Reducing the Duration of Untreated Psychosis in the United States (R34) | Apply Online

FAQs: NIH Grant Opportunity PAR-16-264 (R34) - Reducing the Duration of Untreated Psychosis in the United States

What is the name and mechanism of this funding opportunity?

This opportunity is titled "Reducing the Duration of Untreated Psychosis in the United States (R34)" (PAR-16-264). It uses the NIH R34 mechanism, which is a planning grant intended to support groundwork activities that prepare for larger, more definitive interventions later.

What problem is this grant trying to solve?

The grant targets long delays between the start of psychotic symptoms and the start of appropriate, evidence-based first-episode psychosis (FEP) treatment. These delays are a major practical barrier in early psychosis care in the United States.

What does "duration of untreated psychosis (DUP)" mean in this FOA?

DUP refers to the time between the onset of psychotic symptoms and the initiation of appropriate, evidence-based treatment for first-episode psychosis (FEP).

How long is DUP typically in the U.S., according to the FOA?

Multiple U.S. studies cited in the FOA suggest the delay commonly ranges from one to three years, which the announcement frames as far longer than what is considered acceptable to prevent functional decline.

What DUP benchmark does the FOA highlight as an urgent target?

The FOA points to the World Health Organization benchmark of reducing DUP to three months or less, framing this as an urgent target for communities and systems of care.

Why does the FOA emphasize early intervention in psychosis?

The FOA describes the earliest phase of psychotic illness as a critical window. Prompt, well-organized care during this phase can help prevent avoidable long-term disability and may improve long-term clinical and functional outcomes by changing the illness trajectory that often leads to persistent impairment in schizophrenia-spectrum and related psychotic disorders.

Who is the population of concern for this FOA?

The FOA is grounded in the reality that roughly 100,000 adolescents and young adults experience a first episode of psychosis each year in the United States, and it focuses on improving how quickly people experiencing first-episode psychosis connect to appropriate care.

What care model is the program built around?

The program backdrop is Coordinated Specialty Care (CSC), a team-based, multi-component approach to treating first-episode psychosis.

What services are included in Coordinated Specialty Care (CSC) as described here?

CSC is described as integrating medication management, psychotherapy, family education and support, and rehabilitation services such as supported employment and education.

Is this FOA mainly about proving that CSC works?

No. The FOA notes that CSC has been associated with better outcomes than fragmented approaches, but the emphasis here is on strengthening real-world systems so people are identified quickly and connected to CSC promptly after symptoms begin.

What is the main purpose of an R34 planning grant in this context?

This R34 is meant to fund planning and groundwork activities: measuring local delays to care, understanding how people currently reach (or fail to reach) CSC programs, identifying system bottlenecks, and developing and pilot testing feasible strategies to substantially reduce DUP.

What are the four main expected activities for applicants?

Applicants are expected to: (1) establish a baseline DUP rate in community settings that include CSC programs; (2) map referral pathways into CSC care; (3) identify bottlenecks and gaps along those pathways; and (4) develop and pilot test feasible strategies to substantially reduce DUP for individuals experiencing first-episode psychosis.

What does it mean to "establish a baseline DUP rate"?

It means measuring how long delays are in the specific local community settings being studied (including CSC programs), rather than relying on national averages.

What does "mapping referral pathways" involve?

It involves identifying where people with emerging psychosis first come into contact with systems that could lead to care (such as schools, primary care, emergency departments, community mental health clinics, juvenile justice settings, family outreach, or law enforcement) and documenting how they do or do not get routed into specialized early psychosis services like CSC.

What kinds of first-contact settings does the FOA mention as part of referral pathways?

The FOA provides examples including schools, primary care, emergency departments, community mental health clinics, juvenile justice settings, family outreach, and law enforcement.

What kinds of bottlenecks or gaps does the FOA expect applicants to look for?

Examples listed include lack of awareness of early psychosis signs, misdiagnosis, waitlists, insurance barriers, inadequate screening, poor coordination across agencies, limited clinic capacity, transportation barriers, stigma, and engagement challenges with young people and families.

What does the FOA mean by "feasible strategies" to reduce DUP?

The FOA emphasizes feasibility to signal interest in approaches that can actually be implemented under everyday community conditions, rather than idealized solutions that only work in highly controlled or unusually well-resourced environments.

What is meant by "system-level fixes" in the context of this FOA?

Based on the description, system-level fixes are targeted changes to how communities identify, refer, coordinate, and connect individuals with first-episode psychosis into evidence-based care (particularly CSC), aimed at shortening the pathway from symptom onset to appropriate treatment.

What agency administers this opportunity?

The opportunity is administered by the National Institutes of Health (NIH). The agency listing is shown as HHS-NIH11.

What is the CFDA number listed for this opportunity?

The CFDA number listed is 93.242.

What type of grant category is this listed under?

It is listed as a discretionary grant in the health category.

Who is eligible to apply based on the information provided?

Eligibility is broad and includes state, county, and local governments; public and private institutions of higher education; tribal governments and tribal organizations; public housing authorities; nonprofits with or without 501(c)(3) status; for-profit organizations (other than small businesses) as well as small businesses; and other entities as described in the FOA.

What is the award ceiling for this opportunity?

The listed award ceiling is $225,000.

When was this funding opportunity posted?

The opportunity was posted on May 17, 2016.

What was the closing date for applications?

The opportunity lists an original and current closing date of March 19, 2019.

What is the overall goal of the grant, in plain terms?

In plain terms, the grant supports communities and research-practice partnerships that want to measure their local delays to early psychosis care, understand where and why delays occur, and pilot test practical, targeted improvements that can get people into evidence-based first-episode psychosis treatment much faster.