Full Text MH-92-08

MENTAL HEALTH INSTITUTIONAL CLINICAL TRAINING GRANTS:  PROFESSIONAL
TRAINING FOR RACIAL/ETHNIC MINORITY AND DISADVANTAGED STUDENTS

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

RFA:  MH-92-08

P.T. 44, FF

Keywords: 
  Biomedical Research Training 
  Emotional/Mental Health 
  Mental Disorders 


National Institute of Mental Health

Applications Receipt Date:  April 24, 1992

PURPOSE

This program is designed to support recruitment and education of
racial/ethnic minority and disadvantaged students to become
professionals in the core mental health disciplines of social work,
psychiatric nursing, psychology, psychiatry, and marriage and family
therapy.  The term "minority" in this announcement refers to Blacks,
Hispanics, Asian/Pacific Islanders (including Native Hawaiians and
Samoans), and American Indians/Alaska Natives.  The definition of
disadvantaged students is left to the applicant institution that must
justify it.  It could include the hearing impaired or those with other
handicapping conditions but would not extend to individuals whose sole
disadvantage is economic.

HEALTHY PEOPLE 2000

The Public Health Service (PHS) urges applicants to submit work plans
that address specific objectives of "Healthy People 2000."  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

Accredited and/or approved departments/divisions in the mental health
core disciplines of psychiatric nursing, psychiatry, psychology, social
work, and marriage and family therapy in colleges and universities of
the United States, including territories and possessions, are eligible
to apply.  Multidisciplinary applications are encouraged.  Applications
may be for predoctoral and/or postdoctoral training in any of these
fields.  Requests for support of trainees at multiple levels, e.g.,
master's, post-master's, doctoral, postdoctoral, that are consistent
with the educational patterns of the discipline, may be incorporated in
a single application, where appropriate.  Applications from
historically Black colleges and universities and institutions with
substantial minority enrollment are strongly encouraged.

The disciplines and eligible institutional units are:

o  an accredited college or university school of nursing that offers a
graduate program in psychiatric nursing

o  a department of psychiatry, a division of child psychiatry, or a
division of geriatric psychiatry having an accredited training program
for general and/or child psychiatry residents in an accredited medical
school or a freestanding institution

o  a department of psychology, a school of professional psychology, or
an internship program, each with appropriate accreditation for training
in clinical, counseling, or school psychology

o  a school or department of social work offering accredited
master's/doctoral programs; accredited baccalaureate programs in States
having no graduate program; and post-master's and postdoctoral training
programs

o  a college or university-based accredited graduate program in
marriage and family therapy and accredited post-master's and
postdoctoral training programs

An institution may apply for one clinical training grant in each of the
core disciplines under this Request for Applications (RFA).  However,
NIMH encourages multidisciplinary training programs where appropriate.

MECHANISM OF SUPPORT

This RFA will use the NIH Graduate Training Programs Grant (T01).
Responsibility for the planning, direction, and execution of the
proposed project will be solely that of the applicants.  The period of
support is limited to 3 years.

Direct Costs:  Funds may be used only for those expenses that are
directly related to and necessary for conducting the project and must
be expended in conformance with DHHS cost principles, the Public Health
Service (PHS) Grants Policy Statement, and conditions set forth in this
document.  Federal Regulations at Title 45CFR parts 74 and 92, generic
requirements concerning the administration of grants, are applicable to
these awards.

Support under this program is primarily to provide trainee stipends,
and stipend requests must be included in all applications.  Other
categories of support are permitted at minimal levels under the
conditions outlined below.

Trainee Stipends:  Trainee Stipends are intended to assist minority
and/or disadvantaged students in meeting subsistence expenses and to
enable them to pursue education on a full-time basis.  No part-time
stipends are allowed.  The amount of the stipend is determined by the
academic status of the appointee.  Stipends for full-time trainees
enrolled in educational programs leading to or based on a degree are as
follows:

Prebaccalaureate - These stipends are at a level of $6,504 for a
12-month program, prorated according to actual length of support.

Postbaccalaureate - predoctoral - These stipends will be paid at an
annual (12 months) rate of $8,800, prorated according to the length of
the training program.

Postdoctoral - Postdoctoral stipends range from $18,600 to $32,300 per
year, depending upon the level of relevant experience of the student at
the time of appointment.  These amounts must be prorated according to
actual length of support.

              Years of Relevant Experience        Stipend
                              0                   $18,600
                              1                   $19,700
                              2                   $25,600
                              3                   $26,900
                              4                   $28,200
                              5                   $29,500
                              6                   $30,800
                              7 or more           $32,300

Relevant experience is considered to include activities beyond the
doctoral degree such as internship, residency, teaching, or providing
services in the specific area of training.  For trainees who receive a
stipend for the first time in a second or later year in the NIMH
training program, the level of support shall be determined by relevant
experience before entry into the program, plus full-time years in the
program without a stipend.

