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Date: Fri, 08 Mar 91 09:36 EST
From: Dot Baker <UNCDOT@UNC.BITNET>
Subject: NIH GUIDE - Vol. 20, No. 10, March 8, 1991 - RFA MH9105
To: pjones@UNCVX1.BITNET

Hi,
   #8   Please post as: RFAMH-91-05.910308
 ---------------------------- Text of forwarded message -----------------------
 
$$XID RFA MH9105 MH-91-05 P1O1 *****************************************
 
SHORT-TERM GRANTS FOR TRAINING MEDICAL STUDENTS IN THE
DIAGNOSIS AND TREATMENT OF DEPRESSIVE DISORDERS
 
RFA:  MH-91-05
 
P.T. 34; K.W. 0720005, 0715072, 0745020, 0745060, 0745070
 
National Institute of Mental Health
 
Letter of Intent Receipt Date:  May 1, 1991
Application Receipt Date:  May 22, 1991
 
(Catalog of Federal Domestic Assistance 93.244)
 
Under the authority of Section 303 of the Public Health
Service Act, U.S.C. 242a; 42 CFR, Part 64, the National
Institute of Mental Health will accept applications for
short-term grants to provide training to medical
students in the diagnosis and treatment of depressive
disorders under the single receipt date of May 22,
1991.
 
Darrel A. Regier, M.D., M.P.H.
Director
Division of Clinical Research
 
Alan I. Leshner, Ph.D.
Acting Director
National Institute of Mental Health
 
INTRODUCTION
 
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 used in combination, most
people with depressive disorders can be successfully
treated.  Evidence suggests, however, that clinical
depression is all too frequently poorly recognized and
underdiagnosed, with resulting undertreatment.
Although more than half of all clinically depressed
patients are initially seen in the general medical
system, their symptoms are frequently not diagnosed as
a depressive syndrome and, thus, they are not likely to
receive the proper treatment.
 
The National Institute of Mental Health (NIMH) has
developed the Depression Awareness, Recognition, and
Treatment (D/ART) program to provide the most up-to-
date research knowledge to the general public, primary
care providers, and mental health specialists.
 
This grant program is responsive to the need for
addressing the special issues relating to the diagnosis
and treatment of clinical depression in a medical
setting as well as to the need for training greater
numbers of primary care physicians at early stages of
their professional development.
 
PURPOSE
 
As part of the D/ART program, NIMH seeks applications
from medical schools to develop and implement training
of pre-doctoral medical students in the diagnosis and
treatment of clinical depression according to a basic
curriculum presented in this request for application.
Support is available for the detailed development of
this curriculum, its implementation, and evaluation of
its educational effectiveness and impact.  The goal of
the training is to prepare medical students to deal
with depressive disorders (including major depression
and bipolar disorder) as these disorders appear in
medical settings.  It is not designed to provide
specialty training for psychiatric residents.
 
ELIGIBILITY
 
Applications may be submitted by accredited schools of
medicine and osteopathy.  There is special interest in
applications submitted by departments of family
medicine, internal medicine, obstetrics and gynecology,
and other nonpsychiatric specialties.
 
APPLICATIONS CHARACTERISTICS
 
The applicant should provide:
 
     o    a description of the applying entity, its
          relevant personnel, and its training
          resources
 
     o    a conceptualization of the training program,
          including its goals and objectives
 
     o    a detailed description of the proposed
          training program, including the curriculum
          which must include, but need not be limited
          to the following elements:
 
1)  Epidemiology and Overview of Depression, including
issues of prevalence and incidence, drawing data from
the NIMH Epidemiological Catchment Area Study; risk
factors; disability of clinical depression relative to
chronic medical illness; etiology; and accessibility to
medical treatment of clinical depression
 
2)  Diagnosis and Assessment, including the major
categories of depression in DSM-III R (or subsequent
revisions); overview of major screening instruments for
depression; impact of patient and physician attitudes
on diagnosis (and treatment); and determining severity
of depression
 
3)  Depression within a Medical Setting, including
disability from depression; depression presenting with
somatic symptoms, depression comorbid with alcohol and
substance abuse, depression secondary to medical
disorder; medication-induced depression; the primary
physician's role in diagnosis and treatment of clinical
depression; issues of relapse, recurrence and
chronicity; referral and relationships with other
practitioners; and dealing with suicidality
 
4)  Biological Treatments of Depression, including
pharmacologic treatments, their indications for use,
relative efficacy and side effects, and use in
combination; ECT, light therapy, sleep deprivation
 
5)  Psychosocial Aspects of Depression, including the
psychosocial context in which clinical depression
occurs; the impact on the family; the role and
effectiveness of short-term psychotherapies
(specifically cognitive and interpersonal therapy); the
relative effectiveness of psychosocial therapies; and
the use of pharmacological and psychosocial treatments
in combination
 
6)  Special Issues, including depression in the
elderly, adolescents, the chronically ill, and other
groups of concern.
 
