The NIMH Blueprint for Change Report: Research Priorities in Child and Adolescent Mental Health

doi:10.1097/00004583-200207000-00006

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 41, Issue 7, July 2002, Pages 760-767

https://doi.org/10.1097/00004583-200207000-00006 Get rights and content

ABSTRACT

The National Institute of Mental Health established a special subgroup of its National Advisory Mental Health Council to review major research findings on child and adolescent psychiatric disorders over the past decade and to recommend research priorities for the next decade. This Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment published its report, titled Blueprint for Change: Research on Child and Adolescent Mental Health, in August 2001, and several new research announcements reflecting these new directions have been issued since that time. This article summarizes the rationale for and background to the report, its major conclusions, and the reasons why interdisciplinary and translational approaches to research questions in child and adolescent mental health will help to maximize scientific advances.

Section snippets

BRIEF BACKGROUND

Ten years ago, after the Institute of Medicine released the report Research on Children and Adolescents With Mental, Behavioral, and Developmental Disorders (Institute of Medicine, 1989), the NIMH issued a National Plan for Research on Child and Adolescent Mental Disorders, which helped shape the research agenda for the 1990s (National Advisory Mental Health Council, 1990). As a result of this national plan, research in the field of child and adolescent mental health expanded dramatically. In

KEY RESEARCH FINDINGS

To accomplish the tasks assigned to it, the CAMHCW first reviewed the entire portfolio of child and adolescent research grants funded by NIMH since 1990, spanning all of the major domains of relevant scientific study applied to pediatric populations. This covered studies from the fields of molecular biology, developmental neuroscience, genetics, behavioral science, epidemiology, prevention, treatment, economics, and services research. The CAMHCW then identified key research findings where

CROSSING THE BOUNDARIES: WHY INTERDISCIPLINARY RESEARCH IS NEEDED

While the CAMHCW found the scientific progress to be substantial across many areas of psychiatric research, excitement about it was tempered by concerns about the increasing specialization and disciplinary contraction that threatens to inhibit the application or usefulness of significant public health advances at the very time when an integrated and clinically relevant knowledge base is sorely needed. That is, it became apparent to the CAMHCW that too few scientists were able to draw upon and

THEMES, PRIORITIES, AND RECOMMENDATIONS

In recognition of these challenges, the CAMHCW centered the Blueprint for Change Report around two major themes:

First, interdisciplinary research activities will require that linkages be made and supported across a range of scientific disciplines and between scientists and practitioners. In particular, translational research activities should incorporate (as feasible) perspectives drawn from diverse areas, including developmental neuroscience, genetics, epidemiology, behavioral science,

CLOSING REMARKS

This report was written to serve as a strategic guide for transforming the form, function, and purpose of research on child and adolescent mental health. Three key issues were identified as essential to this transformation: (1) the recognition of the lack of connection between basic science (developmental neurobiology and behavioral science) and clinical intervention development, (2) a commitment to accelerating the pace of intervention development by contextual repositioning of such

NIMH CAMHCW MEMBERS

Chair
Mary Jane England, M.D.
Washington Business Group on Health
Washington, DC
Members
William Beardslee, M.D.
Judge Baker Children's Center
Boston, MA
Marilyn Benoit, M.D.
Howard University Medical School & Hospital and Georgetown University Medical Center
Washington, DC
Barbara J. Burns, Ph.D.
Duke University Medical Center
Durham, NC
Ron Dahl, M.D.
University of Pittsburgh
Pittsburgh, PA
Mary L. Durham, Ph.D.
Kaiser/Group Health and Kaiser
Foundation Hospitals
Portland, OR
Graham Emslie, M.D.
University

REFERENCES (14)

Child Mental Health Foundations and Agencies Network
A Good Beginning: Sending America's Children to School With the Social and Emotional Competence They Need to Succeed
(2000)
SE Hyman
Protecting patients, preserving progress: ethics in mental health research
Acad Med
(1999)
Institute of Medicine
Research on Children and Adolescents With Mental, Behavioral, and Developmental Disorders: Mobilizing a National Initiative, Report of a study by a committee of the Institute of Medicine
(1989)
National Advisory Mental Health Council
National Plan for Research on Child and Adolescent Mental Disorders (DHHS Publication ADM90–1683)
(1990)
National Advisory Mental Health Council's Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment
Blueprint for Change: Research on Child and Adolescent Mental Health (NIH Publication 01–4985)
(2001)
JS Ringgel et al.
National estimates of mental health utilization and expenditures for children in 1998
J Behav Health Serv Res
(2001)

There are more references available in the full text version of this article.

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: From the National Institute of Mental Health, Bethesda, MD.

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SPECIAL COMMUNICATIONThe NIMH Blueprint for Change Report: Research Priorities in Child and Adolescent Mental Health

ABSTRACT

Section snippets

BRIEF BACKGROUND

KEY RESEARCH FINDINGS

CROSSING THE BOUNDARIES: WHY INTERDISCIPLINARY RESEARCH IS NEEDED

THEMES, PRIORITIES, AND RECOMMENDATIONS

CLOSING REMARKS

NIMH CAMHCW MEMBERS

A Good Beginning: Sending America's Children to School With the Social and Emotional Competence They Need to Succeed

Protecting patients, preserving progress: ethics in mental health research

Acad Med

Research on Children and Adolescents With Mental, Behavioral, and Developmental Disorders: Mobilizing a National Initiative, Report of a study by a committee of the Institute of Medicine

National Plan for Research on Child and Adolescent Mental Disorders (DHHS Publication ADM90–1683)

Blueprint for Change: Research on Child and Adolescent Mental Health (NIH Publication 01–4985)

National estimates of mental health utilization and expenditures for children in 1998

J Behav Health Serv Res

SPECIAL COMMUNICATION
The NIMH Blueprint for Change Report: Research Priorities in Child and Adolescent Mental Health