Strategic mental health initiative Mobilizing the driving forces in mental health and neuroscience to support the advancement of knowledge and the transformation of practices

1. CONTEXT

In Québec and in many jurisdictions around the world, the COVID-19 pandemic brought about physical distancing measures that exacerbated several risk factors related to a lack of well-being: isolation, loss of employment or income, family, marital and social tensions, as well as mental health, cognitive and psychological deterioration related to the loss of stimulating activities. In addition to the health-related consequences, the pandemic caused disruptions that have negatively affected the emotional well-being, mental health and safety of individuals, their family and their loved ones. The continued expansion of general social services and mental health services is critical to individual and collective recovery. This singular context reaffirms the importance of an innovative, responsive, strong, efficient and integrated health and social services system, particularly with respect to services for the most vulnerable populations. The issue is a societal one.

In January 2022, the government of Québec released the Plan d’action interministériel en santé mentale 2022-2026 – S’unir pour un mieux-être collectif (PAISM), which seeks, among other things, to “foster optimal mental health for the population and facilitate access to quality care and services for individuals with mental disorders and related symptoms, as well as for their family and their loved ones” [translation]. It also aims to meet research needs in the field.

The action plan is focused on the consideration of all the needs of an individual in a holistic and sustainable perspective. It proposes means to help individuals remain in their living environments throughout their journey. The vision outlined in the PAISM seeks to involve all the stakeholders in the mental health continuum so all Quebecers, regardless of their location, have timely access to actions, services and support that are adapted to their mental health needs. The support of the scientific community will enable the MSSS and health and social services network to successfully lead transformation and innovation in practices and the development of clinical and technological tools rooted in scientific data that are applicable to the entire network.

Beyond improving access to quality mental health care and services, the management and maintenance of good mental health among the population entail significant scientific, medical and social challenges. As a result, it is also important to support research efforts to identify and characterize factors such as objective and quantifiable markers associated with mental disorders. Data in neuroscience research now makes it possible to achieve a better understanding of the brain and the neurological processes that underlie many mental illnesses. These markers then enable caregivers to better grasp the clinical heterogeneity observed in their everyday practices by helping to clarify diagnoses, predict the course of an illness and refine treatment options.

Thus, the advancement of mental health knowledge is critical to better understand needs, transform clinical and organizational practices and develop tools and innovative approaches to better understand illness and provide better care and services. However, there is room for improvement with regard to knowledge use and the implementation of best practices. Narrowing the gap between the generation of knowledge and its use by the health and social services network is a major challenge that led to action 7.1 of the PAISM to support the development, transfer and application of mental health knowledge to strengthen the links between researchers and mental health stakeholders (managers, physicians, caregivers, service users and family members, etc.). The application of research knowledge on current practices fosters reflection and innovation, stimulates decision-making and leads to the continuous improvement and transformation of organizational and clinical practices.

These observations support the development of closer ties between research and practice to build on the different types of research conducted in Québec. The selected projects will establish a close link between practicing stakeholders and members of the scientific community and involve service users and individuals living with a mental health problem, their family and their loved ones in their earliest steps of the project development.

2. PROGRAM OBJECTIVES

Objectives

Proposals submitted as part of this call should foster the development of innovative approaches with high transformative potential leading to significant impacts and departing from more traditional methods. The development, sharing and application of knowledge and close and ongoing conversations between stakeholders are also crucial. Proposals must address one or both of the following objectives:

• Support the advancement of knowledge and development of promising organizational or clinical practices in mental health in partnership with stakeholders in response to the objectives of the PAISM;
• Support the advancement of knowledge in mental health to maximize the impact of mental health and neuroscience research (fundamental–applied continuum) on care and services and promote stronger links between research sectors.

Applicant teams must consider the following aspects when developing their project:

• Diversity, including but not limited to, gender, disability, Indigenous identity, belonging to a racialized group, ethnicity, sexual orientation, religion, age, language, parenthood, immigration, geographic location or socioeconomic status (FRQ’s Equity, Diversity and Inclusion Strategy);
• Context of the pandemic, if applicable;
• Anticipated challenges and constraints, for example:
  • related to new knowledge development such as data access issues;
  • related to challenges implementing promising practices and disruptions in the care and services trajectory.

