U.S. Department of Health and Human Services: Initiation of a Mental Health Family Navigator Model to Promote Early Access, Engagement and Coordination of Needed Mental Health Services for Children and Adolescents (R01 Clinical Trial Required)
The goal of this initiative is to develop and test navigator models that promote early access, engagement, and coordination of mental health treatment and services for children and adolescents who are experiencing early symptoms of mental health problems. The initiative aims to test navigator models that:
- Rapidly engage youth and families in needed treatment and services
- Work closely with the family members and other involved treatment and service providers to optimize care
- Utilize care coordination strategies and novel technologies to help identify, engage, and match youth to mental health treatment and services
- Work with youth and families over an extended period of time to ensure that therapeutic gains are maintained
Navigator models to be tested may include but are not limited to: (a) mental health clinicians who provide evidence-based treatment directly to the youth and family and who also monitor the care coordination activities; (b) health care professionals with mental health expertise as the navigator (e.g., nurses, social workers, counselors) who are not responsible for providing the primary mental health treatment, yet are monitoring coordinated care and communication with the other involved treatment and service providers; or (c) paraprofessionals trained in mental health education and in the application of proven engagement approaches (e.g., motivational interviewing) who monitor coordinated care and communication with the other involved treatment and service providers. Each model will develop and test a set of strategies deployed by the navigator designed to promote early access, engagement, and coordination of mental health treatment and services.
Navigator model settings may be located in mental health clinics, public health agencies (e.g., child welfare and juvenile justice), schools, primary care, or other settings. Navigators should work closely and be integrated with other treatment and service providers to facilitate and monitor routine communication to the treatment providers, youth, and family members. It is anticipated that referrals to a navigator may occur through a range of referral sources (e.g., caregiver, teacher, healthcare provider), depending on the navigator model, and can occur before a formal mental health assessment or screening takes place. Navigator functions should include one or more of the following attributes: (a) overcoming systemic barriers to care (e.g., coordination of screening, diagnosis, and ongoing care from a range of treatment providers); (b) delivering mental health information, education, and psychosocial support to caregivers and youth; (c) utilizing engagement strategies to increase treatment adherence; and (d) problem-solving resource challenges (e.g., healthcare coverage, literacy, transportation, childcare).
Funding is intended to support applications that test personalized navigation approaches that deliver the appropriate amount, intensity, and frequency of needed treatment and services as symptoms wax and wane over time. Applicants are encouraged to propose research that utilizes novel technology (e.g., dashboards, outcome tracking, and therapeutic milestone measurement) to assist navigators in facilitating and optimizing personalized mental health care for each child and adolescent. When possible, applications should incorporate health information technology (HIT) and electronic health records (EHR) to coordinate care across delivery settings. Applications must identify the variables (intervention targets) hypothesized to lead to the intended outcomes of the proposed navigator model, measure whether those variables are engaged during the navigator intervention delivery, and design the study to test whether target engagement mediates the outcome of the navigator intervention.
This initiative is intended to support studies that are statistically powered to provide a definitive test of the navigator model’s effectiveness in comparison to usual care practices or alternative intervention/services approaches. Support for pilot studies to promote the development of and evaluate the initial feasibility, acceptability, and preliminary effectiveness of navigator models is provided via PAR-18-429 (Pilot Studies to Test the Initiation of a Mental Health Family Navigator Model to Promote Early Access, Engagement and Coordination of Needed Mental Health Services for Children and Adolescents (R34) (https://grants.nih.gov/grants/guide/pa-files/PAR-18-429.html).
Amount: A total of $2,160,000 is available to fund 5-6 grants. Budgets may range up to $500,000 per year, for a period of five years.
Eligibility: Higher education institutions; nonprofit organizations; for-profit organizations; governments; and other, including independent school districts, Public Housing Authorities/Indian Housing Authorities, Native American tribal organizations, faith-based or community-based organizations, and regional organizations.
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