Full Text PA-92-65


NIH GUIDE, Volume 21, Number 13, April 3, 1992

PA NUMBER:  PA-92-65

P.T. 34

  Mental Disorders 
  Health Services Delivery 
  Health Care Economics 
  Rehabilitation/Therapy, Emotional 

National Institute of Mental Health


The purpose of this announcement is to encourage research, research
demonstration, and research career development applications for
investigations of mental health care to persons with severe mental
disorders.  The ultimate goal of this initiative is to improve the care
and quality of life of those who suffer from persistent and disabling
mental illnesses.  Applications are sought in the areas of clinical
services, service systems, and mental health economics.


The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This program
announcement, Implementation of Caring for People with Severe Mental
Disorders, is related to the priority areas of mental health objectives
6.4, 6.6, and 6.7.  Potential applicants may obtain a copy of "Healthy
People 2000" (Full Report:  Stock No. 017-001-00474-0) or "Healthy
People 2000" (Summary Report:  Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington, DC
20402-9325 (telephone 202/783-3238).


Applications may be submitted by any public or private, non-profit and
for-profit organizations including universities, colleges, hospitals,
laboratories, units of State and local governments, and eligible
agencies of the Federal Government (for-profit corporations may not
apply for research demonstration support).  Foreign institutions may
only apply for research project grants.  Women and minority
investigators are encouraged to apply.  Special eligibility
requirements for specific support mechanisms are described in the
relevant announcements.

Applications for CSP research demonstration grants may be made only by
State mental health authorities.  It is expected that the primary
researcher will be the Principal Investigator and the State staff
member with project oversight responsibility will be the Project


The Research Resources panel recommended that a broad array of grant
mechanisms be used to encourage investigators at all stages of their
careers to conduct research in the mental health services area.

Research support may be requested through applications for an
individual research grant (R01), a small grant (R03), the First
Independent Research Support and Transition (FIRST) Award (R29), and
the Multi-Institutional Collaborative Research Project (R10).

Support for research projects that include funds for services may be
requested through applications for research demonstration grants (R18),
including Community Support Program (CSP) research demonstration
grants.  Research demonstration projects investigate particular
approaches to providing, organizing, or funding services through
experimental or quasi-experimental studies of interventions applied in
actual service settings.  Such projects involve implementing one or
more interventions and comparing the effectiveness through the use of
one or more control/comparison groups.  A primary goal of a research
demonstration project is to design and evaluate the outcomes of
interventions that, if shown to be effective, can be generalized to
other settings.

Other mechanisms supported by this announcement include:

National Research Service Awards (NRSA)

Predoctoral Individual M.D./Ph.D. Fellowship (F30)
Individual Predoctoral Fellowship (F31)
Individual Postdoctoral Fellowship (F32)
Institutional Training grant (T32)

Research Career Development Awards

Research Scientist Development Award (K02)
Research Scientist Award (K05)
Scientist Development Award for Clinicians (K20)
Scientist Development Award (K21)

Since the R03, R10, R29, NRSA, and Research Career Development
mechanisms have special requirements regarding eligibility, application
format, and review criteria, applicants are strongly encouraged to
consult with NIMH program staff (see INQUIRIES).  Copies of the
specialized announcements for each are available from program staff.

Terms and Conditions of Support

Grant funds may be used for expenses clearly related and necessary to
conduct the proposed research.  Grant funds may not be used to operate
a treatment, rehabilitation, or other service program, except in the
case of a research demonstration grant (R18).

Research demonstration grants are intended to assist in meeting the
costs of planning, developing, and implementing research demonstration
activities necessary to support attainment of project objectives.
Grant funds are to be additive, not substitutive; they are not to be
used to replace existing resources.

Applications for CSP research demonstration grants must include the
following assurance:  "Not more than 10 percent of grant funds will be
expended for administrative expenses."  In addition, the Principal
Investigator and project director of these grants will be asked to
participate in one meeting each year of the grant to share information.
The meetings will be held in the Washington, DC area or other
designated central location.  Questions about the terms and conditions
of support for CSP research demonstration grants may be directed to the
Community Support Program at NIMH.

Grants must be administered in accordance with the "PHS Grants Policy
Statement (Rev. October 1990)."  Federal Regulations at 42 CFR Part 52,
"Grants for Research Projects," and 45 CFR Parts 74 and 92 concerning
administration of grants, are applicable to these awards.

