Progress on NIMH Initiatives (Memorial Theme for Wayne Fenton, MD)

Abstract

The articles in this special issue demonstrate the extraordinary breadth of Wayne Fenton’s career. His work touched the lives of the patients he was treating, their families, and the larger community of researchers. Fenton combined vision with leadership to jump-start the field on a uniquely broad collaboration for therapeutic discovery. Although his tenure at National Institute of Mental Health (NIMH) was brief (from December 1999 until his tragic death on September 3, 2006), he created anationalfocusontheunmettherapeuticneedsinschizophrenia. He became a central figure because NIMH established new programs to address these needs. He was instrumental in developing a unique collaboration among leaders from industry, academia, the Food and Drug Administration, and NIMH. This collaboration has led to rapid and substantial progress. The articles in this theme issue of the Schizophrenia Bulletin provide an update on this progress and commentaries to provide perspective. Wayne Fenton would have felt most strongly about the importance of mental health research being energized by the needs of individuals who live with serious mental illnesses. Fenton’s professional life was divided into 2 passions. First, he was dedicated to helping individuals who were suffering from illnesses such as schizophrenia and their families. The contributions by Heinssen and McGlashan and Carpenter describe his experiences as a clinician at Chestnut Lodge and how they formed his views of serious mental illnesses. During his 18 years at Chestnut Lodge as clinician, investigator, and later medical director, he made significant contributions. It was during these years that Wayne developed the view that treatment of just the psychosis in schizophrenia was a limited approach, and other domains of pathology defined critical unmet needs. This history, and Wayne’s research contributions are set forward in the article by McGlashan and Carpenter. His second interest was the potential of research to alter the course of these illnesses on a much larger scale. His impact on research at NIMH is described in the contribution by Insel and Hyman, the current and immediate past directors of NIMH. We believe that Fenton was unique in his ability to integrate his view of schizophrenia as a clinician with his view of research opportunities. That is, he was keenly aware that research could derive benefit from the presence of a wellgrounded clinician who continually questioned whether research priorities were on track and its research relevant. Stover, Brady, and Marder review how new paradigms for treatment development were implemented in the NIMH research portfolio and detail specific accomplishments that have resulted from these initiatives. It is now widely accepted that drugs with novel mechanisms will be required to advance pharmacotherapy of cognition and negative symptom pathology. The Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) program provided impetus in this area. The article by Stover, Brady, and Marder describes how the MATRICS initiative brought individuals from industry, government, and academia together to address