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National Institute of Mental Health Office for Special Populations and Office of Rural Mental Health Research Orientatio

National Institute of Mental Health Office for Special Populations and Office of Rural Mental Health Research Orientation to The Hispanic Association of Colleges and Universities Neuroscience Center Bethesda, MD July 26, 2006. Robert A. Mays, Jr., Ph.D., MSW

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National Institute of Mental Health Office for Special Populations and Office of Rural Mental Health Research Orientatio

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  1. National Institute of Mental Health Office for Special Populations and Office of Rural Mental Health Research Orientation to The Hispanic Association of Colleges and Universities Neuroscience Center Bethesda, MD July 26, 2006 Robert A. Mays, Jr., Ph.D., MSW Deputy Chief, Office of Rural Mental Health Research and Program Director, Research Training/Infrastructure Office for Special Populations, NIMH 301.443.2847 Rmays@mail.nih.gov

  2. National Institute of Mental Health Mission Statement The mission of NIMH is to reduce the burden of mental illness through research on the mind, brain, and behavior. NIMH takes the lead in understanding the impact of behavior on HIV transmission and pathogenesis, and in developing effective behavioral preventive interventions. The NIMH conducts a wide range of research, research training, and research capacity development, as well as, public information outreach and dissemination to fulfill its mission.

  3. National Institute of Mental Health The NIMH Director’s Page http://www.nimh.nih.gov/about/director.cfm Research Priorities and Strategic Plans • supporting basic science discoveries • translating these discoveries into new interventions that will relieve the suffering of people with mental disorders; and • ensuring that new approaches can be used for diverse populations and in diverse settings. http://www.nimh.nih.gov/strategic/strategicplanmenu.cfm Research Funding: NIMH Reorganized Programs Effective October 2004 http://www.nimh.nih.gov/researchfunding/reorganization.cfm National Advisory Mental Health Council Reports http://www.nimh.nih.gov/council/advis.cfm

  4. Who/What is a Project Officer/Program Director? • Project Officer/Program Director • is a scientist and administrator • manages grants, contracts, cooperative agreements • identifies needs in scientific areas • identifies scientific areas of special interest and communicates interest • reports on scientific progress and program accomplishments

  5. Who/What is a Scientific Review Administrator? • Scientific Review Administrator • is a scientist and administrator • manages the review of grants, contracts, cooperative agreements • appoints members to initial review groups/study sections/special emphasis panels • responds to questions about review at Advisory Councils and Board meetings • if Referral Officer, refers applications to study section for review and to Institute for acceptance into program

  6. National Institute of Mental Health Organization Office of The Director (OD) • Office for Special Populations (OD/OSP) • Office of Rural Mental Health Research (OD/OMHR) • Office of Science Policy, Planning and Communications • Offices on AIDS; Global Mental Health; Resource Management; Prevention; Constituency Relations and Public Liaison; and Diversity and EmployeeAdvocacy Programs Division of Extramural Activities (DEA) Division of Neuroscience and Basic Behavioral Science (DNBBS) Division of Adult Translational Research and Treatment Development (DATR) Division of Pediatric Translational Research and Treatment Prevention (DPTR) Division of AIDS and Health and Behavior Research (DAHBR) Division of Services and Intervention Research (DSIR)

  7. Associate Director for Special Populations: Congressionally Mandated Mission Develop and coordinate research policies and programs to assure increased emphasis on the mental health needs of women and minority populations; support programs of basic and applied social and behavioral science research on the mental health problems of women and minorities; study the effects of discrimination on institutions and individuals, including majority institutions and individuals; support and develop research designed to eliminate institutional discrimination; and provide increased emphasis on the concerns of women and minority populations in the Institute’s training, service delivery, and research programs.