Period of Support

Applicants may request support for up to five years for research and
research demonstration projects.  CSP demonstrations are limited to
three years.  Small grants are limited to two years and may not be
renewed.  FIRST awards are made for five years and are not renewable.
Specific instructions regarding the period of support for NRSA, career
development, and minority supplement grant mechanisms are in the
specialized announcements for these mechanisms.  Annual continuation
awards will be made, subject to continued availability of funds and
progress achieved.



Dramatic progress in clinical and basic research over the past two
decades has led to major advances in diagnosis and treatment of mental
disorders.  As in the rest of medicine, however, this knowledge base
may not be well used in the actual provision of mental health services.
Particularly for persons with severe, persistent, disabling mental
disorders, this situation may mean that diagnoses are in error,
treatment plans are inadequate or ineffective, and essential services
are poorly coordinated or nonexistent.

With any illness, but especially with severe mental disorders that
endure and disable, providing the right medication is essential, but
not enough.  Other services must be provided to assist rehabilitation,
independent living, and quality of life.  Finding ways to improve the
quality, organization, and financing of care is a compelling public
health need.

In response to this need, the National Advisory Mental Health Council
of the National Institute of Mental Health (NIMH) convened three panels
of experts to evaluate the existing state of scientific knowledge on
services for adults with severe mental disorders:  the Clinical
Services Research Panel, the Service Systems Research Panel, and the
Research Resources Panel.  The experts on the panels were asked to
identify major research gaps and resource needs for the future.  The
findings of the three panels are summarized in "Caring for People with
Severe Mental Disorders:  A National Plan of Research to Improve
Services."  The research recommendations proposed by the first two
panels and their consultants are the basis for the research issues
identified in this announcement.

This announcement is divided into two domains:  clinical services
research and service systems research.  Each domain represents a
separate content area that needs intensive study.  However, applicants
may propose research designs that crosscut these domains.  There is a
particular need for research that addresses issues related to members
of special populations such as minorities, women, those living in rural
areas, and homeless persons.  Other NIMH program announcements address
needs for research on mental health services provided for children and

Clinical Services Research


Clinical services research extends the work done in clinical research
and provides questions for further clinical trials. It focuses on how
clinical knowledge, gained in a controlled research environment, is
applied in the larger, relatively uncontrolled environment in which
those with mental illness actually live.  However, equally important,
it is concerned with learning from community clinical practice what
aspects of that care are most important in improving the outcome of
mental health treatments.  The primary goal of clinical services
research is to improve the quality of care in everyday clinical

The true value of clinical research to the treatment of those with
severe mental illness cannot be known until answers are provided to
such questions as:  How accurate are clinical assessments of severely
mentally ill patients made in everyday practice--including assessments
not only of psychological functioning, but of physical and social as
well?  Are the most appropriate treatments for a given disorder, as
revealed through clinical studies, actually provided to those who need
them and, if so, are the outcomes beneficial?

Research Approaches and Issues

Applicants may use a variety of approaches, singly or in combination,
and may address any of a broad range of research issues related to
clinical services for persons with severe mental disorders, including
co-occurring substance abuse disorders.  The following list of research
issues is illustrative, not comprehensive, and other clinical services
research issues may be proposed.

Examples of research topics, by specific content subareas, include:

Characteristics of the Population

o  Long-term, natural history studies of individuals with major mental
disorders, including co-occurring substance abuse disorders, that focus
on the course of illness and the resulting degree of disability, use of
mental health and social services, and the effect of the illness on
family members

o  Studies of treated and untreated populations to assess the types,
patterns, duration, and mutability of mental illness-related
disabilities and the role that socioeconomic and cultural influences
play in the development and course of disabilities

o  Research on the prevalence of severe mental disorders, including
co-occurring substance abuse disorders, and on the service needs of
persons with these disorders who reside in prisons, nursing homes, and
institutions other than mental hospitals

Assessment Research

o  Studies to assess the generalizablity of diagnostic assessment
techniques across major social and cultural groups

o  Studies of how the presence of a severe mental disorder affects the
recognition and management of medical disorders

o  Research on the reliability, validity, and stability of
quality-of-life, social status, and vocational status measures,
particularly for severely mentally ill individuals from different
socioeconomic, ethnic, or cultural groups

Treatment Research

o  Studies of the effectiveness of various treatment modalities,
including day treatment, partial hospitalization, home-based care,
community treatment programs and long-term hospitalization, for
different groups (diagnostic, socioeconomic, ethnic, cultural, gender,
and age) of severely mentally ill individuals at different times in
their illnesses

o  Research on the relative effectiveness of psychotherapeutic drugs
for severely mentally ill individuals in various community settings

o  Studies of the effects of peer support and self-help groups for
those with severe mental illness

o  Research on ways to maximize the role of families in developing and
delivering effective treatment

