Center for Global Mental Health Research Webinar Series: Writing a Successful Individual Training Grant Application Focused on Global Mental Health

Transcript

SUSANNAH ALLISON: Welcome, everyone, to our sixth webinar in the series this year and it is entitled Writing a Successful Individual Training Grant Application Focused on Global Mental Health. I am really glad you could all join.

As I mentioned, this is the sixth webinar in our 2022 webinar series, and I have included a link to the other webinars and a list of the other webinars that we have already given, as well as the last webinar which will focus on post-award issues and will be presented by Tamara Kees from grants management at NIMH, and that will be on Wednesday, November 16th. I really encourage you to go to the website and register for that webinar.

Back to today’s webinar, as a brief overview I will be providing some text for how to write an individual training award application. We are then going to hear from Dr. Aileen Schulte who will be talking about the review process and how to avoid some pitfalls for applicants who are applying.

I am then going to be joined by two experienced NIH researchers, Drs. Fred Ssewamala and Brandon Kohrt, and they are going to be sharing tips on how to put together a strong individual training grant application. Then we will finish with some time for Q&A, so please put your questions in the Q&A box and we will provide you hopefully with the answers.

Just in case you are called away for something important, I want to share a few take-home points at the start. The first is really that the process for applying for an NIH application can sometimes raise a lot of questions so it’s important that you reach out to someone at NIMH early to talk about your application and have them help you with any questions that you might have.

Another is that it is really important to understand that NIH is a big place and there are 27 institutes and centers, so it’s important that you understand what the missions are for each institute and center and what their research priorities are and make sure that you are targeting your application to the right home. Make sure you read closely the funding opportunity announcement that you are responding to and give yourself lots of time to write your application. Make sure you form a good mentorship team, and we will be talking more about this later.

It is also good to get a hold of other successfully funded training grant applications to use as examples. And lastly, we at the Center for Global Mental Health are really dedicated to building research capacity in global mental health, so we are here to answer any of your questions along the road.

I am now going to spend a few minutes just talking about some of the different types of individual training grants at NIH that can focus on global mental health research. This figure lays out the different kinds of award types or mechanisms, as we refer to them, that exist for graduate students, postdocs and early career investigators. Unfortunately, we don’t have any individual awards for high school students or undergrads, but if you are at that stage in your career you could consider applying for a diversity supplement to an existing NIH grant.

As you can see, there are a number of types of awards that exist for graduate students including a dissertation award which is an R36, a fellowship award or F31, and then one that’s for medical students and Ph.D. students which is an F30. We also have an award that helps you transition from graduate school into a postdoc and that is the D-SPAN F99K00.

And then when you move into the postdoctoral research phase there is an F32, and then to help folks transition again from the postdoc into an independent career there are K99R00s or a pathway to independence award. And the last set of awards are the K awards, K01, K08, K23 and K43, and these are all for early career investigators. They are considered early career development awards.

There is a lot of great information about these specific types of awards on two of our prior webinars, so I just wanted to highlight what some of these are on this webinar. But I really encourage you to go back to the previous webinars to learn more about the F31, F30, R36 and the K awards.

We are often asked what types of awards individuals are eligible for if they are not a U.S. citizen or a U.S. national or permanent resident of the United States. This slide attempts to lay out the different types of awards that exist at NIH, specifically at NIMH and at the Fogarty Center, that would allow you to gain additional research training in global mental health. Again, I am not going to go through each line on this but I am happy to share this slide with anyone who reaches out to me or to walk you through it if it would be helpful on a call.

This slide is based on an NIH website that lays out some of the common pitfalls to writing a grant application. What I am going to do in the next few minutes is walk through some tips for how to make sure that your grant application does not run into these problems in review.

My first tip today is to make sure that you give yourself plenty of time to write your application. As you can see, you really need to set aside or make sure that you are giving yourself at least six months to plan out, write and submit your grant application. This is broken down into a few different phase. First you want to start with your planning phase. This involves assessing yourself. Where are you, what skills do you need to move on to the next stage of your career? Who are the best people to involve and help you achieve those goals? So, forming the best mentoring team.

Once you have started your planning phase you can move into the writing phase creating an outline or concept of your grant application. Then it’s important to reach out and discuss your concept with someone at NIH to make sure that you are fitting in with the priorities of that institute or center and to get any guidance from the program staff as you continue to work on it and also to get input from your mentorship team at this stage prior to actually writing out the entire grant. You don’t want to write the entire thing and then find out from one of your mentors that you should have really moved in a different direction.

Lastly, it is really important to give yourself time at the end to get feedback. Make sure that you have a finished draft that you can share and have individuals read through it and not rushed but really able to give you some feedback and make sure that there aren’t glaring issues like typos or missing information. And then just make sure that it’s clearly presented and makes a really strong case for the need for additional training for you in global mental health.

Once you have planned your timeline and you have selected the right mechanism or award type, the next step should be to download and read through the application form instructions. Reading through these instructions will not be similar to reading a Stephen King novel or a Ruth Ware novel, not super-exciting, but it’s really important to understand all of the different components or pieces to an individual training award application.

A lot of times people focus on the research and what they want to do in terms of the research and then maybe on their training, but it is also important to understand and to know that you will also have to have a section on training in the responsible conduct of research that your sponsors and co-sponsors are going to need to send that statement, and that you are going to need letters of support from any collaborators or consultants. So it’s good to know that from the very beginning so that you are not rushed at the end. You don’t want to realize two weeks before the application is due that you need additional information.

This slide just lays out the main components of an F application, and then this slide lays out the main components of a K application. Again, all of this is in the application guide and provides very detailed information on what is needed and required.

This brings us to Tip #2. Make sure that you start with your training goals and that your training goals inform your research plan, not the other way around. The focus of our training award is to provide you with the needed skills to successfully transition from the stage you are at -- whether you’re in graduate school or you’re a postdoc or you’re an early career scientist -- to provide you with the skills that you need now to help you move on to the next stage in your career.

