April 12, 2024
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National Institute of Mental Health (NIMH)
This request for information (RFI) invites input on addressing gaps in: (1) Identifying determinants of mental health disparities beyond the individual level, including, but not limited to, social determinants of health (SDOH) at the social, systemic and structural levels, and (2) Developing culturally responsive, multilevel interventions to address mental health disparities. This RFI seeks input about these research gaps within U.S.-based research from healthcare providers, scientific research communities, patient advocacy groups, people with lived experience, educators, and other interested parties. The NIMH encourages organizations (e.g., patient advocacy groups, professional organizations) to submit a single response reflective of the views of the organization and membership as a whole. Responses may incorporate empirical research, lived experience, public records, and any other sources that may inform the RFI. Feedback is requested on the themes outlined below .
Mental health disparities refer to inequities in the onset, course and severity of mental illness, as well as service access and quality, among health disparities populations. The NIH defines health disparities populations as racial/ethnic minoritized people, sexual and gender minorities, those with low socioeconomic status, rural populations, and persons with disabilities. For example, suicidal thoughts and behaviors are rising among Black, Indigenous and sexual and gender minority youth. Often, individuals belong to more than one health disparity population, and thus exist at the intersections of multiple marginalized identities. Intersectionality refers to the interlocking and overlapping systems of oppression that individuals with multiple marginalized identities experience. Intersectionality is a crucial consideration in multilevel health disparities research, as there may be unique multilevel determinants shaping health disparities at various intersections of identity.
The National Institute of Minority Health and Health Disparities (NIMHD) Research Framework specifies multiple domains of influence on health disparities, including biological (e.g., biological vulnerability), behavioral (e.g., health behaviors), physical/built environment (e.g., transportation access), sociocultural environment (e.g., discrimination), and healthcare systems (e.g., quality of care) factors. Multilevel approaches to address mental health disparities integrate across these domains to include factors at multiple levels of analysis. Many of these risk and resilience factors are conceptualized as social determinants of health (e.g., housing security, food security, built environment, discrimination, health care access, policy). Multilevel interventions, particularly those that target SDOH, have the best promise for addressing mental health disparities, yet there have been few examinations of such interventions. SDOH are key objectives in Healthy People 2030, with some SDOH included as Leading Health Indicators (e.g., environmental exposures, food insecurity), representing the federal governments commitment to ameliorating SDOH to address health disparities.
The NIMH seeks input on (1) Identifying determinants of mental health disparities beyond the individual level, and (2) Developing culturally responsive, multilevel interventions to address mental health disparities. Comments may address, but are not limited to, the bulleted topics below. When appropriate, please also include hyperlinks to pertinent references, databases, or other online resources.
Identifying determinants of mental health disparities beyond the individual level (e.g., SDoMH):
Developing multilevel interventions addressing mental health disparities:
Please direct all inquiries to:
Juliette C. McClendon, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-379-0413
Email: [email protected]