Notice Number: NOT-MH-19-025

Key Dates
Release Date: April 23, 2019
First Available Due Date: June 5, 2019
Expiration Date: January 8, 2022

PAR-19-189

PAR-17-264

PAR-18-007

PA-19-056

PA-19-055

PA-18-350

PA-19-052

RFA-MH-18-700

RFA-MH-18-701

RFA-MH-18-706

Issued by
National Institute of Mental Health (NIMH)

Purpose

Care for suicide crises is often fragmented, with crisis services being provided by on-call therapists or in crowded emergency departments. As a result, some individuals at risk for suicide may fail to receive appropriate services and follow-up, leading to multiple re-admissions, involvement with the criminal justice system, or even a suicide death. Consistent with its efforts to prioritize applied suicide prevention research, NIMH is issuing this Notice to highlight its interest in receiving grant applications focused on applied research that advances the National Action Alliance for Suicide Prevention's Crisis Services Task Force efforts, summarized in the report, Crisis Now: Transforming Services is Within Our Reach. The report states that effective crisis care that saves lives requires a systematic approach, optimized when delivered with the following characteristics: Regional or statewide crisis call centers that use technology to support real-time coordination across a system of care; centrally deployed mobile crisis outreach and support on a 24/7 basis; and types of residential crisis stabilization programs for individuals who need support and observation. In addition to their therapeutic value for the individual in crisis, effective crisis systems that support individuals in suicide distress have been reported to be successful diversions for emergency care and incarceration.

Developing a further evidence-base for effective crisis systems may promote broader community stakeholder interest and implementation of these components of suicide prevention. This Notice specifically encourages applications that leverage time-sensitive opportunities and infrastructure, including collaborations with organizations, through the Substance Abuse and Mental Health Services Administration’s (SAMHSA) recently announced suicide prevention lifeline crisis center follow-up expansion grant program, FOA SM-19-008 Suicide Prevention Lifeline Crisis Center Follow-Up Expansion Grants. The Funding Opportunity Announcement (FOA) supports innovative approaches for the coordination, monitoring, and delivery of crisis services in which National Suicide Prevention Lifeline (NSPL) Crisis Centers would serve as a hub for effective deployment of mobile crisis services, ensuring timely and appropriate access to facility services (e.g., crisis stabilization, crisis respite, hospital/psychiatric hospitalization), and having a primary objective of never losing track of a person in a suicidal crisis as they interface with crisis systems. Among its requirements, FOA SM-19-008 requires grantees to establish a collaborative partnership with local law enforcement for the purpose of diverting individuals with mental health crises from criminal justice settings into mental health treatment settings; and educating law enforcement officers about mental illness and strategies for effectively responding to individuals in crisis.

SAMHSA’s anticipated investment in suicide crisis care approaches offer research opportunities for the field to leverage the infrastructure provided by these grants. Specifically, NIMH applicants should consider potential temporal and functional synergies that could be gained from combined SAMHSA and NIMH funding. However, these topics are also of interest to NIMH where suicide crisis management infrastructure is being developed in communities that do not receive SAMHSA grant funding through FOA SM-19-008. Examples of NIMH studies that are encouraged through this Notice include, but are not limited to those that:

• design and test strategies for optimizing the interface (communication; suicide crisis management chain of care) between crisis centers and other entities where individuals in crisis may be identified (schools, colleges, healthcare, social service agencies) and those that engage in in-person response and transportation (e.g., police and community corrections, fire departments and other first-responders)
• test strategies to promote engagement and continuity of care during known periods of heightened risk, such as care transfers between systems (e.g., handoffs between law enforcement and emergency departments; inpatient psychiatric or substance abuse treatment and outpatient care)
• develop and test clinical decision support tools that can be used to facilitate matching individuals to the appropriate intervention (e.g., in terms of type, intensity, and duration) depending on level of suicide risk
• test inpatient care practices and peer supported respite care for acute reduction of risk, as well as benefits for initiating interventions for more sustained risk reduction
• assess the value of specific crisis services in the context of alternatives to promote implementation of high value services and de-implementation of low value services.
• test mobile technology enhancements for crisis and continuity of care interventions (e.g., cell phone apps and/ or other telephonic monitoring and brief therapy)
• determine the cumulative benefit of implementing multiple components of service delivery considered beneficial in suicide prevention (e.g., continuity of care; community collaboration for safe storage of lethal means; coordination with community crisis response)
• as a component of quality improvement, test specific strategies for training emergency response teams, law enforcement, and crisis providers to initial competency and for encouraging sustained fidelity in the use of research supported assessment and interventions.
• test strategies to optimize the implementation of crisis services in community practice settings.
• utilize analytic frameworks (e.g., RE-AIM) in sufficiently powered studies to measure population health and implementation-oriented outcomes that are relevant to decision makers.
• develop, validate, and refine models (e.g., LOCUS) for determining the optimal level of care across the care continuum (e.g., county-level, state-level, healthcare system-level) for persons with SMI who are also in need of crisis services.

Application and Submission Information:

For funding consideration, applicants must include "NOT-MH-19-025" (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

All requirements of the relevant FOA would need to be followed in any application (and award) that proposes to develop and conduct a study on one of these high priority areas. Possible funding opportunities that can be used to pursue these and other research activities include the following FOAs and any re-issuances of these FOAs through the expiration date of this notice :

Please note that investigators interested in pursuing clinical trial research should review the NIMH Clinical Trials Funding Opportunity Announcements website: http://www.nimh.nih.gov/funding/opportunities-announcements/clinical-trials-foas/index.shtml.

Applicants considering such an application are strongly encouraged to consult with NIMH Program Officials prior to submission.

Applications non-responsive to terms of this NOSI will be not be considered for this initiative.

Inquiries

Please direct all inquiries to:

Intervention Research & SBIR/ STTR Research

Adam Haim, Ph.D.
Telephone: 301-435-3593
Email: [email protected]

Services Research

Michael Freed, Ph.D.
Telephone: 301-443-3747
Email: [email protected]

Mental Health, Suicide and Criminal Justice Research

Denise Juliano-Bult, MSW
Telephone: 301-443-1638
Email: [email protected]