This month’s Director’s Spotlight focuses on the National Institutes of Health’s (NIH’s) role in transforming mental health care through research and discovery. Andrea Beckel-Mitchener, Ph.D., Acting Director of the National Institute of Mental Health (NIMH), co-authored this spotlight on the significant activities and accomplishments of coordinated research efforts at NIH. 

Mental health is essential to overall quality of life and well-being. Declining mental health has become a critical public health concern in the United States, with about 1 in 5 adults and 1 in 7 children aged 3 to 17 years living with a mental disorder. Some populations with the highest prevalence of mental illness include young adults, women, American Indian/Alaska Natives, and people from lower socioeconomic backgrounds. 

Of particular concern, psychological distress among youth has increased significantly in recent years, especially anxiety, depression, and suicidal thoughts and behaviors. Poor mental health is a leading cause of disability in the United States, increasing the risks for many physical health problems, primarily chronic diseases. Mental disorders also contribute to lost productivity, absenteeism from work and school, and higher health care costs. Unfortunately, estimates suggest that only half of people with mental illnesses receive treatment, and this is due to a combination of factors, including stigma, cost, and barriers impeding access to care. 

There is an unmet need for high-quality, evidence-based, and affordable mental health care to improve the lives of people affected by mental disorders. For example, children in the United States have worse mental health than their peers in other high-income nations. Addressing this complex problem will require investment and awareness of the multilevel factors and environmental exposures that influence whole-person health. 

NIH is committed to supporting research to advance our understanding of mental disorders and drive progress toward effective treatments and accessible care. NIH funds research to uncover how the brain regulates behavior, identify novel treatment targets, and improve preventive and therapeutic service interventions.

For example, the Adolescent Brain Cognitive Development Study^SM (ABCD Study®)—the largest long-term study of child health and brain development in the United States—explores the environmental, social, genetic, and biological factors that affect brain and cognitive development, behavior, and health. The study aims to identify the foundational aspects of adolescence that shape a person’s future. 

Further along the research pipeline, NIMH supports multidisciplinary Practice-Based Suicide Prevention Research Centers, where investigators are developing, refining, and testing effective and scalable approaches for reducing suicide rates in the United States. These centers use clinical settings as a place to evaluate and optimize service delivery strategies that can be rapidly integrated into practice, making meaningful impact for individuals receiving care. 

Understanding the behavioral and social factors that contribute to mental health is central to ensuring that interventions and treatments are responsive to the needs of all people. As a coordinating office, the NIH Office of Behavioral and Social Sciences Research (OBSSR) plays a critical role in this work, partnering with NIH institutes, centers, and offices and the wider research community to support mental health research through its co-funding program. 

Over the years, OBSSR has supported projects ranging from the effects of social media on mental distress and isolation (R01HD104187), physical activity interventions for children with attention-deficit/hyperactivity disorder (ADHD) (R21AT010041), and investigations into the brain mechanisms that mediate genetic risk for anxiety and depression (R01MH081884). 

Years of investment in mental health research have led to groundbreaking discoveries. Investigators supported by NIMH conducted foundational research in the 1960s that led to the development of cognitive behavioral therapy (CBT), a type of psychotherapy that helps individuals identify and change negative thoughts and beliefs and develop problem-solving skills. CBT gained widespread adoption in following decades and remains one of the most successful and widely used forms of psychotherapy. This approach has helped millions of individuals develop effective coping skills, enhance daily functioning, and improve their quality of life. 

In 2008, a partnership between NIMH and the U.S. Army—the Army Study to Assess Risk and Resilience in Service members (Army STARRS)—conducted research among soldiers in all phases of service to help reduce suicide rates among members of the military. This multisite, multiyear initiative was the largest study of mental health risk and resilience ever conducted among military personnel and continues to yield data from longitudinal follow-up studies. Results from Army STARRS have informed actionable strategies to enhance mental health and reduce suicide risk both among members of the military and more broadly for civilians. In 2019, other NIH-supported research studies paved the way for two promising therapeutic options approved by FDA: esketamine, a fast-acting, noninvasive option for treatment-resistant depression; and brexanolone, the first drug developed specifically for postpartum depression.

Although there are many accomplishments to be proud of, more work remains. Addressing the mental health crisis is essential, not only for improving individual health and well-being, but also for enhancing social stability, reducing economic burden, and fostering a healthier, more resilient society for all Americans. 

NIH is continuing to improve mental health care by supporting research that explores the following questions:

• What areas of the brain play a role in responses to stress (R01MH122561)?
• How does social media use impact behavioral and mental health outcomes, particularly among youth (R01MH137444)?
• How can technology be leveraged to deliver mental health interventions, particularly among those receiving treatment for chronic health issues (R01AT009974)? 

Continued collaboration across research disciplines, along with a steadfast commitment to improving the quality of life and access to care for those affected by mental illness, is needed to ensure everyone can live their healthiest lives. While challenges certainly remain, the future is brighter for people seeking mental health support.