NIMH’s Approach to Mental Health Disparities Research
- NIMH Strategic Framework for Addressing Youth Mental Health Disparities
- Addressing Mental Health Disparities Through Research
- NIMH’s Role in Mental Health Disparities Research
- NIMH Priorities in Mental Health Disparities Research
- NIMH Health Disparities Research Resources
NIMH Strategic Framework for Addressing Youth Mental Health Disparities
The purpose of the National Institute of Mental Health (NIMH) Strategic Framework for Addressing Youth Mental Health Disparities for fiscal years 2022–2031 is to provide a conceptual approach to help guide NIMH activities, including research funding, stakeholder engagement, and workforce development, related to research on the mental health needs of youth impacted by racial and ethnic health disparities. For the purposes of this Framework, “youth” is defined as persons aged 24 and under.
Addressing Mental Health Disparities Through Research
Striking disparities exist in the prevalence, course, and outcomes of mental illnesses within the United States. Individuals from underserved communities frequently experience reduced access to high-quality, evidence-based mental health services and receive fewer follow-ups in a variety of provider settings.
NIMH supports research to advance policies and practices that aim to reduce mental health disparities, promote equity, and address the needs of individuals from underserved communities and those who are underrepresented in health research.
NIMH encourages researchers to examine underlying causes of mental health disparities as well as to explore ways to test novel approaches to reduce disparities. By studying social, biological, and behavioral mechanisms, we hope to gain a better understanding of disparities in prevalence, course, and outcomes of mental disorders, as well as disparities in access to care across diverse populations.
Race, ethnicity, and sexual and gender minority identity are associated with systemic- and structural-level determinants of mental health status, including socioeconomic status or proximity to care. Because these factors may be associated with differences in responses to interventions and/or engagement with mental health services, research on possible differences related to the etiology of mental disorders may provide information fundamental to the development of more effective interventions.
NIMH’s Role in Mental Health Disparities Research
Disparities Team
In 2018, the NIMH Director established the NIMH Disparities Team to bring together staff from across NIMH Offices and Divisions to better align disparities research portfolios across the Institute.
Office for Disparities Research and Workforce Diversity (ODWD)
To further support efforts to focus on mental health disparities research, and to optimize the structure of the Institute, the NIMH Director created the Office for Disparities Research and Workforce Diversity (ODWD), a component of the Office of the Director. The office was initially announced in early 2019 and was officially established in 2020. Components of ODWD include cross-cutting programs on minority mental health and women’s mental health research, as well as the Office of Rural Mental Health Research (ORMHR).
ODWD coordinates NIMH-funded research initiatives relevant to mental health disparities, minority mental health, women’s mental health, sexual and gender minority mental health, and mental health in underserved rural communities. NIMH has made strides to enhance its focus on mental health disparities research in the United States by ensuring broad, institute-wide coordination to develop and sustain a robust disparities research portfolio.
Mission
The mission of ODWD and the Disparities Team is to:
- Promote mental health equity by ensuring that research is designed explicitly to promote fairness, opportunity, quality, and social justice in access, interventions or treatments, and outcomes
- Promote innovative and high-impact research aimed at enhancing our understanding of mental health disparities and minority mental health
- Find ways to reduce mental health disparities and the impact of disparities on individuals and communities
Vision
The vision of ODWD and the Disparities Team is to promote just, fair, and respectful research that achieves principles of health equity and ensure that all individuals have optimal opportunities and sufficient resources to attain the best mental health possible.
ODWD and the Disparities Team acknowledge that achieving health equity extends to the process of conducting research, including: engaging communities in the identification of needs and research priorities; supporting research practices that are based on respect and build trust; identifying barriers to participation in research studies; building a diverse and equitable health services, research, and health administration workforce; and, including communities in the interpretation and dissemination of research findings. ODWD and the Disparities Team strive to support research and related activities (such as workshops, papers, and requests for public input) that address multilevel and interlocking determinants of mental health disparities, including individual (e.g., health behaviors), interpersonal (e.g., interpersonal violence), community (e.g., built environment), systemic (e.g., health care system bias) and structural (e.g., racism, policy) determinants of mental health disparities. Research and activities supported by ODWD and the Disparities Team will focus on better understanding differential mental health outcomes, health care access, and quality of services for health disparities populations . Research and activities will emphasize marginalized populations, intersectionality , and the impact of syndemics (e.g. COVID-19, HIV, opioid epidemic, or acute and chronic climate events) in exacerbating mental health disparities. Further, ODWD and the Disparities Team strive to support research and activities that utilize common data elements to measure determinants and outcomes (e.g., PhenX toolkit ), as well as those that sample adequately for underrepresented health disparities groups.