The research results must make it possible to build on new knowledge and develop mental health programs and services that are more science- and evidence-based to support practice settings and managers in the health and social services network in the organizational and clinical transformation of services to improve the mental health of all Quebecers.

Targeted research themes

Projects must be designed in a way that integrates one of the following themes and includes one or more of the targeted aspects.

Theme 1. Organizational or clinical transformation of mental health care and services

Projects may address, but are not limited to, one or more of the following issues identified in the 2022–2026 PAISM:

• Access to step-by-step services and care (e.g.: PQPTM);
• Care and services focused on the recovery of individuals, including their family and surrounding people (e.g., school and socio-professional integration, return to work following an absence due to a mental health problem, etc.);
• Services or interventions in crisis situations;
• Partnership between the health and social services network, community organizations and other intersectoral stakeholders;
• Alternatives to psychiatric hospitalizations;
• Clienteles that are marginalized or disaffiliated, or those in the justice system.

Theme 2. Development of innovative tools and approaches to better understand illness and provide better mental health care and services

Projects may address, but are not limited to, one or more of the following issues:

• Promotion of mental health and prevention of mental disorders;
• Support for decision-making, early disease detection, diagnosis and treatment (e.g., neuroimaging, genetic testing, epigenetic analysis, pharmacogenomics, biomarkers, identification of determinants such as social, environmental, biological factors, etc.);
• Mental health impacts of the COVID-19 pandemic;
• Digital health.

Key principles

Proposed projects must remain in keeping with the context, objectives and key principles of the program, as described here.

Applicant teams are encouraged to demonstrate that in their application.

Sustainable health

An asset for society, sustainable health constitutes a comprehensive approach that considers the physical and psychological health of individuals and the environment in which they live. It commits individuals and the community to deploy different interventions at all stages of life to foster optimal health for every individual, including vulnerable populations and future generations. Sustainable health therefore aims to ensure well-being and a better quality of life for all.

Sustainable health thus aims at developing strategies for health promotion, prevention and early intervention of diseases, for health results at a lower cost, and this, with at least 3 levels of declination:

• A better consideration of health determinants / prevention – promotion
• Transformation of service corridors / new actors
• Global health – the transformation of public health by integrating the surrounding natural ecosystems

Applicants must demonstrate how their project contributes to the achievement of sustainable health:

Research in partnership for and with users, their family and their loved ones 

Research in partnership for and with users, their family and their loved ones aims to create a partnership relationship between users, those closest to them, the population and all the individuals and organizations in health research, care and social services. It facilitates the transformation of the role of users, their family and their loved ones (i.e., from passive service recipients to proactive partners) and enables them to take part in health and social services research and care as co-researchers, partners in care and services and experts on their own health and well-being.

Users, their family and/or their loved ones must therefore be involved in the processes to develop and implement the research project, in the research itself and in the dissemination and transfer of the knowledge that is gained, in keeping with the rules that govern patient-oriented research.

Learning health system

The learning health (LHS) system approach seeks to establish a continuous cycle from practice to data (data management), data to knowledge (data development) and knowledge to practice (change management). The development of a partnership between all the individuals and organizations in health research, care and social services fields is a key part of the learning health system approach. The LHS is a dynamic ecosystem of care in which the scientific, social, technological, political and ethical dimensions are aligned and enable the integration of ongoing learning and improvement cycles into current practices. Ultimately, the approach fosters the transfer of emerging knowledge from practices in real settings to best practices.

The overarching goal of the LHS is to improve five key aspects:

• Patient experiences and care outcomes
• Population health
• Efficiency of the health and social services system
• Well-being of health and social services human resources
• Equity in health and social services

 Applicants must demonstrate the extent to which their project establishes a continuous cycle from practice to data, data to knowledge and knowledge to practice or explain why their project does not take a learning health system approach.

Important note

Funded projects must be designed, developed and carried out through a participatory, reflective and intersectoral approach, including the involvement of various stakeholders such as researchers, managers, health and social services professionals, community groups, service users and individuals living with a mental health problem, their family and their loved ones. By taking this innovative approach, the program aims to support the development of basic research in mental health and neuroscience and of relevant evidence-based organizational and clinical practices to implement better practices that will benefit all stakeholders.

