March 25, 2024
National Institute of Mental Health (NIMH)
The National Institute of Mental Health (NIMH) is issuing this Notice of Special Interest (NOSI) to outline priorities for school-based intervention and services research. This NOSI encourages applications that incorporate: (1) end-user/community-engaged approaches with systematic attention to challenges related to gaining access to schools, competing demands/workload issues, workforce shortages, and privacy concerns; (2) research-practice partnerships that leverage existing practice infrastructure (e.g., Project AWARE [Advancing Wellness and Resiliency in Education],Certified Community Behavioral Health Clinics [CCBHCs]); (3) plans to quantify the resources necessary to implement the intervention, tool, or strategy (e.g., provider qualifications, training and supervision requirements, provider administration/delivery time and burden); and (4) strategies that promote health equity.
Consistent with tiered frameworks of intervention delivery in school settings, applications may investigate: (1) mental health promotion (universal or primary prevention) for all students with the direct objective of reducing risk for mental health disorders; (2) mental health prevention (secondary or selective prevention) for a subgroup of students at greater risk for mental health disorders (e.g., due to preexisting vulnerability factors or symptoms) in order to reduce risk; and (3) mental health intervention (indicated or tertiary prevention) for individual students with mental health disorders in order to decrease symptom severity, impairment, and related sequalae. Applications may also propose to study interventions, services, and tools that traverse these levels (e.g., validating and testing approaches for identifying students with or at risk for mental health problems; strategies for facilitating referral and engagement in mental health specialty services, as appropriate; developing and testing strategies to promote the adoption and sustained implementation of research-supported interventions in school-based settings). Representing the range of mental health service delivery models in school and afterschool program settings, interventions and services may be provided by existing school personnel, contracted school personnel, and/or outside providers.
Background
As many as one in eleven children and adolescents in the United States are diagnosed with a mental health disorder, yet only a fraction of these youth ever receive treatment. Unmet treatment need for child and adolescent mental health problems is often greatest among populations with health disparities. These trends were exacerbated during the COVID-19 pandemic, leading the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Childrens Hospital Association to declare a national emergency, while the Office of the U.S. Surgeon General issued an advisory statement on youth mental health.
In 2022, the federal government invested one billion dollars over five years for school-based initiatives to address the escalation of youth mental health problems during COVID-19, including growing the mental health workforce through innovative partnerships to prepare qualified school-based mental health service providers for employment in schools, and increasing access to evidence-based and culturally relevant mental health services. In early 2024, the Centers for Medicare & Medicaid Services (CMS) announced an additional 50 million dollars in planning grants to support the development, implementation, and expansion of school-based health services, with a concentration on mental health services. Taken together, these federal investments demonstrate a clear interest in leveraging schools to mitigate the youth mental health crisis.
Despite the tremendous potential for schools to expand access to evidence-based mental health services, there are unique challenges associated with the delivery of interventions in school settings, including privacy and confidentiality concerns, legal considerations, and constrained resources. Moreover, although numerous evidence-based interventions exist for youth mental health problems, the adoption, fidelity, and sustainability of these interventions in school settings is limited, and translation into routine school practice is slow. Further complicating this issue, the enduring effects of COVID-19 and related school disruptions have intensified youth mental health demand while contributing to a landscape of school workforce shortages and staff burnout. Thus, there are significant gaps in knowledge regarding the effectiveness and implementation of preventive, therapeutic, and services interventions in school settings, and a substantial need for innovative approaches to address these challenges.
Research Objectives
This NOSI encourages research that aligns with Objectives 3.2 and 3.3 and 4.1 and 4.3 of the NIMH Strategic Plan for Research through addressing questions related to the effectiveness, implementation, and scaling of evidence-based practices and services interventions in school and afterschool program settings through school/community partnerships.
In accordance with the NIMH Strategic Framework for Addressing Youth Mental Health Disparities, NIMH is committed to supporting research that reduces disparities and advances equity in youth mental health interventions, services, and outcomes. As such, this NOSI encourages research that seeks to reduce disparities in outcomes for racial and ethnic minority groups, individuals limited by language or cultural barriers, sexual and gender minorities, individuals living in rural areas, socioeconomically disadvantaged persons, and other underserved groups.
To be considered under this NOSI, applications must fall within one or more of the following broad areas:
Considerations for Intervention Research
Applications that involve developing and testing preventive, therapeutic, or services interventions should conform to NIMHs experimental therapeutics framework and evaluate not only the clinical effects of the intervention but also generate information about the mechanisms underlying the response to an intervention. Clinical trials applications that do not adhere to the experimental therapeutics framework will be considered non-responsive. Therefore, applications must specify an intervention target/mechanism and assess whether intervention-induced changes in the target account for the hypothesized outcome. In the case of services interventions, targets/mechanisms might involve change in service-user, family and/or provider behavior, or in organizational/system-level factors to improve access, engagement, continuity, quality, equity, and/or value of services. Studies adapting interventions for new populations or settings should provide an empirical rationale for the adaptation/augmentation target and a clear hypothesis and plan to address the target mechanism by which the adapted intervention will enhance outcomes. See the Support for Clinical Trials at NIMH web page for additional information.
Specific Areas of Research Interest
Examples of specific research areas of interest include, but are not limited to the following:
This NOSI encourages research on potentially scalable preventive, therapeutic, and services approaches that address practice-relevant questions. Accordingly, collaborations between academic researchers and clinical or community practice partners or networks are encouraged. Studies should capitalize on existing practice infrastructure for school-based services, including but not limited to SAMHSA-supported AWARE grant school-based services or services provided through CCBHCs or other existing community mental health services. When possible, NIMH also encourages applications that leverage existing research resources (e.g., practice-based research networks such as the NIMH-supported ALACRITY and Practice-based Suicide Prevention Research Centers, institutions with Clinical and Translational Science Awards). To facilitate the ultimate translation into practice, NIMH encourages research and practice approaches that incorporate the use of routinely collected data (e.g., school records, electronic medical records, other administrative databases) to increase the efficiency of participant recruitment (i.e., more rapid identification and enrollment) and to facilitate the collection of practice-relevant data (e.g., clinical characteristics, longer-term mental health and educational outcomes).
Research Areas of Low Program Priority Under This NOSI
Examples of low priority research areas include, but are not limited to, the following:
Potential applicants are strongly encouraged to contact NIMH Program Officials as early as possible in advance of the application submission date to discuss alignment with priorities and available funding mechanisms [see section VII Agency Contacts].
Application and Submission Information
This notice applies to due dates on or after June 5, 2024, and subsequent receipt dates through March 17, 2026.
Submit applications for this initiative using one of the following notice of funding opportunity (NOFO) or any reissues of these announcements through the expiration date of this notice.
All instructions in the SF424 (R&R) Application Guide and the notice of funding opportunity used for submission must be followed, with the following additions:
Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.
Please direct all inquiries to the Scientific/Research, Peer Review, and Financial/Grants Management contacts in Section VII of the listed notice of funding opportunity.
Scientific/Research Contact(s)
For Treatment Interventions:
Marcy Burstein, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-443-9699
Email: [email protected]
For Preventive Interventions:
Mary Rooney, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-827-1325
Email: [email protected]
For Services Interventions:
Mary Acri, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-910-8230
Email: [email protected]