The outlook for funding of depression research is not very bright. The Republicans' Pledge to America promises that all discretionary nondefense spending will be reduced to 2008 levels. If this pledge is kept, the National Institutes of Health (NIH) --the main national body that sponsors research aimed at understanding and treating diverse health conditions such as cancer, stroke, and depression-- would face a 9 percent cut for 2011. The vise is likely to continue to tighten in future years as the US grapples with massive budget deficits.
Does it really matter?
You could argue that research projects funded by NIH have afforded only modest inroads onto depression. You could argue that still there is much about depression that remains mysterious, including why depression is often refractory to even our best treatments. You could even say that none of the promise of the decade of brain has been fulfilled: Where's my breakthrough?!
But the fact would remain that depression is the most pressing mental health problem in the world. In fact, it is one of the most pressing problems in the world. More people are getting depressed than ever before, at younger ages of first onset. By some estimates, depression now affects fifteen percent of the population. In a chilling prediction, the World Health Organization projects that the amount of disability and life lost due to depression worldwide will by 2020 be greater than war, accidents, cancer, stroke, and all other health conditions except for heart disease. What this means in human terms is that if you walk down any suburban street in America and start knocking on doors, you'll only need to go five or six houses before finding a resident who is struggling with the pain and burden of serious depression.
Large scale research projects that will yield definitive results are expensive to carry out. With budget cuts, fewer projects will be funded. In future years, we may see as few as 10 percent of the ideas proposed by scientists get the needed funds to test them. Almost invariably there will be less room for big ticket items like large multi-site clinical trials designed to understand and improve depression treatments. If the funding environment is as grim as I expect it will be, the only thing I can say for sure is that ideas, careers, and discoveries will be snuffed out.
This is not a politics blog but it is worth pointing out that the yearly budget for the entire National Institutes of Health (with its sprawling 27 institutes) is about 30 billion dollars. The entire yearly budget for the institute charged with all of mental health (NIMH) is 1.5 billion dollars. To put these numbers in perspective, it will cost about 105 billion dollars in 2010 to carry on the war in Afganistan. In this context of the total federal budget, the cost of depression research essentially amounts to rounding error. Given the devastating personal and societal toll of depression, we should ask the US Congress to round up.
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