The applicant should also provide:
 
     o    for each component of the curriculum, a
          description of 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 used
 
     o    a detailed description of how the curriculum
          will be implemented
 
     o    the proposed number and level of students to
          be trained
 
TERMS AND CONDITIONS OF SUPPORT
 
The mechanism of support for these awards will be the
Continuing Education Grants (T15).
 
Period of Support
The period of support is 1 year.
 
Average Size of Award
It is expected that up to 10 awards will be made, each
award not to exceed $15,000 total (direct and indirect)
costs per award.  Funds made available under this grant
may not be used to supplement existing training or
other support for such training.
 
Direct Costs
Grants described in this announcement are awarded
directly to eligible applicants.  Direct cost items are
allowable for teaching costs associated with this
program.  They include personnel, consultants,
materials, supplies, reproduction and printing costs,
rental equipment, minor equipment items, and other
items which are directly related to the proposed
training program and are otherwise unavailable from the
institution.  Funds are not available for tuition or
other subsidies of medical students.  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
242 A are applicable to this awards.
 
*  Public Health Service Grants Policy Statement, DHHS
Publication No. (OASH) 90-50,000 (rev. 10/1/90)
 
APPLICATIONS PROCEDURES
 
It is suggested that those who apply send a brief
letter of their intention to Harold Goldstein, Ph.D.,
Director of Training, D/ART.  Dr. Goldstein is also
available for consultation on program development.  A
letter of intent is not binding, nor a
necessary requirement of applications but is useful in
planning the review of applications.  This letter
should be received by May 1, 1991 at the address below.
Preparation of the application may proceed
simultaneously.
 
For questions of eligibility, fiscal and administrative matters
and for assistance in
developing applications, prospective applicants should
consult:
 
Harold Goldstein, Ph.D.
Director of Training
Prevention Research Branch
Division of Clinical Research
National Institute of Mental Health
Parklawn Building, Room 14C-02
5600 Fishers Lane
Rockville, MD  20857
Telephone:  (301) 443-4140
 
Applicants should use the grant application kit (PHS
398, revised 10/88) available from the Prevention
Research Branch, Rm 14C-02, Parklawn Bldg., 5600
Fishers Lane, Rockville, MD 20857, (301) 443-4140.
 
To identify this application as a response to an RFA,
check 'yes' on item 2 page one of the PHS 398 form.
Also enter in item 2 the number and shortened title of
this RFA (MH-91-05, Short-Term Grants for Training
Medical Students in the Diagnosis and Treatment of
Depressive Disorders).  THE RFA LABEL FOUND ON THE PHS
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
YOUR 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 later unless
specifically requested by the Executive Secretary of
the review committee.  No site visits will be made.
 
The applicant should include a project abstract which
should not exceed two single-spaced typewritten pages.
The narrative section of the application should not
exceed 20 pages; appendices may not be used
inappropriately to expand the narrative section.
Applications exceeding this limitation will be
returned.
 
The original and five copies of the application must
be submitted to:
 
Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**
 
One additional copy of the application must be
submitted directly to:
 
NIMH Division of Extramural Activities
Parklawn Building, Room 9C-15
5600 Fishers Lane
Rockville, MD  20857
Attention:  Mrs. Edna Hardy-Hill
 
REVIEW
 
Review Procedures
 
A dual review system is used to insure 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.
 
Applications submitted in response to this announcement
are not subject to the intergovernmental review
requirements of Executive Order 12372 as implemented through DHHS
regulations at 45 CFR Part 100.
 
 
Review Criteria
 
Each grant application is evaluated on its own merits
and will be reviewed according to the following
criteria:
 
     o    experience in education on mental disorder
          issues
 
     o    compliance with the requested application
          characteristics
 
     o    appropriateness and feasibility of the
          content, methods and organization of the
          project to specified project goals and
          objectives
 
     o    quality of the proposed program evaluation
 
     o    quality of the resources of the applying
          organization
 
     o    qualifications of the program director and
          other staff
 
     o    number and range of students to be trained,
          especially the minorities and women
 
RECEIPT AND REVIEW SCHEDULE
 
                          National Advisory
Receipt of     Initial    Mental Health          Earliest
Application    Review     Council Review       Start Date
 
May 22, 1991   July 1991  September 1991     September 1991
 
Applications submitted after the receipt date will be
returned to the applicant without review.
 
AWARD CRITERIA
 
The responsibility for award decisions on applications
recommended for approval 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.

