Full Text PAR-94-073

CENTERS FOR RESEARCH ON SERVICES FOR PEOPLE WITH MENTAL HEALTH DISORDERS

NIH GUIDE, Volume 23, Number 22, June 10, 1994

PA NUMBER:  PAR-94-073

P.T. 04

Keywords: 
  0730057 
  Biomedical Research, Multidiscipl 


National Institute of Mental Health

Application Receipt Date:  October 1

PURPOSE

The National Institute of Mental Health (NIMH) announces the
availability of support for multidisciplinary Centers for Research on
Services for People with Mental Disorders.  The purpose of these
Centers is to promote, develop, and conduct multidisciplinary
research that can help to improve the organization, financing,
delivery, quality, effectiveness, and outcomes of services for
persons of all ages with mental disorders.

Support is available for research centers focused in whole or in part
on mental health services for children and adolescents, adults,
elderly persons including those with Alzheimer's disease and other
dementia, and persons with mental disorders who are involved with or
at risk of becoming involved with the legal system.  Support is also
available for centers focused in whole or in part on mental health
economics and on methodological issues in mental health services
research.  Centers are encouraged to include minorities and women in
all facets of their research program; however, centers focused
entirely on services for minority populations should apply for
support under Program Announcement 92-122, "Minority Mental Health
Research Centers."

This program announcement (PA) addresses one of the major
recommendations set forth in Caring for People with Severe Mental
Disorders: A National Plan of Research to Improve Services.  It
complements the NIMH report, "Implementation of Caring for People
with Severe Mental Disorders: A National Plan of Research to Improve
Services," which invites applications for research project grants,
research demonstrations, and career development applications in
support of this National Plan.

This PA also addresses recommendations for services research
contained in the National Plan for Research on Child and Adolescent
Mental Disorders and in the NIMH announcement, "Implementation of The
National Plan for Research on Child and Adolescent Mental Disorders."

This PA supersedes and replaces NIMH program announcements PA-92-94,
"Centers for Research on Services for People with Severe Mental
Disorders," and PA-92-20, "Centers for Research on Mental Health
Services for Children and Adolescents."  Its scope is broader than
these two earlier program announcements, because discussions of
health care reform have emphasized the need for the NIMH to develop a
center program that covers the entire mental health service system,
including services provided in general medical settings and other
agency, institutional, and community contexts.

HEALTHY PEOPLE 2000

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 PA,
Centers for Research on Services for People with Mental Disorders, is
related to the priority area of mental health and mental disorders.
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).

ELIGIBILITY REQUIREMENTS

Applications may be submitted by for-profit and non-profit domestic
organizations and by public and private institutions, such as
universities, colleges, hospitals, laboratories, units of State or
local governments, and eligible agencies of the Federal government.
Applications from minority and women investigators are encouraged.

MECHANISM OF SUPPORT

This PA will use the National Institutes of Health (NIH) Specialized
Center (P50) mechanism.  Responsibility for the planning, direction,
and execution of the proposed project will be solely that of the
applicant.  The total project period for applications submitted in
response to this PA may not exceed five years.

The funding cap for a Center for Research on Services for People with
Mental Disorders is $600,000 in direct costs for the initial project
year, with annual increases of four percent thereafter, plus
negotiated institutional indirect costs.  Applications that request
direct costs in excess of this amount will be returned to the
applicant without review.

