Key Dates

Related Announcements

PAR-21-132 – Confirmatory Efficacy Clinical Trials of Non-Pharmacological Interventions for Mental Disorders (R01- Clinical Trial Required)

PAR-21-131 – Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions (R34 -Clinical Trial Required)

PAR-21-129 – Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (Collaborative R01)

PAR-21-130 – Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (R01 Clinical Trial Required)

PAR-19-189 – Pilot Services Research Grants Not Involving Clinical Trials

RFA-MH-21-110 – Service-Ready Tools for Identification, Prevention, and Treatment of Individuals at Risk for Suicide (R01 Clinical Trial Optional)

RFA-MH-21-111 – Service-Ready Tools for Identification, Prevention, and Treatment of Individuals at Risk for Suicide (R34 Clinical Trial Optional)

RFA-MH-21-112 – Service-Ready Tools for Identification, Prevention, and Treatment of Individuals at Risk for Suicide (R43/44 Clinical Trial Optional)

PA-21-110 – Pilot and Feasibility Studies in Preparation for Substance Use Prevention Trials (R34 Clinical Trial Optional)

PAR-21-023 – Multi-Site Studies for System-Level Implementation of Substance Use Prevention and Treatment Services (R34 Clinical Trial Optional)

PA-20-183 – Research Project Grant (Parent R01 Clinical Trial Required)

PA-20-185 – NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

PAR-21-022 – Multi-Site Studies for System-Level Implementation of Substance Use Prevention and Treatment Services (R01 Clinical Trial Optional)

PAR-20-238 – Intervention Research to Improve Native American Health (R01 Clinical Trial Optional

PAR-20-180 – Identifying Innovative Mechanisms or Interventions that Target Multimorbidity and Its Consequences (R01 Clinical Trial Optional)

PAR-20-214 – Research to Improve Native American Health (R21 Clinical Trials Optional)

PA-20-195 – NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed

Issued by

National Institute of Mental Health (NIMH)

National Institute on Drug Abuse (NIDA)

Purpose

Purpose

The purpose of this Notice of Special Interest (NOSI) is to encourage research focused on detection and intervention to prevent or treat mental health concerns, symptoms or disorders including drug-related conditions among unemployed and underemployed people participating in employment programs and job training settings (referred to here as “employment service customers” or “customers”). Considering the COVID-19 pandemic, the sharp rise and potentially long duration of unemployment raises concerns about the development and worsening of mental health symptoms and disorders, drug use behaviors, and suicide risk and necessitates further research to confirm the efficacy or demonstrate effectiveness of strategies in this area.

Background

Previous research demonstrates that unemployment is a risk factor for psychological distress, mental health concerns, drug use problems, and suicide. While the conditions that lead to unemployment may differ (small business closing vs. dislocated worker status) and the dynamics contributing to risk are complex, it is imperative to identify settings where unemployed individuals can be screened for mental health and substance use concerns and engaged in prevention efforts and treatment as needed. Employment and training settings (e.g., training/retraining programs, job search support programs, etc.) provide such venues. Individuals utilizing these services are often negatively impacted by unidentified and/or undertreated mental health issues, which can lead to worsening of symptoms and creates greater challenges to seeking and securing work. This in turn impacts functioning, creates further barriers to treatment seeking, and contributes to persistent hardship, as there is evidence unemployment has a causal effect on mental health symptoms and problematic substance use. Addressing the mental health and substance use of unemployed and underemployed individuals is even more pressing given the detrimental impact that COVID-19 and associated policies to contain its spread have had on the economy, the effects of which are estimated to persist for the next several years.

The population of individuals receiving services through employment and training settings is diverse, reflected by, but not limited to, programming and partnerships for opportunity youth ( young people ages 16-24 who are disconnected from school and work), dislocated workers, individuals with limited education or limited English proficiency, older adults, people living in economically depressed areas and/or rural communities, American Indian/Alaska Natives, Veterans, farmworkers, recipients of the Supplemental Nutritional Assistance Program (SNAP), and recipients of Temporary Assistance for Needy Families (TANF). While Vocational Rehabilitation is a core program of the Department of Labor one-stop system, additional provision of behavioral health programming in employment and training programs could lead to greater near-term (e.g., behavioral health treatment engagement, mental health symptom reduction, increased job-seeking behavior, decreases in problematic substance use and/or associated risks for use) and long-term (e.g., sustained employment, improved health care coverage, sustained remission of mental health symptoms, permanent housing, etc.) goal attainment.

