Reducing the Duration of Untreated Psychosis in the United States (R01 Clinical Trial Required) | PAR 18 233

Opportunity Information: Apply for PAR 18 233

The National Institutes of Health (NIH) funding opportunity "Reducing the Duration of Untreated Psychosis in the United States (R01 Clinical Trial Required)" (PAR-18-233) is a research project grant aimed at improving how quickly adolescents and young adults experiencing a first episode of psychosis (FEP) get connected to effective, evidence-based care. The public health problem driving this program is large and time-sensitive: roughly 100,000 young people in the U.S. experience FEP each year, and the earliest stage of illness is widely seen as a crucial window where prompt treatment can change the long-term course of schizophrenia-spectrum and related psychotic disorders. The FOA emphasizes that while treatment models have improved, the system still routinely fails to get people into care quickly enough.

A central concept in this announcement is the duration of untreated psychosis (DUP), meaning the time between the onset of psychotic symptoms and the start of appropriate specialized treatment. The FOA highlights that many U.S. studies find DUP commonly ranges from one to three years, which is far longer than what is considered clinically ideal. This delay matters because outcomes tend to be better, both short-term and long-term, when treatment begins closer to the onset of psychosis. In contrast, long untreated periods are associated with greater functional deterioration, making recovery and return to school, work, and relationships harder.

The clinical service model the FOA is trying to help more people reach sooner is Coordinated Specialty Care (CSC), a team-based approach for FEP that integrates medication management, psychotherapy, family education and support, and rehabilitation services (such as supported education and employment). CSC has a stronger evidence base than traditional fragmented treatment approaches and has been associated with improvements in symptoms, functioning, and broader life outcomes. However, the announcement is clear that even the best CSC programs cannot achieve their full benefit if individuals arrive late, after months or years of untreated symptoms.

The main purpose of the grant is therefore practical and implementation-focused: to support research that tests workable, reproducible strategies to substantially reduce DUP by removing bottlenecks and closing gaps along the pathway into CSC. That pathway can include many steps where delays occur, such as recognizing early symptoms, navigating first contacts with schools or primary care, referral processes from emergency departments or community clinics, waitlists, insurance or administrative barriers, and challenges engaging young people and families who may be frightened, uncertain, or mistrustful. The FOA is aligned with the World Health Organization target of reducing DUP to three months or less, and it seeks projects that can move real-world systems meaningfully toward that benchmark rather than producing results that are difficult to replicate outside a research setting.

This is an R01 mechanism, meaning NIH is looking for full-scale research projects with strong designs, and the title specifies "Clinical Trial Required," indicating that applicants are expected to conduct a clinical trial as part of the proposed work. In practice, this points to testing interventions or system strategies under controlled, measurable conditions, with outcomes that directly capture whether DUP is reduced and whether more people successfully reach and engage in CSC in a timely way.

Eligibility is broad and includes many types of U.S.-based organizations: state, county, and local governments; special districts; independent school districts; public and private institutions of higher education; federally recognized tribal governments and other tribal organizations; public housing authorities; nonprofits (both with and without 501(c)(3) status); for-profit organizations (other than small businesses) and small businesses; and other eligible entities. The FOA also calls out additional eligible applicants such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving institutions, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISISs), faith-based or community-based organizations, regional organizations, eligible federal agencies, and U.S. territories or possessions. Foreign institutions and non-U.S. entities are not eligible to apply, and non-U.S. components of U.S. organizations are not eligible; however, foreign components, as defined by NIH policy, are allowed.

Administrative details included in the source information identify this as a discretionary NIH grant in the health area (CFDA 93.242). The original closing date listed is March 19, 2019, and the FOA creation date is November 21, 2017. The award ceiling and expected number of awards are not specified in the provided data, which often means applicants must consult the full NIH posting or related notices for budget expectations, institute-specific guidance, and current submission cycles.

Overall, this opportunity is aimed at moving the U.S. system closer to a standard where psychosis is recognized quickly, referrals happen rapidly, and young people are engaged in CSC early enough to preserve functioning and improve long-term trajectories. The emphasis is not on proving CSC works, but on solving the real-world delays that keep people from reaching CSC in time.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Reducing the Duration of Untreated Psychosis in the United States (R01 Clinical Trial Required)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.242.
• This funding opportunity was created on 2017-11-21.
• Applicants must submit their applications by 2019-03-19. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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