NIMH director Thomas Insel refuted charges that that he helped Charles Nemeroff obtain a position at the University of Miami after his controversial departure from Emory University.

The Chronicle of Higher Education reported that Insel gave assurances that Nemeroff would not lose a two-year eligibility for federal funding and could retain his work in an advisory capacity. Nemeroff's departure followed disclosures that he violated federal policy and Emory's own rules about disclosures. Among those of greatest concern to NIMH was that Nemeroff was receiving fees from GlaxoSmithKline at the same time he was conducting a study involving them.

The Chronicle story set off a news cycle in which Insel described how NIMH is regaining public trust by reducing conflicts-of-interests. The proposed rules, \ open for public comment until July 20, rely on self-disclosure allowing universities to police themselves, something professionals prefer but don't always do well or persuasively. The Chronicle said:

"The actions by Dr. Insel, during a period of heavy Congressional pressure on the NIH to institute reforms, raise new questions about the NIH's stated commitment to attacking the problem of financial conflicts of interest in taxpayer-financed medical research."

Criticism of Insel notes the timing of his initial statement, "NIMH -- Reducing Conflict of Interest, Ensuring Public Trust," one day after The Chronicle story. His blog the following week argued the facts had been distorted.

The issues have been on the radar for years, intensified by Sen.Charles Grassley (R-IA) who has asked for accountability and included a sunshine provision into the health reform law. Too, the Government Accounting Office (GAO) has regularly investigated these relationships. A 2006 report found 41 cases of conflicts of interest in universities although it did not believe these were necessarily deliberate instances of "non-compliance."

The focus on a voluntary compliance is the heart of the new recommendations at NIMH leading doubters to question Insel's leadership in this endeavor. Professional and corporate groups often claim an ability to self-police, and psychiatry is no exception. Last week the American Psychiatric Association, hard hit by the publicity surrounding prominent members (including Nemeroff and its past president, Alan Schatzberg) established a special committee to oversee a code of conduct about disclosure, advertising, and outside relationships. A press release announced the new set of guidelines, and executive director James Scully told the WSJ Health Blog, their goal was to keep educational formats free of industry influence.