NIMH and NIDA encourage approaches that account for the heterogeneity of co-morbid and contributing circumstances (e.g., substance use, trauma history, homelessness, childcare needs and responsibilities, food insecurity, lack of access to adequate healthcare, length of unemployment, criminal record) that impact both the behavioral health and job readiness of those seeking employment opportunities. Therefore, research is needed to adapt and test approaches to meet the range of basic needs and behavioral health needs typically experienced by employment service customers. A focus on the population accessing services through public and non-profit employment and training centers offers a unique opportunity to reach many individuals suffering from mental health and substance use concerns who experience barriers to engaging with traditional health care systems.

Given the general lack of a healthcare presence in employment and training settings, it is important to consider tailored approaches to address mental health symptomology, substance use, and suicide risk that can be feasibly delivered in the setting, are compatible with the daily workflow, and match customer, staff, and organizational preferences and capacity. Depending on the capacity within the setting, components might include low-burden approaches to screening/risk detection, strategies to promote referral and connection with behavioral health treatment/services, scalable preventive or therapeutic interventions, and complementary social services. NIMH and NIDA encourage studies that test intervention and service delivery strategies that incorporate features that are specifically designed to enhance scalability and sustained implementation, including but are not limited to: consumer-facing technology (e.g., self-administered content) and provider-facing technology (e.g., technology to support staff training and sustained implementation fidelity); expert consultation via existing resources or other sustainable means (e.g., telehealth); or other robust design features that promote scalability and sustained implementation fidelity.

NIMH Research Priorities

NIMH encourages research that addresses Institute priorities and is aligned with the recommended areas outlined below. Appropriate topics include, but are not limited to:

Intervention and Services Research

For research to confirm the efficacy or establish the effectiveness of interventions or services, NIMH supports studies that employ an experimental therapeutics approach, whereby clinical trials are designed not only to test the intervention effects on outcomes of interest, but also to inform understanding of the intervention’s mechanisms of action. As such, applications that propose to develop and/or test the efficacy/effectiveness of preventive, therapeutic, or services interventions must include specification of the intervention target(s)/mechanism(s) and assessment of intervention-induced changes in the presumed target mechanism(s) that are hypothesized to account for the intervention outcome. In the case of services interventions, targets/mechanisms might involve mutable consumer- or provider-behaviors, or organizational-/system-level factors that are intervened upon in order to improve access, continuity, quality, equity, and/or value of services. Studies adapting existing preventive, therapeutic, or services interventions to specifically target customers in employment and training settings should provide a justification for the unique targets to be tested. Research generating new information about factors causing/reducing disparities in outcomes is strongly encouraged as it may inform other intervention areas. See the Support for Clinical Trials at NIMH web page for additional information regarding dedicated Funding Opportunity Announcements (FOAs) for NIMH clinical trials research support.

Preventive Interventions

• Studies examining the effectiveness of preventive interventions tailored for delivery in employment and training settings in reducing risk for mental health (e.g., depression, anxiety, and suicide) and co-occurring substance use disorders
• Preventive intervention research tailored for delivery in employment and training settings that addresses mental health disparities (e.g., racial/ethnic, rural, underserved, sexual and gender minority (SGM) populations)
• Preventive studies for customers in employment and training settings that examine questions of what works best, for whom, and under what condition

Treatment Interventions

• Studies that optimize and test scalable, first-line, low-intensity interventions that can be feasibly offered in these settings, including technology-assisted approaches
• Effectiveness research that tests stepped-care approaches tailored for customers in employment and training settings that feature lower intensity/lower risk evidence-based treatments as first-line interventions, with decisions regarding treatment completion, maintenance therapy, or step-up to more intensive care based on objective measures of treatment response

Services Interventions

• Research focused on low-burden approaches for screening, risk detection, and referral that increase engagement/connection with needed mental health treatment/services
• Research to develop and test the effectiveness of models in which delivery of mental health services and supports incorporate front-line staff of employment and training settings

NIDA Research Priorities

Substance use is a preventable cause of numerous medical and societal problems, and often co-occurs with other behavioral health conditions. There has been significant progress leading to the identification of modifiable risk and protective factors, as well as effective strategies to prevent substance use and substance use disorders, but challenges remain. Evidence based interventions may not be broadly adapted and sustained, resulting in individuals who are at-risk or experiencing substance use disorders not receiving appropriate services.