RESEARCH OBJECTIVES

Examples of the types of services research issues that might be
addressed by a Center are listed below.  The list is illustrative,
rather than comprehensive.  It is expected that additional relevant
and important research topics will be identified by investigators who
respond to this program announcement.

o  Studies of the prevalence of mental disorders (including
co-occurring substance abuse disorders) and associated disability in
various types of service settings

o  Studies of access to needed mental health services and barriers to
care

o  Research on clinical and related services provided to persons with
mental disorders by mental health professionals, general health care
personnel, and other providers in different types of service
settings, including accuracy of diagnoses, appropriateness, quality,
and effectiveness of care, and short- and long-term outcomes for
patients and their families

o  Research on rehabilitation services for persons with mental
disorders

o  Research on the organization and financing of services for persons
with mental disorders, including services provided and paid for by
State and local governments and the private sector

o  Studies of costs and cost-effectiveness of services for persons
with  mental disorders in various settings, including new and
alternative types of services and case management

o  Research on cost-containment strategies in mental health care
(e.g., managed care, capitated care, contracted care)

o  Studies of effects of major changes and innovations in the
structure, financing and delivery of mental health services at
various levels of government and in the private sector

o  Research on the interface between mental health services and other
types of services needed to maintain people with mental disorders in
the community, including research on models of coordinated and
consolidated care

o  Studies of self-help programs, groups, and organizations for
persons with mental disorders

o  Research on the role of families in caring for persons with mental
disorders, including assessment of appropriateness and effectiveness
of family education programs and family support programs

o  Studies of the impact of various mental health laws, civil rights
legislation, and administrative regulations on delivery and
effectiveness of mental health services

o  Research to test the validity and reliability of measurement
instruments for use in services research (e.g., outcome measures)

o  Research on development of methodology for mental health services
research

Program specifications.  A Center should be planned and organized for
the purpose of addressing major gaps in scientific knowledge in the
field of mental health services research on people with mental
disorders.  Centers must be multidisciplinary, including
investigators from disciplines such as psychiatry, general internal
medicine, family medicine, pediatrics, geriatric medicine,
pharmacology, psychology, social work, nursing, epidemiology,
biostatistics, economics, sociology, public health, law, and
political science.

The Principal Investigator will serve as Director of the Center and
provide scientific and administrative leadership by devoting at least
50 percent of his/her time to the Center, including time spent on
Center research projects that are clearly related to and supportive
of the overall Center plan for research on services for people with
severe mental disorders.  The Center Director must be responsible for
the planning, coordination, and efficient operation of the Center
program, preparation of the budget, control of expenditures, staff
appointments, and space allocation.  Another individual may be
designated to be responsible for the day-to-day administration of the
Center.

Each Center should clearly define a cohesive and parsimonious set of
research core areas that will be addressed by Center study teams.
This selection should be justified on the basis of the public health
significance of the issues to be addressed, the current state of
scientific knowledge, the feasibility of doing research in the
designated areas (e.g., availability of measurement instruments and
populations to study), and the potential impact of the research for
assisting improvement of mental health services. The plan for each
research core area must be clearly defined for the entire period of
support requested.

Center costs may include salary of core personnel, including the
Center Director, research expenses, and research resources shared
across Center projects such as statistical consultation, data storage
and analysis, and equipment.  Support may also be provided for
developmental studies within core areas that involve conceptualizing
services research problems and research approaches, establishing
relationships with service providing agencies and policymakers,
developing and refining research instruments, analyzing mental health
system data, and conducting exploratory and developmental research.
It is expected that these Center developmental activities will lead
to applications submitted to NIMH and other agencies by Center
investigators for independently funded services research projects
(e.g., R01s).

If a proposed Center is to be located in a university, research
institute, mental health agency, or other larger organization, the
prospective organizational, administrative, and managerial
relationships between the proposed Center and the host organization
must be addressed.  Each Center is expected to have an administrative
structure that will contribute to efficient operation, sound
financial practices, and effective use of available resources.

Center Organizational and Research Plan.  Each Center must describe
an overall organizational and research plan for the requested period
of support.  The organizational plan should describe the
administrative organization, including its relationship to the
applicant institution, and arrangements for planning, coordinating,
and evaluating the Center program.  Relationships with public mental
health systems and other entities (e.g., research institutes,
departments of psychiatry and behavioral science, State Mental Health
Authority, educational or correctional organizations) should be
described.  The applicant must submit (as an appendix to the
application) a letter of agreement signed by the responsible officer
of each associated organization, stating that cooperation, research
facilities, services, or other relevant assistance will be available
on a continuing basis.  Appropriate clearances from each associated
organization must be submitted that state that the proposed research
meets that institution's research review requirements (e.g.,
Institutional Review Board responsible for activities involving human
subjects).

