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January 1998

Principles and Mechanisms: A Response to the Career Scientist Award Controversy

Arch Gen Psychiatry. 1998;55(1):17-18. doi:10.1001/archpsyc.55.1.17

THE CONTROVERSY over the proposal by the National Institute of Mental Health (NIMH), Rockville, Md, to limit their Career Scientist Award Program (K-05) brings into stark relief 6 important issues related to science policy for the field. It is also clear that within many of these issues there is broad agreement on principles, but less clarity about the mechanisms for implementing those principles.

Despite the unprecedented growth in National Institutes of Health (NIH), Bethesda, Md, research funding to academic departments of psychiatry (growing from $80.2 million in 1984 to $341 million in 1995),1 the past several years have seen a leveling off of these figures as well as a plateauing of NIMH research funds in general. The "steady-state funding" of NIH described by Harold Varmus, MD, in his Shattuck lecture several years ago2 is a stark reality that Steven E. Hyman, MD, and his staff at NIMH must face on a day-to-day basis. At the same time, academic medical centers are fighting for their very survival in the era of managed care. The cross-subsidization of academic activities by clinical revenues is simply not as feasible as it once was. Both sides need to deal with each other's reality.