If you start with your research and you back into your training goals it sometimes can be problematic because sometimes we want to do more of what we already know, but that is not the goal of an individual training award. The goal of a training award is for you to build on what you already know and expand and learn new skills. So it's important to really start with laying out what are all your strengths, what are all the things that you have already accomplished to date, and where are the areas that you need to learn more, what are your areas for growth. And start to lay out what those training goals for your award might be.

Sometimes people have training goals that focus on learning more about a theoretical perspective. Sometimes there’s a goal that is focused on learning a new statistical analytical approach. Oftentimes there’s a goal or a component to a goal about improving your writing skill or your ability to disseminate findings from your research.

One of the most common concerns raised during the review of a training grant is that the training plan does not include enough detail, so really make sure that there is no question as to how you are going to achieve your training goals. I think this is where it’s really important, once you have drafted your training plan, to get your mentors’ input but also to maybe get someone else from outside of your team to review it. I think sometimes it helps to have someone with fresh eyes who won’t make assumptions about how you are going to learn a new skill, so it’s really important that you lay out all of the training activities.

I have listed a few of them here, and it’s good to know that training activities can be more formal like additional courses, attending workshops or seminars, going to meetings, and they can be more informal. It can involve guided readings from some of your mentors. It can include getting together with other individuals who are learning about a new topic area. It’s good to have a mix of both formal and informal in your training plan.

And it is good to think outside the box a little bit about what are some of the things that you could do. You can go and travel to another site to learn about different techniques or approaches.

Then, once you have developed your training goals you can start thinking about what your research aims are going to be. At this point it’s really good to look at what is being funded by NIH. I definitely recommend using NIH RePORT to look and search for funded Fs or Ks from NIMH to learn about what the scope is for existing Fs and Ks, and also how best to frame your research aims. I think it can be really helpful to read through lots of examples of grants that have been funded and what the research aims are for those grants.

And your specific aims pages when you start writing that, you really need to start off with what the problem is. In global mental health, for example, is it an issue with lack of access? Is it an issue with stigma being a barrier to engaging in treatment or staying engaged in treatment? Is it an issue of not having an evidence-based intervention that can be easily implemented within a specific context? So really make sure you lay out what the problem is, and then provide information about how your research is going to address that gap and what the solution is going to be, and that should then lead into the goals of your research plan.

My last tip for today is to form a good mentorship team. I want to make sure that I draw attention to the fact that I am saying mentorship team. It is not just one mentor or sponsor; you really should be thinking about your entire mentorship team for an individual training award, especially in global mental health, because one person is not going to be able to provide you with all of the training needs that you will have during your award.

Now, it is important to have at least one person on your mentorship team who has a track record of NIH funding. They can provide you with insights around the NIH process and support you as you’re thinking about next steps in terms of obtaining NIH funding. And it’s really important that you include individuals who have mentored others, and it’s nice to be able to reach out to individuals who have been mentored by them to learn more about their style.

People have different styles of their mentorship and it’s important to know what type of mentors you work best with and go into perhaps a new mentoring relationship knowing as much as you can about that person. In addition to knowing about their scientific strengths it is important to know about their mentoring style as well, and it’s good to learn from others who have been mentored by them.

It is important that you have individuals on your mentorship team that really complement your primary mentor’s strengths, but everyone on that team should have a unique role and should be helping you to achieve your training goals. Every training goal should have at least one or two mentors that are going to be helping you to achieve that goal.

For global mental health applications, it is extremely important that your team includes in-country mentorship. You really want to ensure that any global mental health research is collaborative with in-country, that it involves multiple members of that community and is not at all a situation here someone is just coming in with their agenda to do work, but that the research is collaborative and really involves strong leadership from the community where that research is taking place.

Just some tips that you can share with folks who are going to be your mentors or sponsors on your grant application. Make sure that they specify in their letters of support exactly how they are going to help you. How often are they going to be meeting with you, what kinds of skills are they going to help you attain? Are they going to provide reading, are they going to meet with you in person, are they going to meet with you over Zoom? Both are fine but you need to really make sure that is clear.

Make sure that they document the ways that they are going to be supporting you. Maybe it’s through additional travel on one of their NIH grant applications where they will be providing you with data. Again, it is really important that if you’re laying that out as part of your research plan, that that is then repeated in your mentors’ or sponsors’ documents of support. And it is really important for your mentors and sponsors to detail their experience as a mentor and the outcomes of their mentees.

Lastly, just a few tips around writing describing yourself in your application. There are two main places for this in an application. One is in the biographical sketch and the other is in your candidate background. It is okay for information to be in multiple places in a grant application. In fact, sometimes that’s helpful because it helps to reiterate important information that you want the reviewers to really understand and make sure that they walk away -- After reviewing and reading your grant you want them to really make sure they understand.

Be sure when you’re talking about yourself that you reiterate the important experiences that you had. Make sure your passion for research, and specifically for global mental health, comes through. This does not have to include personal information, but I think it’s important that the reasons why you are excited and passionate about doing work in the global mental health space come through in your application.

It is also important that you highlight your commitment to a research career in global mental health, lay out all your achievements, your experiences and the potential and really where you want to go. And then highlight other relevant experiences you have had, whether that’s leadership opportunities, teaching, the mentoring of others. Those are all really important components that can make you stand out as an applicant.

I am now going to turn the microphone and camera over to Dr. Aileen Schulte. Aileen is a scientific review officer and a referral officer at NIMH, and she is going to be talking to us about some of the key points around NIH grant application submission and the assignment process to help you avoid some problems that folks can encounter in the process. Thanks so much, Dr. Schulte.

AILEEN SCHULTE: Thank you, Dr. Allison, for the opportunity to speak today. I am going to talk about the process of submitting an application to NIH. As many of you who follow this series may recall, there was a previous webinar in the series that included a presentation by Nick Gaiano who was Branch Chief of Extramural Review Branch at NIMH. That was the first webinar in the series, and you can refer to his presentation for much more detail about NIH submission rules.

Today I am going to focus on some things that might be more relevant for human subjects research, clinical trials and some things that might be particularly challenging about navigating the submission process at NIMH.