Stipends for full-time trainees enrolled in postdoctoral programs that
are not degree related may be paid commensurate with the trainee's
career status and experience in accordance with the above schedule.
Maximum support is $32,300, prorated according to the length of the
program.

Allowances are available for medical students to engage in
not-for-credit supervised clinical experience and/or related special
studies/projects in any of the NIMH-supported programs in psychiatry.

Teaching and Associated Costs:  Direct cost items are allowable for
teaching costs associated with these projects.  Direct cost items
include personnel, consultants, supplies, travel, reproduction and
printing costs, rental equipment, minor equipment items, and other
items that are directly related to the proposed clinical training
program and are otherwise unavailable from the institution.  It is
expected that the educational institutions will fund a substantial part
of the support for personnel costs.  Teaching costs may be requested up
to a ceiling of $1,500 per predoctoral stipend and $2,500 per
postdoctoral stipend.  No teaching costs are permitted except in
association with stipends.

Other Trainee Costs:  In addition to stipends, the institution may
request funds for tuition, fees, and trainee travel.  Trainee travel
costs are allowable only between the institutional and field training
site, or in the special cases indicated on page 7-16 of the PHS Grant
Policy Statement.  Requests for tuition may not exceed $8,000 per
stipend.

Indirect Costs:  All grants under this RFA will be reimbursed at eight
percent of total allowable direct costs or actual indirect costs,
whichever is less.

Payback Provisions:  Any trainee who receives a clinical traineeship in
psychology, psychiatry, psychiatric nursing, social work, or marriage
and family therapy, in an established training program, designed to be
for a period of 180 days or more under an NIMH clinical training grant,
must pay back a period of obligated service equal to the length of the
traineeship.  The period of support need not be continuous.  Any
support received for any period of time under previous NIMH clinical
training grants, if the stipend and/or other allowances were awarded on
or after September 1, 1981, will be added to the total length of
service required.  The conditions of the obligated service requirement
are set forth in 42 Code of Federal Regulations Part 64a, and include
a triple damages repayment provision for failure to fulfill the
obligated service.  No trainee may receive a stipend or other allowance
from the grant until he/she has signed and submitted a Payback
Agreement form, a Statement of Appointment of Trainee form (PHS 2271),
and a certification of Non-Delinquency on Federal Debt.

Additional information on payback requirements is available from:

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

FUNDS AVAILABLE

In fiscal year 1992, approximately $800,000 will be available to fund
approximately 10 to 16 awards under this RFA.  Support may be requested
for up to three years.  Since this program is proposed in the
President's fiscal year 1992 budget for phase-down over three years,
the NIMH can make no commitment beyond the first year.  Therefore, the
objectives and activities of the first year must be designed to be
significant with or without funding in future years.  Each award may be
no more than $80,000 in total costs.

OBJECTIVES

Background

Racial and ethnic minorities are expected soon to become one quarter of
the United States population.  Projections are that the need for mental
health services will rise proportionately, particularly in the public
sector where most minority persons are served.  There is increasing
evidence also that when minority persons require mental health services
they most often seek mental health professionals of a race or ethnicity
similar to their own or choose settings staffed by mental health
professionals who demonstrate responsiveness to their needs.
Currently, minorities represent less than 10 percent of mental health
professionals.  The need to increase the number of racial and ethnic
minority mental health professionals is clear so that they may not only
serve their own communities but also contribute to improving the
overall quality of the mental health system by promoting its
responsiveness to the unique needs of culturally diverse groups.

Goals and Scope

The National Institute of Mental Health(NIMH) offers clinical training
programs for racial/ethnic minority and disadvantaged students to
enhance the quality and effectiveness of services to persons with major
mental disorders.  Applications must focus in depth on one or more of
the priority populations described below.  Programs must demonstrate
that they incorporate the latest diagnostic and treatment procedures
and the latest relevant research findings.  The priority service
populations for this RFA are:

o  Severely and Persistently Mentally Ill Adults:  This priority
population includes, but is not limited to, adults with schizophrenic
disorders, major mood disorders, including homeless persons with these
disorders, and persons with co-morbidity, i.e., the mentally ill who
are also alcohol and/or drug abusers.

o  Children and Adolescents with Severe Mental Disorders:  Serious
emotional disturbances of children and adolescents include, but are not
limited to, childhood psychoses, major mood disorders, disruptive
behavior and personality disorders, and serious developmental disorders
or alcohol and/or drug abuse when combined with other mental disorders.


