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What’s New and Promising from the New York State Office of Mental Health Psychiatric Research Institutes

The NYS Office of Mental Health (OMH) operates two institutes, making our psychiatric research enterprise among the largest in the country. We are proud of the work underway at the institutes, knowing that their continued clinical advances will improve the lives of New Yorkers, as well as people throughout this country and the world.

The OMH Institutes are the NYS Psychiatric Institute (PI), affiliated with Columbia, and the Nathan Kline Institute (NKI), affiliated with the NYU Langone School of Medicine. Dr. Jeffrey Lieberman directs PI and Dr. Donald Goff directs NKI. Both institutes report to the Office of the Chief Medical Officer of OMH. Here are some highlights from each.

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PI began as the New York State Pathological Institute in 1896. Since 1925, OMH has worked with Columbia University in an historic, public academic partnership. Psychiatrists, scientists, psychologists, social workers and nurses work closely together to conduct both basic and clinical research designed to better comprehend mental disease from the molecular level to the societal implications of mental disorders.

PI is an internationally recognized leader in psychiatric research, with 180 researchers who successfully competed last year for $119 million in federal government, foundation, pharmaceutical and biotech funding to support research ranging from molecular neuroscience to mental health services and policy in many brain disorders and patient populations.

PI’s mission is to better understand how the brain works, what causes both normal and abnormal human behavior, how we can improve psychiatric treatment, and implement programs and models of care that will best serve individuals and communities. Some highlights of the current research at PI are summarized as follows.

Research on Anxiety, Mood, Eating, and Related Disorders. PI researchers are advancing the understanding of and treatments for conditions such as anorexia nervosa, social anxiety disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), neuroinflammatory disorders (including tic-born infections such as Lyme disease and chronic fatigue syndrome) and somatic conditions (such as illness anxiety and conversion disorders). Over 40 faculty researchers in this area are conducting 24 different funded research studies.

We are using state-of-the-art neuroimaging (including functional MRI) to better understand how the brain functions in individuals with anxiety disorders, OCD, PTSD, and chronic pain. By learning about how these disorders affect the actual functioning of the brain, our researchers seek to discover innovative ways to treat those ill with these conditions.

In addition, the PI Eating Disorders Clinic provides outpatient and inpatient research and treatment program focused on the underlying mechanisms of anorexia nervosa and bulimia. Likewise, the Depression Evaluation Service, an outpatient research clinic, conducts studies on the causes of and treatment for depression for those who have failed conventional care.

The New York State Center of Excellence for Cultural Competence conducts research that improves the quality and cultural competence of mental health services to help reduce health and health care disparities in New York State and nationwide. We focus on six research initiatives: integration of physical and mental health services, access to language interpreters, culturally competent engagement, suicide prevention, mental health policy and social determinants of mental health, and first-episode psychosis.

Substance Use Disorders Research. PI is developing and disseminating innovative treatments for those suffering from substance use disorders. We are also working to combat the stigma of these conditions as well as training the next generation of addiction investigators and clinicians.

Researchers in this area are at the forefront of confronting the current opioid crisis. This includes: evaluating the abuse potential of novel pain medications (such as kappa opioid partial agonists and substance P antagonists), studying how an individual’s genetic make-up can be used to improve treatment outcomes, and partnering in national efforts to ensure that evidence-based interventions, what actually works for people with substance use disorders, are delivered to individuals and their families, across New York and throughout the country.

MIND Research Program: Molecular Imaging and Neuropathology

MIND applies neuroimaging to study how brain dysfunction can lead to mood disorders and suicidal behavior.

MIND also leads the Silvio O. Conte Center for Suicide Prevention, the only such federally-funded suicide research center in the country. Its mission is to investigate the neurobiology of mood disorders and suicide risk, and development preventive strategies.

Psychotic Disorders. The mission of this program is to advance our understanding of the causes, natural history, underlying pathology and treatment of schizophrenia and related psychotic disorders. One aspect of this research is to develop measures of violence potential for people with incipient psychotic disorders, including an instrument for violence assessment and a biomarker indicative of imminent potential for violence. In addition, this research seeks to align scientific investigation with the needs of public mental health programs and initiatives, as well as build research into the education programs and clinical services of the department and the OMH system of care.

Currently funded research in Psychotic Disorders is supported by 38 grants or contracts, including 24 NIH awards.