The research part of the overall Center plan should include a section
that specifies and justifies the cohesive and parsimonious set of
research core areas that will be addressed by Center study teams, the
overall goals and objectives of the Center, the principal areas of
research to be emphasized in the Center, major theoretical and policy
orientations that will guide the Center, the disciplines to be
included, and the plans for coordination among the various research
activities of the Center.

Research Core Areas.  For purposes of this announcement, a research
core area is defined as an important area for services research
within which a Center plans to develop and conduct interrelated
research projects.  Since services research is inherently
interdisciplinary, projects within a core area should seek to
incorporate collaborative relationships among scholars representing
complementary disciplines.  Separate descriptions must be provided
for each major research core area, including summary descriptions of
exploratory and developmental research projects to be supported in
each core area and how these projects will relate to and support each
other.  These descriptions should cover the relevant literature and
existing knowledge; objectives and significance of the research;
research design; proposed study samples; research investigators and
estimated percentages of effort; budget; and timetable for project
implementation.

Budget.  Budgets for the Center core and for each research core area
should be presented in aggregate as well as separately.
Additionally, the applicant institution should indicate in specific
terms its cash and in-kind support for the Center.  In-kind support
should be significant and may include such items as administrative
support, equipment, and time contributions of institutionally
supported researchers and research assistants who will participate in
the Center.

Applicants from institutions that have another research center (e.g.,
a health services research center) may wish to identify this center
as a collaborator in the proposed plan of studies.  If so, a letter
of agreement from the program director or principal investigator
should be included with the application.

Although a Center should be involved in attracting new investigators
into the field of mental health services research, funds from the
Center may not be used to support training activities other than
those incidental to the conduct of specific research projects.
Centers may apply to NIMH for separate research training funds
available under the National Research Service Award Program of the
U.S. Public Health Service.

STUDY POPULATIONS

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN
SUBJECTS

It is the policy of the NIH that women and members of minority groups
and their subpopulations must be included in all NIH supported
biomedical and behavioral research projects involving human subjects,
unless a clear and compelling rationale and justification is provided
that inclusion is inappropriate with respect to the health of the
subjects or the purpose of the research.  This new policy results
from the NIH Revitalization Act of 1993 (Section 492B of Public Law
103-43) and supersedes and strengthens the previous policies
(Concerning the Inclusion of Women in Study Populations, and
Concerning the Inclusion of Minorities in Study Populations), which
have been in effect since 1990. The new policy contains some
provisions that are substantially different from the 1990 policies.

All investigators proposing research involving human subjects should
read the "NIH Guidelines For Inclusion of Women and Minorities as
Subjects in Clinical Research," which have been published in the
Federal Register of March 9, 1994 (FR 59 11146-11151) and reprinted
in the NIH Guide for Grants and Contracts, Volume 23, Number 11,
March 18, 1994.

Investigators also may obtain copies of the policy from the program
staff listed under INQUIRIES.  Program staff may also provide
additional relevant information concerning the policy.

APPLICATION PROCEDURES

Applicants are to use the research grant application form PHS 398
(rev. 9/91).  The number and title of this program announcement,
PAR-94-073, "Centers for Research on Services for People with Mental
Disorders," must be typed in item number 2a on the face page of the
PHS 398 application form.

Applications for a Center grant must include: (1) an overall
organizational and research plan, and (2) separate, more detailed
plans for the research core areas that are proposed as foci for
Center activity.  For purposes of the page limitations of sections 1
through 4 of PHS 398, the overall Center research plan and
organizational plan should be considered one component with a 25-page
limit.  A maximum of 25 additional pages may be used for each
research core area that the Center will address.

