Full Text PAR-94-073 CENTERS FOR RESEARCH ON SERVICES FOR PEOPLE WITH MENTAL HEALTH DISORDERS NIH GUIDE, Volume 23, Number 22, June 10, 1994 PA NUMBER: PAR-94-073 P.T. 04 Keywords: 0730057 Biomedical Research, Multidiscipl National Institute of Mental Health Application Receipt Date: October 1 PURPOSE The National Institute of Mental Health (NIMH) announces the availability of support for multidisciplinary Centers for Research on Services for People with Mental Disorders. The purpose of these Centers is to promote, develop, and conduct multidisciplinary research that can help to improve the organization, financing, delivery, quality, effectiveness, and outcomes of services for persons of all ages with mental disorders. Support is available for research centers focused in whole or in part on mental health services for children and adolescents, adults, elderly persons including those with Alzheimer's disease and other dementia, and persons with mental disorders who are involved with or at risk of becoming involved with the legal system. Support is also available for centers focused in whole or in part on mental health economics and on methodological issues in mental health services research. Centers are encouraged to include minorities and women in all facets of their research program; however, centers focused entirely on services for minority populations should apply for support under Program Announcement 92-122, "Minority Mental Health Research Centers." This program announcement (PA) addresses one of the major recommendations set forth in Caring for People with Severe Mental Disorders: A National Plan of Research to Improve Services. It complements the NIMH report, "Implementation of Caring for People with Severe Mental Disorders: A National Plan of Research to Improve Services," which invites applications for research project grants, research demonstrations, and career development applications in support of this National Plan. This PA also addresses recommendations for services research contained in the National Plan for Research on Child and Adolescent Mental Disorders and in the NIMH announcement, "Implementation of The National Plan for Research on Child and Adolescent Mental Disorders." This PA supersedes and replaces NIMH program announcements PA-92-94, "Centers for Research on Services for People with Severe Mental Disorders," and PA-92-20, "Centers for Research on Mental Health Services for Children and Adolescents." Its scope is broader than these two earlier program announcements, because discussions of health care reform have emphasized the need for the NIMH to develop a center program that covers the entire mental health service system, including services provided in general medical settings and other agency, institutional, and community contexts. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS-led national activity for setting priority areas. This PA, Centers for Research on Services for People with Mental Disorders, is related to the priority area of mental health and mental disorders. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0) or "Healthy People 2000" (Summary Report: Stock No. 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 for-profit and non-profit domestic organizations and by public and private institutions, such as universities, colleges, hospitals, laboratories, units of State or local governments, and eligible agencies of the Federal government. Applications from minority and women investigators are encouraged. MECHANISM OF SUPPORT This PA will use the National Institutes of Health (NIH) Specialized Center (P50) mechanism. Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for applications submitted in response to this PA may not exceed five years. The funding cap for a Center for Research on Services for People with Mental Disorders is $600,000 in direct costs for the initial project year, with annual increases of four percent thereafter, plus negotiated institutional indirect costs. Applications that request direct costs in excess of this amount will be returned to the applicant without review. RESEARCH OBJECTIVES Examples of the types of services research issues that might be addressed by a Center are listed below. The list is illustrative, rather than comprehensive. It is expected that additional relevant and important research topics will be identified by investigators who respond to this program announcement. o Studies of the prevalence of mental disorders (including co-occurring substance abuse disorders) and associated disability in various types of service settings o Studies of access to needed mental health services and barriers to care o Research on clinical and related services provided to persons with mental disorders by mental health professionals, general health care personnel, and other providers in different types of service settings, including accuracy of diagnoses, appropriateness, quality, and effectiveness of care, and short- and long-term outcomes for patients and their families o Research on rehabilitation services for persons with mental disorders o Research on the organization and financing of services for persons with mental disorders, including services provided and paid for by State and local governments and the private sector o Studies of costs and cost-effectiveness of services for persons with mental disorders in various settings, including new and alternative types of services and case management o Research on cost-containment strategies in mental health care (e.g., managed care, capitated care, contracted care) o Studies of effects of major changes and innovations in the structure, financing and delivery of mental health services at various levels of government and in the private sector o Research on the interface between mental health services and other types of services needed to maintain people with mental disorders in the community, including research on models of coordinated and consolidated care o Studies of self-help programs, groups, and organizations for persons with mental disorders o Research on the role of families in caring for persons with mental disorders, including assessment of appropriateness and effectiveness of family education programs and family support programs o Studies of the impact of various mental health laws, civil rights legislation, and administrative regulations on delivery and effectiveness of mental health services o Research to test the validity and reliability of measurement instruments for use in services research (e.g., outcome measures) o Research on development of methodology for mental health services research Program specifications. A