The Center for Practice Innovation (CPI) provides extensive educational and training on evidence-based practices, what works in real practice, how to deliver it, and how to continuously improve services. The success of CPI is evident in that its work is being used in many other regions of the country.

CPI also oversees OnTrackNY, a 21-site program that is a national leader in the delivery of coordinated specialty care for individuals within two years of the onset of non-affective psychosis.

The Global Mental Health Program (GMHP) aims to reduce the burden of mental illness in under-resourced communities throughout the world. GMHP works closely with the World Health Organization (WHO) in conducting field studies and technical consultation to update the International Classification of Diseases (ICD), the diagnostic system used by all WHO member nations to capture public health data and set national health and mental health policies.

Last but not at all least at PI, is the new, groundbreaking, NIMH-sponsored center, “Optimizing and Personalizing interventions for people with schizophrenia Across the Lifespan” (OPAL). The OPAL Center will create an infrastructure to enable research that tests ways to accelerate the development and use, in real clinical settings, of effective, individualized treatments for schizophrenia.

In addition to the research areas described above, PI’s other research programs include: Neuroscience, to study how the brain works; Child and Adolescent Psychiatry, to advance child mental health; Epidemiology & Population Science, to identify what puts us at risk for mental illness; Gender, Sexuality and Health, to serve HIV and LGBT communities; Brain Aging and Mental Health, to study how age impacts mental health; Behavioral & Psychosomatic Medicine, to determine how medical illness affects our mental health; and Mental Health Data Science, to ensure that our researchers use the latest methods for data analysis.

It is no overstatement to say that the PI research enterprise is broad, deep and innovative. Its work is among the best in this country and the world. And PI, is but one of the two OMH research institutes.

The Nathan Kline Institute was established in 1952. It is in New York’s Hudson Valley, less than an hour from Manhattan, on the campus of the OMH’s Rockland Psychiatric Center. NKI is affiliated with the NYU, Langone School of Medicine.

In 2015, NKI was rated among the top one percent of international research institutes. This ranking, which we are proud to convey, is based on the impact of its scientific publications – the national and international journal reports by its remarkable scientific investigators. Moreover, three NKI investigators are among the top one percent of the most highly cited scientific authors in the world.

The NKI’s Center for Dementia Research (CDR) has received more than $25 million in federal awards in the past year, alone. It is principally funded by the National Institutes of Health, including the highly prestigious Program Project Grant.

The Center’s work has special promise for understanding the causes and of developing novel therapies for Alzheimer’s Disease (AD). Discoveries by CDR scientists have stimulated research world-wide, revealing promising new targets for drug development to slow or prevent AD.

The Center for Brain Imaging and Neuromodulation explores the functioning of our brains. Their work uses highly sophisticated neuroimaging and electrophysiology techniques combined with new methods drawn from basic neuroscience. Their aim is to identify brain circuit dysfunction in psychiatric illness, and thus pursue and develop new treatments for mental and addictive disorders.

The federally-funded “NKI/Rockland Project” has NKI scientists performing non-invasive, brain scans in over 1000 members of the Rockland community. Their work has produced more than 200 published scientific articles reporting on healthy brain development over the lifespan. This research serves as a leading guide, nationally and internationally, for understanding the developmental origins of psychiatric illness.

Investigators in NKI’s “Social Solutions and Services Research Division” recently received a large federal grant to support their studies of the impact of social determinants of health (i.e., racial discrimination and socioeconomic disadvantage) on psychiatric and physical health. Their work involves a long-term study of individuals who were first enrolled 30 years ago in New York City. This particular project combines clinical and social science interviews with biological and behavioral measures of stress to examine how adverse life experiences affect health over time.

The Emotional Brain Institute studies the development of anxiety disorders, particularly the impact of early life experiences in animals and humans. The team of highly innovative investigators at NKI are now exploring emotional development, the impact of early maternal contact, sleep, and methods of coping with anxiety.

In addition to the well-established NKI clinical research programs in schizophrenia and mood disorders, there are new programs in Obsessive Compulsive Disorder and Suicide. This work has received funding to develop novel, human biomarkers to guide optimal, clinical strategies for the biological and psychosocial treatments of these conditions.

It is a great privilege to be involved with these two extraordinary research institutes. The future for discovery has never been greater.

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