NIMH, LMICs, & CHIRMH: Funding for global mental health research

Back in March of this year I wrote about Vikram Patel’s call for more international mental health research:

As for research, Dr. Patel noted that 90% of mental health research is done in the developed North (and within that, most in the US), and insisted that that must change. Research must guide practice in order to avoid the mistake of simply applying US or European models elsewhere. Along these lines, he pointed to recent funding interest in global mental health, even by the US’s NIMH (specifically, a recent blog post by director Thomas Insel titled “Disorders without Borders” — good grief!), a research body not known to fund many international projects.

Since then the National Institutes for Mental Health (NIMH) has come up with more than just ominous blog titles. As I was trolling program announcements (“PAs” — the mechanism by which the National Institutes of Health says to researchers what they are really interested in paying for) earlier today I stumbled across several intended to fund research outside of the global North (that’s North America and Europe), or in the language used in these PAs, “LMICs” — “low- to middle-income countries.” Most of these were offered in a variety of funding amounts, from $50,000 to $250,000 (US dollars) per year over 2-5 years.

Here a a few. There’s the basic public health PAR-10-278: Global Research Initiative Program, Basic/Biomedical Sciences, intended to

promote productive development of foreign investigators from low- and middle-income countries (LMICs), trained in the U.S. or in their home countries through an eligible NIH funded research or research training grant/award.

For neurologists there’s PAR-11-031: Brain Disorders in the Developing World: Research Across the Lifespan, which

encourages exploratory/developmental planning grant applications proposing the development of innovative, collaborative research and research training projects, between high income country (HIC) and low- to middle-income country (LMIC) scientists, on brain and other nervous system function and disorders throughout life, relevant to LMICs.

There’s even an ethics PA: PAR-10-174: International Research Ethics Education and Curriculum Development Award,

applications from institutions/organizations that propose to develop masters level curricula and provide educational opportunities for developing country academics, researchers and health professionals in ethics related to performing research involving human subjects in international resource poor settings.

(Not a bad idea for folks in the North involved in international research either, I might add.)

By far the biggest news among these titles is the new RFA-MH-11-070: Collaborative Hubs for International Research on Mental Health (U19). “U series” grants (look at the “U19” in parentheses at the end of the title) are meant to pay for academic infrastructure — scholarly institutes and centers that produce a lot of research and are thought to be indicators of universities’ general research prowess. Here’s the full “purpose” section:

The National Institute of Mental Health invites applications to establish Collaborative Hubs for International Research on Mental Health (CHIRMH).  This program aims to establish three regional hubs to increase the research base for mental health interventions in World Bank designated low- and middle-income countries (LMICs) through integration of findings from translational, clinical, epidemiological and/or policy research.  Each regional hub is to conduct research and provide capacity-building opportunities in one of six geographical regions (i.e., East Asia and the Pacific; Europe and Central Asia; Latin America and the Caribbean; Middle East and North Africa; South Asia; Sub-Saharan Africa).  The purpose of the CHIRMH program is to expand research activities in LMICs with the goal of providing the necessary knowledge, tools, and sustainable research-based strategies for use by government agencies, non-governmental organizations, and health care institutions to reduce the mental health treatment gap.  The mental health treatment gap refers to the proportion of persons who need, but do not receive care.  As a group, awardees will constitute a collaborative network of regional hubs for mental health research in LMICs with capabilities for answering research questions (within and across regions) aimed at improving mental health outcomes for men, women, and children.

The treatment gap for mental disorders across the world is large and leads to chronic disability and increased mortality for those affected.  Research is needed to identify effective treatment and prevention strategies to close this gap. Mental health research that ultimately enables effective services to preempt, prevent, and treat mental disorders requires both infrastructure and partnerships.  Tackling the urgent challenges of the treatment gap demands effective collaborations among researchers, mental health service users, mental health service providers, and government agencies that will implement and sustain services.  Therefore, a goal of this FOA is to support research partnerships and activities in LMIC settings that will stimulate research to address the prevention and treatment of mental disorders and ultimately increase the evidence base for mental health interventions.

Notably, the PA states that “This program is not intended to support research that can be conducted primarily in and/or by United States or other high income country institutions.” This has the potential to be the start of something big, a US-funded development effort for global mental health. The NIMH is committing $2 million to this effort in 2011, and applicants are eligible for awards up to $500,000 per year for up to 5 years. (Letters of intent are due December 21 and applications due January 21, 2011, for those of you thinking about applying.)

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