The National Research Action Plan (NRAP)

In 2012, President Obama issued an Executive Order, “Improving Access to Mental Health Services for Veterans, Service Members, and Military Families.”  Section 5 of the Executive Order establishes goals for improvements in research and development, specifically identifying Post Traumatic Stress Disorder (PTSD), other mental health conditions, and Traumatic Brain Injury  (TBI) as illnesses where we need better understanding of underlying mechanisms so that we may make progress in future prevention, diagnosis and treatment efforts.  The National Research Action Plan (NRAP) is a coordinated effort between the Departments of Defense, Veterans Affairs, and Health and Human Services, created in response to the Executive Order. The aspirational vision shared by the NRAP agencies is to provide practitioners with the most effective ways to prevent or treat these conditions in the civilian and military populations, including service members, Veterans, and their families. NRAP provides a comprehensive approach to accelerating research on PTSD and TBI, as well as strategies for preventing suicide among veterans and active duty personnel.  The NRAP identifies coordinated strategies for: 1) identifying biomarkers for diagnosis and treatment, 2) understanding the mechanisms the give rise to PTSD, 3) new treatments based on mechanisms; 4) improved data sharing and use of electronic health records, 5) collaborative research on suicide prevention,  and 6) enrolling at least 100,000 service members in a longitudinal mental health study and planning for long term follow up.   This presentation will review the NRAP priorities, with specific attention paid to efforts to fuel PTSD and suicide  prevention research across military, veteran and civilian populations.  For example, in order to overcome limited integration of data and outcomes across prevention studies, the NIMH provided a supplement to the NIH PhenX platform for PTSD and suicide prevention in order to develop a standard set of common data elements.  Additionally, as we currently lack the ability to predict who will suffer from mental health problems versus those who will recover naturally after a trauma exposure, an FY15 concept has been cleared for a potential future initiative to develop algorithms to predict different post trauma trajectories and to evaluate promising targets for prevention.  There have also been several recent efforts in the area of suicide prevention to improve tools to identify individuals at elevated risk.  Discussion will also focus on future opportunities that may stimulate additional prevention research as we work to achieve the goals of the Executive Order.