The Need for More Basic Research
The development of superior medications that can better treat negative symptoms will probably require a better understanding of the disease process itself. That means better understanding of the basic biology of the brain.
If scientists can identify more of the pathways and functions that are affected by schizophrenia, they will be more likely to create medications that specifically target the critical abnormalities underlying the disease.
In the short term, hope lies in the advances we can expect to see in more effective and safer treatments for schizophrenia and other difficult health care challenges. These improvements will follow continued basic scientific research in the fields of genetics, behavior, and neurobiology. Two obvious fields of fruitful research will be genetic research and noninvasive imaging studies of brain structure and function.
Alert
Progress in medicine is like figuring out what is wrong with a sagging wall. First, you need to know how the wall is constructed, where the supports are, and what materials are present. Then you can diagnose the problem. If you know nothing about walls, you won't be able to figure out why the wall is failing or how to fix it.
Luck Doesn't Count for Much
There is always a very slim chance that serendipity — a lucky accident or unexpected observation recognized by a prepared mind — will yield a new insight that will lead to another big leap in our understanding and treatment of schizophrenia.
Serendipity has played a major role in scientific discovery in the past. Today, however, overwhelming control of scientific inquiry is in the hands of federal funding agencies and for-profit companies. This makes serendipitous or unexpected discoveries significantly less likely.
Granting Favors
Many researchers report that in order to receive funding for their grant applications, they have to have a significant percentage of the work already done, complete with results they can share in the grant application. True exploratory research means a scientist does not know what she will discover when she sets out on a course of inquiry. That is the rare exception today, not the rule. Granting agencies want to know exactly what they will be getting for their money. This emphasis on predictable research might not serve consumers as well as grant administrators assume it does.
No one seriously believes planned serendipity is the best way to speed up our knowledge of diseases like schizophrenia. Giving scientists greater flexibility and choice in how and what they will research, however, might stimulate some fresh insights that could speed up the incremental progress we've seen in recent years.
Trends in Government Research Funding
In the last ten years, the budget of the National Institute of Mental Health (NIMH) has increased around sixfold, from $230 million to $1.4 billion. Unfortunately, factors such as the economy and other government spending priorities are resulting in cuts in federal funding of health care and mental illness prevention programs, according to NIMH.
In addition, only a small fraction of the NIMH budget is dedicated to schizophrenia research. Critics charge it is disproportionately low given the prevalence, severity, and cost of schizophrenia. Even if the percentage of funding devoted to schizophrenia research increases in the future, it means much research time and opportunity has already been lost. Future progress is being slowed by poor funding and poor allocation of funds. It is an area where advocates could make a difference by getting the attention of members of Congress.