Unemployment may be a risk factor for and/or a consequence of substance use. In response to this NOSI, NIDA encourages research that addresses Institute priorities. Possible research areas include, but are not limited to:

• Studies to develop and test substance misuse prevention approaches in the context of employment training and support systems. Investigators are encouraged to consider multi-level prevention programs that include structural and individual level interventions and examine the mechanism by which interventions exert their impact on substance use risk and behaviors
• Preventive intervention research with groups who may be underemployed or out of the labor force as a result of stigma based on race, ethnicity, sexual orientation/identity or criminal record in reducing substance use risk, disorders, and consequences, and treatment gaps
• Research occurring within communities where economic or other broader factors have affected employment opportunities, including urban, rural/agricultural, and remote settings affected by industry changes, layoffs, or downsizing
• Services research that develops and tests strategies to implement and sustain, evidence-based prevention interventions in employment and training related settings
• Research focused on low-burden approaches for screening, risk detection, and referral that increase engagement/connection with needed substance use treatment services
• Research to develop and test the effectiveness of models in which delivery of substance use treatment services and supports incorporate front-line staff of employment and training settings
• Research focused on peer or social supports to enhance engagement with substance use treatment services
• Studies that optimize, implement, or test scalable, low-intensity interventions that can be feasibly offered in these settings, including technology-assisted approaches

Research involving efforts to provide education only about substance use risks to individuals engaged in employment programs and job training settings are not of interest to NIDA. Of interest would be interventions targeting mechanisms that place individuals at risk for substance use. Researchers are encouraged to include validated behavioral, health, or service-related outcomes whenever possible. Investigators are strongly encouraged to consider the public or private organizations or systems that may, ultimately, support and sustain the intervention, developing interventions that are feasible for the setting and, where appropriate, in partnership with stakeholders and/or ‘end users.’ The system(s) that will ultimately support this intervention should be considered at all phases of intervention development to avoid the development of interventions that are not sustainable outside of research settings or without research funds.

Application and Submission Information

This notice applies to due dates on or after June 15, 2021 and subsequent receipt dates through September 8, 2023. 

Submit applications for this initiative using one of the following funding opportunity announcements (FOAs) or any reissues of these announcement through the expiration date of this notice:

• PAR-21-132 – Confirmatory Efficacy Clinical Trials of Non-Pharmacological Interventions for Mental Disorders (R01- Clinical Trial Required)
• PAR-21-131 – Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions (R34 -Clinical Trial Required)
• PAR-21-129 – Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (Collaborative R01)
• PAR-21-130 – Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (R01 Clinical Trial Required)
• PAR-19-189 – Pilot Services Research Grants Not Involving Clinical Trials
• RFA-MH-21-110 – Service-Ready Tools for Identification, Prevention, and Treatment of Individuals at Risk for Suicide (R01 Clinical Trial Optional)
• RFA-MH-21-111 – Service-Ready Tools for Identification, Prevention, and Treatment of Individuals at Risk for Suicide (R34 Clinical Trial Optional)
• RFA-MH-21-112 – Service-Ready Tools for Identification, Prevention, and Treatment of Individuals at Risk for Suicide (R43/44 Clinical Trial Optional)
• PA-21-110 – Pilot and Feasibility Studies in Preparation for Substance Use Prevention Trials (R34 Clinical Trial Optional)
• PAR-21-023 – Multi-Site Studies for System-Level Implementation of Substance Use Prevention and Treatment Services (R34 Clinical Trial Optional)
• PA-20-183 – Research Project Grant (Parent R01 Clinical Trial Required)
• PA-20-185 – NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)
• PAR-21-022 – Multi-Site Studies for System-Level Implementation of Substance Use Prevention and Treatment Services (R01 Clinical Trial Optional)
• PAR-20-238 – Intervention Research to Improve Native American Health (R01 Clinical Trial Optional
• PAR-20-180 – Identifying Innovative Mechanisms or Interventions that Target Multimorbidity and Its Consequences (R01 Clinical Trial Optional)
• PAR-20-214 – Research to Improve Native American Health (R21 Clinical Trials Optional)
• PA-20-195 – NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed

All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:

• For funding consideration, applicants must include “NOT-MH-21-230” (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.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.

Inquiries

Scientific/Research Contact(s)

Stephen O'Connor, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-480-8366
Email: stephen.o'connor2@nih.gov

Amy B. Goldstein, Ph.D.
National Institute on Drug Abuse (NIDA)
Telephone: 301-827-4124
Email: amy.goldstein@nih.gov