US mental-health agency’s push for basic research has slashed support for clinical trials

By Sara Reardon

Roy Perlis is done with clinical research. The psychiatrist at the Broad Institute in Cambridge, Massachusetts, has led about 20 clinical trials on depression and other mood disorders over the past two decades. But he has given up seeking grants from the US National Institute of Mental Health (NIMH) — the world’s biggest funder of mental-health research — since it began promoting a new way to investigate mental illness. The agency urges researchers to study the biological roots of disease, rather than specific disorders.

This shift has been having profound impacts on mental-health research in the United States, but the magnitude of the transformation is only now coming to light. An analysis by Nature suggests that the number of clinical trials funded by the NIMH dropped by 45% between 2009 and 2015 (see ‘Rethinking mental-health studies’). This coincides with the agency’s launch, in 2011, of the Research Domain Criteria (RDoC) — a framework for research on the mechanisms of mental illness. The NIMH’s roll-out of RDoC included asking researchers to focus more on the biological bases of behaviour — such as brain circuitry and genetics — than on the broader symptoms that clinicians typically use to define and classify mental illness.

The NIMH’s embrace of fundamental research has infuriated many clinical researchers, who see it as an attempt to invalidate their methods — and say that there is scant evidence to support the idea that using RDoC will lead to greater insight or better treatments for mental illness. Many of these researchers also note that NIMH funding for clinical trials has declined steadily over the past decade, adding to the perception that the agency now favours research that uses the RDoC framework.

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