The history of the National Network of Depression Centers cannot be completely told without first retelling an earlier history; that of another class of chronic, widespread diseases: cancer.
The cancer experience
It is hard to imagine a time when cancer was considered an affliction of the weak, and an irreversible death sentence. But just a generation ago, cancer too was steeped in stigma and misunderstanding. The word ‘cancer’ was uttered only in whispers, or referred to indirectly as ‘the big C.’ Too often, reluctance to face the possibility of cancer and fear about the effects of therapy meant that symptoms went unchecked until the disease progressed beyond effective treatment. Scientific efforts to understand and address cancer fell sorely short. But, due in large part to coordinated efforts by opinion leaders, policy makers and experts in academic medicine, the tide began to turn in 1960 when the National Cancer Institute (NCI) began providing grants for cancer research.
The next and more significant leap forward came in in 1971, as President Richard Nixon signed the National Cancer Act, portrayed as a declaration of a “war on cancer.” With that pronouncement came the authorization of $1.5 billion for the establishment of a National Cancer Program, including establishing a “Centers of Excellence” model with the inauguration of the first 15 NCI-designated Cancer Centers to disseminate advances in diagnosis, treatment and prevention to patients across the country.
Founded in 1995, the National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 23 of the world's leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives. (For more information, visit NCCN.org.)
The net impact of these and other events: Between 1975 and 2007, mortality rates for some of the most prevalent cancers have declined by double digits, and the five-year survival rate for all cancers combined improved by more than a third.
During the same time frame, no such impressive strides were made in the understanding and treatment of depression and bipolar disorder. That recognition led us to pursue a cancer-like strategy to speed our progress in addressing these complex and pervasive illnesses.
Adapting the cancer model
In 2007, leaders in the field from the top academic medical centers in the country gathered to explore ways to apply the lessons learned in the war on cancer to depression and bipolar illnesses and related mood disorders. A key first step was the establishment of Centers of Excellence. These Centers of Excellence would lead a coordinated effort to generate new knowledge and educate a new generation of specialists in healthcare and across the broader community, eventually reaching all Americans with a message of understanding and hope, to transform the depression landscape.
The need to facilitate collaboration between these centers was the impetus to form the National Network of Depression Centers (NNDC), effecting meaningful transformation in the field by bringing together the leading specialists from across the country to develop and implement best practices for diagnosis, treatment, outreach and advocacy. Only by working together can we develop the infrastructure needed for large-scale clinical trials, data registries, standardized assessment, stigma reduction, and delivery of care to all Americans.
In 2008, a charter was adopted to form the National Network of Depression Centers (NNDC), a 501 (c)(3) nonprofit organization with 16 founding member institutions. Priorities were identified, and work began in our committees and task groups. Membership in the NNDC has since expanded to 21 esteemed institutions, and continued growth is anticipated.