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There are times, Mr. Chairman, really in the history of every biomedical research discipline when the conceptual framework combines with the scientific technology to restructure and reorient an entire field and to thrust it forward in a quantum leap of progress. That is precisely what is happening at the NIMH today. And we would urge your strong consideration to maintain that thrust by the consideration of the budget that NAMI and the others are requesting for the NIMH of this year, $867.9 million.

We are prepared to answer any questions you may have. [The statement follows:]


Thank you Chairman Harkin, it is indeed a pleasure to appear before you and this distinguished Subcommittee today in behalf of the National Alliance for the Mentally Ill (NAMI) of which I am a member. As you know, ten years ago, a grassroots group of people; consumers, families and friends dedicated to conquering serious mental illness, created NAMI. As you also know, we have learned more about the brain in the last 10 years, than in all previous years of research. I do not think these two events are unrelated. NAMI's mission, now entering its second decade


The Decade

of the Brain is to eradicate mental illness and to improve the quality of life for those who suffer from these no-fault brain diseases. From 1980, we have grown to over 1,000 affiliates nationwide and approximately 130,000 members.

Mr. Chairman, I quote: "We must also expand our research efforts if we are to learn more about how to prevent and treat the crippling or malfunction of the mind." Mr. Chairman, those words were contained in the Message To The Congress from President John F. Kennedy on February 5, 1963. He emphasized in that Message, "Although we embark on a major national action program for mental health, there is still much more we need to know. We must not relax our effort to push back the frontiers of knowledge in basic and applied research into the mental processes, in therapy, and in other phases of research with a bearing upon mental illness."

Now, just last month, President Bush's Coordinator for the Decade of the Brain effort, Dr. D. Allan Bromley, wrote in NAMI's research quarterly, The Decade of the Brain, "It has always seemed astonishing to me that we know vastly more about the first microsecond of the existence of our universe, or about the

the sun,


constituents of any atom, or about the interior of we do about the three pounds of tissue inside our own heads. Brain research is truly one of the great frontier areas of science

it is a frontier that promises enormous practical payoff in the form of new treatments and possibly new ways of prevention."

Mr. Chairman, I agree with Dr. Bromley, that even in these enlightened times, it is clear that mental illness, a problem of major proportions which adversely affects our health, well-being, and productivity as a Nation, is still shrouded in mystery, shame, and stigma.

The prevalence and destructive consequence of mental illness
Each year, mental disorders wreak

in the U.S. is well documented.


havoc on over 30 million adults in this country. In fact, one in every five citizens at some point in their lives will experience debilitating conditions as schizophrenia, depression, Alzheimer's disease, manic depressive illness or anxiety disorders. Tragically, only one-fifth of all adults with a diagnosable mental illness in this country actually receive the treatment they need. In addition to this and perhaps even more alarming is

the fact that some 8.1 million youngsters suffer from mental illness and often go untreated for years, even though effective help is available. But even these chilling statistics cannot

measure the cost of the untold human suffering experienced by our citizens every day. Indeed, this suffering often leads vulnerable individuals to turn to suicide as a way out of continuing their

frequently unnecessarily painful lives.

risk factor for suicide in this country.

Depression is the major

The severe disability directly caused by mental disorders is also clear even if one considers only the amount of time Americans spend in treatment for them. For example, only heart disease is associated with more bed days per month than depression. Depression, in fact, has been shown to have a higher morbidity rate than many other chronic medical conditions, including heart disease, lung disease and hypertension.

The direct and related

costs of mental disorders add up to a staggering $129 billion each


Mr. Chairman, I also agree with Dr. Bromley that unparalleled research opportunities exist, and, I can point with pride to the

fact that NIMH has launched a concerted and powerful effort not

only to overcome mental disorders but also to eliminate associated intransigent and discriminatory stigra 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.


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


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 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.

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