Rehabilitation Research

o  Studies to determine what types and combinations of rehabilitation
services are most beneficial for severely mentally ill individuals with
different clinical, social, and economic circumstances

o  Studies of how well State vocational rehabilitation systems provide
services, what diagnostic, socioeconomic, and ethnic groups of persons
with severe mental illness are enrolled in State programs, and the
outcomes for those enrolled

o  Research on the effect of housing policies on comprehensive
rehabilitation programs

o  Research on ways to maximize effective use of family expertise and
client preferences in planning rehabilitation services

Outcomes Research

o  Studies of the reliability and validity of instruments in multiple
outcome domains (clinical, rehabilitative, humanitarian, and public
welfare), particularly for understudied populations, e.g., severely
mentally ill persons who are homeless, migrants, minorities, rural

o  Studies of outcome utilities for individuals, families, and

o  Research on the appropriateness, in assessing health status among
those with severe mental disorders, of general health status, physical,
and psychosocial functioning measures, that were developed to assess a
general or medically ill population

o  Research testing the performance over time of instruments measuring
inherently unstable patient or client characteristics

o  Research to develop new analytic methods or adapt existing ones to
handle the difficulties encountered in analyzing longitudinal data from
multiple domains and perspectives

Service Systems Research


Service systems research focuses on the organizational, financial, and
social issues related to the provision of services to persons with
severe mental disorders.  Its goal is to identify the optimal ways to
organize and finance mental health and related services to meet the
multiple and varying needs--psychological, social, and economic--of the
individuals who suffer from severe mental disorders and of the
individuals who provide care to them.  This section of the announcement
will focus on the organization, financing, and structure of service
systems, as well as legal issues, human resource development, and
issues related to stigma; the subsequent section will focus on the
economics of providing mental health care and related services.

A basic premise of service systems research is that multiple challenges
confront those who seek to develop effective ways of providing
state-of-the-art clinical services to all persons with severe mental
illness.  Therefore, it is essential that answers to questions such as
the following be found:  How can various types of care--from clinical
management to rehabilitation, housing, and income support-- be better
integrated?  How can clinical personnel be recruited, trained, and
retained, especially in geographical areas with a low concentration of
providers?  What methods of treatment coordination are most
cost-effective or cost- beneficial?  What are the linkages among supply
and quality of board and care homes, the level of Social Security
Income (SSI) payments, and housing market forces?  What incentives are
needed to reduce community admissions to State mental hospitals and
ensure quality outpatient treatment and rehabilitation services?  Can
the law be used creatively to provide safe, affordable housing for
clients?  To what extent do courtroom uses of psychiatry reinforce
perceptions of mentally ill people as violent and what is the ratio of
violent crime to nonviolent crime among different subgroups of those
with severe mental illness?

Research Approaches and Issues

Applicants may use a variety of approaches, singly or in combination,
and may address any of a broad range of research issues related to
service systems research.  The following list of research issues is
illustrative, not comprehensive, and other service system research
issues may be proposed.

Examples of research topics, by specific content subareas, include:

Improving Service Systems

o  Research to develop brief screening methods for identifying
individuals in the community who are afflicted with severe mental
illness that can facilitate swift and appropriate referrals to specific

o  Research on the acceptability of alternative mental health service
models to severely mentally ill persons and their families

o  Studies of patterns of and reasons for differential use of mental
health services by different ethnic groups

Structure of Care

o  Studies of ways families can best be involved in working with and
integrating the various elements of service systems

o   Research on ways to link mental health, general health, substance
abuse, and social service systems components

o  Research on the provision of mental health services in locations
other than mental health specialty settings, such as general hospitals,
nursing homes, criminal justice facilities, and primary health care

o  Studies of the costs and effects on patients of changes in the
organization of mental health services in a State or region

The Allocation of Financial Resources:

Financing of Care

o  Analysis of the interactions of mental health care financing among
State Mental Health Agencies, Medicaid, Medicare, and private insurers

o  Studies of financial incentives that promote the development of
programs for severely mentally ill persons who have special needs

o  Research on the use and cost of mental health services by severely
mentally ill individuals receiving Social Security Disability Insurance
(SSDI) and Supplemental Security Income (SSI) benefits