I am not going to spend a lot of time on this slide because I think Dr. Allison covered this very well. You must apply through a specific funding opportunity announcement, and that FOA tells you all of the rules for the limits of any award that you would receive, who is eligible, when you submit. Importantly, it outlines the review criteria by which you would be evaluated by reviewers. And as you can see, in red at the bottom of this slide there may be additional content that is requested in Section IV.2. If there are additional instructions about how to write your application you will want to read that very carefully.

Importantly, when we at NIH write FOAs and if there are additional review criteria, we try as much as possible to make sure that there are parallel instructions that go with each of the additional review criteria, so it is important to keep that in mind.

In general it’s important to keep in mind that there are different types of FOAs, and that leads to different implications for what NIH does when it receives your application. For example, we have parent announcements that cover a wide range of topics that do not have additional review criteria. I’m showing the alphanumeric string here, one K23 FOA, PA-20-206. When you submit to a parent announcement, as I said, there are no additional instructions. It may also be the case that many institutes at NIH are involved in that FOA or can receive applications from that FOA and you will see that at the beginning of the FOA itself, the list of participating institutes.

It is also the case that you could be assigned to different review committees or study sections as we call them. For parent announcements it’s important to be aware of both what your programmatic assignment is; that is, what institute or center your application is assigned to, and also what is the review assignment or locus of review.

Other FOAs are much more specific in content. Those alphanumeric strings would include PAR or RFA. RFA stands for request for applications. These are often limited to a small number of institutes or centers. They often have very specific instructions that you must follow. If there are set-aside funds for the RFA or the PAR then there is only one locus of review. There’s only one review assignment for any application submitted to those FOAs.

While parent announcements can be very general it is also important to keep in mind that you might find links within the FOA itself that do have additional IC --institute or center -- IC-specific information. For example, for NIMH there is often additional information about expectations for clinical trials that might be connected to a funding opportunity announcement. This slide is for a parent F31, which would link you to institute priorities for any institute or center participating on this FOA, and you could also find staff contacts -- in other words, program officers -- that you could talk to about your application before submission. And that, of course, is very important.

Also within an FOA you will see links to various NIH websites that describe our expectations for defining whether or not you are proposing human subjects research or whether you are conducting a clinical trial. As part of the application process you have to define both of those things, and it’s important to understand the NIH definition of those terms rather than just answer those questions off the top of your head, so to speak.

Both of these links will connect you to decision trees where you can answer questions in relation to your research and you will be given guidance about whether or not your proposed research involves subjects, whether or not it involves a clinical trial. On those web pages you can submit questions to the NIH policy office, Office of Extramural Research, or of course you can consult with your program officer if you are unsure about how to answer those questions. But again, it is very important to know those answers before you start your submission process.

Some additional problems that could be encountered. You want to make sure you follow all of the rules that are part of the SF424 instruction guide that Dr. Allison showed you earlier. This includes a variety of things. The list I have here is just a select list. Make sure you use one of the allowable fonts. Don’t try to squeeze more content in so that it becomes unreadable for reviewers. Make sure you know any specific instructions that go with your FOA.

In terms of attachments, the FOA will indicate whether or not you can include additional attachments, but there is a very broad rule about what can be included in an appendix to an application, and not much is allowable for inclusion in an appendix. It’s basically blank data collection instruments or blank informed consent documents and that sort of thing, so please don’t attach things in an appendix that you just can’t fit in elsewhere. That is not a very good idea.

Also part of your application package is this form. Apologies for the small font but I hope you get the general idea. This is an Assignment Request Form, or ARF. All you have to do when you fill out the ARF is just indicate the funding opportunity announcement that you’re applying to, and in the top set of blue boxes you can request institute or center assignment. Again, if you’re applying to a parent announcement where there are multiple institutes or centers involved you can request an assignment to a particular institute or center. That’s a very good idea if you have already spoken to an institute or center representative like a program officer. This top section gives you the opportunity to include a first, second or third choice.

The blue arrow and blue boxes on the bottom refer to the locus of review, LOR. If you have discussed with an NIH staff member the likely study section where you should be assigned you can include that as a first, second or third choice. Again, that’s very important or certainly something you should consider if you’re applying to a parent announcement. But again, if the FOA does not allow various opportunities for different IC assignments or different loci of review, then that is less important in an ARF.

One question we often get is what can I do as an applicant after I submit, and that’s a very good question. One thing you can do is check the status of your application in your eRA Commons account. This is a screenshot of what you may see in your eRA Commons account, and over time there may be information added to this page. This is where you can go to see where your application has been assigned in terms of the institute or center assignment and also the review assignment.

If you do request a particular institute or center assignment it may not be granted because we have very specific rules about what is supposed to be assigned where, but you can check what happens to your application on this page. There may be contact information here for your assigned program officer or your scientific review officer.

You will see the meeting date at the bottom. Eventually a meeting date will pop up. That is different than the council date. The council date refers to the second level of review. But for your first level of peer review your meeting date will show up generally about two months before the meeting will occur, and you can use that information there to look up a meeting roster on the internet. The meeting roster, however, will only be available about 30 days prior to the meeting.

Another thing you can do after you submit is you could submit post-submission material. NIH has a notice linked here that describes how you can submit post-submission material. This goes through your scientific review officer, and there are specific things that you would be allowed to submit up to 30 days prior to the review meeting.

For example, you are allowed to submit a brief pdf document that describes a new publication or an article that is accepted for publication. Sometimes people email me and ask can I send you the article. No, because we have a publish policy that says I can only accept news of the article accepted for publication, and I am happy to do so.

For Ks and Fs, if your mentor’s funding changes, you can submit an update about that. Or if you have any change in the key personnel on your application.

I think we mentioned a few times that it is important to contact NIH representatives at various stages of the submission process. This chart just illustrates that mainly your contact prior to review would be your program officer, like Dr. Allison, so you can contact them to discuss your initial research idea.

You also want to be in touch with them after the review to discuss the summary statement that you receive, any questions about potential funding. Your scientific review officer can answer questions about your review assignments, the review roster, anything like that. A grants management specialist is someone who you would be in contact with if your application is considered for funding.

