Key Dates

Related Announcements

• January 13, 2023 - Innovative Pilot Mental Health Services Research Not Involving Clinical Trials (R34 Clinical Trial Not Allowed). See NOFO PAR-23-105.
• January 6, 2023 - Innovative Mental Health Services Research Not Involving Clinical Trials (R01 Clinical Trials Not Allowed). See NOFO PAR-23-095.
• March 2, 2021 - Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (R01Clinical Trial Required). See NOFO PAR-21-130.
• March 2, 2021 - Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions (R34 -Clinical Trial Required). See NOFO PAR-21-131.
• May 12, 2020 - Mentored Clinical Scientist Research Career Development Award (Parent K08 – Independent Clinical Trial Required). See NOFO PA-20-202
• May 12, 2020 - Mentored Clinical Scientist Research Career Development Award (Parent K08 – Independent Clinical Trial Not Allowed). See NOFO PA-20-203.
• May 12, 2020 - Mentored Patient-Oriented Research Career Development Award (Parent K23 - Independent Clinical Trial Not Allowed). See NOFO PA-20-205.
• May 12, 2020 - Mentored Patient-Oriented Research Career Development Award (Parent K23 - Independent Clinical Trial Required). See NOFO PA-20-206.
• May 6, 2020 - Mentored Research Scientist Development Award (Parent K01 – Independent Clinical Trial Required). See NOFO PA-20-176.
• May 6, 2020 - Mentored Research Scientist Development Award (Parent K01 – Independent Clinical Trial Not Allowed). See NOFO PA-20-190.
• May 5, 2020 - NIH Pathway to Independence Award (Parent K99/R00 - Independent Clinical Trial Required). See NOFO PA-20-187.
• May 5, 2020 - NIH Pathway to Independence Award (Parent K99/R00 - Independent Clinical Trial Not Allowed). See NOFO PA-20-188.

Issued by

National Institute of Mental Health (NIMH)

Purpose

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 Children’s 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:

• Sustainable and acceptable strategies for operationalizing mental health risk and identifying students who might benefit from interventions to services.
• Development and validation of decision support tools informed by data-driven decision making (DDDM), to help align interventions and mental health specialty services with indicated need.
• Development and optimization of service-ready mental health interventions and services.
• Services interventions to promote detection, engagement, and referral to mental health specialty settings.
• Implementation research to address workforce training needs.

Considerations for Intervention Research

Applications that involve developing and testing preventive, therapeutic, or services interventions should conform to NIMH’s 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:

• Sustainable and acceptable strategies for operationalizing mental health risk and identifying students who might benefit from prevention, treatment, or services interventions.
  • Universal screening and monitoring strategies that are acceptable and appropriate for students and families from diverse cultural, racial, and ethnic backgrounds, and other underserved groups.
  • Low burden, systematic approaches that leverage existing school data sources (e.g., student information systems [SISs], attendance records, report cards, digital gradebooks, discipline records, etc.) to guide the identification of students at risk who might benefit from mental health interventions or services.
• Development and validation of decision support tools informed by DDDM including:
  • Tools designed to guide the selection of evidence-based approaches that will be offered within the school district across multiple tiers (mental health promotion, prevention, and intervention) based on the current need and available resources.
  • Tools that support decision making related to matching students to the intervention(s) and service(s) with the appropriate intensity and focus given the nature and severity of the presenting concerns.
  • Tools that consider and address potential biases in decision-making (i.e., algorithmic fairness) in order to promote positive  mental health outcomes for school districts and students across  cultural, racial, and ethnic backgrounds, and other underserved groups. 
• Development and optimization of service-ready mental health interventions and services.
  • Optimization and testing of research-supported interventions and services that can be readily deployed in school settings using available resources and personnel.
  • Refining and testing strategies for implementing interventions with fidelity by personnel in school settings (e.g., incorporating technology and other design features that enhance scalability and prevent threats to fidelity).
  • Optimization of tiered approaches that can be used for prevention through treatment, including stepped-care approaches that might involve identifying students for specialty mental health care.
  • Adaptation and optimization of existing evidence-based interventions and services in order to substantially improve treatment response, care, and/or uptake for students and families from various  cultural, racial, and ethnic backgrounds, and other underserved groups.
  • Refining and testing the utility of low burden measurement-based care tools (e.g., technology-assisted tools, telephone monitoring) to inform and enhance interventions and services in school-based settings.
• Services interventions to promote detection, engagement, and referral to mental health specialty settings.
  • Services interventions to promote detection, engagement, and referral (e.g., to CCBHCs or other mental health specialty services). 
  • Services interventions that address disparities in the detection, engagement, and referral of students and families from diverse cultural, racial, and ethnic backgrounds, and other underserved groups.
  • Strategies that can be used to facilitate communication between caregivers and school-based providers in order to promote family engagement in services that are initiated in schools.
• Implementation research to address workforce training needs.
  • Studies that optimize and test provider-, organizational-, or systems-level interventions and strategies to increase the uptake, implementation, fidelity, and sustained use of evidence-based interventions.
  • Studies that test effective, sustainable strategies for training and supervising existing personnel in the delivery of research-supported interventions/strategies for sustained implementation and fidelity.
  • Studies that test strategies to support the adoption and spread of low-burden evidence-based programs for sustained implementation.
  • Studies that examine factors associated with the use of interventions and services that are not supported by evidence, and that test strategies to reduce or eliminate (i.e., “de-implement”) these practices, allowing for the redistribution of resources to support evidence-based intervention and services.

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:

• Descriptive studies
• Studies that test preventive and therapeutic interventions that are not informed by evidence-based practices.
• Studies of mental health promotion (e.g., wellness programs) that are not explicitly designed to reduce risk for mental health disorders.
• Studies in which school staff are trained to provide interventions without attention to the scalability and sustainability of the training and supervision model.

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.

• PAR-23-105 – Innovative Pilot Mental Health Services Research Not Involving Clinical Trials (R34 Clinical Trial Not Allowed)
• PAR-23-095 – Innovative Mental Health Services Research Not Involving Clinical Trials (R01 Clinical Trials Not Allowed)
• PAR-21-131– Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions (R34 -Clinical Trial Required)
• PAR-21-130 – Clinical Trials to Test the Effectiveness of Treatment, Preventive, and Services Interventions (R01Clinical Trial Required)
• PA-20-206 – Mentored Patient-Oriented Research Career Development Award (Parent K23 - Independent Clinical Trial Required)
• PA-20-205 – Mentored Patient-Oriented Research Career Development Award (Parent K23 - Independent Clinical Trial Not Allowed)
• PA-20-203 – Mentored Clinical Scientist Research Career Development Award (Parent K08 – Independent Clinical Trial Not Allowed)
• PA-20-202 – Mentored Clinical Scientist Research Career Development Award (Parent K08 – Independent Clinical Trial Required)
• PA-20-190 – Mentored Research Scientist Development Award (Parent K01 – Independent Clinical Trial Not Allowed)
• PA-20-176 – Mentored Research Scientist Development Award (Parent K01 – Independent Clinical Trial Required)
• PA-20-188 – NIH Pathway to Independence Award (Parent K99/R00 - Independent Clinical Trial Not Allowed)
• PA-20-187 – NIH Pathway to Independence Award (Parent K99/R00 - Independent Clinical Trial Required) 

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:

• For funding consideration, applicants must include “NOT-MH-24-165” (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

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: marcy.burstein@nih.gov

For Preventive Interventions:

Mary Rooney, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-827-1325
Email: mary.rooney@nih.gov

For Services Interventions:

Mary Acri, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-910-8230
Email: mary.acri@nih.gov