Center should be planned and organized for the purpose of addressing major gaps in scientific knowledge in the field of mental health services research on people with mental disorders. Centers must be multidisciplinary, including investigators from disciplines such as psychiatry, general internal medicine, family medicine, pediatrics, geriatric medicine, pharmacology, psychology, social work, nursing, epidemiology, biostatistics, economics, sociology, public health, law, and political science. The Principal Investigator will serve as Director of the Center and provide scientific and administrative leadership by devoting at least 50 percent of his/her time to the Center, including time spent on Center research projects that are clearly related to and supportive of the overall Center plan for research on services for people with severe mental disorders. The Center Director must be responsible for the planning, coordination, and efficient operation of the Center program, preparation of the budget, control of expenditures, staff appointments, and space allocation. Another individual may be designated to be responsible for the day-to-day administration of the Center. Each Center should clearly define a cohesive and parsimonious set of research core areas that will be addressed by Center study teams. This selection should be justified on the basis of the public health significance of the issues to be addressed, the current state of scientific knowledge, the feasibility of doing research in the designated areas (e.g., availability of measurement instruments and populations to study), and the potential impact of the research for assisting improvement of mental health services. The plan for each research core area must be clearly defined for the entire period of support requested. Center costs may include salary of core personnel, including the Center Director, research expenses, and research resources shared across Center projects such as statistical consultation, data storage and analysis, and equipment. Support may also be provided for developmental studies within core areas that involve conceptualizing services research problems and research approaches, establishing relationships with service providing agencies and policymakers, developing and refining research instruments, analyzing mental health system data, and conducting exploratory and developmental research. It is expected that these Center developmental activities will lead to applications submitted to NIMH and other agencies by Center investigators for independently funded services research projects (e.g., R01s). If a proposed Center is to be located in a university, research institute, mental health agency, or other larger organization, the prospective organizational, administrative, and managerial relationships between the proposed Center and the host organization must be addressed. Each Center is expected to have an administrative structure that will contribute to efficient operation, sound financial practices, and effective use of available resources. Center Organizational and Research Plan. Each Center must describe an overall organizational and research plan for the requested period of support. The organizational plan should describe the administrative organization, including its relationship to the applicant institution, and arrangements for planning, coordinating, and evaluating the Center program. Relationships with public mental health systems and other entities (e.g., research institutes, departments of psychiatry and behavioral science, State Mental Health Authority, educational or correctional organizations) should be described. The applicant must submit (as an appendix to the application) a letter of agreement signed by the responsible officer of each associated organization, stating that cooperation, research facilities, services, or other relevant assistance will be available on a continuing basis. Appropriate clearances from each associated organization must be submitted that state that the proposed research meets that institution's research review requirements (e.g., Institutional Review Board responsible for activities involving human subjects). The research part of the overall Center plan should include a section that specifies and justifies the cohesive and parsimonious set of research core areas that will be addressed by Center study teams, the overall goals and objectives of the Center, the principal areas of research to be emphasized in the Center, major theoretical and policy orientations that will guide the Center, the disciplines to be included, and the plans for coordination among the various research activities of the Center. Research Core Areas. For purposes of this announcement, a research core area is defined as an important area for services research within which a Center plans to develop and conduct interrelated research projects. Since services research is inherently interdisciplinary, projects within a core area should seek to incorporate collaborative relationships among scholars representing complementary disciplines. Separate descriptions must be provided for each major research core area, including summary descriptions of exploratory and developmental research projects to be supported in each core area and how these projects will relate to and support each other. These descriptions should cover the relevant literature and existing knowledge; objectives and significance of the research; research design; proposed study samples; research investigators and estimated percentages of effort; budget; and timetable for project implementation. Budget. Budgets for the Center core and for each research core area should be presented in aggregate as well as separately. Additionally, the applicant institution should indicate in specific terms its cash and in-kind support for the Center. In-kind support should be significant and may include such items as administrative support, equipment, and time contributions of institutionally supported researchers and research assistants who will participate in the Center. Applicants from institutions that have another research center (e.g., a health services research center) may wish to identify this center as a collaborator in the proposed plan of studies. If so, a letter of agreement from the program director or principal investigator should be included with the application. Although a Center should be involved in attracting new investigators into the field of mental health services research, funds from the Center may not be used to support training activities other than those incidental to the conduct of specific research projects. Centers may