Thank you for your time today. Happy to answer any questions later.

AILEEN ALLISON: Thank you so much, Dr. Schulte. We are now going to move to our panel discussion with Drs. Fred Ssewamala and Brandon Kohrt. I am going to introduce the two of them although I don’t think they need introducing, and then we will jump in with some questions.

Dr. Brandon Kohrt is a professor of psychiatry and behavioral science and global health and anthropology at George Washington University where he holds the Charles and Sonia Akman professorship in global psychiatry and directs the Center for Global Mental Health Equity. Dr. Kohrt has worked with populations affected by war and political violence, disasters and other forms of adversity around the world.

Dr. Kohrt’s work also addresses reducing stigma in healthcare settings to improve the quality of mental health services. He was a commissioner on the recent Lancet Commission on Depression and Commission on Ending Stigma in Mental Health, and he collaborates regularly with UNICEF and the World Health Organization.

Dr. Fred Ssewamala is the William E. Gordon distinguished professor at Washington University in St. Louis. He holds a joint appointment in the Washington University School of Medicine and he directs the International Center for Child Health and Development, or ICCHAD, and Smart Africa Center. He leads innovative interdisciplinary research that informs, develops and tests economic empowerment and social protection interventions aimed at improving life chances and long-term developmental impacts for children and adolescent youth impacted by poverty and health disparities in low-resource communities.

I think both of you have been mentors to many individuals and I think also have been reviewers for the NIH review process. I’m wondering, as you have been in both of those roles, what concern or weakness do you see come up regularly for training grants that focus specifically on global mental health research?

BRANDON KOHRT: Thank you, Susannah, for the opportunity to share today. I am really drawing upon my own experiences having an F31 and a K and then having mentored a number of F and K awardees and lots of reviewing. Two caveats. One is just that a lot of the advice I’m giving is from mistakes that I’ve made, and I think you learn a lot in the process. And just to reassure people that you actually have an incredibly supportive team at NIH to learn about this process and to develop things as you go. And what’s great about these mechanisms is you can often reapply, so don't be afraid of making mistakes. You can learn a lot that way.

The second caveat, to just frame all of my responses, is that these are incredible training opportunities and they should be fun. You are dedicating two, three, five years of your life to these types of awards so it should be things that you really enjoy and inspire you. Mistakes are okay, and this should be really a fun and rewarding process.

Three concerns that I often see -- and this echoes some of the things you already said, Susannah. One is just a lack of specificity. Often we get generic training goals that kind of feel like they came out of a millhouse of, oh, this is what everybody puts in. So you often see things like I want to be an expert in implementation science or in clinical trials or in mixed methods research, and there is not really specificity in that training goal which makes it really then hard to judge how this candidate will make a unique contribution with their F or K or other award. And we’ll talk a little bit about how to address that in subsequent questions.

A second issue is redundancy -- and it was really helpful mentioning RePORT earlier as well -- that it looks like this has been done before, that this person’s focus -- there’s some aspect, maybe they’re changing the population or the country a little bit or the intervention, but really this is redundant to other things out there. So how are you actually developing unique skills if you’re doing something very close to what has been done before? And I think that is really important, to have a good understanding of the literature so that you’re doing something more unique. And I will provide some suggestions for how to do that going forward.

I think the third in particular to global mental health is that there’s a lack of time actually interacting with other researchers and especially with participants in the study. It is not uncommon to see a training program where, over five years, maybe there are three or four two-week trips to the country where this work is being done, and that’s just really hard to develop your skills when it’s so episodic. It doesn’t mean you have to spend five years in a different country; there’s a lot that can be done in the US that can be harmonized with a global project, but just a lack of time with direct collaborators and with the participants and beneficiaries in that research project is often a concern that I see raised in these reviews.

Those would be my three suggestions: being as specific as one can, not being redundant to other types of expertise and studies that are out there, and really demonstrating as much time as you can that was spent with the people who will ultimately benefit from your research.

SUSANNAH ALLISON: Thanks so much, Brandon. I can definitely agree with all of those, from listening to the reviews.

FRED SSEWAMALA: Susannah, thank you first of all for inviting me and thanks so much. You guys have done an excellent job. I like this webinar, so thank you so much. I think this is the second one where I have been part of it.

Just to add, without being redundant, which Brandon has already talked about and I won’t repeat what he has already said which I have seen in the review process. But I want to say that -- also which Susannah mentioned, and what Lynn mentioned during the presentation and now what Brandon has mentioned during his presentation -- these are real issues. But I just want to add a few here.

The first one I want to add is over-selling yourself. Sometimes what happens -- I mean, trying to find that balance. You get a candidate who has oversold themselves and then you are like what would this add to their training? Are you really still interested in career development or should you now move on to an R? Because if you have print publications or whatever, and they are very high-impact factors, you have already been funded at R21 level or you have been funded, whatever, and then -- but you are working with these strong mentors and they are the same people that you are going to continue working with. So sometimes the question is what is the value added.

The other thing is that some of those under-sell themselves, and then the question sometimes is you haven’t expressed interest in global mental health. That’s fine. And you are trying to make a leap into global mental health or into research, but you don’t have any publications at all, or you may have one, so you haven’t really taken that enthusiasm. You haven’t shown that really you are enthusiastic about this area. And so the question is, is this the right mechanism for you at this particular time, or should we think about another mechanism to prepare you for that K?

That is really always very informative to the reviewers in saying I think this person either is not read or they didn’t put in enough time given the charge. Maybe they just put stuff together. And it goes back to what Brandon talked about in terms of generic aims and generic career development goals. I don’t think this person really, these goals fit with what they have put in.

The other part that we have seen is remember they are funding a candidate; they are not funding an institution, so they are interested in your career development, and that is really going to be very score-driving in a way. The environment is there, the mentors are there -- of course you need to have strong mentors, but we are interested in your career development plan and career development goals and objectives. And you paid less attention there and you spent more time praising your mentors or spent your time on your research.

Remember, before you get to a research plan, who are you. Because unlike others that I may not be able to take them from Washington University if Washington University says no, a K goes with you as a trainee.