Impact of Cost-Containment Policies

o  Studies that examine impacts of cost-containment policies on the
provision of mental health care to severely mentally ill persons within
and across different managed care systems, e.g., health maintenance
organizations, preferred provider organizations, and utilization review

o   Studies of capitated payment systems for severely mentally ill
individuals and the effectiveness of capitation in financing
comprehensive, coordinated, continuing care

o  Research that addresses the financial impact of various forms of
managed mental health care on patients, providers, and payers

Cost-Benefit/Cost-Effectiveness Studies

o  Cost-benefit and cost-effectiveness analyses of alternative
treatment, rehabilitation, and case management modalities, including
studies of family care

o  Cost-effectiveness analyses of innovative financing mechanisms for
providing services to persons with severe mental disorders and mental
disorders that co-occur with substance abuse disorders

o  Analyses of costs and benefits of providing a comprehensive range of
health and human services for severely mentally ill persons, including
housing, social services, income security, and employment assistance

Legal Issues

o  Research on ways to screen, refer, and/or treat severely mentally
ill individuals who enter the criminal justice system

o  Studies that track and contrast the careers of minority and
nonminority severely mentally ill individuals through the criminal
justice, mental health, and substance abuse treatment systems

o  Research on the effects of outpatient commitment programs

o  Studies of the ability of professionals to predict violence by
severely mentally ill persons

Human Resources Issues

o  Studies to assess the outcome of programs designed to recruit,
train, and retain minority and nonminority mental health professionals,
particularly in underserved areas, in nontraditional settings, and for
underserved populations

o  Research on how changes in professional and other regulations, such
as licensure and reimbursement, affect programs available to severely
mentally ill persons

o  Studies of the effectiveness of professional and paraprofessional
workers in various types of service settings; the impact of specific
configurations of staff treatment teams; the effects of matching
clients and providers based on gender, culture, ethnicity, and age; and
the effects of consumer and family members as providers of services

Overcoming Stigma

o  Research to determine the prevalence of different types of illegal
acts--from loitering to child molesting and assault--committed by
severely mentally ill persons and those without evidence of severe
mental illness

o  Longitudinal research on public attitudes toward people with severe
mental illness, focusing particularly on cultural, ethnic, and class

o  Research to determine the effectiveness of efforts to improve public
attitudes toward persons suffering from
severe mental illness


Applications for grants and cooperative agreements and proposals for
contracts that involve human subjects are required to include
minorities and both genders in study populations so that research
findings can be of benefit to all persons at risk of the disease,
disorder or condition under study; special emphasis should be placed on
the need for inclusion of minorities and women in studies of diseases,
disorders and conditions which disproportionately affect them.  This
policy applies to all research involving human subjects and human
materials, and applies to males and females of all ages.  If one gender
and/or minorities are excluded or are inadequately represented in this
research, particularly in proposed population-based studies, clear
compelling rationale for exclusion or inadequate representation should
be provided.  The composition of the proposed study population must be
described in terms of gender and racial/ethnic group, together with a
rationale for its choice.  In addition, gender and racial/ethnic issues
should be addressed in developing a research design and sample size
appropriate for the scientific objectives of the study.

Applicants/offerors are urged to assess carefully the feasibility of
including the broadest possible representation of minority groups.
However, NIH and ADAMHA recognize that it may not be feasible or
appropriate in all research projects to include representation of the
full array of United States racial/ethnic minority populations (i.e.,
American Indians or Alaskan Natives, Asians or Pacific Islanders,
African Americans, Hispanics).  Investigators must provide the
rationale for studies on single minority population groups.

Applications/proposals for support of research involving human subjects
must employ a study design with minority and/or gender representation
(by age distribution, risk factors, incidence/prevalence, etc.)
appropriate to the scientific objectives of the research.  It is not an
automatic requirement for the study design to provide statistical power
to answer the questions posed for men and women and racial/ethnic
groups separately; however, whenever there are scientific reasons to
anticipate differences between men and women, and racial/ethnic groups,
with regard to the hypothesis under investigation, applicants should
include an evaluation of these gender and minority group differences in
the proposed study.  If adequate inclusion of one gender and/or
minorities is impossible or inappropriate with respect to the purpose
of the research, because of the health of the subjects, or other
reasons, or if in the only study population available, there is a
disproportionate representation of one gender or minority/majority
group, the rationale for the study population must be well explained
and justified.

The NIH/ADAMHA funding components will not make awards of grants,
cooperative agreements, or contracts that do not comply with this
policy.  For research awards that are covered by this policy, awardees
will report annually on enrollment of women and men, and on the race
and ethnicity of subjects.