3. APPLICANT ELIGIBILITY

Conditions

The team will be composed of a minimum of 3 people:

• One principal investigator responsible for submitting the application with status 1, 2 or 3 as defined in the Common General Rules (CGR) of the Fonds de recherche du Québec (FRQ);
• One co-investigator with status 1, 2 or 3 as defined in the CGR;
• One co-investigator user (service users or living with mental health illness) their family or loved ones with status 4e) as defined in the CGR.

Additional individuals may be added to the team as co-investigators, with no restrictions on the number:

• Co-investigators: status 1, 2, 3 et 4, as defined in the CGR.

The involvement of a practitioner (e.g., a person in a management position in the health and social services network) as a 4(c) co-investigator, as defined in the CGR, is strongly encouraged.

Clarifications in relation to the status 4c), 4d) et 4e) :

• The involvement of a practitioner – status 4c), artists – status 4d), or individual contributors – status 4e), if relevant, must be specified in the proposal.

Additional collaborators:

People can join the team as collaborators.

The role and status of each team member must be clearly stated in the application documents. All team members must adequately demonstrate their active contribution to the proposed project and indicate their level of involvement. The engagement of user communities must also be detailed.

The Fonds de recherche strongly encourage collaborations between researchers with expertise in different research areas, as well as the integration of young researchers into the teams.

Multiple applications

A researcher may submit only one project under this Call for Proposals as a Principal Investigator and may join only one project as a co-Investigator.

Professional Order

Team members who are health and social services professionals will need to demonstrate that they are registered with their professional order in Quebec, have a valid license to practice in Québec and have a professional liability insurance.

Ethics

Principal Investigator(s) and co-Investigators must comply with the ethical regulations as defined in the CGR.

Basic training in research ethics (Québec)

Basic training in research ethics is mandatory for all principal investigators and co-investigators when their research project or program focuses on human subjects.

Research on human subjects involves:

• the participation of human subjects,
• the use of human biological material (parts, products, tissues, cells, genetic material from the human body, a living or deceased person)
• assisted reproduction activities or the use of embryos derived there from them, within the meaning of the Act respecting clinical and research activities in relation to assisted reproduction (L.R.Q. chapter A-5.01)
• the use of administrative, scientific or descriptive data from human beings.

This basic training consists in the realization of modules 1 and 3 of the online tutorials developed by the Ministère de la Santé et des Services Sociaux (MSSS) as a training program in research ethics.  Module 1 is a minimum level of training in research ethics required for all FRQ researchers.

Researchers must have completed this basic training before the start of payments.

Basic training on the social acceptability of the use of health data

Basic training on the social acceptability of sharing and using health data is offered to all team members whose projects involve health and social services information.

The training includes the following modules: 

• Definition of social acceptability
• Guiding principles and best practices
• Tools and services available to teams
• Description of the support offered by the FRQ

This basic training will take place during an online webinar that researchers can attend prior to application submission, if available. Details on how to access this training will be shared later.

Researchers funded under this program, whose projects involve health and social services information, will be required to complete this core training. Details will be outlined in the award letter.

4. REQUIRED DOCUMENTS – PRE-PROPOSAL

The submission of the pre-proposal must be done via the electronic Portfolio before the closing date of the call by the principal investigator.

• Any document that is missing or does not comply with the rules of the program and electronic forms, but is deemed critical to eligibility or assessment, renders the file ineligible
• Items required but absent from the file will not be claimed.
• All documents received after the filing date of the pre-proposal will not be considered and there can be no update of the files.
• A document not required but transmitted with the pre-proposal will be removed from the file before evaluation.

No extension will be allowed. Any form not submitted by the indicated deadlines and times will be automatically rejected.

