Full Text MH-92-09

SHORT-TERM CLINICAL TRAINING GRANTS IN DIAGNOSIS AND TREATMENT OF
DEPRESSIVE DISORDERS

NIH GUIDE, Volume 21, Number 7, February 21, 1992

RFA:  MH-92-09

P.T. 44

Keywords: 
  Biomedical Research Training 
  Depression 
  Diagnosis, Medical 
  Psychotherapy 


National Institute of Mental Health

Letter of Intent Receipt Date:  May 4, 1992
Application Receipt Date:  May 19, 1992

PURPOSE

As part of the Depression Awareness, Recognition and Treatment (D/ART)
program, the National Institute of Mental Health (NIMH) seeks
applications for programs of short-term (not to exceed five days
duration) continuing education.  Each program will be carried out at
several locations (minimum of six different sites per year) and will
provide continuing education for primary care providers and mental
health professionals.  Support is available for the development,
implementation, and evaluation of training programs that are designed
to foster more effective recognition, diagnosis, and treatment of major
depressive disorders including manic depression and clinical
depression.  This initiative is intended to provide for the development
of effective training that is directly tied to major recent research
findings and clinical knowledge and that incorporates didactic and
experiential modes of teaching; it is not, however, designed to test
training models.  The focus is on training providers to more
effectively diagnose and treat clinical depression in adults and
adolescents; childhood depression does not fall within the scope of
this announcement.

The training is intended to give primary care providers and mental
health professionals with a didactic and experiential program that will
increase their capacity to recognize, diagnose, and treat clinical
depression effectively, in a manner appropriate to their discipline.
Training must include recent major research findings on psychosocial
and pharmacological aspects of treatment.

HEALTHY PEOPLE 2000

The Public Health Service urges applicants to submit work plans that
address specific objectives of "Healthy People 2000" (see objectives
6.13, 6.7).  Potential applicants may obtain a copy of "Healthy People
2000" (Full Report:  Stock Number 017-001-00474-0) or "Healthy People
2000" (Summary Report:  Stock Number 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington, DC
20402-9325 (Telephone:  202-783-3238).

ELIGIBILITY REQUIREMENTS

Applications may be submitted by:

o  a department of psychiatry in, or associated with, a school of
medicine, or a free-standing mental health institution with an approved
psychiatric residency program

o  a university-based department of psychology offering doctoral
training in clinical psychology, or a school of professional psychology
with appropriate accreditation for doctoral training in clinical
psychology

o  a college or university school of nursing which offers a graduate
program in psychiatric nursing

o  a school of social work with a graduate program

All applicants must have experience and demonstrated capacity in the
provision of continuing education tied to research on depressive
disorders and must use multidisciplinary teams of trainers.

MECHANISM OF SUPPORT

This RFA will use the NIH Continuing Education Grant (T15).
Responsibility for the planning, direction, and execution of the
proposed project will be solely that of the applicants.

Terms and Conditions of Support

Period of Support:  The period of support is up to three years (with a
maximum of $125,000 total costs per year), though no firm commitment
can be made beyond the first year.  Therefore, activities in the first
year must be significant with a minimum of six programs provided at six
different sites in each grant year.

Average Size of Award:  It is expected that up to four awards may be
made, each award not to exceed $125,000 total (direct and indirect)
costs per award in fiscal year 1992.  Funds made available under this
grant may not be used to replace currently existing training or other
support for such training.

Direct Costs:  Funds may be used only for those expenses that are
directly related and necessary to carry out the project and must be
expended in conformance with DHHS cost principles and conditions set
forth in this document.

All budget items must be fully justified at the level requested.
Grantees are expected to be familiar with and comply with applicable
cost policies.

Teaching Costs:  Direct cost items are allowable for teaching costs
associated with these programs, i.e., personnel, consultants,
materials, supplies, travel, reproduction and printing costs, rental
equipment, minor equipment items, and other items that are directly
related to the proposed training program and are otherwise unavailable
from the institution.

FUNDS AVAILABLE

Period of Support:  The period of support is up to three years (with a
maximum of $125,000 per year), though no firm commitment can be made
beyond the first year.  Therefore, activities in the first year must be
significant with a minimum of six programs provided at six different
sites in each grant year.

Average Size of Award:  It is expected that up to four awards may be
made, each award generally not to exceed $125,000 total (direct and
indirect) costs per award in fiscal year 1992.  Funds made available
under this grant may not be used to replace currently existing training
or other support for such training.

Direct Costs:  Funds may be used only for those expenses which are
directly related and necessary to carry out the project and must be
expended in conformance with DHHS cost principles, the Public Health
Service Grants Policy Statement, and conditions set forth in this
document.  Regulations at 42 CFR Part 242a and Title 45 CFR Part 74 and
92 requirements concerning the administration of grants, are applicable
to these awards.