The Department of Health and Human Services has regulations for the
protection of human subjects and has developed additional regulations
for the protection of children.  A copy of the human subject
regulations (45 CFR 46, Protection of Human Subjects) and those
pertaining specifically to children are available from the Office of
Protection from Research Risks, National Institutes of Health,
Bethesda, MD 20892, telephone 301/496-7041.  Specific questions
concerning protection of human subjects in research may be directed to
NIMH staff members listed under INQUIRIES.


Applicants are to use the Public Health Service research grant
application form PHS 398 (rev. 9/91).  The number (PA-92-65) and the
abbreviated title of this announcement, "Caring for People with Severe
Mental Disorders," must be typed in item number 2a on the face page of
the PHS 398 application form.  Applicants must also specify the
appropriate code for the support mechanism they are applying under,
e.g., FIRST (R29), small grant (R03), research demonstration (R18).
Applications for the Individual NRSA (F32) must use the application
form PHS 416-1 (rev. 7/88).

Application kits containing the necessary forms may be obtained from
business offices or offices of sponsored research at most universities,
colleges, medical schools, and other major research facilities.  If
such a source is not available, the following office may be contacted
for the necessary application material:

Grants Management Branch
National Institute of Mental Health
5600 Fishers Lane, Room 7C-05
Rockville, MD  20857
Telephone:  (301) 443-4414

The signed original and five legible copies (two copies of fellowship
forms) of the completed application must be sent to:

Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**

Applications for CSP demonstration grants must comply with the
intergovernmental review requirements of Executive Order 12372.
Through this process, States, in consultation with local governments,
are provided the opportunity to review and comment on applications for
Federal financial assistance.  Applicants must contact their State's
single point of contact (SPOC) as early as possible to determine the
applicable procedure.  A current listing of SPOCs are available from
the Community Support Program.  SPOC comments must be forwarded 60 days
after the application receipt date to:  Stephen J. Hudak, Chief, Grants
Management Section, 5600 Fishers Lane, Room 7C-23, Rockville, MD 20857.
The NIMH does not guarantee to accommodate or explain comments from the
SPOC after that date.


Applications will be assigned on the basis of established PHS referral
guidelines.  Applications will be reviewed for scientific and technical
merit by an initial review group (IRG) composed primarily of
non-Federal scientific experts.  Final review is by the appropriate
National Advisory Council.  With the exception of small grants and NRSA
individual fellowship applications, which are not reviewed by Council,
only applications recommended by the Council may be supported.
Summaries of IRG outcomes are sent to applicants as soon as possible
following IRG review.

Review Criteria

General review criteria for scientific/technical merit review of R01,
R03, R29, R18, and R10 applications include:

o  Significance of the research objectives to the public health goals
of this announcement

o  Adequacy of the theoretical and conceptual framework of the proposed
research and appropriateness of research methods

o  Evidence of familiarity with and understanding of relevant research
literature and mental health services issues

o  Potential contribution of the project to improving services for
persons disabled by severe mental disorders

o  Quality of project design and methodology, including appropriateness
of control or comparison groups, reliability and validity of
instruments to assess key variables, methods to identify and minimize
biases and threats to validity, and specification of statistical power
and sample sizes (i.e., numbers of cases needed for statistical

o  Adequacy of representation of the multiple disciplines important for
mental health services for persons with severe mental disorders and
adequacy of arrangements to produce collaboration and cooperation among
investigators from various disciplines

o  Demonstrated scientific and technical capability, experience, and
level of commitment of the proposed research staff

o  Extent of institutional support and commitment to the proposed
research program

o  Relevance of proposed research to minorities and females

o  Adequacy of facilities, general environment, core resources,
collaborative relationships, and support from service providers and
civic leaders for the development and implementation of the proposed

o  Evidence of cooperation and commitment from persons and
organizations whose support is essential for the conduct of the
research; appropriateness of the collaborative arrangements

o  Adequacy of plans to protect research participants

Additional criteria used in the review of research demonstration (R18)
projects include:

o  Extent to which the applicant demonstrates a clear understanding of
the scope and range of service needs among persons with severe mental
illness and the adequacy and appropriateness of proposed services for
identifying and meeting the needs of the population

o  Adequacy of the proposed strategy and mechanisms for management and
coordination of the research and service aspects of the demonstration
project and feasibility of the proposed management plan and timetables
detailing each task

o  Extent to which the applicant has anticipated the barriers to
implementing the demonstration project and has proposed adequate

