Tom Insel faces scrutiny

8 Jun

Dr. Tom Insel is the director of the U.S. National Institute of Mental Health (NIMH) and also chairs the Interagency Autism Coordinating Committee (IACC). As such, he has been placed under a lot of scrutiny and criticism from some sectors of the autism community.

He now faces scrutiny from other quarters.

Science Insider has a story, NIH Conflicts Overhaul Bumps Up Against Psychiatry’s Old Boys Network. The story is also in the Chronicle of Higher Education as As He Worked to Strengthen Ethics Rules, NIMH Director Aided a Leading Transgressor.

The scrutiny involves Dr. Insel’s actions in possibly supporting a former colleague from Emory Universiy, Dr. Charles B. Nemeroff, in his effort to find a new position at the University of Miami. Dr. Nemeroff was sanctioned at the time for conflict of interest issues, including a two year ban by Emory on applying for NIH funding.

From the Chronicle:

A yearlong effort by the National Institutes of Health to toughen its policies against financial conflicts of interest was led by an administrator who quietly helped one of the most prominent transgressors get hired by the University of Miami after a decade of undisclosed corporate payments led to his departure from Emory University, a Chronicle investigation has found.

The administrator, Thomas R. Insel, director of the National Institute of Mental Health, also encouraged the researcher, Charles B. Nemeroff, to apply for new NIH grants, even though Emory had agreed on its own to restrict Dr. Nemeroff from NIH grant eligibility for two years. The NIH also allowed Dr. Nemeroff uninterrupted eligibility to serve on NIH advisory panels that help decide who receives NIH grant money.

From Science Insider:

Nemeroff then applied for a job at the University of Miami’s medical school. According to e-mails that The Chronicle obtained, the school’s dean, Pascal Goldschimidt, e-mailed Insel in July 2009 to ask for a “confidential opinion” regarding Nemeroff. Insel replied that he could not provide a written recommendation but could talk to Goldschmidt informally by phone, which he apparently did, according to the e-mails. (Goldschimdt told The Chronicle he wanted to be sure Nemeroff could receive NIH grants and that Insel assured him “that Charlie was absolutely in fine standing.”) At the time, Insel co-chaired a new NIH committee to revise federal COI regulations; NIH proposed changes in those rules last month.

Addendum:

Dr. Insel discusses issues involved in the above in his blog post NIMH – Reducing Conflict of Interest, Ensuring Public Trust. Given that his post in to a U.S. Government website, I don’t see a problem reproducing it in whole here:

Over the past five years, there have been several psychiatrists implicated in financial conflicts of interest (fCOI). Some of these psychiatrists were funded by NIMH. Two questions have been raised: is fCOI a greater problem for psychiatrists than other medical specialties? And is NIMH part of the problem or part of the solution? I addressed the first question in a recent JAMA commentary.

The second question – what is NIMH’s role? – is raised by allegations that NIMH has not taken this problem seriously and that as Director, I have failed to take action against those who have been accused. These allegations are particularly surprising to me because the Institute has done so much to ensure that the research we fund meets the highest standards of integrity—free of bias or hidden agendas. Beginning in August 2008, NIMH established a new internal process to review all grants prior to funding and all nominees for advisory panels prior to appointment to identify potential fCOI issues. When concerns arise, we require the institutions involved to provide additional information regarding compliance with the current fCOI Regulations to ensure the fCOI has been managed, reduced or eliminated.

The Institute is taking additional steps to preserve the integrity of NIMH-supported research. NIMH is developing a training course to help those in academic psychiatry understand the reasons for Regulations regarding fCOI.

In addition, as part of our mission, NIMH supports research to study problems in the use of evidence based practices, such as the continued under-utilization of psychosocial treatments and the ways by which certain medications may become overused.

Concurrently with the Institute’s aggressive stance to address fCOI, NIH (with NIMH in a leading role) has proposed a new approach towards strengthening Federal Regulations. A Notice of Proposed Rulemaking was published on May 21, 2010 outlining a more rigorous approach to investigator disclosure, management of conflict by universities, and federal oversight. Available for public comment until July 20, 2010, we urge our many partners to review and comment on these proposed revisions to the current fCOI Regulations. We are hopeful that with strengthened Regulations, the Institute will be more efficient and proactive in minimizing potential sources of bias in research.

There is an additional question being asked of those who have violated existing policies: Will they be permitted to apply for grants? Any scientist can apply for NIH funding unless he or she has been “debarred”, the result of an official process via the HHS Office of Research Integrity. Absent this, all applicants must be treated fairly and equally.

NIMH has a critical national mission: to transform our understanding and treatment of the nation’s most disabling disorders (WHO 2008). This will require the best minds from government, academia, and the private sector working for the public good and not for personal gain. As the steward of public funds at NIMH, I am committed to ensuring that we support science that is unequivocally in the public’s interest, unambiguously supported by the public trust.

The second-to-the-last paragraph addresses one issue raised in the Chronicle story–that of the status of Dr. Nemeroff’s ban from applying for NIH grants. He was banned by his University, Emory, not the NIH. Dr. Insel informed U. Miami that Dr. Nemeroff was not banned or “debarred” by NIH.

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One Response to “Tom Insel faces scrutiny”

  1. John M. Nardo MD June 14, 2010 at 19:07 #

    Insel’s backpedaling doesn’t hide the truth – he’s in the game with Charlie Nemeroff. I hope people will act on what Insel does rather than what he says. Just another good old boy…

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