The brain is the least studied and understood organ in our body. It not only controls our physical well-being but also plays a significant role in our mental health. According to some reports, up to 25% of the U.S. population suffers from mental health issues, including conditions such as depression, PTSD, and schizophrenia. These conditions could potentially lead to life-threatening behaviors like suicide attempts and suicide itself. In fact, suicide has become the second leading cause of death among children and young adults; in 2010, it was the fourth leading cause of death. Currently, 12.2 million people experience serious thoughts of suicide each year, 3.2 million make a plan to commit suicide, and approximately 1.2 million actually attempt it. Tragically, around 50,000 people lose their lives to suicide annually.
A report published by Deloitte estimates that the economic cost of mental health issues is about half a trillion dollars this year and could reach $14 trillion by 2040. According to independent nonprofit organizations like IAMHRF, there is a significant inequity in mental health research investment, especially in translational research. For example, normalized per capita spending on mental health research in the United States is just 50 cents per person, whereas spending on cancer research is at least one to two orders of magnitude higher. The combined budgets for the National Institute of Mental Health (NIMH) and the National Institute of Neurological Disorders and Stroke (NINDS)—the two institutes primarily responsible for brain health research—are approximately $4-5 billion, while the military budget for fiscal year 2024 is $884 billion.
As a nation, we need a transformational change in how we view brain health. This requires moving beyond the social sciences to approach brain health through physical sciences, as we do with other diseases. Achieving this shift demands a major increase in investment for basic, applied, and translational research aimed at understanding not only how the brain functions but also how its malfunctions lead to devastating conditions such as Alzheimer’s, Parkinson’s, multiple sclerosis (MS), and serious mental health conditions—often referred to as serious mental illness by the White House—which are associated with life-threatening behaviors.
The Brain Health Moonshot Act aims to establish a multidisciplinary, cross-institutional public-private partnership to promote research in brain health. The primary goal of this act is to expand public-private partnerships significantly to better understand the root causes of brain health conditions associated with life-threatening behaviors (LTBs) through a risk and physical sciences based approach. Mental health conditions are currently treated largely through a social science lens, with many varieties of monoamine-based drugs prescribed on a trial-and-error basis. These medications often fail to work for a substantial subset of individuals due to factors such as individual pharmacogenetic differences, side effects that hinder adherence, and a lack of alignment between the drug targets and the underlying causes of many mental health conditions. Additionally, the molecular basis of these conditions is poorly understood. Currently, no molecular diagnostics exist to identify biomarkers for specific subpopulations, and diagnosis relies on observations and questionnaires that are subjective and potentially biased.
A secondary goal of the Brain Health Moonshot Act is to better understand the biological and molecular causes of brain diseases such as Alzheimer’s, Parkinson’s, and multiple sclerosis.
Mental Health in the United States: Current Challenges and Costs
- Prevalence and Severity : Approximately 25% of the U.S. population suffers from mental health conditions, including depression, PTSD, and schizophrenia. These issues are linked to life-threatening behaviors, such as suicide, which is the second leading cause of death among children and young adults (up from fourth in 2010).
- Suicide Statistics : Annually, about 12.2 million Americans have serious suicidal thoughts, 3.2 million develop a plan, and 1.2 million attempt suicide, leading to nearly 50,000 deaths.
- Economic Impact : The financial burden of mental health is about $500 billion annually and is expected to soar to $14 trillion by 2040, as per Deloitte’s projections.
Investment Disparities in Mental Health Research
- Funding Inequities : Despite the enormous social and economic costs, mental health research is significantly underfunded. The U.S. spends just $0.50 per person on mental health research, considerably less than what is invested in cancer research.
- Budget Constraints : The combined budgets for the National Institute of Mental Health (NIMH) and the National Institute of Neurological Disorders and Stroke (NINDS) are roughly $4-5 billion, dwarfed by the $884 billion military budget for FY2024.
Call for a Science-Driven Approach to Brain Health
- Beyond Social Sciences : Mental health is often framed as a social science issue, but there is a growing need to understand it as a biological science, comparable to other diseases.
- Research Needs : An exponential increase in funding is essential to conduct basic, applied, and translational research on brain function and malfunction, specifically regarding life-threatening brain health conditions (LTBs) and diseases like Alzheimer’s, Parkinson’s, and MS.
The Brain Health Moonshot Act
- Objective : This Act aims to establish a cross-institutional public/private partnership to promote interdisciplinary research on brain health.
- Primary Focus : The initiative would initially concentrate on understanding the biological and molecular foundations of mental health conditions linked to life-threatening behaviors, shifting away from trial-and-error approaches with monoamine-based drugs.
- Challenges with Current Treatment : Many current drugs target mechanisms that may not be relevant to certain mental health conditions and do not account for genetic differences, leading to variability in effectiveness and issues with adherence.
- Need for Molecular Diagnostics : Diagnosis for mental health disorders relies on subjective assessments (questionnaires, observation) with no objective molecular diagnostics or biomarkers, complicating accurate diagnosis and treatment.