Additional specific review criteria for small grants (R03), FIRST
awards (R29), and other support mechanisms (e.g., R10s) are included in
the specialized announcements for these mechanisms.  Applicants are
advised to refer to the appropriate announcement before preparing an

Receipt and Review Schedule

All applications, except those requesting support for NRSA training and
fellowships, will be reviewed in accordance with the following review

Receipt Dates     Initial     Advisory Council     Earliest
New/Renewal       Review         Review           Start Date

Jun 1/Jul 1**     Oct/Nov        Jan/Feb           Apr 1
Oct 1/Nov 1**     Feb/Mar        May/Jun           Jul 1
Feb 1/Mar 1**     May/Jun        Sep/Oct           Dec 1

**Competing continuation, supplemental, and revised applications are to
be submitted on these dates.

NRSA institutional training applications have a single receipt date of
May 10; NRSA Predoctoral Individual M.D./Ph.D. fellowship applications
have a single receipt date of September 10.  All other NRSA individual
fellowship applications are accepted on the following schedule:

Receipt Dates        Initial Review     Start Date

Jan 10                   May/Jun          Aug
May 10                   Oct/Nov          Jan
Sep 10                   Feb/Mar          May

Applications received after a given receipt date will be held for the
next scheduled receipt date or returned to the applicant without review
if so requested by the applicant.


For applications that are assigned to the NIMH, special encouragement
is given to those that involve active collaborations between academic
researchers and public sector agencies in planning, undertaking,
analyzing, and publishing research pertaining to persons with severe
mental illness.  The Public Academic Liaison (PAL) initiative is based
on the premise that important new advances in understanding and
treatment of severe mental illness can result from improved linkages
between the Nation's scientific resources and the public sector
agencies and programs in which many persons with severe mental illness
receive care.  The scope of the PAL initiative encompasses public
sector agencies of all types that deal with children, adolescents,
adults, and elderly persons with severe mental disorders.

In addition, the NIMH will give preference in funding to projects
involving underserved populations (e.g., minorities, those who live in
rural areas) and projects that include females and minorities in study

Factors considered in determining which applications will be funded
include IRG and Council recommendations, program needs and priorities,
and availability of funds.


NIMH staff are available for consultation concerning application
procedures before or during the process of preparing an application.
Potential applicants may contact the NIMH as early as possible for
information and assistance in initiating the application process and
developing an application.

Inquiries related to clinical services research may be directed to:

Ann A. Hohmann, Ph.D., M.P.H.
Telephone:  (301) 443-3364

Cille Kennedy, Ph.D.
Telephone:  (301) 443-1330

Kathy Magruder, Ph.D., M.P.H.
Telephone:  (301) 443-3364

Junius Gonzales, M.D.
Telephone:  (301) 443-1330

Inquiries related to service systems research may be directed to:

Chuck Windle, Ph.D.
Telephone:  (301) 443-4233

Ecford Voit, Ph.D. (mental health law)
Telephone:  (301) 443-3728

Agnes Rupp, Ph.D. (mental health economics)
Telephone:  (301) 443-4233

Paul Widem (mental health economics)
Telephone:  (301) 443-4233

To address correspondence to any of the above named persons, use the
following address:

Services Research Branch
Division of Applied and Services Research
National Institute of Mental Health
5600 Fishers Lane, Room 18C-14
Rockville, MD  20857

Inquiries related to Community Support Project research demonstrations
may be directed to:

Neal B. Brown, M.P.A. or Fran L. Randolph, Dr.P.H.
Community Support Section, SDCSB
Division of Applied and Services Research
National Institute of Mental Health
5600 Fishers Lane, Room 11C-22
Rockville, MD  20857
Telephone:  (301) 443-3653

For further information on grants management issues, applicants may

Stephen J. Hudak
Chief, Grants Management Section
National Institute of Mental Health
5600 Fishers Lane, Room 7C-23
Rockville, MD  20857
Telephone:  (301) 443-4456


The activities of this program are described in the Catalog of Federal
Domestic Assistance Nos. 93.125, 93.242, 93.282, and 93.281.  Awards
are made under authorization of the Public Health Service Act, Title
IV, Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC
241 and 285) and administered under PHS grants policies and Federal
Regulations 42 CFR 52 and 45 CFR part 74.  Applications for Community
Support Program demonstration grants (described in the Catalog of
Federal Domestic Assistance No. 93.125), must comply with the
intergovernmental review requirements of Executive Order 12372.


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