So I think spending time on your career development plan and goal is extremely important. And sometimes unfortunately some of the applications that you get, they spend less time on that and then they spend a lot of time on their research plan and it’s like this is really not an R; it’s really a K.

I will stop there without repeating what others have said.

SUSANNAH ALLISON: Thank you so much, Fred. Those are all excellent points I think. And I think this is where it is helpful to be able to work with someone who has mentored others and being able to successfully obtain individual awards because they can help you to figure out how much space to devote to your research versus your training plan.

Because you are right; you don’t want your whole application to just focus on your research because the research is a vehicle for you to get your training goals, and I think that is a really important message here. So while, yes, you will be conducting research, the goal of that research is to advance your research career in global mental health. So I think working with folks who have that experience and also getting examples of successful grant applications -- I mentioned this before.

Another point I wanted to make is but don’t get one and then just follow it to a T because there are a lot of different examples, and I think for different people they are going to have to highlight different strengths that they have or different gaps. So don’t take that and use it as a template; use it as an illustrative example, but make sure that you are -- as Fred was saying -- you are highlighting what makes you a good candidate for this award. What are your strengths? What is your passion for global mental health, and how are you going to be advancing your career through this award?

When you are working with a mentee, what aspects of their experience do you consider when being asked if they are competitive for an F or a K? We are often asked would I be competitive for this type of an award. As a mentor, how do you help to answer that question?

FRED SSEWAMALA: First of all, when I am approached either by people I know or by people who have been referred to me, the first thing I always want to know as I prepare someone and try to figure out whether they are competitive, I always tell them and any student that I’m working with, remember, you are interviewing me to see whether I am the right mentor for the career development that you want to do, and I am also going to be interviewing you to see whether you are the right mentee for me to engage with.

I always want to get their personal statement first, and I always want to get their CV. I don’t expect that they are well accomplished, but I just want to know is this really -- They may want to get in that area, but you’re talking about global work. And most places, when you’re doing global work you are not going to Switzerland or Geneva; you are talking about these low-resourced communities. And sometimes you can be successful, sometimes you may not be successful.

So I want to see the passion when I’m picking someone and say is this the right -- It could be the right path, but maybe it is not me to take you through that path. Because I do this work and I have worked with some students and they are going there a month and they say this is not for me, which is okay. But I want to make sure, am I the right person to take him through that. And I look at your personal statement and we will go through that.

The other thing I always want to figure out is have you talked with -- Who else have you talked to, and who else is going to be with me in this journey? Like Susannah indicated and as Aileen also mentioned, there is no mentor who knows it all. So if they are interested in issues of methods and issues of strength and how do you work with young people who have been affected by war and HIV and all that, maybe I am the one.

If they are interested in qualitative work, that is going to be working with refugees and immigrants, but because you are not originally from Uganda and you are like I am approaching you because you’re from Uganda, then I’m like, look, I can give you the geographical understanding and context, but maybe I am not the right person to be your lead mentor.

I am preparing you to be able to write a successful career development plan but a successful K. And because I know reviewers who look like me will look at your application and say but is Fred the right person. And because mentors in most cases will also -- now I know Brandon and I know other people -- they will say, you know what, I am not the right person, but I think I can support you if you approach so-and-so.

And remember I always tell people that mentors are extremely busy, and if they are busy then tell them exactly what is your ask. What is it that you are expecting them to give you? What is it that you are expecting them to do for you?

So I always have to go through that with my mentees or people that plan to work with me. I say if you approach Dr. Susannah or if you approach Dr. Kohrt, what is that you are going to ask them to do. Not simply say I want you to be my mentor. Okay, I will get back to you on that. But someone cannot say yes without knowing exactly what they expect you to do.

So I try to connect them. And this is not something that is written. I didn’t want to repeat what Susannah already mentioned but I am telling you exactly practically what I do. That is why I’m not going through the normal consider this and consider this, but I’m telling you exactly organically how I do it.

Then I am able to connect you with other mentors because it is extremely important that I make that door open for you and I say, okay, I will write that introductory letter or that introductory email and let them know that you’re a person who would be a good candidate.

I have had some mentees wait. As long as I know that they are still within the timeframe of being funded, I have told them -- in fact I have one now. I told them let’s work on your publication list. I know that you are interested in a K, but if they look at your CV you have nothing, so you won’t be competitive. So how about if we spend the next year working together so that you get a couple publications or three in there so that at least you can show your interest. By then I’m judging whether you are persistent, whether you are really passionate about this field and whether we can work together.

So I have tried to do that as I prepare them. And people have waited. I always hate it when someone is rushing -- you know what, I just want to apply next month, or in six months from now or nine months from now -- when they have nothing on their CV. So I think that patience -- because remember you are in this for the long haul, forever. This is going to be your career. It’s not that you are doing it for two years or three years. You are going to get money for five or four years depending, and then you are going to have this for the next 30 years because you have been trained.

So I think patience. I try to get my trainees to be patient and for them to work with me. And if I am not the right person then for me to open the door to others, and for me also to make them think is global mental health or global work the right path for them. If it is not, maybe they do global work but work with some people here. Because it doesn’t mean you have to go to a different country to do global work. We have refugees, we have immigrants, we have a lot of global work which can be done here.

SUSANNAH ALLISON: You raise a lot of good points, and I am going to pick up on one because I get asked this a lot, which is how many publications do I need to have to be competitive for whatever training grant application. I think you’re right. It is hard to answer that question because every field is a little bit different, every person is a little different in what they have done, but I think you would not be very competitive if you came in for a K award and you did not have any publications.

So I think you’re right. Sometimes it’s just not the right time, and it is time to build up and get yourself those experiences that are going to make you more competitive before you submit your grant application. So it’s good to get that advice from people like Fred and Brandon or someone from NIH as well. We can tell you if we think it might be better for you just to wait and get more publications and more experience.

I think especially for a K you really need to show some interest and some dedication to the area that you are going to be getting more training in. You already have to have some building blocks in place that you are then building on top of for your K award.