  8. National Institute of Mental HealthSpecial Populations Program Organization

  9. Office for Special Populations and Office of Rural Mental Health Research Director for Special Populations Ernest Marquez, Ph.D. and Acting Director, Office of Rural Mental Health Research Deputy Director for Special Populations Sherman Ragland, MSW Chief, Office of Rural Mental Health Research Anthony Pollitt, Ph.D. Deputy Chief, Office of Rural Mental Health Research Robert Mays, Ph.D., MSW Chief, Women’s Mental Health Programs Catherine Roca, M.D. Deputy Chief, Women’s Mental Health Programs Kathy O’Leary, MSW Chief, Research Scientist Development Michael Sesma, Ph.D. Program Program Director, Research Training and Infrastructure Robert Mays, Ph.D., MSW Social Science Analyst Sheila Bolt Administrative Assistant (Pop Tracking) Dawn Corbett Administrative Assistant Jeanette Smith 301.443.2847

  10. Research Scientist Development: One Step at a Time! Faculty TenureR01 Mentor New Faculty K01, R21, R03 Post-Doc e.g.Fellowship, Training Grant, Diversity Supplements e.g. Training Grants, Fellowships Diversity Supplements Graduate Undergrad e.g. Supplements, T34 COR Stipends High School e.g. Collaborative Networks, R25 COR Stipends

  11. National Institute of Mental HealthResearch Training and Career Development Timetable Approx. Stage of Research Training and Development Mechanism of Support Predoctoral Institutional Training Grant (T32) GRADUATE/ MEDICAL STUDENT Predoctoral Individual NRSA (F31) Predoctoral Individual MD/PhD NRSA (F30) Dissertation Research Grant (R36) Postdoctoral Institutional Training Grant (T32) Postdoctoral Individual NRSA (F32) POST DOCTORAL/ CLINICAL RESIDENCY Mentored Research Scientist Development Award (K01) Mentored Clinical Scientist Development Award (K08) Mentored Patient-Oriented Research Career Development Award (K23) Scientist Development Award for New Minority Faculty (K01) B/Start (R03) EARLY Small Grant (R03) Exploratory/Developmental Grant (R21/R34) Research Project Grant (R01) Independent Scientist Award (K02) MIDDLE CAREER Midcareer Investigator Award in Patient-Oriented Research (K24) http://www.nimh.nih.gov/researchfunding/training.cfm SENIOR

  12. OSP – Mental Health Research Training and Infrastructure Grants and Research Supplements T34 Career Opportunities in Research Education and Training (COR) Honors Undergraduate Program R25 Career Opportunities in Research Education and Training (COR) Honors High School Program R24 Minority Research Infrastructure Support Program Research Supplements to Promote Diversity in Health-Related Research (PA-05-015)

  13. Career Opportunities in Research Education and Training (COR) Honors Undergraduate Research Training Grant (T34) PAR-01-008 Annual Submission: May 10 • Provide research education and mentorship • Awarded to four-year public or private institutions • Must have 50% > racial and ethnic minority students • Limited to four to ten Juniors and Seniors: 3.0 > GPA • $300K in Direct Costs annually; five year renewals • Stipend ($10.2K) and partial tuition/fees • Stipend support cannot exceed two years. • Tuition and fees: 100% of first $3K and 60% of costs • Up to 50% effort of personnel; some secretarial/lab support • Consultants, travel, research supplies, computer time, publication costs for trainee papers • Actual Facilities and Administrative cost or 8% of Direct Costs which ever is less

  14. NIMH COR Institutions T34 COR LocationsProgram Directors Grambling State U. Stacey Duhon, Ph.D. Hampton University Nancy Duncan, Ph.D. Howard University Lloyd Sloan, Ph.D. Jackson State U. Pamela Banks, Ph.D. Morehouse College M. Weber-Levine, Ph.D. Clark Atlanta University Spelman College Karen Brakke, Ph.D. Morris Brown Morgan State U. Terra Bowen-Reid, Ph.D. SUNY, Old Westbury Steven Pryor, Ph.D.

  15. NIMH COR Institutions T34 COR LocationsProgram Directors Hunter College V. Quinones-Jenab, Ph.D Mercy College James Towey, Ph.D. San Francisco State U. Sacha Bunge, Ph.D. Cal State U., Northridge Carrie Saetermoe, Ph.D. Cal State U., Long Beach Chi-An Chun, Ph.D. San Diego State U. TheresaCronan, Ph.D.

