Notice Number: NOT-MH-12-017
Key Dates
Release Date: February 17, 2012
Response Date: April 27, 2012
Issued by
National Institute of Mental Health (NIMH)
National Institute on Drug Abuse (NIDA)
National Institute of Alcohol Abuse and Alcoholism (NIAAA)
Purpose
The National Institute of Mental Health (NIMH), National Institute on Drug Abuse (NIDA), and National Institute on Alcohol Abuse and Alcoholism (NIAAA) are seeking input to identify the types of research tools needed to support rapid advancement in suicide prevention research. Specifically, this request asks interested parties to provide input on the following topics: a) the key methodological roadblocks that currently exist in suicide prevention research, and b) new paradigms and theoretical models with the potential to spark innovative research. A methodological roadblock is defined as a critical, unresolved challenge that is clearly limiting progress along an important suicide prevention research pathway. New research paradigms and theoretical models are novel ways of thinking about suicidal behavior and avenues for its prevention.
This Request for Information (RFI) is issued as an invitation to interested parties to contribute these specific methodological challenges and new conceptual paradigms for inclusion in a compendium of ways to facilitate suicide prevention research progress.
Although some progress has been made in understanding suicide risk factors and in developing suicide prevention interventions, major advancement in the field as a whole continues to be hampered by conceptual, methodological, logistical and ethical challenges. NIMH, NIDA, and NIAAA seek input on specific methodological roadblocks and nominations of new theoretical models and/or paradigms in order to advance the science of suicide prevention. The Institutes invite ideas from researchers working in diverse disciplines, including suicide prevention and related disciplines, such as: affective disorders, alcohol and drug abuse, and other mental illnesses; clinical trials; clinical epidemiology; biostatistics; preventive medicine; primary care; emergency medicine; pain management; geriatric psychiatry and other clinical disciplines where large numbers of suicidal individuals are found. Input from researchers who have developed methodologies or models for other external causes of death (e.g., homicides, accidents) and other major public health problems (e.g., tobacco cessation; HIV prevention) are also encouraged to submit promising approaches. In addition, the Institutes seek input from mental health professionals, suicide prevention and patient and family advocates, individuals who have survived a suicide attempt, private and public mental health care providers and administrators, the pharmaceutical and biotechnology industry and other interested groups or individuals.
Background
The National Strategy for Suicide Prevention (NSSP http://www.sprc.org/library/nssp.pdf ) called for establishing a public-private partnership to help guide the implementation of the goals and objectives in the NSSP. The National Action Alliance for Suicide Prevention (NAASP) is a part of that partnership. It has a vision that the US should be “a nation free from the tragic experience of suicide” (http://actionallianceforsuicideprevention.org/?page_id=5). The NAASP currently has 13 task forces working on important issues in suicide prevention. NIMH, NIDA, and NIAAA, as collaborators in the NAASP Research Task Force Effort, are working to develop a research agenda that has the potential to reduce morbidity (attempts) and mortality (deaths) each, by at least 20% in 5 years, and 40% or greater in 10 years if implemented successfully. Suicide prevention continues to be a major focus of NIMH, NIDA, and NIAAA, due to the frequent co-occurrence of alcohol and other substance abuse problems and mental disorders among individuals who engage in suicidal behaviors.
An important step forward in understanding suicide prevention research challenges was the Institute of Medicine (IOM) 2002 report, “Reducing Suicide: A National Imperative,” (http://www.nap.edu/openbook.php?isbn=0309083214) which identified a number of critical research gaps, methodological challenges, and research infrastructure needs. The report also identified opportunities for collaborations among state and federal entities, and professional health care organizations to improve prevention and treatment efforts. High on the list of unresolved methodological challenges, for instance, are issues surrounding the relative rarity of suicide as an outcome event. Other challenges include a lack of screening tools with predictive validity for use in linking appropriate patients to effective interventions. Among other limitations, these challenges prevented the Agency for Healthcare Research and Quality’s US Preventive Services Task Force from recommending routine suicide screening by primary care physicians (http://www.uspreventiveservicestaskforce.org/3rduspstf/suicide/suiciderr.htm). In clinical trials research informed strategies for: identifying individuals at increased near term risk of suicide; and guiding decisions about the mediator and moderator variables to be routinely included in analytic models, are lacking. At the population level, studies are limited by a lack of research to inform selection of comparator (control) conditions or sites. The field needs more innovative models that address multiple levels (e.g., individual, immediate social context, community) of risk and protection, and provide evaluation of the interplay between biological and environmental contributions to suicidal behavior. Animal models are scarce and under-developed, and laboratory paradigms for use with human subjects are only now beginning to appear. Such focused, scientific efforts are essential to support a suicide prevention research agenda and infrastructure capable of generating empirically-validated approaches that can successfully reduce the frequency of suicide and nonfatal suicidal behavior.