Brandon, what do you think about in terms of working with mentees and having them be ready for a K or F submission?

BRANDON KOHRT: I echo all the things that Fred shared and will maybe highlight a few more points. Going back -- and I know we’re reiterating this but -- the K or even an F is supporting you and your development, so the project doesn’t have to be perfect, doesn’t have to be comprehensive. If you just want a really good trial of something you need to find a different mechanism to do that. And so you should really be creative in the process of what do you want to be contributing to the field, and you are not going to accomplish all that in the periods of an F or a K or a training grant. But what is that unique niche that you as an investigator will address.

It’s much more exciting and interesting when I have somebody who comes to me with a project and it’s totally out there and we figure out, okay, how can we get NIH to fund you to do this versus, oh, this is what I’ve seen 12 other people get funded to do so I’m going to submit my training grant to do more of the same. This is funding to support innovation, and that should be part of what you focus on. Is that really creativity? What is that gap that’s out there?

And I think the second part of that creativity in terms of filling the gap is the evidence and the experience part. If you say I’m totally innovative; I am going to go and do this, and then in two seconds on Google I find a review or a protocol paper that’s already doing it, then you haven’t done your homework to say I am actually filling a gap that’s there.

So things like reading systematic reviews, reading Delphi studies, reading priority-setting papers, reading the documents that come out in terms of the NOCES or a WHO world mental health report. What do those documents say that those gaps are so that you can be creative and harmonize with those existing gaps. And that’s a great way to prepare for one of these rewards, is to do a review, a narrative review or a scoping review so that you really have a grasp of that and don’t seem like you are unaware –

SUSANNAH ALLISON: Brandon, you have frozen. We will wait for him to re-join.

FRED SSEWAMALA: I just want to reiterate a point that for the research plan that you are proposing for the study, it is not your life’s work, so keep it manageable. Because if you’re telling me you are going to do something at the level of a 01 and you have all this, then the question is where will you have time for the training.

So it is not your life’s work. Make it very manageable and know that that is just one writing aspect of the application. Brandon, I was just filling in your gap, so please take it from here.

BRANDON KOHRT: Good team work. I just wanted to say part of it is the existing literature gap, but (lost audio)

SUSANNAH ALLISON: Well, I think Brandon was making an excellent point about how you do need to be creative about what new skills are you going to be learning that are going to help you to make a unique contribution to the field. So you’re right; are you just learning all the things that you have seen other people learn. And there can be a great outcome of doing some sort of review, because a good part of the process is reviewing it and, hey, get a paper out of it at the same time. It’s a win-win. It helps prepare you for that application and it’s making you even more competitive because you’re getting a publication out there on that review.

And I like the idea of creativity, of finding that unique niche for yourself. Based on all the things you have done already and where you want to go, how is this training plan going to make you someone who is going to be invaluable to the field? Is it better understanding some of the ethical challenges of doing work in global mental health research? Is it better understanding the role of stigma and how to intervene? I think there are so many important gaps especially when we talk about global mental health that you can focus on to really further develop and make yourself someone that others seek out to work with.

I think a really important part that we have touched on already is forming a really good mentorship team, so I would love to hear from you both about how do you help your mentees. And, Fred, you talked about this already, recognizing how you can help mentees and where it might not be your strength and it might be someone else’s strength, and you have put people in touch with other mentors to invite onto the team. I think that’s a great way of understanding what it is that you can give to someone, helping them to identify what they need and what their ask is for people and then helping them to network.

I think that is a really important part of being a good mentor, is helping people to network before they submit their grant application, during the grant and especially towards the end of an individual training award when that person is transitioning to the next phase, whether it’s going on to get a postdoc or getting a tenure track position. Helping mentees to network is such an important part of being a mentor.

So what is your advice to potential applicants about forming their mentorship team?

BRANDON KOHRT: I am happy to start if my internet holds on so I will jump in. I’m sure Fred can fill in the gaps. I think an obvious one in global mental health is who are your global partners, who is onsite in that setting where you are going to work, who is going to be a mentor. And it can’t work to have eight mentors in the U.S. but then you’re working in Uganda or Nepal or Liberia or somewhere else. But even if their publication background might not be in the same degree or NIH funding track record, you can always get a U.S. person that might have more of that. But really there is no substitute for a person who’s working on that site where the study is being done.

In fact, to a prior point, ideally, even if you have published with that person before, even if it’s just a commentary or something, but to show that you are able to work with that onsite mentor is so much stronger with a prior publication.

Another piece is I think there is increasing availability and increasing expectation that you have people with lived experience, and so the Global Mental Health Peer Network, we have been able to jointly submit grants with them and have key personnel who are from the Global Mental Health Peer Network. They have a research division. There might be local organizations. They don’t always have to be a mentor; they could be a consultant, a collaborator, a COI, but someone who has lived experience as part of that team is so vital. And having them at the development stage as opposed to waiting until you’re trying to publish your final paper and then get somebody’s input.

And then I think the third aspect of mentorship is the practitioner intersection. Is there someone who has engagement with policymaking with other practitioners with large NGOs, INGOs, who could be part of this. And again, it doesn’t exactly have to be an NIH formal mentor but somebody who is going to write a letter of support with you and you meet with regularly can be a consultant or a COI or a collaborator because that shows you have a connection to then make real-world impact from the work that you are doing.

So really, who is onsite at the setting where the work is being done. Can you have somebody who has lived experience that will help guide you in that process, and then making sure somebody is in that intersection of the policy-practitioner world. Thanks.

SUSANNAH ALLISON: All excellent points. And thanks for really making sure that that is something that everyone hopefully heard especially around doing global mental health research. It is not going to work, it is not going to be good research, is not going to be a successful application if you do not have true collaborative collaborations in-country and are working with them in a meaningful way and not just when you develop the protocol and you need their stamp of approval. It’s just not going to be a good project if that’s the way you are going to run it, and I don’t think it will get reviewed well either.