  16. NIMH COR Institutions T34 COR LocationsProgram Directors Cal State U., Los Angeles Thanh Tran, Ph.D University of Puerto Rico, Rio Piedras Guillermo Bernal, Ph.D. Long Island University Carol Magai, Ph.D. University of New Mexico, Phillip May, Ph.D. Albuquerque University of Texas, El Paso Michael Zarate, Ph.D. University of Nebraska, Lincoln Les Whitbeck, Ph.D.

  17. R25 High School Opportunities in Research Education (COR) Training Program (PAR)-01-009 Annual application: May 10 • Model, mentor, and teach mental health research to high school students • Sponsored by an Undergraduate COR T34 • Five year grant up to $35K per year to the T34 COR • Total of six Junior and Seniors with 3.0 > GPAs • Stipend up to $2K per AY or summer session • Personnel, consultants, travel, supplies • Facilities and Administrative costs or 8% of Direct Cost which ever is less

  18. R25 High School Opportunities in Research Education (COR) Training Program Institutions High School COR SitesProgram Directors Howard University Lloyd Sloan, Ph.D. Jackson State U. Pamela Banks, Ph.D. U. of Puerto Rico, Rio Piedras W. Arocho-Rodriquez, Ph.D. SUNY, Old Westbury Steven Pryor, Ph.D. Cal Sate U. Northridge Sherry Span, Ph.D.

  19. R24 Minority Research Infrastructure Support Program (M-RISP) PAR 01-029 Increase the capacity to conduct mental health research • An Infrastructure Development Plan ($100K) • Two or more Independent Research Projects ($60K) • 400K annually in Direct Costs for three years • Five year competitive renewals • Institutions with 30% > racial/ethnic minority students and past three years with efforts to increase • Annual Submission: June 1

  20. M-RISP Institutions M-RISP LocationPrincipal Investigator Lehman College Bronx, NY Kevin Sailor, Ph.D. Howard University Lloyd Sloan, Ph.D. University of Puerto Rico, Rio Piedras Guillermo Bernal, Ph.D. University of Puerto Rico Nidza Lugo, Ph.D. Medical Sciences Campus U. Texas, El Paso Michael Zarate, Ph.D University of Hawaii John A. Burns School of Medicine Naleen Andrade, Ph.D.

  21. M-RISP Institutions M-RISP LocationPrincipal Investigator Meharry Medical College James Townsel, Ph.D. Tennessee State U. Baqar Husaini, Ph.D. Chicago State U. Esther Jenkins, Ph.D. SUNY at Old Westbury George Stefano, Ph.D. San Francisco State U. Rafael Diaz, Ph.D. Howard University John Massari, Ph.D Medical School

  22. M-RISP Institutions M-RISP LocationPrincipal Investigator University of Texas, San Antonio Raymond Garza, Ph.D. San Diego State University Theresa Cronan, Ph.D. California State University, John Jung, Ph.D. Long Beach California State University, Carrie Saetermoe, Ph.D. Northridge

  23. Research Supplements to Promote Diversity in Health-Related Research (PA-05-015) • Used to attract and encourage individuals, or modify resources to an existing grant • Support attached to an existing award • Requested by the Principal Investigator • Awarded to the Institution • Principal Investigators of Research Grant Mechanisms: R01,R10, R18, R22, R24, R35, R37, P01, P30, P40, P41, P50, P51, P60, U01, U10, U19, U41, U42, or U54 • Exceptions can be made to eligibility requirements • Funding decision take approximately six to eight weeks • Usually one research supplement per grant

  24. Diversity Supplements • For all stages of the research career from high school to assistant professor/research associate • Support for Minority, Disadvantaged and Disabled individuals • Additional funds are awarded to a Principal Investigator to include a minority or disadvantaged individual on their NIH funded project • Great way to join a research project and successful research team • Also, provides funds for equipment to allow reasonable accommodations for the disabled individual

  25. Diversity Supplements High School Students: • $3K for student for summer experience, or $6.25 hourly part-time • Two year program encouraged • Equivalence of two three-month, full-time periods desired Undergraduate Students: • Student salary should be consistent with institutional salary policy • Hourly rate more than $8.00 needs justification • Additional $200.00 per month for travel and supplies • Three full months of effort expected for at least two years

