Basic behavioral research — which in the case of health means the study of fundamental psychological and social processes not aimed at a specific illness or condition — may be about to enter a new era at the National Institutes of Health (NIH).
In early May, Congress was expecting NIH to deliver a plan for (1) diversifying support for basic behavioral science research and training across several NIH institutes and (2) establishing an infrastructure, including a home base, for basic behavioral research not related to the disease missions of specific institutes. The House and the Senate jointly conveyed this expectation in a strongly-worded provision in the instructions for the fiscal year (FY) 2006 NIH budget.
(Time out for a civics refresher: The President proposes, Congress disposes; that is, Congress sets the annual spending for all federal activities, including NIH and other science agencies. If only it were that simple. Whether out of a general resistance to Congressional involvement in its affairs, a bias against behavioral research, or a narrow view of health — or, most likely, some combination of all three — NIH has ignored repeated Congressional requests and the advice of independent panels of experts calling for a behavioral science program at the National Institute of General Medical Sciences, NIGMS. Now, back to the story at hand.)
Basic behavioral research was one of just two or three issues Congress addressed in its 2006 fiscal plan for NIH, which by itself is enough to indicate that this is a priority. But, aware of NIH’s history in the face of Congressional pressure on this topic, a bipartisan quartet of House members went a step further. Following the President’s signing of the NIH appropriations for 2006, they wrote the agency’s director, Elias Zerhouni, specifically to transmit and underscore the FY 2006 provision and “to stress the continued Congressional interest in basic behavioral science research at NIH.”
“As we have previously indicated, our interest stems from the fact that in any oversight of health issues, a core finding is that behavior is central to many of our Nation’s leading health concerns: heart disease; stroke; lung disease; obesity; AIDS; suicide; teen pregnancy; drug abuse; depression; neurological disorders; alcoholism; violence; accidents; etc., and that much basic research is needed to effectively address these conditions,” wrote Reps. James T. Walsh (R-NY), Patrick Kennedy (D-RI), James A. Leach (R-IA) and Brian Baird (D-WA). Walsh and Kennedy are senior members of the House Appropriations Committee and Baird (a psychologist) and Leach are long associated with mental health issues at NIH.
“With one of the largest budgets in history at NIH, we have no question that a comprehensive basic behavioral science research program can be initiated,” said the legislators.
Rep. Kennedy, who along with APS initiated the effort on basic behavioral science research at NIH, feels strongly about the importance of this research.
“The reason is clear: whether you’re talking about smoking, diet, memory, addiction, drug adherence, mental illness – behavior implicates nearly every institute’s work. And conducting basic science and training that has significance to multiple institutes is a key purpose of NIGMS.”
While clearly frustrated by NIH’s delays, Kennedy expressed optimism about the May report: “After eight years, we may finally see some steps towards building a basic behavioral science program at NIGMS.”
On the other side of Capitol Hill, Sen. Daniel K. Inouye (D-HI), a senior member of the appropriations committee and one of the Hill’s strongest supporters of psychological science research, was equally direct in a March 6, 2006 letter to Zerhouni, conveying his “great disappointment in your organization’s continued inattention” to appropriations report language on basic behavioral science research at NIH and NIGMS in particular.
“As you can tell, there continues to be strong Congressional support for NIH to develop a reasonable process to establish a supportive infrastructure for behavioral research and training at NIGMS,” Inouye wrote to the NIH director, noting that he was expecting a response by May 1st.
Sen . Arlen Specter (R-PA) , chair of the Senate subcommittee that oversees NIH, has also weighed in numerous times, most recently by supporting the FY 06 conference report language (described above) calling for NIH to develop a structural framework for basic behavioral science. Senator Specter, in a September 10, 2003 Senate floor colloquy with Senators Inouye and Harkin, said that “basic behavioral research is essential if we are to address the many public health issues plaguing our nation.”
The Dance of Legislation
These recent events are the latest in a process that started eight years ago with a recommendation by APS to strengthen basic behavioral science at NIH by creating a research and training program at the National Institute of General Medical Sciences (NIGMS, known informally as NIH’s “basic research” institute). Specifically, APS Executive Director Alan Kraut noted to Congress that NIGMS was not fulfilling its statutory mandate to support basic behavioral research and training. (A chronology of the major events leading up to the present.)