FRED SSEWAMALA: Just to add without repeating what Brandon has said so well. Reach out early. Don’t get to people two weeks before, or even a month before and say I have this idea -- and this goes back to what Brandon has mentioned, that you want them to be participating. Let them read your application, let them read your career implementation plan. Because if you reach out late, how is this person going to help you? Remember, they are not going to be your mentors when you get funding; they should already show that they can work with you.

That’s why Brandon talked about if you can even publish mid analysis that would be great because if you can get to know their work style, which I think Dr. Susannah talked about earlier, then you can see whether they are the right people for you. So reach out early and involve them in the development of your application.

Now, you cannot determine whether they send back comments or not, but at least give it to them and let them -- either give you comments or not, but don’t say I assumed you are extremely busy. The moment you know they are extremely busy, maybe they are not the right people for you because we are all very busy, but we need to create that time. As a professor, I am obliged to do mentorship; that is part of my service. That I don’t have to only mentor people at Washington University, but people all over the globe.

The other thing you have to think about is schedule meetings. Emails are fine, but especially now with Zoom, but now virtually, whichever way you want to do it, Skype, Zoom, whatever, schedule that meeting and just talk to that person and see whether the chemistry is right. Because you don’t want to propose someone and then you draft the letter for them, maybe you did and then they put in very great stuff, and then at the end of the day they fund you and you can’t get this person even to help you connect you to that NGO or IO, whatever. And then you are really thinking about if they are a mentorship team.

Then, whenever possible, make sure that -- and this is political, but I will say it. You really want to make sure that the mentorship team that you have, that they get along. You don’t want them, when they get in the room, fighting each other. So you are like, gosh, is this how academia works. You really want to see do these people even get along.

So those are things to think about. And I think you can always get that from your primary mentor and say yes, I think you cam work with that person but I am not comfortable working with him. Then you have to figure out what makes it uncomfortable for my primary mentor to work with that person. Maybe they have a history. Remember in academia people have history where they have been taken advantage of and that kind of stuff.

So try to navigate that. It is very delicate, but it is reality, it’s real. I don’t want to paint a rosy picture like everything is going to go well and everyone gets along and we all sing Kumbaya. Sometimes we don’t. I’ll stop there.

SUSANNAH ALLISON: Those are all excellent points and I think really speak to that slide on the timeline for putting together an application like this and forming your mentorship team. That planning is really part of the first couple of months that you’re working on your application and you’re planning it out. It shouldn’t be, as has been said, something that you try to fill in with people a few weeks before you submit your grant application. That is going to come through in your application.

Reviewers often can tell when a mentor in a specific area has not reviewed your grant because you’re proposing to learn more about it, so you aren’t an expert in that yet, but reviewers are assuming that the person who is going to be helping you to learn about latent class analysis or implementation science theoretical approaches has read through your training plan in that area and has given you feedback. If it doesn’t sound like that person has read through that portion of your application, reviewers will pick up on that.

As Fred said, it is important that you -- Everyone is different in their mentoring style and the type of mentor that they do well with, so it is important, when you submit that application, that you already know how you work with the people that are going to be on your team.

This has been a really wonderful conversation, I have to say. It has really been invaluable to hear from you both, your thoughtful approach to mentoring -- knowing you both, I know you are very thoughtful -- and to be able to share all of your experience with the folks that are joining us today, so thank you so much for this really helpful conversation.

I might turn us over to the Q&A to see if there are some things that we might be able to answer live. There is a question from Emma. If you are an early career investigator, who should we be seeking for mentorship? Does either of you want to take a stab at that?

BRANDON KOHRT: I would just say start with what you really want to be doing and then see how the field is doing on that, because if someone is doing a part of that they are probably really excited about taking that in any direction. But really figuring out first and foremost what do you want to do, what is in the field that has been or has not been done around that topic, and then reaching out.

FRED SSEWAMALA: I am a Ph.D., so I am just going to use this, I am not an MD. So I’m assuming that you did your Ph.D., you have a dissertation, you have someone you have worked with. And I think that is also where I would begin and say how much do you know about this, and can you connect me to this person. I want to get now into implementation science. I know you are not an implementation scientist but who do you know in that field that can help me?

Also, sometimes reading helps you figure out who is leading that field, and sometimes you want to be connected to that person, and then that person may not be the person to mentor you but will connect you to some colleague and say actually I am extremely busy at this time, but I know that my colleague here can help you.

So the reading you do about the area, the connections you already have from your current mentors or current collaborators that you have should be able to help you open the doors into a new field.

SUSANNAH ALLISON: All great ways to find the right people who will have the time and skillset needed to help you get the training that you need.

Considering that we’re focusing on global mental health, can you speak to the funds with the PI and the US collaborating with researchers in Africa?

FRED SSEWAMALA: I didn’t understand. Speak to the funds?

SUSANNAH ALLISON: Yes, funds. I will just say in terms of funds for Fs, there is very limited money for an F application or an F award, an F31. Most of the funds are for you as a graduate student to get a stipend. There is some travel money. It’s quite limited in terms of there’s really rarely any money that can go into an international country.

For a K award, you do have a larger amount of money that you can apply for, for your research costs. I wonder if you could comment on thinking about those research costs, the research funds in a K, thinking about where those funds should go.

BRANDON KOHRT: I really appreciate the individual who brough this up because it is so important from an equity perspective. You start figuring this out with your F and your K so that by the time you get an R you can really be sensitive to these imbalances in financial power.

At a K, everybody is getting 8 percent indirects, but suddenly you move on to an R01 or something like that and your institution gets 60 percent indirects but then your colleagues in Liberia or Malawi or Peru get 8 percent indirect. So there is a lot of disparity in terms of where wealth is distributed, so we just all need to be sensitive to that and think about how best to work with it.

At even the F level, but you can do it much more effectively I think at the K, it’s just travel funds to have your foreign mentors come to the US for a conference, for a program, organize an in-person mentorship meeting, so at the very least those travel funds are a great way to support a mentor who doesn’t get salary support as part of a K or an F. But travel funds is a great starting point, and then there are other things you can try to explore in the future.