  26. Diversity Supplements Post-Baccalaureate and Post-Master’s Degree Students: • Recent graduates to spend up to two years in mental health related research while applying for graduate/medical/dental or other schools • Student salary should be consistent with institutional salary policy • Should not exceed graduate student salary, an additional $3K per year can be requested for supplies and travel, but no equipment purchases. Graduate Research Assistants: • Students enrolled in master’s or doctoral degree programs in biomedical, behavioral, clinical, social sciences, and medical school • Compensation may include tuition remission in-lieu of wages • Salary can not exceed first year postdoctoral comparable work • Additional $4K per year for supplies and travel, but no equipment

  27. Diversity Supplements Individuals in Postdoctoral Training • Participate in ongoing research that develops a productive researcher • Encouraged to apply for independent support before end of supplement; no support if on a research or training grant • Work with predoctoral mentor usually not approved; salary can not exceed $50K per year • Additional $6K per year for supplies and travel, but no equipment Investigators Developing Independent Research Careers: • Support to staff and faculty with doctoral a degree • R01, P01, P50, G12, K01, K02, K07, K08, K12 ineligible • Short-term – full-time (3-5 months per year) for four years • Long-term – minimum 30% effort per year for four years • Salary consistent with institutional policy • $10K per year for supplies and travel, equipment with NIH approval

  28. SUPPLEMENTS TO PROMOTE REENTRY INTO BIOMEDICAL AND BEHAVIORAL RESEARCH CAREERS PA-04-126 • Returning Investigators • Individuals with at least two years postdoctoral research experience; eligible for doctoral research staff/faculty positions before departure • Women and men who departed to care for children, parents, or other family responsibilities; relocation with spouse, partner, or close family member; non-research endeavors to retire debts incurred during training; interruption due to incapacitating illness or injury • Not intended for career changes for individuals without prior research training • Full or part-time participation, but part-time not less than 50% effort; candidate should not be engaged in full-time paid research • Salaries consistent with institutional policy • $10K per year for supplies and travel, equipment with NIH approval • Early coordination with NIMH Program Official recommended

  29. ReEntry Supplements • Additional funds are awarded to a Principal Investigator to include a researcher on their existing project who has been out of a research career for 8 years or less due to health or life choices (e.g. parenting) • For postdoctoral and investigator level candidates • Great way to join a research project and successful research team and to get funds for a promising research who has taken time off to raise a family, deal with a major illness or family obligation.

  30. Information on Potential Parent Grants for Supplemental Grant Applications • Search CRISP (Computer Retrieval Information on Specific Projects) for abstracts of funded projects that would be eligible for a supplement opportunities on the NIH website. • http://www. crisp.cit.nih.gov/ • Contact Institutes (i.e. Program Officers) to learn how supplements are evaluated/awarded and areas of program priority; practices and program interests vary http://www.nimh.nih.gov/grants/supplement.cfm

  31. NIH Loan Repayment Programs • For health professionals conducting research and the LRP repays up to $35,000 of educational loans • Must be U.S. citizen, national or permanent resident • Must have advanced degree • Must be affiliated with NIH as postdoc, K awardee, first-time PI on R01, R03, R21 or U01, or first-time director on certain sub-projects • More information at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-01-064.html

  32. Extramural Loan Repayment Programs • For health professionals conducting research in non-profit institutions: • Clinical Research LRP • Pediatric Research LRP • Contraception & Infertility Research LRP • Health Disparities Research LRP • Clinical Research LRP for Individuals from Disadvantaged Backgrounds

  33. NIH Loan Repayment Program for Health Disparities Research • Pays off educational loan debt • Maximum award is $35K per year • 50% of awards must be made to individuals from health disparities populations • Affiliation with NIH is not required • Once accepted into program, persons must conduct at least two years of research relevant to health disparities • http://www.lrp.nih.gov/

  34. Extramural Clinical Research Loan Repayment Program for Individuals from Disadvantaged Background • Disadvantaged background refers to (1) environment that did not encourage or prepare person to enroll and graduate from a health professions school or (2) family was poor • Two years research service is required • Maximum of $35K per year paid to lender • Go to www.lrp.nih.gov

  35. Select National Initiatives Supporting Rationale for Diversity in Mental Health Research Careers • Mental Health: A Report of the Surgeon General (1999). • Translating Behavioral Science into Action: A Report of the National Advisory Mental Health Council’s Behavioral Science Workgroup (1999). • Ensuring a Strong U.S. Scientific Technical, and Engineering Workforce in the 21st Century, Report of the National Science and Technology Council (2000). • Addressing the Nation’s Changing Needs for Biomedical and Behavioral Scientists, Report of the National Research Council (2000). • Public Law 106-525, the Minority Health and Health Disparities Research and Education Act of 2000.

