U.S. mental health care needs an overhaul, argues former NIMH director Tom Insel : Shots

For over a decade, psychiatrist and neuroscientist Dr. Thomas Insel headed the National Institute of Mental Health and directed billions of dollars into research on neuroscience and the genetic underpinnings of mental illnesses.

“Our efforts were largely to say, ‘How can we understand mental disorders as brain disorders, and how can we develop better tools for diagnosis and treatment?'” Insel said in an interview with NPR.

But in the very first pages of his new book, Healing: Our Path from Mental Illness to Mental Health, he admits that the results of that research have largely failed to help Americans struggling with mental illnesses.

“Our science was looking for causes, while the effects of these disorders were playing out with more death and disability, incarceration and homelessness, and increasing frustration and despair for both patients and families,” writes Insel.

But Insel’s book is less about the failure of science in helping people and more a critique of almost every aspect of the mental health system.

NPR sat down with Insel to talk about how he came to realize where America had failed and his journey to find the answers to addressing the country’s mental health crisis.

The interview has been edited for clarity and length.

What were some of the scientific discoveries and developments you oversaw during your time at NIMH?

We did several large clinical trials for depression, for schizophrenia, for bipolar disorder. The bottom line for most of those was that in the real world of care, medical treatments were not as good as we thought. And I think that was an important insight that really charged us to say we’ve got to do better in terms of developing more effective medications.

At the same time, I think we had a greater awareness, particularly in the later years of my tenure, that we could begin to combine treatments in a way that was very effective. And where we saw this the most was in how we began to address the first episode of psychosis for young people with a disorder like schizophrenia or with a form of bipolar disorder. What we began to understand is, that by combining medication and psychological and cognitive therapies, bringing in families and giving agency to the young person involved, providing academic and employment support, we could actually help kids recover. And that we could get to a point where kids who had

Read More.. Read More