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Issued by

National Institute of Mental Health (NIMH)

Purpose

This Request for Information (RFI) seeks input on how the National Institute of Mental Health (NIMH) might learn about and remedy research gaps in knowledge to address mental health disparities in rural people and communities.

Background

The NIMH Office for Disparities Research and Workforce Diversity, as well as the Office of Rural Mental Health Research, promotes innovative research that can address mental health issues facing rural residents and communities.

Mental health conditions affect individuals of all ages and can place significant burdens on patients, families, and communities. The prevalence of serious mental illness and most psychiatric disorders is comparable between US adults living in rural and metropolitan areas. However, adults and children residing in rural locations do not receive mental health treatment as frequently as adults and children in metropolitan areas. Rural providers tend to have less specialized training compared to providers in metropolitan areas. The reasons for underlying disparities in mental health treatment for rural populations are well documented and include limited availability of specialty mental health care, the lack of trained mental health providers and coordinated care, and the underutilization of available services. NIMH is committed to identifying critical research needs and to funding innovative studies focusing on reducing disparities in rural and frontier communities. This RFI seeks information from researchers and providers as well as affected patients, families, community members, and other concerned stakeholders.

Information Requested

This RFI invites comments and suggestions on any or all of the following research topics and how they might reduce or eliminate mental health disparities in rural places. Comments may include, but are not limited to the bulleted topics below. When appropriate, please also include hyperlinks to pertinent references, databases, or other online resources.

• Identifying the gap areas that can be addressed through research.
• Endorsing specific research topics and questions.
• Proposing new avenues to address with research.
• Novel hypotheses on any of the questions, as well as specific suggestions for approaches to answering any of the questions.
• In addition, exploring how the research topics might intersect with and impact diverse populations, to include for example race and ethnicity, culture (including mountain and frontier), immigration status, and sexual and gender minorities, as well as additional challenges faced by rural residents.

Research needs for improving access to and use of effective treatment and prevention services in rural communities

Your response may touch upon such topics as:

• Research to increase the impact and use of telehealth and telepsychiatry, and integrated care models (e.g., collaborative care) to serve individuals in rural communities.
• Research that would increase the use of effective, evidence-based interventions for sustainable mental health and substance use prevention and treatment, as well as effective screening and referral procedures for mental, developmental, and substance problems in rural healthcare settings.
• Research to increase the number of mental health care providers in rural areas, as well as improve access to culturally and contextually competent care.
• Research to improve prevention and treatment services of rural children, who experience high rates of mental, behavioral, and developmental symptoms.

Research needs for addressing mental health within the context of other health problems as well as social determinants of health within the rural context

Examples of specific comments include, but are not limited to:

• Research to reduce the higher disability rate related to mental health diagnosis found in rural areas.
• Research approaches to explain the nature of the relationship between social determinants of health, mental health, and substance misuse, especially in terms of suicide and overdose, in rural places and yield likely points for intervention.
• Research approaches to determine the causal inter-relationships between rural culture, mental health, and substance use (e.g., alcohol, tobacco) and misuse.
• Research to address the mental health needs of minority groups (e.g., African American, American Indian) living in rural communities.
• Specific needs for research on mental health education and communication strategies in rural areas, and how might the diversity present in rural places affect this need.

Measurement, methodology, approach, and analytic strategies that would boost progress in rurally oriented research

Examples of specific comments include, but are not limited to:

• How firearm injury and mortality research focused on suicide prevention can best be conducted in rural communities.
• Research approaches to show how to promote individual, family, community, and cultural resiliency among rural and frontier people and communities including people of color.
• Research approaches to address stigma as a barrier to seeking behavioral health services to improve treatment outcomes for patients in rural communities.
• Strategies to empower and inspire the research community to conduct innovative research that is methodologically well-suited for rural settings and likely to yield interventions that would be adopted.

How to Submit a Response

Responses to this RFI may be submitted via email to [email protected] or on the submission website by April 15, 2021. Please include the Notice number, "NOT-MH-21-190", in the subject line. Response to this RFI is voluntary. Responders are free to address any or all the categories listed above and/or to provide feedback on any relevant issues. The submitted information will be reviewed by NIH staff.

This request 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 NIH does not intend to make any awards based on responses to this RFI or to otherwise pay for the preparation of any information submitted or for the Government's use of such information.

The NIH will use the information submitted in response to this RFI at its discretion and will not provide comments to any responder's submission. However, responses to the RFI may be reflected in future funding opportunity announcements. The information provided will be analyzed and may be aggregated in presentations and reports. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).

Inquiries

Please direct all inquiries to:

Dawn Morales, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-827-9668
Email: [email protected]