o  Elderly with Mental Disorders:  Mental disorders of the aging
include Alzheimer's disease and other dementias; affective disorders
with associated medical, behavioral, cognitive, social, and emotional
aspects; and anxiety disorders; late-onset schizophrenia; and
personality disorders.

o  Mentally Ill in Rural Areas:  This population includes individuals
with severe and persistent mental and emotional disorders living in
rural areas, especially those areas--rural towns and communities-- with
low population density and limited access to health, mental health, and
social services.  Applicant institutions selecting this priority must
include a strategy for the recruitment of minority and/or disadvantaged
students from rural areas and the development of a curriculum
addressing rural mental health issues.

o  Racial/Ethnic Minorities, particularly Native Americans, with Mental
Disorders:  While minority persons are represented among the priority
service populations listed above, developing and implementing targeted,
culturally appropriate mental health services for minorities within
these groups (i.e., minority adults, minority children and adolescents,
minority elderly, and minorities in rural areas) are a complex and
challenging priority.  Applicant institutions selecting this priority
must, therefore, demonstrate a capacity to develop and implement a
focused, culturally appropriate clinical training program with a
curriculum and clinical experiences based on culturally relevant
concepts and the latest scientific findings.

Other cross-cutting priorities are linkages between academic programs
and State/community service systems, i.e., public-academic linkages
(PAL) and linkages with clinical researchers and research trainers.
Therefore, training institutions are strongly encouraged to collaborate
with State and local mental health and State and local alcohol and drug
abuse service systems in order to make training sites available in
public facilities and to ensure that trainees receive high-quality
relevant clinical experiences in these settings.  Similarly,
intra-institution collaboration with ongoing clinical research
components is also encouraged.

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.

APPLICATION PROCEDURES

Prospective applicants are strongly encouraged to consult NIMH staff
regarding eligibility and assistance in developing applications.
Applications kits (PHS 398, Rev. 10/88) containing the necessary forms
and Special Instructions may be obtained by contacting the Education
and Training Branch staff listed at the end of this announcement.
Applicants must use the Special Instructions included in the
application kit that are specifically designed for this NIMH
Institutional Clinical Training Grant program.

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

The applicant must include a project abstract that may not exceed the
space provided in the application.

The narrative section of the application may not exceed 20 pages.
Appendices may be used, but not to expand the narrative section.
Applications exceeding this limitation will be returned without review.
The original and four copies of the application must be submitted to:

Division of Research Grants
Westwood Building, Room 240,
5333 Westbard Avenue
Bethesda, MD  20892**

The RFA label (found in the application form PHS 398) must be affixed
to the bottom of the face page of the original copy of the application.
Failure to use this label could result in delayed processing of your
application such that it will not reach the review committee in time
for review.

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

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

Receipt And Review Schedule

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

April 24, 1992    June/July   September 1992      September 1992
                    1992

Applications received after the above receipt date will be returned to
the applicant without review.

Application Characteristics

Applications must include a brief description of the applicant
educational institution and, where appropriate, associated service and
clinical research settings, including background, history, programmatic
focus, organization, resources, personnel, and record of
educational/service/research linkage achievements.  Any existing mental
health and substance abuse clinical or research training activities in
the priority area(s) addressed by an application must be described.  A
carefully organized plan for teaching the mental health skills
necessary must be presented.  Of particular interest are linkages of
ongoing or proposed clinical training activities with clinical research
or research training at the applicant institution.

Each application must include a description of:

o  the pool from which minority and/or disadvantaged trainees will be
recruited, recruitment strategies, selection criteria, number of
minority or disadvantaged students to be enrolled, and the total number
of trainees, including those who would not receive a stipend but who
would benefit directly and indirectly from the supported training

o  goals and objectives of the training

o  curricula content that addresses ethnic and cultural issues

o  specific steps to be taken for the recruitment, retention, and
graduation of minority and/or disadvantaged trainees

o  key faculty members and clinical supervisors or field instructors,
especially minorities who will serve as role models, including their
assignments of responsibility to the program, and other qualifications,
experience, and roles

o  history and current structure of the proposed education/training
program, with an overall characterization of principles and conceptual
framework around which the program is organized

o  differences between the proposed program and ongoing general mental
health training at the institution highlighting how the proposed
program enhances ongoing training particularly in the focused priority
area

o  educational and training components of the proposed program,
highlighting which courses and clinical experiences are proposed but
not yet implemented:

- a didactic component that is designed to make available to the
student the latest scientific knowledge regarding the designated
priority population, including minority content where appropriate