Although investment in suicide prevention research has increased since 2002, it has not expanded to the degree recommended by the IOM. Given challenging budget times, federal funding for suicide research will need to be more strategic and prioritized than ever before. This RFI offers an opportunity for the research community to identify and prioritize the critical “bottlenecks” that impede progress, to suggest solutions to one or more significant problems, and to nominate new paradigms for approaching this work.
For these reasons, NIMH, NIDA, and NIAAA seek the perspectives of multiple stakeholders to ensure that the most critical methodological questions are being addressed and the most promising innovative approaches are supported. NIH-supported research is improved when it is informed by broad scientific and public input. In keeping with a major theme in the NIMH’s National Advisory Mental Health Council Workgroup Report titled: The Road Ahead: Research Partnerships to Transform Services, NIH seeks the perspectives of all those interested in suicide prevention to ensure that the right questions are being addressed and that cutting edge theories are pursued.
Request for Information
The NIMH, NIDA, and NIAAA solicit input from any and all organizations and individuals interested in significant methodological and conceptual issues inherent in suicide prevention research. To adequately identify a methodological roadblock, a description of the type of research in which the roadblock exists and conceptualization of the research pathway and goal being hindered by the roadblock may need to be outlined in the response, in addition to the description of the roadblock itself. In describing a new paradigm, the context to which it is to be applied may likewise need to be described.
Provide a response no more than 1000 words (approximately 2 pages in length), including, if possible, a one-sentence description for each submitted Paradigm Innovation or Methodological Roadblock.
- For Candidate Paradigms:
Example of one-sentence description: A Theoretical Model of Person-Environment Interactions that Elicit and Mitigate Suicidal Behavior.”
Your response can include, but need not be limited to, information about:
- Important scientific goals that would benefit from the proposed paradigm.
- How the proposed paradigm would facilitate movement toward achieving the research goal.
- The research processes needed to develop the proposed paradigm.
- Sources of information that help illustrate the importance of the paradigm (e.g., scientific citations, public records, individual research projects, private/insurer databases, etc.).
- For Methodology Roadblocks:
Example of one-sentence description: “Validating Proxy Outcomes for Use in Rare Events Research.”
Your response can include, but need not be limited to, information about:
- Important scientific goals hampered by the methodological roadblock.
- How solving the methodological roadblock would facilitate substantial movement toward achieving the research goal.
- Research processes that may be needed to solve the methodological roadblock challenge.
- Sources of information showing the significance of the blocked research goal and/or the importance of the roadblock, if available (e.g., scientific citations, records, research projects, databases).
Confidentiality
Responses to this RFI are voluntary. Results will be shared internally with scientific working groups convened by the NIH and the National Action Alliance for Suicide Prevention, as appropriate. Proprietary, classified, confidential, or sensitive information should not be included in your response. The Government reserves the right to use any non-proprietary technical information in summaries of the state of the science, and any resultant solicitation(s). The NIH may use the information gathered to develop grant, contract, or other funding priorities and initiatives.
This RFI is for information and planning purposes only and should not be construed as a solicitation or as an obligation on the part of the Federal Government, the National Institutes of Health (NIH), or individual NIH Institutes and Centers. The NIH does not intend to make any awards based on responses to this RFI or pay for the preparation of any information submitted or for the Government's use of such information.
How to Submit a Response
Responses will be accepted through April 27, 2012. All comments must be submitted electronically to [email protected] . You will receive an electronic confirmation acknowledging receipt of your response, but will not receive individualized feedback on any suggestions.
Inquiries
Specific questions about this RFI should be directed to:
Attention: RFI on Suicide Prevention
National Institute of Mental Health
6001 Executive Boulevard, Room 7136 MSC 9635
Bethesda, MD 20892-9635
Email: [email protected]
and Human Services (HHS)
