Advances in Mental Health Reseach
Implications for Practice
Research conducted over the past several decades has contributed greatly to the nature,
breadth, and efficacy of interventions available for treating severe mental illness, and
research now underway promises significant further enhancements in the near future. Yet,
in sharp contrast, the quality of care typically provided to people with severe mental
illnesses does not reflect the dramatic expansion of our knowledge about the brain and
behavior and, in turn, of our refinement of scientifically based diagnostic and
therapeutic capacities.
The gap between what is known and what is practiced undermines the
credibility of all clinical mental health services providers and presents the research
community with an urgent challenge: To be more effective in communicating the results of
research and thus to help frontline clinicians provide state-of-the-art care to patients
through the course of illness.
One source of disparity between what currently is known and what is
practiced is the relative infrequency of research exposure or experience in clinical
training for all of the core mental health professions. This volume, published by the
National Association of Social Workers (NASW) with funding from the National Institute of
Mental Health (NIMH) in recognition of the Institute’s 50th anniversary, is an
important step toward redressing this disparity.
Social work as a discipline has had a significant presence within NIMH
since the Institute’s beginning in the late 1940s. That presence continues today at
the policy level and, to a lesser but important extent, in research. Through the 1970s,
the profession of social work related to the Institute primarily through service-related
and clinical training programs. Two decades ago, almost every school of social work in the
country had an NIMH training grant, and the Institute annually provided 1,500 or more
clinical training stipends to social work students. Today, although the focus of NIMH has
shifted decisively away from clinical training and onto scientific research, maintaining
and nurturing our long relationship with social work remains in the best interest of
people with mental illness and of NIMH. With the membership of the NASW exceeding 155,000,
more than half of whom are involved in mental health services delivery, strengthening the
links between the research mission of NIMH and the interest and expertise of social
workers is critical.
Over five decades, NIMH has played a critical role in supporting and
conducting research and then in moving that research out of the realms of description and
speculation and into the realms of neuroscience and clinical practice. It is now commonly
held that mental illnesses are disorders of the brain that can be understood in terms of
well-characterized neural and neuropathologic processes. Although much remains to be
learned, we must not forget that even as we exploit powerful new molecular and cellular
tools, our ultimate goals cannot be reductionist. The symptoms and signs of disorders such
as affective illnesses, anxiety disorders, attention deficit disorder, schizophrenia, and
others affect human beings at the levels of behavior and subjective experience. It is
vitally important that we understand human behavior, cognition, and emotion; how these
become altered with mental illness; and how we can translate our knowledge into improved
clinical interventions.
Thanks to our increasingly strong research base, the most important
message that I have to convey, in my role as Institute director, is simple and
straightforward: Mental illnesses are real brain disorders that can be diagnosed with
precision and for which effective treatments exist. Appropriate treatment can make an
extraordinary difference in the lives of people who have these severe disorders. Although
I sometimes feel I repeat myself, it seems that every time I deliver this message (whether
to legislators, to general medical audiences, to research colleagues, or even to mental
health advocates) the light goes on in someone’s eyes.
Advances in Mental Health Research: Implications for Practice, edited
by Janet B. W. Williams and Kathleen Ell, links research to treatment in a direct and
understandable manner. The goals of NIMH-sponsored research are more effective diagnosis,
treatment and, eventually, prevention of mental disorders. With each advance, the science
of our field is having an increasingly immediate and greater impact on how we diagnose and
treat mental disorders. Information drawn from many basic disciplines makes clear that all
brain activity (and, in turn, the onset of mental disorders and their treatment) reflects
the impact of disparate environmental influences on genetic and molecular processes. This
insight argues strongly for NIMH’s support of research on matters of profound
interest to the discipline of social work. We must seek research opportunities that will
establish connections across disciplines and levels, even as we continue research within
single levels of analysis, including the molecular, cellular, circuits, integrative
functions, organism, and psychosocial context levels, and we must be energetic in
translating the knowledge we acquire into new and effective treatments and improved
service delivery systems.
The first implication of an emphasis on basing clinical practice on an
empirical scientific foundation is obvious: To remain relevant and accountable, all mental
health clinicians must be able to read, interpret, and understand the potential for
research in its applications to clinical practice. A second implication is that not only
must social workers know about mental illness research, but that increasing numbers of
social workers also ought to consider seeking careers or roles in research.
The need to improve the lives of people with mental disorders makes it
imperative that all professionals in the field share and benefit from the insights and
knowledge of others. Advances in Mental Health Research is an important contribution
toward that end.
Steven E. Hyman, MD
Director, National Institute of Mental Health |
