Increasing Engagement in Treatment for Behavioral Health

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Topic Description

Post Date: July 8, 2026

Expiration Date: July 8, 2028

Purpose:

This topic focuses on increasing engagement with different forms of treatment among individuals with diagnoses for which there exist significant treatment gaps, with specific focus on psychiatric disorders. The lack of treatment for these common disorders leads to an overwhelming and preventable burden to individuals, families, and communities.

Background:

Psychiatric disorders are common, ranging from one to 20% of the U.S. population, depending on the diagnosis. Despite the frequency with which these disorders occur, the majority of individuals who have them do not receive specific treatment for these conditions, which leads to worse prognosis and increased drain on individuals and societies. At the same time, evidence-based care exists for these disorders, although significant barriers abound, including but not limited to lack of insurance coverage, limited provider availability, and low demand. Reducing this treatment gap requires innovative approaches, which include increased outreach to patients, higher quality care, design and adaptation of treatments to meet people where they are, and improved access to treatment.

While not true of all psychiatric disorders, many begin with mild or moderate symptoms, progressing to severe forms of disease in the absence of treatment. Alcohol use disorder (AUD) is a particular example of this phenomenon, impacting approximately 10% of U.S. adults, while fewer than 20% receive specific treatment for the condition. Over time, untreated severe AUD is associated with high rates of morbidity and mortality, despite multiple possible points of intervention over the course of the illness. Other psychiatric disorders often have lengthy prodromal phases, e.g., schizophrenia, before acute onset. This period offers an opportunity to engage high risk individuals in preventive treatment, to reduce the risk of transition to severe disease.

Finally, while increasing rates of initial treatment engagement is critically important, equally vital is increasing rates of sustained treatment engagement. Dropout rates of treatment for severe, chronic mental illness are often high, leading to worsened prognosis, higher rates of complication, and relapse, potentially to more treatment-resistant forms of the disease. Thus, approaches to treatment engagement must also consider how best to engage individuals in care, but how to keep them in care, when doing so is clinically indicated.

Participating ICOs

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Relevant research approaches under this topic include studies focused on:

  • Qualitative research with healthcare professionals and individuals along the spectrum of alcohol misuse to identify best practices for treatment engagement.
  • Education for healthcare providers across disciplines on the importance of engaging people in some form of treatment.
  • Design and testing of strategies specifically created to improve rates of engagement in professionally led evidence-based treatment for AUD.
  • Screening, brief intervention, and referral to treatment for AUD within settings focused broadly on mental health, not specific to AUD, e.g., community mental health centers, inpatient psychiatric facilities.
  • Efficacy and effectiveness studies on the impact of digital interventions, either standalone or integrated with other behavioral healthcare, on alcohol-related outcomes.
  • Dissemination of effective and developmentally informed AUD treatment and hazardous drinking prevention in real world contexts.
ICO Scientific Contact:
Laura Kwako, Ph.D.
[email protected]

National Center for Complementary and Integrative Health (NCCIH)

NCCIH supports research on integrating complementary and integrative health (CIH) approaches into primary care to manage mild or moderate symptoms of psychiatric conditions (e.g., mild depression, anxiety, smoking, impaired sleep), with appropriate referral pathways or self-care strategies. CIH approaches include natural products (e.g., dietary supplements, botanicals, probiotics) and mind–body interventions (e.g., meditation, yoga, hypnosis, acupuncture, art/music therapies).

Priorities include:

  • Testing CIH approaches in primary care to support treatment, referral, and self-care of psychiatric conditions.
  • Testing whether CIH approaches may enhance engagement in standard behavioral health treatment for psychiatric conditions.
  • Evaluating impact of CIH interventions on individuals, families, and communities for prevention or reduction of disease burden.
IC may give special consideration to support meritorious applications in this topic area.
ICO Scientific Contact:
Lanay Mudd, PhD
[email protected]

National Institute on Drug Abuse (NIDA)

Relevant research approaches under this topic include studies focused on:

  • Implementation-effectiveness studies of integrated care models for mental health, substance use disorders, and related comorbidities across the lifespan. 
  • Longitudinal research to clarify long-term outcomes for people with co-occurring mental health and substance use disorders, including polysubstance use, recovery, prevention, and quality of life. 
  • Engaging youth and emerging adults with trauma or violence exposure, and those in high-risk groups such as child welfare or juvenile justice, in effective interventions. 
  • AI- and health technology-based approaches, including telehealth and mobile health, especially for rural and underserved populations, as well as studies of patient engagement and of training and supervision models for clinicians delivering telehealth care.
ICO Scientific Contact:
Sean Lynch, PhD, LCSW
[email protected]

Office of Behavioral and Social Sciences Research (OBSSR)

OBSSR is interested in behavioral and social science aspects of increasing engagement with different forms of treatment among individuals with diagnoses for which there exist significant treatment gaps, with specific focus on psychiatric disorders.

This office does not award grants. Applications must be relevant to the objectives of at least one of the participating Institutes or Centers listed in this topic.
Tribal Health Research Office (THRO)
This office does not award grants. Applications must be relevant to the objectives of at least one of the participating Institutes or Centers listed in this topic.
ICO Scientific Contact:
Sheila Caldwell, PhD
[email protected]

Christopher Barnhart, PhD
[email protected]

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