  36. Select National Initiatives Supporting Rationale for Diversity in Mental Health Research Careers (Cont’d) • An Investment in America’s Future: Racial and Ethnic Diversity in Mental Health Research Careers; A Report of the National Advisory Mental Health Council’s Workgroup on Racial and Ethnic Diversity in Research Training and Health Disparities Research, (2000). • Mental Health: Culture, Race, and Ethnicity; A Supplement to Mental Health: A Report of the Surgeon General, (2001). • Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care; A Report of the Institute of Medicine, (2002). • The NIH Strategic Plan and Budget to Reduce and Ultimately Eliminate Health Disparities (2001 and 2004 interim).

  37. Rationale for Racial and Ethnic Diversity • Declining birth rate and aging of current scientific workforce: racial and ethnic minorities grow from 26% to 48% of the census by 2050. • Immigration conduit is becoming unreliable due to home nations’ efforts to attract native scientists working abroad (H1-B Visa). • National Research Council and National Science and Technology Council reports recommend increased use of racial and ethnic minority groups to fill scientific workforce shortages. • Pedagogical outcomes generated by diversity enrich the learning, research, and healthcare environments. Racial and Ethnic Diversity in Mental Health Research Careers, A Report of the National Advisory Mental Health Council’s Workgroup on Racial and Ethnic Diversity in Research Training and Health Disparities Research, (2000).

  38. NIMH 1999 Funding Outcomes: • African Americans, Hispanics, and American Indians submitted 5.2% of the applications received by NIMH with 3.9% funded. • Asian American and Pacific Islanders submitted 5.2% of the applications to NIMH with 5.5% funded. • NIH funded 32% and NIMH funded 27% of competing research applications. Racial and Ethnic Diversity in Mental Health Research Careers, A Report of the National Advisory Mental Health Council’s Workgroup on Racial and Ethnic Diversity in Research Trainingand Health Disparities Research, (2000).

  39. NIMH Five-Year Strategic Plan for Reducing Health Disparities Reducing health disparities requires multiple approaches; therefore, the NIMH Health Disparities Strategic Plan encompasses these four Areas of Emphasis: 1) Increase the knowledge base by which disparities are documented and understood. 2) Improve outcomes of interventions and services through research. 3) Expand institutional research infrastructures, research training, and career development. 4) Enhance public information outreach and dissemination.

  40. OSP Activities: Health Disparities Research • Ascertain that IRG memberships are diverse and possess expertise needed to evaluate research in minority populations/communities • Facilitate development of ways to accurately measure extent of mental health disparities • Find ways to augment role of pharmacogenetic and pharmacokinetic studies in health disparities • Facilitate conduct of basic behavioral research on cultural differences in stress and coping • Facilitate behavioral research on cultural differences in resilience • Facilitate efforts to overcome health disparities related to health service delivery and use

  41. OSP Activities: Health Disparities Research • Facilitate research on health disparities related to treatment response, adherence, outcome, and quality • Facilitate research on suicide/depression and other severe mental illness in minority populations • Facilitate effective implementation and dissemination of preventive interventions for HIV/AIDS • Co-fund health disparities research and behavioral research at minority serving institutions • Determine extent and outcomes of existing health disparities research in NIMH.

  42. NIMH OSP Vision During the next five years OSP aspires to develop and implement research policies and programs that increase the Institute’s emphasis on the mental health needs of women, racial and ethnic minorities, rural populations, and persons of Low-SES; In that regard, we will diligently encourage programs of basic and applied social and behavioral research on the prevention, causation, treatment, and cure of mental illnesses that are disparately prevalent among women, racial and ethnic minorities, rural populations, and persons of Low-SES; We will champion the use of goals, objectives, action plans, and performance outcomes as were work to reduce the burden of mental illness for all Americans.

