Historian Says NIMH's Own Director Admitted $20 Billion in Brain Research Didn't Help the Mentally Ill

On episode #502 of the Lex Fridman Podcast, released September 17, historian Andrew Scull told host Lex Fridman about what he called a "devastating" moment in recent psychiatric history: an admission from former National Institute of Mental Health director Thomas Insel that roughly $20 billion in brain-focused research funding had failed to improve outcomes for people with mental illness.

Scull, discussing his research into the history of psychiatry, walked Fridman through how that outcome came to pass. NIMH was founded in the late 1940s to advance research, training and care for the mentally ill. But Scull says the agency's direction shifted in the 1990s, during what the first President Bush declared the "decade of the brain," when NIMH increasingly staked its mission on the idea that mental illness was fundamentally a brain disease.

That reframing, Scull argued, is exactly what made the field attractive to institutions chasing hard data. "It's the kind of thing that really appealed to medical school deans," he said, once NIMH and pharmaceutical companies began funding basic research into neurobiology and genetics. Psychiatry, he noted, had "been something of an orphan" within medicine before that funding arrived and "became much more popular" once it did.

Fridman framed the underlying tension as a split between studying the mind as a brain problem, which lends itself to lab rigor and data, versus a mind problem rooted in psychotherapy and cognitive science, which he said is less amenable to scientific rigor.

Scull called Insel's reckoning "a pretty devastating statement," and it's the reason he raised it: two decades of well-funded, data-driven neuroscience research, and by Insel's own account, patients were no better off than when the spending began.

Heard on Lex Fridman Podcast — #502 – Psychiatry, Insane Asylums, Mental Illness, ECT, Lobotomies, Freud & Jung (2026-09-17).