EARLY HISTORY

Like the institutes established within the National Institutes of Health (NIH) during the postwar years, the creation of NIMH reflected a shift in federal policy that dramatically increased support for biomedical research programs that target specific diseases. From the beginning, however, the mission of NIMH was unique. The institute 's authorizing legislation, the National Mental Health Act of 1946, incorporated three distinct missions:

  1. to support research relating to the cause, diagnosis, and treatment of psychiatric disorders;

  2. to train mental health personnel by providing individual fellowships and institutional grants; and

  3. to award grants to states for the establishment of clinic and treatment centers and for demonstration studies dealing with the prevention, diagnosis, and treatment of neuropsychiatric disorders. 1

In short, NIMH was founded on the premise that there is an inherent interrelatedness among the components of the “three-legged stool”—research, training, and services. This premise, reflected the views of Robert Felix, then director of the Division of Mental Hygiene, who drafted the proposal that led to the National Mental Health Act. 2 Felix regarded mental disorders as a public health problem, one that required not only the discovery of the causes of the disorders but also improved training of personnel and better methods of treatment and prevention.3 Felix attempted to realize this vision as he helped to shape NIMH and later served as its first director, a position he held for 15 years (1949–1964).

From the inception of NIMH, there was controversy over its placement within the Public Health Service (PHS). Since it would incorporate the Division of Mental Hygiene, a services agency, some argued that NIMH should be placed in the Bureau of State Services. Others, including Felix and the National Advisory Mental Health Council (established under the act), argued that NIMH should become an institute of NIH, in order to focus its efforts on research and training and to clearly identify mental health and psychiatry with the field of biomedicine. 4 The latter view prevailed, and NIMH remained in NIH until 1967.

To some extent, however, the research portfolio of the NIMH differed from other NIH institutes. In addition to basic and clinical biomedical research, NIMH strongly supported behavioral research and some social science research. The enthusiasm for including



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