only to overcome mental disorders but also to eliminate associated intransigent and discriminatory stigma which has further victimized mental patients and their families. I am also pleased that NIMH continues to provide leadership at the national level on the major issues involving mental illness and mental health. plans, As a part of its leadership role, NIMH has completed a series of four strategic three of which are already being implemented. Each is designed with a separate, distinct strategy in mind, and all are aimed at attacking, through research, the biggest mental health problems of our day. These are Approaching the 21st Century: Opportunities for NIMH Neuroscience Research; The National Plan for Research on Schizophrenia and the Brain; The National Plan for Research on Child and Adolescent Mental Disorders; and a new, soon to be released, and highly promising plan, Caring for People with Mental Illness: A National Plan of Research. This new research plan represents a systematic, science-based attack on the inadequacy and low quality of services provided to severely mentally ill persons in this country. I am pleased to report that NAMI is sponsoring two seminars to explain the details of this exciting plan to members and staff. Dr. Jack Burke, Director of the Division of Applied and Services Research, will direct the NIMH presentations on May 8 from 9:00 am to 11:30 am in this building, Room SD-562, and on June 6 in the Gold Room 2168 of the House Rayburn Building from 8:30 am until 11:00 am. Mr. Chairman, taken together, these four research plans provide an over-arching strategy to guide NIMH research programs throughout this decade. Unfortunately, however, despite President Kennedy's challenge over a quarter of a century ago, the unfair and unreasonable attitudes associated with illnesses of the mind and brain were carried-over into our public policies for many years. As a result, the mental health field was chronically and severely under-funded and has been struggling to catch-up. The Office of Management and Budget (OMB), and the Congress, for some time were considered as having an unhealthy tradition of inequitable support for basic biomedical research as compared to other physiological diseases. But now, with the Decade of the Brain Resolution and Proclamation generating special interest in these projects, followed by the action by your's and the House's Labor-HHS-Education Appropriations Subcommittees last year, we are hopeful Congress is now realizes it is absolutely imperative to fund more research on diseases of the brain. However, Mr. Chairman, the proposed budget for fiscal year 1992 does not indicate any change in this situation at OMB, but I hope the Congress does live up to their Decade of the Brain promises, as they did last year, making significant increases for the NIMH budget. Therefore, I come here today with optimism to advocate for an increase in research funding for NIMH. In order to take optimum advantage of existing circumstances, this Subcommittee should adopt NAMI's alternative budget which is endorsed by the Mental Health Liaison Group (MHLG). The MHLG is a Washington-based mental health coalition of over 50 national provider, professional, and citizen advocacy organizations concerned with mental illness and substance abuse consumer, problems. Although the President's budget shows a $40 million increase in funding for research activities over FY 1991 levels, the President's request is actually a reduction of $.3 million below the amount needed to maintain the current levels (* providing the same services adjusted for the rate of inflation) for all the programs in NIMH. This means the overall award rate for competing grants will decrease from 28 percent in FY 1991 to 23 percent in FY 1992, the lowest in NIMH history. and 402 343 315 458 23% 21% 30% **[TOTAL NIMH In addition to research; includes homeless state planning grants; CSP/CASSP, homeless and prevention demonstrations; protection and advocacy; clinical training] The NAMI/MHLG alternative budget would increase the total NIMH budget to $867.9 million. The difference ($113.6 million) between the President's request for research and the NAMI/MHLG recommendations, as compared to the shortfall ($271.9 million) you will note in the table concerning the major National Plans, is due to our understanding of the limited resources available in the current fiscal environment. However, this Subcommittee, as soon as additional resources becore available, should implement the NAMI/MHLG recommendations to fully meet the budget requirerents called for in the National Plans which I know are of high priority to this and the House In this Subcommittee on Labor-HHS-Education Appropriations. regard, it is important to emphasize, only with the NAMI/MHLG budget proposal that I present to you today, would NIMH be able to fund four new basic and clinical Research Centers; two new organization and financing Research Centers; and maintain momentum on NIMH's major blueprints for action during the 1990's, including the National Plans: some The National Plan for Research on Child and Adolescent_Mental Disorders 11 s moving vigorously ahead with the Child and Adolescent **rategy as requested by the Congress. The Plan is a Treatment Study Prevention of Kental Disorders and Problems; and Research Training and Career Development. Levers 7 mentally 121 persons suffer from long tex, mental disorders that have a profound impact on all *eir lives. They experience diverse, disruptive attendant high levels of disability. Some examples mental disorders are schizophrenia, schizophreniform disorder. psychotic disorders, and ranic Priorities for clinical and rehabilitative care TRAKTAY 14, be detailed in the Plan include: Assessment. Treatment * Yestation, and Outcore. 2) Priorities for service system Coordination and Continuity, Law and Mental *-4 Financing. 3) Initiatives in research resources Dational Plan for Schizophrenia Research generated a initiatives including advances in molecular genetic rage techniques as well as imaging, electrophysiology, and the treaters. The report on Opportunities for Cence Research foruses on the increases in knowledge hrough clinical reuroscience, such as brain imaging, engveries which have established the ability to reproduce and grow human brain cell cultures. Planning for these research strategies revealed complementary and shared elements that led to combining the plans into a single, cost-efficient initiative including: Therapeutic Medications Development, Diagnostic Centers for Psychiatric Linkage, Integration of Basic and Clinical Approaches, Regional Imaging Centers for the Study of Mental Disorders, and Molecular Neurobiology. substance ADAMHA BLOCK GRANT In recent years, researchers have discovered that many individuals with serious mental illnesses also suffer from abuse disorders, particularly during acute phases of their mental illnesses. This is something, Mr. Chairman, which many of our family members who have experienced the mental illness of a loved one can vouch for. Unfortunately, most mental health providers in the community are not equipped to treat substance abuse disorders. Similarly, most substance abuse providers are not knowledgeable about or willing to treat mental illnesses. As it is currently structured, the Alcoholism, Drug Abuse, and Mental Health Administration (ADAMHA) Block Grant is an ideal mechanism for focusing federal resources into the comprehensive treatment needs of individuals with mental illnesses and substance abuse disorders. Mr. Chairman, we look to your Subcommittee for leadership in emphasizing the importance of dual planning and coordinated efforts by Block Grant recipients in treating individuals with these dual diagnoses. PROJECTS TO AID THE TRANSITION FROM HOMELESSNESS Mr. Chairman, it is conservatively estimated that 35% of all homeless individuals are seriously mentally ill. Many of these individuals also suffer from substance abuse disorders. Last year, Congress passed important legislation designed to address the needs of this population called "Projects to Aid the Transition from Homelessness" or PATH. The intent of PATH is to link housing and services for persons who are homeless and mentally ill, including those who suffer from |