The past 15 years have seen the development of advanced methods for studying the interaction between the brain, behavior, and the environment, such as tools for mapping the human genome and neuroimaging techniques to visualize the brain. The new five-year strategic plan of the National Institute of Mental Health (NIMH) is designed to maintain momentum in research and transform the diagnosis, treatment, and prevention of mental disorders.

"To fulfill the Institute's public health mission, we need to make sure that breakthroughs in science become breakthroughs for people with mental disorders," writes NIMH director Thomas R. Insel, M.D., in a foreword to the 37-page document. "This strategic plan represents NIMH's commitment to continue the accelerated pace of scientific progress by generating the best mental health research that will have the greatest public health impact and continue to fuel the transformation of mental health care."

The plan identifies four strategic objectives to guide its research efforts over the next five years:

•Promote discovery in brain and behavioral sciences to fuel research on the causes of mental disorders

•Chart mental illness trajectories to determine when, where, and how to intervene

•Develop new and better interventions that incorporate the diverse needs and circumstances of people with mental illnesses

•Strengthen the public health impact of NIMH-supported research.

These objectives include redefining mental disorders into observable and measurable components that are more closely aligned with the biology of the brain; fostering broad sharing of data and resources among the scientific community; and training and supporting new researchers in ways that inspire creativity and innovation.

The plan breaks down the four objectives into strategies to achieve specific goals, with one-page illustrative sidebars. For example, one strategy for goal 3 (develop interventions) is to use research on the biological causes of a disorder to inform and develop interventions that target the disorder's core features. A sidebar summarizes research on the brain's "fear circuitry"—how the brain adapts to and extinguishes fear. Recent studies have found that fear extinction in the brain is an active learning process, not a passive process of forgetting. Understanding neuronal and cellular mechanisms of fear extinction can lead to new pharmacologic and behavioral therapies to treat anxiety disorders. This knowledge has already been used to develop an intervention for people with fear of heights.

The strategic five-year plan represents the culmination of a year-long process involving the efforts of scientific experts, advocacy groups, and NIMH staff. An initial draft of the plan was posted on NIMH's Web site, and more than 500 members of the public provided input. The draft plan was also presented to the National Advisory Mental Health Council for council members' comments. This feedback was incorporated into the plan.

"Our success cannot be measured solely by our traditional `outputs': the numbers of grants, papers, or discoveries supported," Dr. Insel writes in his foreword. "In addition, NIMH must measure success by `outcomes': how well the research we support provides the evidence base for mental health care providers to preempt illness for those at risk …, enhance recovery for those affected, serve diverse and previously under-served populations, and reduce premature mortality among persons with mental illness."

The NIMH strategic plan is available on the NIMH Web site at www.nimh.nih.gov.