Principal investigator

• FRQS electronic « Pre-proposal » form (FRQnet) (PDF version available in the Tool box);
• Canadian Commun CV (funding CV version FRQNT, FRQS ou FRQSC (last updated between June 1, 2021, and the competition deadline);
• Detailed contributions (last updated since June 1, 2021); consult the document Guidelines for the file attached to the CV in the toolbox for the content of detailed contributions. Detailed contributions must be submitted with the CV;

To be attached in the section Other documents:

• Canadian Commun CV and detailed contributions for co-investigators with status 4a), if applicable
• Abridged CVs for co-investigators with status 4b), 4c) and 4d)
• Letter(s) of motivation or interest in participating in the project for co-investigators with status 4e) (users and/or close family)

Co-investigator with status 1, 2, 3 and 4a)

• Canadian Commun CV (funding CV version FRQNT, FRQS ou FRQSC (last updated between June 1, 2021, and the competition deadline);
• Detailed contributions (last updated since June 1, 2021); consult the document Guidelines for the file attached to the CV in the toolbox for the content of detailed contributions. Detailed contributions must be submitted with the CV.

Important :

• Co-investigators with 4(a) status will be required to submit their CCVs and detailed contributions in PDF format to the principal investigator.

Co-investigator with status 4b), 4c) and 4d)

• An up-to-date abridged CV of no more tant two (2) pages, in PDF format, and suited to the call for proposals; consult the document CV abrégé FRQ in the toolbox for more information.

Important : These documents should all be forwarded to the principal investigator.

Co-investigator with status 4e)

• Letter of motivation or interest in PDF format mentioning their motivation or interest in participating in the project, the nature of the expertise they bring and their role in the project (form available in the Toolbox)

Important : These documents should all be forwarded to the principal investigator.

Important information

Consent and FRQnet Account

Each co-applicant must provide consent to be included in the team by the pre-application deadline or the principal investigator will not be able to submit the pre-application form. Co-investigators who do not yet have a FRQnet account are encouraged to follow the “création de compte FRQnet” procedure available in the Toolbox.

5. REQUIRED DOCUMENTS - PROPOSAL

The submission of the proposal must be done via the electronic Portfolio before the closing date of the call by the principal investigator

• Any document that is missing or does not comply with the rules of the program and electronic forms, but is deemed critical to eligibility or assessment, renders the file ineligible
• Items required but absent from the file will not be claimed.
• All documents received after the filing date of the pre-proposal will not be considered and there can be no update of the files.
• A document not required but transmitted with the proposal will be removed from the file before evaluation.

No extension will be allowed. Any form not submitted by the indicated deadlines and times will be automatically rejected.

All documentation transmitted for the pre-proposal will be available for the proposal. The principal investigator will have the opportunity to update these documents. Therefore, in addition to the documents submitted during the pre-proposal, the following documents will be required: 

Principal investigator

• FRQS electronic « Proposal » form (FRQnet) (PDF version available in the Tool box);

To be attached in the section Other documents:

• Schedule of proposed activities of the cluster.
• Clinician: a letter from the management of the clinical department or the dean of the faculty specifying how many hours will be freed from their clinical obligations to carry out the research project (only for persons who do not hold a FRQS career scholarship)
• Letter(s) of support from the institution(s) with which the principal investigator is affiliated. In these letters of support, the institutions must indicate the type of support, financial or in-kind, that will be provided to the project throughout the funding period granted by the FRQS and its partners (maximum two (2) pages per letter)
• Letter(s) of support from the institution(s) where the research project will be conducted if different from the principal investigator’s institution of affiliation. These letters of support must indicate the institution’s commitment to the project throughout the funding period granted by the FRQS and its partners (maximum two (2) pages per letter)
• Document demonstrating how the project contributes to the attainment of sustainable health (form available in the Toolbox)
• Letter(s) of support from other relevant partners (maximum one (1) page per letter, for a maximum of five (5) letters)
• Documents required for Status 4 co-investigators if there has been a change in team composition following the pre-application stage

Co-investigator with status 1, 2, 3 and 4a)

• Clinician: a letter from the management of the clinical department or the dean of the faculty specifying how many hours will be freed from their clinical obligations to carry out the research project (only for persons who do not hold a FRQS career scholarship)

Important:

Co-investigators with Status 2 will need to forward their letter from the clinical department chair or dean in PDF format to the principal investigator.

Important information

Consent & FRQnet Account

Each co-applicant must provide consent to be included in the team by the pre-application deadline or the principal investigator will not be able to submit the pre-application form. Co-investigators who do not yet have a FRQnet account are encouraged to follow the “création de compte FRQnet” procedure available in the Toolbox.