apply to NIMH for separate research training funds available under the National Research Service Award Program of the U.S. Public Health Service. STUDY POPULATIONS INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This new policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43) and supersedes and strengthens the previous policies (Concerning the Inclusion of Women in Study Populations, and Concerning the Inclusion of Minorities in Study Populations), which have been in effect since 1990. The new policy contains some provisions that are substantially different from the 1990 policies. All investigators proposing research involving human subjects should read the "NIH Guidelines For Inclusion of Women and Minorities as Subjects in Clinical Research," which have been published in the Federal Register of March 9, 1994 (FR 59 11146-11151) and reprinted in the NIH Guide for Grants and Contracts, Volume 23, Number 11, March 18, 1994. Investigators also may obtain copies of the policy from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. APPLICATION PROCEDURES Applicants are to use the research grant application form PHS 398 (rev. 9/91). The number and title of this program announcement, PAR-94-073, "Centers for Research on Services for People with Mental Disorders," must be typed in item number 2a on the face page of the PHS 398 application form. Applications for a Center grant must include: (1) an overall organizational and research plan, and (2) separate, more detailed plans for the research core areas that are proposed as foci for Center activity. For purposes of the page limitations of sections 1 through 4 of PHS 398, the overall Center research plan and organizational plan should be considered one component with a 25-page limit. A maximum of 25 additional pages may be used for each research core area that the Center will address. Application kits containing the necessary forms may be obtained from office of sponsored research at most universities, colleges, medical schools, and other major research facilities and from the Office of Grants Information, Division of Research Grants, National Institutes of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone 301/710-0267. The signed original and five copies of the completed PHS 398 must be sent to: Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, MD 20892** REVIEW CONSIDERATIONS Applications will be reviewed for scientific and technical merit by an NIMH initial review group (IRG) composed primarily of non-Federal scientific experts. A second level review will be made by the National Advisory Mental Health Council; review by Council may be based on policy considerations as well as scientific merit. By law, only applications recommended for consideration for funding by the Council may be supported. Summaries of IRG discussions are sent to applicants as soon as possible following IRG review. Review Criteria. Criteria to be used in evaluating scientific/technical merit of Center applications are: o Scientific and technical significance and originality of the proposed research o Appropriateness and adequacy of the research approach and methodology proposed to carry out the research o Qualifications and research experience of the principal investigator and other key personnel o Availability of resources needed for the proposed research o Capability of the Center leadership, management systems, and organizational structure to coordinate and carry out the proposed program of research and research development o Representation on the Center staffing plan of the multiple disciplines needed to conduct mental health services research, and adequacy of arrangements to insure effective collaboration among investigators from these disciplines o Linkages to major public and/or private mental health service systems serving persons with mental disorders o Potential of the Center program to generate high quality proposals for additional extramural research support o Appropriateness of the proposed budget and duration in relation to the proposed research o Adequacy of the proposed means for protecting against or minimizing adverse effects to human subjects AWARD CRITERIA Factors considered in determining which applications will be funded include IRG and Council recommendations, PHS program needs and priorities, and availability of funds. Applications will be received and reviewed once a year according to the following NIMH schedule: Application Receipt Date: October 1 Initial Review: February/March Advisory Council Review Date: May/June Earliest Start Date: July 1 As part of the NIMH Public-Academic Liaison (PAL) initiative, preference may be given to applications that involve active collaborations between academic researchers and public sector agencies in planning, undertaking, analyzing, and publishing research pertaining to persons with severe mental disorders. The PAL initiative is based on the premise that important new advances in understanding and treatment of severe mental disorders can result from improved linkages between the Nation's scientific resources and the public sector agencies and programs in which many persons with severe mental disorders receive their care. INQUIRIES Written and telephone inquiries are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues to: Thomas L. Lalley, M.A. Division of Epidemiology and Services Research National Institute of Mental Health 5600 Fishers Lane, Room 10C-06 Rockville, MD 20857 Telephone: (301) 443-3364 Inquiries regarding rural mental health research may be directed to: Charles D. Windle, Ph.D. Office of Rural Mental Health Research National Institute of Mental Health 5600 Fishers Lane, Room 10-104 Rockville, MD 20857 Telephone: (301) 443-9001 For information on fiscal issues related to grant applications, inquiries may be directed to: Diana Trunnell Grants Management Branch National Institute of Mental Health 5600 Fishers Lane, Room 7C-15 Rockville, MD 20857 Telephone: (301) 443-3065 AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance 93.242. Awards are made under authorization of the Public Health Service Act, Title IV, Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and 285). Grants must be administered in accordance with the PHS Grants Policy Statement (rev. 4/94). Federal Regulations at 42 CFR Part 52 and 66, "Grants for Research Projects" and 45 CFR Parts 74 and 92 concerning administration of grants, are applicable to these awards. This program is 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. The Public Health Service strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. .
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