  43. Guiding Principles of OSP Operations The principle business of NIMH is to support investigator initiated research and to train investigators to carry out the NIMH mission. Therefore OSP endeavors to: Promote and use science to increase knowledge about the prevention, causation, treatment, and cure of mental illnesses. Reduce the under representation of special populations in the research arena to eliminate disparities and improve the health of all Americans. Disseminate valid and reliable knowledge to reduce the burden of mental illness for people in general and special populations specifically. Partner with ICs to assure effectiveness and efficiency, leverage resources, and provide quality stewardship of the public’s resources.

  44. Office of Rural Mental Health Research Mandated By Congress In 1991 Senate Appropriations Committee Directed NIMH to Expend $10.5 Million for Rural Mental Health Research and an additional $4.5 Million for Rural Native American and Alaska Native Research each Fiscal Year

  45. Office of Rural Mental Health Research Annual Expenditures (Millions of Dollars) 1991 - $10 MILLION 1996 - $32 MILLION 1992 - $22 MILLION 1997 - $24 MILLION 1993 - $17 MILLION 1998 - $25 MILLION 1994 - $ 25 MILLION 1999 - $ 27 MILLION 1995 $ 28 MILLION 2000 - $ 34 MILLION 2001 - $33 MILLION - 91 GRANTS 2002 - $30 MILLLION - 79 GRANTS 2003 - $33.9 MILLION - 97 GRANTS 2004 - $34.5 MILLION - 75 GRANTS 2005 - $32.4 MILLION - 65 GRANTS

  46. Office of Rural Mental Health Research Recent Initiatives to address: The President’s New Freedom Commission on Mental Health Final Report “Achieving the Promise” Transforming Mental Health Care in America, July 2003” Goal 3: Disparities in Mental Health Service are Eliminated 3.1 Improve access to quality care that is culturally competent. 3.2 Improve access to qualitycare in rural and geographically remote areas. Goal 6: Technology is used to Access Mental Health Care and Information 6.1 Use health technology and telehealth to improve access and coordination of mental health care, especially for Americans in remote or in underserved populations. 6.2 Develop and implement integrated electronic health record and personal health information systems.

  47. Office of Rural Mental Health Research During 2004-2005 scientific meetings were conducted to address these aims: Aim #1: Develop and implement plans to study the efficacy, effectiveness, and efficiency of eMental Health (use of telecommunications) as a way to improve access to specialized mental healthcare in rural, remote, and isolated populations Aim #2 Determine if the face-to-face therapeutic process translates via eMental Health Aim# 3: Determine if individualized (culturally appropriate) care can be delivered through eMental Health models  The scientific meetings were conducted in these locations and hosted/co-hosted by: Boulder City, CO (NIMH); Salt Lake City, UT(NIMH); Memphis, TN (NIMH and University of Tennessee Medical School, Memphis; Austin, TX (NIMH); Davis, CA (NIMH and UC Davis Medical School (S. Aquilar-Gaxiola), California Endowment & Telemedicine eHealth Center.

  48. Rural Mental Health Care Summary Much has been learned about the severity of the problem and barriers to rural care. Thus our Office has focused on interventions to enhance the delivery of mental health care to this population

  49. Studies Needed to Address Rural/Urban Disparities in Use, Quality, and Outcomes of Care Rost, Fortney, et.al. (Medical Care Research and Review, 2002) analyzed studies conducted between 1993 to 2000 and their findings informs us that these questions about rural populations should be addressed: What Is the quality of care received by the severely mentally ill? How do total out-of-pocket expenditures differ for rural/urban residents? What role has managed care played in the delivery of mental health care? How can rural residents be encouraged to enter mental health care treatment? Stigma in small towns is a major deterrent to seeking care and/or remaining in care, what methods can be used to overcome stigma?

  50. Studies Needed to Address Rural/Urban Disparities in Use, Quality, and Outcomes of Care Can quality of rural care be enhanced by modifying successful urban models? Can mental health care be delivered at least as effectively through telecommunications as it can in a face-to-face encounter? Our Funding Opportunity Announcement is available on the NIMH Website at http://grants1.nih.gov/grants/guide/pa-files/PA-04-061.html

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