6. TERM AND AMOUNT OF GRANT

7. ELIGIBLE EXPENDITURES

Eligible

In addition to the list of eligible expenses detailed in Section 8 of the FRQ CGR (which can also be found in the Budget section of the electronic application form), the following expenses are eligible:

Release from teaching duties or salary support for researchers with status 3:

• College researchers with status 3, as defined in the CGR) with or without teaching duties who join a research team may receive release time from their teaching duties or salary support of up to 20% of gross salary, to be provided within the grant budget.
• The amounts requested should be entered in the Budget section of the electronic form; budget line items are provided for this purpose. It is the responsibility of the Principal Investigator to identify each college co-investigator for whom salary support is requested.
• In the case of a university managing institution, this amount must be included in the budget and may be transferred directly to the college with which the CCTT is affiliated in the case of a CCTT researcher

Compensation for research and administrative staff shall follow the standards of the affiliating institution and reflect benefits and annual salary increases.

Non-eligible

Any expense not listed as an eligible expense in the CGR is considered ineligible unless authorized in the program rules.

Note

No amount may be transferred outside Quebec

8. ÉVALUATION

Pre-application

Pre-applications are reviewed to ensure the applicant team’s composition and status meet the criteria set out in the program rules. Only teams whose pre-application is deemed eligible will be asked to submit a full application. The FRQS will provide teams with confirmation on whether their pre-application was accepted or not via e-mail.

Full application

This program is the result of a public-private partnership linked to an agreement between four (4) partners. The evaluation of this program follows the terms and conditions specified in this agreement, and therefore differs from the usual evaluation procedures of the FRQ.

The process to review full applications involves three steps:

1. Evaluation of scientific excellence
2. Evaluation of the excellence of the strategic positioning in relation to government priorities (for projects selected in the first stage)
3. Final selection of projects for funding by the Steering Committee

STEP 1: SCIENTIFIC EXCELLENCE EVALUATION

A peer committee will conduct a scientific excellence evaluation of each application, in keeping with the FRQ rules applicable to evaluation committees. A score of 75% is required at this step. Only applications that receive a score of 75% or higher will move on to the strategic prioritization stage.

The evaluation criteria are as follows:

1. Team composition (20%)

1. 1. Quality of the team members’ experiences and achievements;
   2. Diversity and complementarity of the team members’ expertise, and collaboration strategy;
   3. Adequate integration of the various stakeholders, including users, their family and their loved ones, in all project stages;
   4. Quality of the support pledged by institutions and relevant partners, as applicable.
2. Excellence of the proposal (35%)

1. 1. Scientific quality of the project and methodological rigor;
   2. Contribution to the advancement of knowledge;
   3. Clarity of objectives;
   4. Originality of the project and its innovative character as it breaks with traditional approaches;
   5. Demonstration that the project is part of a learning health system (LHS) approach or adequate justification, as applicable;
   6. Potential to transform mental health practices within the health and social services system;

3. Feasibility and budget (20%)

1. 1. Demonstration of the project’s scientific, technical and operational feasibility;
   2. Soundness of the timeline and relevance of monitoring indicators, as applicable;
   3. Detailed and realistic justification for the budget.

4. Knowledge mobilization or technology transfer strategy (20%)

1. 1. Extent and quality of the knowledge mobilization strategy for the various potential users of the research results, including decision makers (outreach, appropriation and application);
   2. Involvement and degree of collaboration of community partners and potential users of the research results throughout the project’s implementation and follow-up;
   3. Originality of the knowledge mobilization strategy, range of target audiences (academics, users, partners, etc.) and diversity of the proposed dissemination initiatives in addition to scientific publications.

5. Equity, diversity and inclusion (EDI) (5%)

The evaluation of this criterion focuses on the applicant team’s effort (and not the institution’s) to foster diversity, equity, and inclusion in the three following areas. The criterion does not address team composition. *

• Training: specific actions already taken and/or planned to promote EDI in the training of the next generation (recruitment practices, coaching, career development, etc.);
• Research: when relevant, consideration of EDI when designing and conducting the research project (topics, methodology, etc.) and dissemination and mobilization of knowledge to diverse audiences;
• Involvement: specific actions already taken and/or planned to promote EDI in the research setting, sector or general area (committees, inclusive scientific events, awareness activities, etc.).

