Request for Information (RFI): Input on Public Mental Health Research Questions for NIMH’s interest in Suicide Prevention Efforts in Emergency Medicine Departments

Notice Number: NOT-MH-08-013

Key Dates
Release Date: June 16, 2008
Response Date:  July 25, 2008

Issued by
National Institute of Mental Health (NIMH) (www.nimh.nih.gov)

The National Institute of Mental Health (NIMH) is seeking input on strategies to enhance suicide prevention efforts within emergency medicine department (ED) settings, where many individuals at high risk for suicide are seen.  Advice on identifying the most important mental health research questions is sought from the emergency medicine and clinical research communities, mental health professionals, suicide prevention and patient advocates, individuals who have survived a suicide attempt, private and public mental health service systems and providers, the pharmaceutical and biotechnology industry, and other interested groups or individuals.

Background

Research that will reduce the burden of suicidality (deaths, attempts, and ideation) continues to be a major focus of the NIMH.  While there have been substantial strides in our understanding of suicide risk factors, and initial progress in reducing suicidal behaviors per se, the development and implementation of practical screening tools and procedures and practical interventions are critically needed.   Emergency medicine departments (EDs) are seeing increasing numbers of individuals who have attempted suicide (Larkin et al, 2005).  Despite this increase in demand, there exist no empirically-based practices for screening, further evaluation of high-risk individuals, or for appropriate referrals for follow-up care.  The National Strategy for Suicide Prevention (http://mentalhealth.samhsa.gov/suicideprevention/default.asp) identified the ED setting as an opportune site to increase the proportion of suicidal patients who could receive adequate follow-up as a way to prevent suicide (see Objective 7.1).  In conjunction, community providers also need practical and effective strategies to best serve the high-risk individuals referred from EDs.

For these reasons, NIMH seeks the perspective of its multiple stakeholders to ensure that the right questions are being addressed in the area of suicide prevention efforts within the ED setting.  NIMH research is improved when it is informed by broad scientific and public input. In keeping with a major theme in the NIMH’s National Advisory Mental Health Council (NAMHC) Council Workgroup Report: The Road Ahead: Research Partnerships to Transform Services http://www.nimh.nih.gov/council/advis.cfm .NIMH seeks the perspective of its multiple stakeholders to ensure that the right questions are being addressed.

Request for Information

The NIMH solicits input from any and all organizations and individuals interested in suicide prevention research in the ED setting.  Specifically, information on the following topics are sought with regard to their potential to reduce suicide attempt or re-attempt rates within a 12 month follow-up period of being seen in an ED.  Information that can address potential diverse needs of the variety of patients seen in the ED (e.g., pediatric, geriatric, veteran status) is also sought.

  1. Are there existing reliable and valid screening instruments for ED providers (for use by ED nurses in particular) to assess suicide risk?
  2. What are the most appropriate approaches for further suicide risk evaluation to optimize appropriate discharge and referral efforts?
  3. What are the patterns of service utilization post discharge from the ED with regard to referral adherence and/or later attempt risk?
  4. What are promising and/or effective brief interventions that can take place in the ED to improve adherence to an appropriate referral after discharge (e.g., “patient navigators,” referral to mental health, substance abuse treatment, primary care)?
  5. What interventions (in person, printed materials, electronic resources) can facilitate continuity of care post discharge from the ED?
  6. What interventions can provide practical strategies to help community providers best serve high-risk individuals referred from the ED?

Responses should be no more than 1000 words in length and should:

  1. specify which question is being addressed (1, 2, 3, 4, 5 and/or 6 above);
  2. explain the source of information (scientific citations; public records;    individual research projects; private/ insurer data bases); and
  3. refine the specific research question to be addressed (either from those listed above or those relevant but not described here).  If possible, outline suggested protocol components, e.g., relevant treatment and comparison conditions, estimated sample size and time scale.

Responses

This request for information is for planning purposes only and shall not be construed as a solicitation for applications or as an obligation on the part of the government. The government will not pay for the preparation of any information submitted or for the government’s use of that information.

Responses will be accepted through Friday July 25, 2008.  Electronic responses are preferred and may be addressed to NIMHsuicideprevention@nih.gov (Please include the Notice number NOT-MH-08-013 in the subject line).  Responses may also be sent by letter or FAX to the following address:

NIMH Suicide Prevention
Division of Services and Intervention Research
6001 Executive Boulevard, Room 7161, MSC 9629
Rockville, MD  20852-9629
FAX:  (301) 443-0118

Receipt of responses will be acknowledged. No basis for claims against the government shall arise as a result of response to this request for information, or in the government’s use of such information, either as part of our evaluation process or in developing specifications for any subsequent announcement. The general content of responses may be shared anonymously with the NIMH and its potential collaborating (NIDA, NIAAA, SAMHSA, CDC) partners.


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