The National Plan for Research on Child and Adolescent Disorders: A Report Card at the Midway Point

The National Academy of Sciences' Institute of Medicine has issued a "Report Card" at the midpoint of the National Plan for Research on Child and Adolescent Mental Disorders implemented by the National Institute of Mental Health (NIMH). The Plan called for substantial and progressive increases from FY 1990 through FY 1994, with funding in the final year of $283 million. The Plan recommended especially large increases in child-focused aspects of basic behavioral and biomedical research. Actual funding has reached only $26 million instead of the proposed $78 million. The number of funded studies in child and adolescent psychopharmacology increased only modestly between FY 1987 and FY 1993, going from 9 to 16. NIMH intramural programs on childhood mental disorders received a 9% reduction. These funding changes have occurred at a time when overall funding for NIMH research has increased. In fact, the relative increase in child research in nearly zero. From FY 1987 to FY 1993, total research funding for NIMH increased by 150% after correcting for inflation, compared to 150–165% in child-oriented areas. Within these constraints, the NIMH leadership has been particularly creative and effective in making use of the available funds. Major initiatives in a variety of directions have been implemented. In view of the reasonable hopes instilled by The Decade of the Brain and the NIMH National Plan for Research on Child and Adolescent Mental Disorders, the continuing dearth of biomedical grants in child and adolescent psychiatry is surprising.