* The applicant team should not provide information on team members’ belonging to marginalized and/or underrepresented groups.

More information is available in the EDI guidelines in the toolbox.

Sustainable health:

Applicant teams must complete a form to demonstrate how the project contributes to the attainment of sustainable health. While there is no score for this key principle, submission of the form is mandatory.

STEP 2: EVALUATION OF THE EXCELLENCE OF THE STRATEGIC POSITIONING OF PROJECTS SELECTED IN THE FIRST STAGE

A strategic committee made up of stakeholders with a comprehensive perspective of mental health issues in Québec will review the applications that earned a score of at least 75% by the scientific excellence evaluation committee. The commettee will rank the projects according to the government’s strategic priorities with respect to mental health needs and issues. It is important to note that the scientific content of the application will not be reviewed a second time at this stage and that the members of this strategic committee will not have access to the score given for scientific excellence by the experts in order to avoid evaluation bias.

The criteria used to assess the excellence of  the strategic positioning of projects will be shared in the application submission stage.

STEP 3: FINAL SELECTION OF PROJECTS SELECTED FOR FUNDING BY THE STEERING COMMITTEE

The Steering Committee of this program, composed of representatives of the four (4) partners, will vote for the final selection of projects to be funded, based on the results obtained by the committees of the first two evaluation stages, as stipulated in the agreement signed by all stakeholders.

Two (2) projects in each axis will be selected for funding, depending on which projects pass the strategic evaluation.

IMPORTANT:

Research projects selected for funding will be required to meet all applicable regulatory reporting obligations arising from the project, including reporting of adverse events to Health Canada, to the extent required by law.

In addition, projects selected for funding by the Steering Committee will be subject to Janssen Inc.’s internal review process, which is used to ensure that Janssen’s legal, compliance, intellectual property, pharmacovigilance and safety requirements are met. If necessary, partners may make recommendations to the relevant team. This step is not a scientific re-evaluation and is not eliminatory, nor is it intended to direct the results of the research or to infringe on the academic freedom of the researchers.

9. RESULTS AND FOLLOW-UPS

Internal Database – Janssen Inc.

For the purpose on compliance with internal procedures, the full content of funded proposals will be made available in Janssen’s internal database. This database is accessible to duly authorized personnel of Janssen and its subsidiaries, both in Canada and internationally.

Follow-up of projects

A project monitoring structure involving, among others, the partners will be put in place as soon as the grant is awarded. Other stakeholders involved in mental health could participate in this monitoring committee. The first meeting of the committee with the awardees will take place three months after the research teams begin their work.

An annual follow-up meeting with the follow-up committee will be organized by the FRQS and will require the participation of all those who received a grant under this call for proposals.

Reports submission

By accepting the grant, the award holders undertake to provide:

• Annual financial reports and a final financial report at the deadlines indicated by the FRQ-S.
• An annual scientific report and a final scientific report, no later than three months after the end of the grant; details will be provided in the award letter.

Dissemination and use of results by partners

The grantees undertake to authorize the funding agencies to use the final report and the research results that have been publicly disseminated by the researcher (in the context of a scientific publication, conference, colloquium, conference or publication on a website), in particular for the purpose of reproduction, translation, performance or communication to the public by any means whatsoever, as well as any other form of use. This use must be made in compliance with copyright and only for non-commercial purposes.

Open access

Peer-reviewed publications resulting from the research made possible by this award will be required to be released on an immediate open access (non-embargoed) basis under an open license in accordance with the Open Access Policy (revised 2022).

10. EQUITY, DIVERSITY ET INCLUSION

The partners seek to contribute to the support a research ecosystem based on equity, diversity and inclusion. The individuals who receive funding are encouraged to prioritize the EDI principles within the context of their research activities. Further details are available in the FRQS’s statements on equity, diversity and inclusion.

11. INTELLECTUAL PROPERTY

Funding agencies acknowledge that awardee researchers and their host institution possess the intellectual property rights, under the internal regulations of the host institution and in accordance with the terms of the research contract.

12. PARTNERS

Fonds de recherche du Québec – Santé (FRQS)

Ministère de la Santé et services sociaux (MSSS)

Ministère de l’Économie et de l’Innovation (MEI)

Janssen Inc.