- an experiential component that involves direct service to priority
population patients or clients, including minorities, as well as
exposure to issues of service delivery

o  training that promotes an understanding of research methodologies
and the incorporation of research findings into clinical practice

o  support for the proposed program by the educational/training
institution and any related State/community service systems

o  linkages between the academic institution and public mental health
service systems

o  linkages between clinical researchers and research and clinical
trainers within the institution

o  professional activities of all trainees who have completed this
specialty program in the last five years, indicating minority or
disadvantaged students, with particular attention to the effects of
previous NIMH grant support, if any

o  number of students currently enrolled in the educational/training
program directed to the designated priority service populations,
indicating minority or disadvantaged students so enrolled

o  an evaluation plan that addresses all aspects of the training
program including formative and summative evaluations to provide
feedback for program improvement

REVIEW CONSIDERATIONS

A dual review system is used to ensure expert, objective review of the
quality of applications.  The first step, peer review for educational
and technical merit, is by primarily non-Federal experts.  Notification
of the review recommendations will be sent to the applicant after the
initial review.  The final review is by the National Advisory Mental
Health Council.  Only applications recommended for approval by the
Council will be considered for funding.

Review Criteria

Each grant application is evaluated on its own merits.  The following
criteria are used in the initial review:

(1) Quality of education/training program

o  clarity of the goals of the proposed educational/training program
and their consonance with the purposes and requirements of this RFA

o  relevance, feasibility, and specificity of the content, methods, and
organization of the training program in relation to specified project
goals and objectives, including minority content where appropriate

o  subpopulations adequately addressed

o  soundness of the plan for providing balanced didactic and
experiential educational content, including existing and/or new and
innovative curricular offerings and teaching methods oriented to the
priority population(s), including minority content where appropriate

o  inclusion in the curriculum of up-to-date research findings and
scientific knowledge about diagnostic and treatment services for the
priority population(s), including minority content where appropriate

o  inclusion of research methods and evaluation

o  appropriateness of plans for evaluating the proposed program

(2) Budget adequacy of the budget projections and other resources for
carrying out the project activities

(3) Quality of public-academic linkages

o  degree to which the educational plan has been developed and will be
implemented in conjunction with public mental health systems and
services, and commitment of key personnel and institutions to
public-academic linkages
o  availability and extent of trainee experience in publicly funded
(including private non-profit) clinical programs

(4) Quality of faculty

o  expertise with the priority population(s), including national
leadership and publications

o  clinical qualifications of faculty, including appropriateness as
minority role models

(5) Quality of students/trainees feasibility of the plan to recruit
from a high-quality pool of minority and/or disadvantaged students and
to retain and graduate competent students

(6) Training record

o  evidence of applicant's history and commitment to educate
professionals for publicly funded service to the identified priority
population(s), as documented in the career patterns of graduates of
this specialty program in the last five years

o  evidence of:  (a) successful use of previous minority and
disadvantaged NIMH grants, if any, and (b) capacity to train minority
and disadvantaged professionals for service in the priority areas

AWARD CRITERIA

Awards will be made on the basis of the following criteria:

o  quality of proposed education/training programs as determined by the
review process

o  balance among programs directed to the priority populations, among
the disciplines and, where appropriate, among geographic, especially
rural, locations

o  availability of funds

INQUIRIES

Staff of the NIMH will provide consultation and technical assistance to
prospective applicants regarding this RFA.  Those who direct training
toward Native Hawaiians, Samoans, and other Native American Pacific
Islanders are particularly encouraged to apply and seek consultation
and technical assistance early in the application process.  Staff
consultation on clinical training grants is available from the
following:

General Information:

Lemuel B. Clark, M.D.
Chief, Education and Training Branch
Telephone:  (301) 443-5850

Social Work and Marriage and Family Therapy:

Neilson F. Smith, Ph.D.
Chief, Social Work Education Program
Telephone:  (301) 443-5850

Psychiatry:

Melvyn R. Haas, M.D.
Chief, Psychiatry Education Program
Telephone:  (301) 443-2120

Psychology

Paul Wohlford, Ph.D.
Chief, Psychology Education Program
Telephone:  (301) 443-5850


Psychiatric Nursing:

Carol Bush, Ph.D., R.N.
Chief, Psychiatric Nursing Education Program
Telephone:  (301) 443-5850

The mailing address for all the above is:

Education and Training Branch
Division of Clinical Research
National Institute of Mental Health
5600 Fishers Lane, Room 7C02
Rockville, MD  20857

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.  This program is not subject to the intergovernmental review
requirements of Executive Order 12372 or review by a Health Systems
Agency.

.

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