Application kits containing the necessary forms may be obtained from
office of sponsored research at most universities, colleges, medical
schools, and other major research facilities and from the Office of
Grants Information, Division of Research Grants, National Institutes
of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone
301/435-0714.

The signed original and five copies of the completed PHS 398 must be
sent to:

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

REVIEW CONSIDERATIONS

Applications will be reviewed for scientific and technical merit by
an NIMH initial review group (IRG) composed primarily of non-Federal
scientific experts.  A second level review will be made by the
National Advisory Mental Health Council; review by Council may be
based on policy considerations as well as scientific merit.  By law,
only applications recommended for consideration for funding by the
Council may be supported.  Summaries of IRG discussions are sent to
applicants as soon as possible following IRG review.

Review Criteria.  Criteria to be used in evaluating
scientific/technical merit of Center applications are:

o  Scientific and technical significance and originality of the
proposed research

o  Appropriateness and adequacy of the research approach and
methodology proposed to carry out the research

o  Qualifications and research experience of the principal
investigator and other key personnel

o  Availability of resources needed for the proposed research

o  Capability of the Center leadership, management systems, and
organizational structure to coordinate and carry out the proposed
program of research and research development

o  Representation on the Center staffing plan of the multiple
disciplines needed to conduct mental health services research, and
adequacy of arrangements to insure effective collaboration among
investigators from these disciplines

o  Linkages to major public and/or private mental health service
systems serving persons with mental disorders

o  Potential of the Center program to generate high quality proposals
for additional extramural research support

o  Appropriateness of the proposed budget and duration in relation to
the proposed research

o  Adequacy of the proposed means for protecting against or
minimizing adverse effects to human subjects

AWARD CRITERIA

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

Applications will be received and reviewed once a year according to
the following NIMH schedule:

Application Receipt Date:      October 1
Initial Review:                February/March
Advisory Council Review Date:  May/June
Earliest Start Date:           July 1

As part of the NIMH Public-Academic Liaison (PAL) initiative,
preference may be given to applications that involve active
collaborations between academic researchers and public sector
agencies in planning, undertaking, analyzing, and publishing research
pertaining to persons with severe mental disorders.  The PAL
initiative is based on the premise that important new advances in
understanding and treatment of severe mental disorders 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 disorders receive their care.

INQUIRIES

Written and telephone inquiries are encouraged.  The opportunity to
clarify any issues or questions from potential applicants is welcome.
Direct inquiries regarding programmatic issues to:

Thomas L. Lalley, M.A.
Division of Epidemiology and Services Research
National Institute of Mental Health
5600 Fishers Lane, Room 10C-06
Rockville, MD  20857
Telephone:  (301) 443-3364

Inquiries regarding rural mental health research may be directed to:

Charles D. Windle, Ph.D.
Office of Rural Mental Health Research
National Institute of Mental Health
5600 Fishers Lane, Room 10-104
Rockville, MD  20857
Telephone:  (301) 443-9001

For information on fiscal issues related to grant applications,
inquiries may be directed to:

Diana Trunnell
Grants Management Branch
National Institute of Mental Health
5600 Fishers Lane, Room 7C-15
Rockville, MD  20857
Telephone:  (301) 443-3065

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic
Assistance 93.242.  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).  Grants must be
administered in accordance with the PHS Grants Policy Statement (rev.
4/94).  Federal Regulations at 42 CFR Part 52 and 66, "Grants for
Research Projects" and 45 CFR Parts 74 and 92 concerning
administration of grants, are applicable to these awards. This
program is not subject to the intergovernmental review requirements
of Executive Order 12372, as implemented through DHHS regulations at
45 CFR Part 100, or Health Systems Agency review.

The Public Health Service strongly encourages all grant recipients to
provide a smoke-free workplace and promote the non-use of all tobacco
products.  This is consistent with the PHS mission to protect and
advance the physical and mental health of the American people.

.

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