U.S. Department of Health and Human Services: 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 Clinical Trial Required)

This initiative seeks to support pilot work on navigator models that might support the design and implementation of a subsequent larger scale project to:

• 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 developed and pilot tested may include but are not limited to the following: (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 (e.g., nurses, social workers, counselors) who serve as the navigator and coordinate care and communication with other involved treatment and service providers, but do not provide primary mental health treatment; 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 develop and pilot 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 conduct 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 uses the R34 activity code and runs in parallel to a companion ROI Initiative PAR-18-428 (https://grants.nih.gov/grants/guide/pa-files/PAR-18-428.html) which supports empirical testing of navigator model strategies in full-scale trials in this topic area. The applicant should propose the developmental work to be performed that would enhance the probability of success in a full-scale trial.

Amount: A total of $2,160,000 is available to fund 5-6 grants that range up to $225,000 per year and $450,000 over the three year project period.

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.

Link: https://grants.nih.gov/grants/guide/pa-files/PAR-18-429.html

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