The issue resonated with members of Congress far more than with the leadership of NIH, but rather than compel NIH outright to establish this program, there began what would be a lengthy process that unfolded according to a kind of elaborate and at times arcane protocol that governs the interactions between the legislative and executive branches; and so there was an annual (think “Groundhog Year” instead of Day) pas de deux (think Fred and Ginger), in which the Senate or House, or sometimes both, asked NIH to establish a basic behavioral science program at NIGMS, and NIH ignored them or stalled, hoping it would be forgotten. The dance continued though three directors of NIGMS and three directors of NIH. (On second thought, maybe this is closer to “They Shoot Horses, Don’t They?”) It should be noted that during this same time, the NIH budget was doubled by Congress.
The legislators were at first patient with NIH’s recalcitrance, but as time went on, their patience began wearing thin and the messages grew stronger, and included not just a few sentences in an appropriations report, but also letters, statements in the Congressional Record, a meeting or two, and even draft legislation that would have gone ahead and established a basic behavioral program at NIGMS.
In a July, 2003 meeting with Reps. Kennedy and Baird, Judith Greenberg, then acting director of NIGMS and NIH deputy director Raynard Kington asked the legislators to hold off on introducing their bill on NIGMS because NIH was planning to make an assessment of basic behavioral science across all institutes. Kington indicated that NIGMS would be part of the study. Baird and Kennedy agreed, but warned NIH against using the study as a stalling tactic.
Less than two months later, during the Senate’s debate on the NIH budget for FY 2004, Sens. Specter, Inouye, and Tom Harkin (D-IA), ranking minority member of the NIH appropriations subcommittee, included a colloquy (a scripted dialogue, published in the September 10, 2003 Congressional Record) in which they discuss the importance of basic behavioral research in addressing the nation’s public health concerns, and recapping the lengthy track record of congressional report language calling for a basic behavioral research program at NIGMS. The three Senators pledged to work together on this issue. (See the October, 2003 Observer, for more detailed coverage of the Senate colloquy on basic behavioral research at NIH.)
The Institute That Dare Not Speak Its Name
The study Kington told Reps. Kennedy and Baird about in mid-2003 was not announced until October 2003, and didn’t get underway until April 2004, when an ad hoc group of distinguished experts was convened under the auspices of the NIH Director’s influential advisory committee. Members of the ad hoc group included APS Past Presidents Susan Fiske and Robert Levenson, plus APS Fellows Laura Carstensen, Richard Davidson, William Greenough, and James Jackson. Called the NIH Working Group on Research Opportunities in the Basic Behavioral and Social Sciences, the panel issued a report in December 2004 with two main recommendations:
- A secure and stable home should be established at NIH that can serve to foster basic behavioral and social sciences research that is not closely linked to the missions of the categorical Institutes and Centers [ICs]. This will require both staff with appropriate expertise in the behavioral and social sciences and budget sufficient for the task; and
- the basic behavioral and social science research programs that are currently functioning well within ICs should continue in their present form. Efforts should be made to encourage basic behavioral and social science researchers whose research is applicable to specific diseases, conditions, or developmental periods to seek support from the relevant ICs.
The Working Group’s report is available online at http://obssr.od.nih.gov/Documents/…/Report_complete.pdf.
The first recommendation is to establish a basic behavioral program at an “unnamed” non-disease specific and non-age specific institute that is obviously intended to be NIGMS. (In fact, that’s just how NIGMS is described in a document re-written in NIH-ese by the staff to the Working Group.) The second recommendation affirms that basic behavioral research is an NIH-wide enterprise and that basic researchers should be applying to a variety of institutes where their work might have relevance. The latter won’t be a cakewalk, cautions Alan Kraut.
“Without people who appreciate the range of behavioral science in leadership positions within NIH institutes and centers, behavioral science isn’t at the table when the big decisions get made,” Kraut told the working group during one of its early meetings. “And there is no doubt in my mind that this appreciation is sorely lacking at many institutes.” That is a major reason APS recommends adding an administrative structure at NIGMS to address basic behavior. It wouldn’t depend so much on the “kindness of strangers.”
Fueling the urgency of the basic behavioral research issue was a change at the National Institute of Mental Health (NIMH), which until recently was the traditional home of basic behavioral science research related to health. As reported last year (Observer, February 2005), NIMH has shifted priorities, and increased its support for translational and clinical research at the expense of basic behavioral science.
We’ll report back on NIH’s response (or lack thereof) to the May 1 deadline Congressional deadline.