In the years since that briefing report was published we have borne witness to a steady, albeit hushed, revolution. Some of the Alliance’s members have become actively engaged in applying neuroscience and biotechnology advancements in their practices, as this report details.

Others have forged linkages with universities and researchers as a way to better understand and prepare for the formal integration of neuroscience into their traditional practices. A few have been approached by larger, better capitalized behavioral health organizations in takeover, merger, or partnership attempts—we’ll examine one of those agencies in a case study to be published later this year.

But all have been touched in some way by neuroscience—through the pharmaceutical industry and its new drugs prescribed for many human service clients, the better understanding of the mind-body link within the psychology and psychiatric fields, or the emergence of evidence-based practice, driven by research and increasingly demanded by funders and reimbursement streams.

In their respective sections, authors Carl Zimmer and Laudan Aron define the specific neuroscience advancements most likely to impact nonprofits in the next decade (Zimmer), and the implications those advancements will stimulate (Aron).

Their findings and assessments are remarkable for their depth, clarity, and direction—it is one thing to grasp the concepts of emerging science; it is altogether another thing to communicate those concepts in a manner that is accessible and compelling.

Indeed it was Carl Zimmer who, in a discussion on the impact of neuroscience developments on troubled youth, capsulized a critical issue for providers of nonprofit behavioral health care. “Society,” he said, “views these kids as bad people. But science says they simply have ‘bad’ brains.”

In his section discussing neuroscientific developments, Zimmer argues that much of the recent attention-grabbing neuroscience headlines (for example, stem cell research) will not have much impact on behavioral health care in the next decade.

Instead, he winnows the magnitude of neuroscience advancements down to five critical areas that his research suggests will impact nonprofits in direct and/or significant ways: the emergence of more accurate diagnostic tools through genotyping and brain imaging; the use of electrical stimulation to treat behavioral health issues; the development of better drugs based on better neuroscientific understanding of brain-based disorders; the use of imaging technologies to establish and monitor treatment strategies for behavioral health care patients; and the combining of talk-based therapies with cognitive-enhancing drugs.

For her part, Aron posits that advances in neuroscience will accelerate the medicalization of behavioral health care, leading to further specialization of all behavioral health functions—assessment, treatment and post-treatment—and affecting both the types of services that are delivered to clients and the sequencing of those services.

That said, she suggests that advancements in neuroscience will add to the understanding of the importance of healthy social and physical environments in life, and because of that, there will be additional support forthcoming for more and better early intervention and prevention efforts—including effective counseling and other psychosocial interventions.

She presents a strong case that these advancements will require providers to be much more knowledgeable and “evidence-based” in their thinking (both for clinical and business reasons), to engage in more consumer education (and reeducation), and to quicken their shift from institutional- and facility-based delivery of behavioral health services to home- and community-based settings.

Finally, she observes that advancements in neuroscience will require new institutional relationships and partnerships, including linkages between more traditional nonprofit social service agencies and psychiatric and medical-surgical hospitals or private diagnostic and screening centers with sophisticated imaging and other medical equipment.

The intersection of neuroscience, biotechnology, and behavioral health described here is an extraordinary and astonishing accomplishment in our lifetime. Although not a definitive list, this paper suggests the complexity created by these advancements does indeed pose a number of critical programmatic, organizational, ethical, social, and political challenges for the nonprofit behavioral health sector.

And yet, as the report also suggests, there is magnificent opportunity—to embrace new approaches, new partners, new ways of thinking and doing business. We welcome you to the new frontier.

• diagnostic and treatment advancements that are likely to impact nonprofit human service providers,
• potential organizational capacity changes in response to those advancements,
• ethical considerations raised by advancements and their impact on nonprofits, and
• emerging public policy issues.

Through focus groups and telephone interviews, researchers probed the implications of neuroscience advancements on those providers.

We begin with a synthetic interpretation of the overall findings of this project. Though atypical, this organization confronts the reader immediately with the essential lay of the land, places the two constituent studies in context, and obviates the need for a separate Executive Summary.

Subsequent sections provide the essential supports for this interpretation, setting forth a narrative summary of the survey results (Part II), offering the survey data themselves in outline form (Part III), and interpreting the interviews and focus groups, with the raw data appended (Part IV).