All budget items must be fully justified at the level requested.
Grantees are expected to be familiar with and comply with applicable
cost policies.

Teaching Costs:  Direct cost items are allowable for teaching costs
associated with these programs.  They include personnel, consultants,
materials, supplies, travel, reproduction and printing costs, rental
equipment, minor equipment items, and other items that are directly
related to the proposed training program and are otherwise unavailable
from the institution.

Trainee Expenses:  Trainee expenses are not allowable for support.
Participants may not be charged for training.

OBJECTIVES

Background

Serious depressive disorders are a major public health problem in the
United States.  Because of the existence of effective psychological and
pharmacological treatments, which are often most effective when used in
combination, most people with depressive disorders can be successfully
treated.  Evidence suggests, however, that depression often is poorly
recognized, undertreated, or incorrectly treated in the health and
mental health system.  The NIMH developed the D/ART program to provide
the most up-to-date research information on depressive disorders to the
general public, primary care providers, and mental health specialists.

The NIMH particularly encourages applications for programs that contain
the following:

o  part of the curriculum must focus on such special populations such
as the aged, adolescents, women, and minorities, which include, but are
not limited to, Blacks, Hispanics, American Indians, Alaskan Natives,
and Native Hawaiians

o  a coherent plan for training staff of Employee Assistance Programs
(EAP)

o  a coherent plan to address issues of co-morbidity and depression

STUDY POPULATIONS

SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING IMPLEMENTATION OF NIH
POLICIES CONCERNING INCLUSION OF WOMEN AND MINORITIES IN CLINICAL
RESEARCH STUDY POPULATIONS

In compliance with ADAMHA policy, ADAMHA grants and cooperative
agreements are required to include both women and minorities in study
populations, unless compelling scientific or other justification for
not including either women or minorities is provided.  All clinical
programs supported by ADAMHA are required to comply with this policy.

LETTER OF INTENT

Prospective applicants are asked to submit, by May 4, 1992, a letter of
intent that includes a descriptive title of the proposed research, the
name, address, and telephone number of the Principal Investigator, the
identities of other key personnel and participating institutions, and
the number and title of the RFA in response to which the application
may be submitted.  Although a letter of intent is not required, is not
binding, and does not enter into the review of subsequent applications,
the information that it contains is helpful in planning for the review
of applications.  Letters of intent are to be submitted to:

Dr. Harold Goldstein
Director of Training, D/ART Program
Prevention Research Branch
Division of Clinical Research
National Institute of Mental Health
Parklawn Building, Room 10-85
5600 Fishers Lane
Rockville, MD  20857
Telephone:  (301) 443-4140

APPLICATION PROCEDURES

Applicants are to use the grant application kit PHS 398 revised 9/91).
Application kits are available from the Prevention Research Branch,
Room 10-85, Parklawn Building, 5600 Fishers Lane, Rockville, MD  20857,
telephone (301) 443-4140.  Applications submitted after May 19, 1992,
will be returned to the applicant without review.

To identify this application as a response to this RFA, check 'yes' on
item 2 page one of the PHS 398 form and enter the number and title of
this RFA:  MH-92-09, Short-Term Clinical Training Grants on Depressive
Disorders.  THE RFA LABEL FOUND IN THE PHS 398 KIT MUST BE AFFIXED TO
THE BOTTOM OF THE FACE PAGE OF THE ORIGINAL COMPLETED APPLICATION FORM.
FAILURE TO USE THIS LABEL COULD RESULT IN DELAYED PROCESSING OF THE
APPLICATION SUCH THAT IT MAY NOT REACH THE REVIEW COMMITTEE IN TIME FOR
REVIEW.

Applications must be complete and contain all information needed for
initial and Advisory Council review.  No addenda will be accepted
unless specifically requested by the Scientific Review Administrator of
the initial review group (IRG).  No site visits will be made.

The applicant must include a project abstract that may not exceed two
single-spaced typewritten pages.  The narrative section of the
application may not exceed 25 pages; appendices may not be used
inappropriately to expand the narrative section.  Applications
exceeding this limitation will be returned to the applicant.
Applicants submitting revised applications of earlier submissions must
follow the instructions in the application kit regarding such
revisions.