Collaborations with Other NIH Institutes, Centers, and Offices
Collaborations and partnerships are critical to strengthen NIMH’s efforts to enhance and support disparities research, and ultimately reduce mental health disparities. To that end, and in accordance with the 21st Century Cures Act , NIMH continues to partner with other NIH Institutes, Centers, and Offices (ICOs) to ensure activities take into account the health needs of NIH-designated U.S. health disparity and racial and ethnic minority populations and are focused on reducing health disparities.
NIMH engages actively and frequently with NIH ICOs focused specifically on research on disparities, such as the National Institute on Minority Health and Health Disparities (NIMHD) , the Tribal Health Research Office (THRO) , and the Sexual and Gender Minority Research Office (SGMRO) .
Community Engagement
NIMH also recognizes the need for community engagement in all stages of research to increase our understanding of the causes of, and approaches to eliminating, mental health disparities. Input from external stakeholders can inform health disparities research across basic, translation, clinical, and implementation science—helping to broaden its acceptability, dissemination, and impact.
NIMH Priorities for Mental Health Disparities Research
NIMH has developed a set of priority areas focused on identifying mechanisms associated with disparities in the prevalence, course, and outcomes of mental illnesses, and on testing interventions aimed at promoting equity and improving the mental health status of racial and ethnic minorities and other NIH-recognized health disparities groups in the United States.
NIMH will use the following priorities to strategically guide the activities of Divisions, Offices, and Teams that support health disparities research. These Priority Areas align with, and serve to supplement, the NIMH Strategic Plan for Research.
- Priority Area 1: Build Capacity for Conducting High-quality Research on Mental Health Disparities. Enhance capacity for research on mental health disparities and minority mental health by supporting: dedicated research hubs and networks; learning communities to share best practices and methodological innovation to advance health equity research; large cohort studies with sufficient power to examine multilevel factors and disaggregate demographic subgroups or examine intersectionality; and, training and career pathways that focus on mental health equity. Foster a health services, research, and health administration workforce that values and incorporates diverse perspectives, reflected in a diverse workforce of trainees, investigators, program and review officials, and NIMH leadership.
- Priority Area 2: Support Community-Engaged Research. Support research that engages health disparities populations and that values authentic voices, champions respect and dignity, avoids exploitation, and encourages empowerment and agency from underrepresented, underserved, and under-resourced communities, thereby contributing to a sustainable culture of inclusion and meaningful partnerships between study participants, communities, and researchers.
- Priority Area 3: Identify Mechanisms by which Mental Health Disparities Arise and Persist. Support research to identify mechanisms contributing to the persistence of inequities among underserved and minoritized populations – including at the intersections of marginalized identities – in the incidence, severity, and trajectories of mental health symptoms and diagnoses, including suicidal thoughts and behaviors. Support research to identify modifiable targets to guide the development and testing of novel or optimized interventions and strategies to reduce inequities. Encourage researchers to adapt the NIMHD Research Framework to examine multiple levels (e.g. individual, interpersonal, community, and societal) of mental health and multiple domains of mental health determinants (biological, behavioral, physical/built environment, sociocultural environment, and structural factors including health care systems, legal system, and public and economic policies).
- Priority Area 4: Support Implementation Science to Reduce or Eliminate Mental Health Disparities. Advance implementation science research to improve access to and utilization of quality care among health disparities populations. Support approaches that engage partners from minoritized, under-resourced, and underserved communities and prioritize health equity in evaluation and decision-making criteria.
- Priority Area 5: Support Research on Integrated Care Models for Reducing and Eliminating Mental Health Disparities. Support research that integrates mental health care with physical health care. Support collaborations between specialized and primary care clinicians as well as allied health professionals for delivery of services in a variety of community settings including schools, social and faith-based organizations, and restorative justice programs.
Note: Potential applicants are strongly encouraged to consult with NIH staff as early as possible when developing plans for an application. This early contact will provide an opportunity to clarify NIH policies and guidelines and help to identify whether the proposed project is consistent with NIMH program priorities. Contact information for NIMH program staff, as well as a brief description of NIMH’s research programs, can be found on the Extramural Programs and Contacts webpage.