on the world economy than HIV/AIDS, cardiovascular disease, diabetes, or cancer, in part because they rob people of their ability to function during their most productive years. In 2010, mental illness cost the world about $2.5 trillion. By 2030, the World Economic Forum estimates the cost will exceed $16 trillion.

Nor is the toll strictly economic. Three times as many mentally ill people are incarcerated as are hospitalized. Every year since 1999, the adult suicide rate has increased. It's estimated that every day 22 veterans with untreated mental illness take their own life. Suicide is the third-leading cause of death in young people.

Three immediate steps would help address this crisis:

• First, increase the federal budget for research while fully funding the BRAIN Initiative. Despite the increasing need for such research — which promises breakthroughs not just into mental illness, but Alzheimer's and Parkinson's Disease — the NIH budget is actually $1.2 billion less than it was four years ago. Adjusted for inflation, the NIH's mental health arm, the National Institute of Mental Health, receives the same level of funding as it did 15 years ago — despite the fact that neuroscientific advances have brought us to the verge of a new era. For instance, new drugs being studied offer promise to reduce major symptoms of severe depression within hours or days rather than weeks or months. We need to build on this life-saving research.
• Second, enforce the law and improve the system. The 2008 Mental Health Parity and Addiction Equity Act was a big step toward guaranteeing equality of treatment and care in mental health. But the law has not yet been fully implemented, and discrimination remains widespread. It still takes too long for the mentally ill to receive help. "Separate and unequal" is not an acceptable standard.
• Third, increase cooperation. From the development of semiconductors to particle physics, many industries have grown by pooling knowledge. It was the coordinated efforts of activists, government and pharmaceutical companies that turned HIV/AIDS from a feared and fatal illness into a serious but manageable chronic disease. In the same vein, pharmaceutical companies, private and public foundations, and the government should work together to advance scientific research into mental illness.

All of us have a friend or family member who struggles with a mental illness. It has been 15 years since President Clinton declared that "Americans with mental illness should have the same opportunity all Americans have to live to the fullest." We now have the opportunity and the know-how to make that aspiration a reality. Let's seize the moment.

Former U.S. Rep. Patrick Kennedy, D-R.I., was a chief sponsor of the 2008 Mental Health Parity Act. Husseini Manji is head of neuroscience research at Janssen Research & Development, LLC, a Johnson & Johnson company, and the former chief of the Laboratory of Molecular Pathophysiology and director of the Mood & Anxiety Disorders Program at the National Institute of Mental Health.

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