The original and four copies of the application must be submitted to:

Division of Research Grants
National Institutes of Health
5333 Westbard Avenue,, Room 240
Bethesda, MD  20892**

In addition, one additional copy of the application must also be sent
directly to:

NIMH Division of Extramural Activities
Parklawn Building, Room 9C-02
5600 Fishers Lane
Rockville, MD  20857
Attention:  Clinical Training Review Administrator

Application Characteristics

The applicant must provide:

o  a description of the applying entity, its relevant personnel, its
training resources, and its prior experience in the provision of
continuing education in the area of clinical depression

o  the rationale underlying the conceptualization of the training
program, including specific assumptions, goals, and objectives

o  a concise review and critical assessment of the most up-to-date
research in clinical depression and a discussion of how the research
will be incorporated into the training program

o  the concepts of depressive disorders on which the training program
is to be based

o  a detailed description of the proposed training program, including
proposed curriculum, that contains the following elements:

1) a balanced approach to psychosocial and biological aspects of
depression

2)  didactic components, i.e., lectures and formal presentations that
include research and clinical knowledge to be developed to provide
students with the context for better diagnoses and treatment of
depressive disorders

3) selection and development of the experiential components in which
the students will be directly involved

4) explanation of how the integration of the didactic and experiential
components will provide students with the attitudes and competencies to
provide effective services

5) a plan for materials development as appropriate

6) for each area of training, the content to be addressed, the teaching
materials to be used, the proposed faculty, the time frames to be
allotted to each training module, and the teaching methods to be
employed

o  a description of the proposed participants, the manner of
recruitment and selection, and the relevance of the training to their
specific needs

o  a description of the number of training programs to be offered, the
sites at which the training is to be presented, the rationale for site
selection, and the total number of proposed students to be trained

o  a comprehensive and detailed plan for an evaluation to establish the
effectiveness and generalizability of the program including before and
after measures as well as a plan for a follow-up of students who have
completed training and an assessment of the value of curricular content
and training experiences

o  a focus on improving the skills and knowledge of health care
professionals in the pharmacological and psychological treatments for
depressive disorders

o  a comprehensive scope that addresses issues of diagnosis, treatment,
case management, development of coordinated treatment plans, and
relationships with other health care professionals

o  a focus particularly on the early diagnosis and treatment of
outpatients with depressive disorders

o  a broad base in the approach to continuing education including
experiential, interactive, and didactic teaching methods

o  innovative plans for recruiting mental health and health
professionals as students

REVIEW CONSIDERATIONS

Review Procedures

A dual review system is used to ensure knowledgeable, objective review
of the quality of applications.  Initial peer review for scientific,
educational, and/or technical merit is by groups of non-Federal experts
called Initial Review Groups.  Final review is by the National Advisory
Mental Health Council.

Review Criteria

Each grant application is evaluated on its own merits.  The following
criteria will be used:

o  relationship of the goals of the proposed project to the purposes of
this announcement

o  appropriateness and feasibility of the content, methods, and
organization of the project to specified project goals and objectives

o  quality of the training program plan and its linkages to major
research findings and clinical knowledge

o  balance in the curriculum between psychosocial and pharmacological
treatments

o  multidisciplinary team of trainers

o  multi-model training using a variety of educational techniques
including didactic and experiential training methods

o  effectiveness of the plans for recruiting trainees and outreach
efforts to geographic locations throughout the training area

o  previous experience in the provision of continuing education
programs

o  quality of the resources of the applying organization

o  qualifications of the program director and other staff

o  adequacy of the evaluation plan

o  adequacy of the budget projections and other resources for carrying
out the project activities

Receipt and Review Schedule

                              National Advisory
Receipt of       Initial      Mental Health       Earliest
Application      Review       Council Review      Start Date

May 19, 1992     Jul 1992     Sep 1992            Sep 1992

AWARD CRITERIA

The responsibility for award decisions on applications recommended by
the National Advisory Mental Health Council lies solely with authorized
NIMH program staff.  The basic criteria to be used in making award
decisions will be the quality of the proposed project as determined
during the review process and the availability of funds.  Priority in
funding will be given to approved applications from geographic areas,
particularly rural, which have not yet been served by D/ART grants.

INQUIRIES

For further information regarding administrative details, contact:

Harold Goldstein, Ph.D.
Director of Training, D/ART Program
Prevention Research Branch
Division of Clinical Research
National Institute of Mental Health
Parklawn Building, Room  10-85
5600 Fishers Lane
Rockville, MD  20857
Telephone:  (301) 443-4140

For information regarding grants management issues, contact:

Stephen J. Hudak
Chief, Grants Management Section
Grants Management Branch
National Institute of Mental Health
Parklawn Building, Room 7C-26
5600 Fishers Lane
Rockville, MD  20857
Telephone:  (301) 443-4456

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance
No. 93.244.  Applications will be accepted under the authority of
Section 303 of the Public Health Service Act (42 U.S.C. 242a), 42 CFR
Part 64.  Applications submitted in response to this RFA are not
subject to the intergovernmental review requirements of Executive Order
12372 as implemented through DHHS regulations at 45 CFR Part 100 or
Health Systems Agency review.

.

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