For the Public Good Highlights from the Institute of Medicine, 1970-1995 (1995) / Chapter Skim
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HEALING THE MIND-BODY SPLIT: HEALTH POLICY ADDRESSES THE BRAIN AND BEHAVIORAL SCIENCES
HEALING THE MIND-BODY SPLIT: HEALTH POLICY ADDRESSES THE BRAIN AND BEHAVIORAL SCIENCES
Pages 113-127
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From page 113... ...
Recognizing the need to advance scientific opportunities for clarifying the roles of behavior in major physical and mental disorders, with special attention to prevention of disease and maintenance of health, TOM President David Hamburg created in 1978 a new division Mental Health and Behavioral Medicine, which was renamed the Division of Biobehavioral Sciences and Mental Disorders in 1989. This division, and the members of its oversight board, brought the unique perspectives of the biobehavioral and social sciences to policy research in its studies and complemented the studies conducted by other TOM divisions by actively promoting cross-division collaborations.
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From page 114... ...
, for example, contains an example of fruitful collaboration between the Division of Mental Health and Behavioral Medicine and the Division of Health Promotion and Disease Prevention that resulted in the chapter "Strategies for the Prevention of Mental Disorders." This chapter secured a place for these "forgotten" disorders among the preventable medical diseases and conditions to be tackled as part of the newly emerging set of federal initiatives directed toward the goal "Health for All by the Year 2000." PREVENTION AND TREATMENT OF SUBSTANCE ABUSE The Tnstitute's reports on drug and alcohol abuse have resulted in greater support of research in those previously neglected fields and have brought conceptual clarity to the complex issues of effective treatment for these chronic, relapsing health problems. The report Alcoholism, Alcohol Abuse and Related Problems: Opportunities for Research (1980)
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From page 115... ...
In its report, the committee found that there was an imbalance of attention toward regulation that, in specific ways, affected treatment negatively by limiting physicians' medical judgments. Nonetheless, the committee recommended continued regulation to assure communities that the methadone clinics located in them were being supervised and to provide de facto clinical practice guidelines, allowing the government to shut down clinics where services were below standard.
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From page 116... ...
; to improving collaboration between government and industry to develop new medications; and to implementing better, more rational, approaches to structuring the methadone treatment environment. The evidence is clear that nicotine and alcohol addiction and their health consequences account for a much greater cost to society than all illicit drugs combined and that both must be addressed as high-priority concerns.
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From page 117... ...
This caution was based on concerns about the effects of long-term regular use of sleeping pills. Special caution was advised when prescribing sleeping pills to elderly patients, because of the likelihood that they may have physical problems or mental conditions aggravated by the drugs and by other medicalions they are taking.
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From page 118... ...
The final committee report integrated the conference papers with available research and literature. The policy recommendations from this report were strengthened by an early and compelling economic analysis of the societal costs of behavior-related diseases and comparisons between those costs and the overall federal research investment.
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From page 119... ...
Adolescent pregnancy and initiation of substance abuse in adolescence were other major themes. Greater attention to research into the behavioral risk factors for cardiovascular disease was recommended, as was the development of a better understanding of the role of psychosocial treatment strategies in addition to medications for optimal management of chronic diseases such as hypertension and diabetes.
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From page 120... ...
There is no question that research finding increased for the biobehavioral aspects of diseases related to stress and behavior. For example, the National Cancer Institute and the National Heart, Lung, and Blood Institute substantially increased their behavior-related research programs.
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From page 121... ...
, commissioned by NIMH, resulted in a congressional request to the NIMH to form a National Plan for Research on Child and Adolescent Mental Disorders. The homelessness report was mandated in 1985 by the Health Professionals Training Act (P.~.
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From page 122... ...
Unlike reports of the early 1980s, however, it made highly specific policy recommendations, including calling for NIMH to develop a national plan for research on child and adolescent mental health and to provide leadership to other federal agencies that address research issues pertaining to children and youth. Further, the committee made explicit budgetary recommendations, defining amounts of suggested funding for 5 years in the areas of career development and research training, as well as for research in epidemiology, treatment, prevention, services, behavioral and social sciences, developmental neuroscience, and NIMH intramural research programs.
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From page 123... ...
A major impact of this report has been the clarification of basic concepts and the definition of a continuum of preventive interventions ranging from universal programs aimed at an entire population, to selected programs aimed at populations at risk, and finally, to indicated programs aimed at individuals who can be identified as targets for early intervention. Prior confusion about these concepts and different uses of terms, particularly at the points of intersection of prevention and early intervention, have hampered the effective translation of research into actual practice and have made comparisons across different research programs exceedingly difficult.
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From page 124... ...
In addition, the office added a senior staff position to coordinate social and behavioral research programs across the NIH institutes. CONTRIBUTIONS TO BASIC AND CLINICAL NEUROSCIENCE Many of the IOM reports on substance abuse and mental health research and treatment have addressed research needs in the basic and clinical neurosciences, defined research agendas, and offered recommendations for strengthening neuroscience research programs in specific agencies.
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From page 125... ...
This study assessed the feasibility and ways of implementing a set of digital and electronic resources, including networks, that would support coliaboration of neuroscientists across the world and provide accessible and annotated brain maps, which could be used to aid research. The recommendations in the report were championed by NIMH, which now leads a multiagency program, the Human Brain Project, dedicated to supporting research projects that advance the construction of such resources.
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From page 126... ...
The Institute's overall goal is to bnug the problems of substance abuse and mental illness to the mainstream of science, public health, and medicine. In looking back over the TOM's activities since the late 1970s, it is apparent that there has been progress in achieving these goals of integration, as well as major strides in the enhancement of public understanding of the dynamic interplay among behavior, health, and mental health.
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From page 127... ...
Research on Mental Illness and Addictive Disorders: Progress and Prospects, 1984. Research and Training for the Secret Service: Behavioral Sciences and Mental Health Perspectives, 1984.
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