FRED SSEWAMALA: Just to add to that, I just came back from NIH where we have this K43 with the LAUNCH program funded, and this equity question came up in regard to the funds that go to the developing countries, the 8 percent. I think hopefully NIH will do something about that. I think definitely it is a challenge to institutions in developing countries to be able to implement a strong portfolio, and even to support.

For example, we have someone that we worked with and I was part of the mentorship team for a K43, and then there is 8 percent which went to university which frankly did not even pay for their office space. So the challenge was, okay, they have to release this person from teaching 75 percent of their time or whatever, but they don’t feel that as an institution they are even able to recover the expenses that they were spending on this person. So that’s NIH.

The other thing is our partners in the developing countries -- I’m just talking about developing countries because that is where I work. Sometimes even when a trainee has been bought out, they are still required to do what they were doing before. So the question sometimes is, okay, now I’ve got this K and this person kept saying -- the department chair kept saying I got this K so that I can grow, but now I still have almost the same teaching load as I did before I got this K.

So I think that is where sometimes it is difficult to get that balance. The institution didn’t get enough resources just to pay for what they are supposed to cover -- power, internet, space and all that. But sometimes the person receives these funds but they cannot be released from the work they were doing.

I don’t know whether this addresses your question, but I think that is something that needs to be navigated and hopefully NIH can help out as we grow this area of career development especially in developing countries.

SUSANNAH ALLISON: I know this issue is getting a lot of attention so we will have to kind of wait and see how it continues to move forward. I have seen a really nice uptick in terms of training award applications that really include some capacity-building.

We often think of a training award as being focused on the applicant and the applicant’s training, but I have seen a nice uptick in folks who are putting in Ks and saying, look, I am going to be getting this mentorship from these folks, but I am also going to be working very closely with maybe someone who is in-country who is at that same level to kind of bring them along with them because there are not as many opportunities for these types of awards. Or, as part of my training, how am I going to learn to be a better mentor, and getting additional training and being a mentor to others.

So I think that is a really nice way, while it is an individual training award, to also have a capacity-building component to it as well for others.

I think we will just have time for maybe one more question, and then if we did not answer your questions I think we can -- If we didn’t get to your question please reach out to me and send me your question directly and I will respond to it.

Jasper Lee asked how many mentors are too few and too many. I do get this question quite a lot. What is the ideal range for the number of mentors?

FRED SSEWAMALA: I really frankly don’t know whether there is a number, but this is my rule of thumb. Where do you need a mentor? Do you need a mentor to help you with methods, one? Do I need a career mentor? I am a person of color; the way I navigate academia is different from probably a person of majority, so do you need someone like me to take you through simply navigating academia or navigating NIH funding, whichever it may be? Do you need someone in your substantive area?

I think it really depends. Of course, if you are going to have eight mentors then it becomes an issue maybe. But the way I talk to my mentees is where do you think you  need substantive help, and where do you need -- not every mentor is going to take you into the methods if they are not statistical experts so you may need someone there. You may need someone who helps you navigate your career and the issue is not talking about your work but getting in the job market. You need a mentor. How you survive in academia?

I am not a medical doctor but I’m sure that in medicine also they will tell you how do you work on a ward and that kind of stuff and deal with patients.

If I think about substantive areas and I think about issues of methods and I think about career -- so maybe four, but that is a number that I have not thought about that much. But I hope you get the idea that you have to really think about what are the different fields within my area, what is it where I want to gain expertise and where I need help and that kind of stuff. And how many people do I need there.

Because even with methods, it doesn’t mean that someone who does very good sampling also knows how to do very good statistical analysis around this issue. So maybe methods you need two, or you may need three depending on which new methods you want to learn. So it’s a great question and I don’t know whether I gave the answer but that is how I approach it when I think about mentors.

SUSANNAH ALLISON: That is how I usually answer it too. It depends. But once you get up to about eight, I think reviewers start to get a little nervous that you are spending your whole K or your whole F just on meetings with your mentors and you’re not going to have the time to work on your research.

FRED SSEWAMALA: Just one thing to add. Managing mentors is also work. These are people and you are trying to figure out their schedule and sometimes you have to bring them together.

SUSANNAH ALLISON: True. Brandon, any thoughts?

BRANDON KOHR: I have never been on a panel where somebody said this person didn’t have enough mentors. I have never ever heard that. What I do hear, and exactly what Fred said, they don’t have a mentor for this topic and this is what they’re focusing on. So the content should drive the individuals. There is no magic number. Nobody has ever said they should have six more mentors.

Also keep in mind, as I said before, collaborators, co-investigators and consultants. Some of these things that you need more targeted support for might fit better in those roles rather than making everybody, all eight people, a mentor. Maybe it’s three mentors, two consultants, two collaborators. So keep that in mind.

SUSANNAH ALLISON: Great. Great point to end on. Thank you all so much. I think this has been really helpful, and I hope all of you listening have learned some valuable tips for putting together what we hope is a successful individual training award focused on global mental health research.

I am now going to turn the microphone over to Dr. Leo Cubillos, who is the Director for the Center for Global Mental Health Research here at NIMH and he is going to close us out.

LEONARDO CUBILLOS: Thank you, Susannah. This was a lovely conversation. Thank you, Fred, Brandon and Aileen for your important contributions. I heard a lot of good information that is very helpful, and I also heard very useful things that are helpful for people that are in their training career. I will say that it is useful for applicants at different levels of their careers as well. So thank you so much.

I just want to mention the next and last webinar of the 2022 Center for Global Health Research Webinar Series. This webinar will take place on November 16th at the usual time, 10:00 a.m. eastern time. The topic will be kind of a continuation of the webinar we had back in May. Again, all these webinars are already posted for you to view online.

Back in May we spoke about aspects that we should keep in mind that we do the pre-award grants management aspects. Next month, November 16th, in a couple of weeks, we will be doing the post-award aspects of the grants management. The presenter will again be our colleague, Tamara Kees. So I would like to invite you to this last webinar of 2022 and we will be announcing during that webinar some topics that we will be presenting for the 2023 webinar series.

Thank you again for your time, and I wish you all a great day. Brandon, Fred, Aileen and Susannah, thank you so much for everything.