The 21st Century Cures Act—a bill passed by Congress last week—includes provisions for funding the National Institutes of Health and facilitating the process of drug approval, but many in the research community are also taking note of its potential to pave the way for mental health reform.
The bill passed in a rare show of strong bipartisan support, with the House voting Nov. 30 to pass it 392 to 26 and the Senate passing it 94 to 5 last Wednesday. It authorizes $4.8 billion in funding for the NIH—approximately half of the original boost in its budget outlined by an earlier draft of the legislation—and it also allocates $1 billion to help states tackle the opioid epidemic and funds the creation of suicide prevention programs and mental health services for children.
Basic mental health research may be boosted as well, and Duke is one of the top programs in the country for mental health research, explained David Weiner, interim chair of psychiatry and behavioral sciences. He added that in the past year, Duke has received close to $30 million in federal funding for those fields, not including money from philanthropic donations
Weiner noted, however, that nationwide, mental health resources are not meeting the demand. Even at Duke, the hospital often does not have sufficient resources like beds available for mental health patients, he explained, adding that some of these issues are systemic in nature.
“Many of these patients do not have insurance or private funding to pay for mental health treatment," he said.
Other avenues for receiving care are extremely limited, requiring patients to rely on Duke's resources, he noted.
Despite the promises of the legislation, Weiner acknowledged that the specifics of this bill are unclear from its wording. The bill pushes for mental health "parity"—meaning equal treatment and coverage for mental health conditions and substance use disorders, as for any other physical condition—but does not describe how to ensure compliance with this, he explained.
“Sometimes these regulations make sweeping statements without figuring out the details," Weiner said.
If the bill is able to follow through on its goals, however, access to mental health and substance abuse treatment will dramatically increase, he noted.
Weiner described the epidemic of opioid abuse as “one of the greatest problems facing our country."
Dr. Dan Blazer, former chair of the psychiatry department and former dean of medical education, said that he had no doubt some of the bill's funding will go toward autism research, for which Duke has a growing program in the Center for Autism and Brain Development.
Duke also has strengths in psychotherapy research, Blazer said, and particularly in its consideration of empirical studies of psychotherapy, or using data instead of just interviews.
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