We take pride in the mentees’ accomplishments. Our evaluation has clarified direct links between the training activities and measurable outcomes, such as grant proposals and publications. Likewise, the mentees’ narrative evaluations suggest that these programs have contributed to their progress. We conclude that focused efforts in training minority junior faculty and graduate students in mental health services research can facilitate career development.
In these programs, we also have identified several limitations and challenges for the future. For instance, mentees have voiced conflicts regarding competing personal needs; divergent demands of family, peers, and institutions; and conflicting values. Mentees wishing to do research have struggled with also wanting predictable and secure salaries and funding sources, with emphasis on “hard money.” Among physicians and mental health professionals, clinical demands have diverted them away from research. For women and some men with families, additional demands have consumed time and energy. Since clinicians in academic settings usually can earn adequate salaries and can support their families through clinical and teaching activities, mentees have experienced conflict in assuming the risk of giving up this relatively secure funding for less certain grant revenues. Finally, since the beginning of the programs we have planned to turn over the leadership as principal investigators to minority faculty members as they advance in their careers. However, because minority faculty members at UNM have not yet obtained competitive R01 research grants as principal investigators, they have chosen to keep the senior faculty members as directors until they do reach the milestone of a funded R01 project.
Reflecting another limitation of the programs, mentees also have experienced substantive conflicts between pursuing research versus other work that they believed would exert favorable effects within their institutions or communities. Some junior faculty members have decided to pursue high-level administrative careers within minority-focused institutions. In such roles (for instance, among mentees who have accepted positions in the Indian Health Service or local service organizations), their knowledge of mental health services research plays an important role in collaborative efforts with researchers who focus on the unique needs of their target populations. Some clinicians have required firsthand experiences to decide which research activities proved most appropriate for them. As a result, these mentees have chosen to pursue research on biological problems in mental health rather than services research. Competing teaching responsibilities sometimes have affected the ability to conduct research, especially for mentees based in state universities that do not customarily allocate time for research to teaching faculty members. Given these issues, the fact that many of the junior investigators have obtained K awards and other grants within 2 years after joining the training programs suggests that these efforts have achieved some degree of success. The passionate narrative evaluations that mentees have provided also attest to the programs’ generally favorable effects on their lives and careers.
The funding and infrastructure required to maintain career development programs for minorities in mental health services research remain fragile and need sustained support by NIMH and other funding agencies. Through the M-RISP and MEP, we have tried to create an umbrella mechanism to develop synergistic funding sources and to generate wider educational opportunities. To enhance our mentees’ research careers, we have provided an atmosphere in which they could develop networks of mutual support that would extend to regional and national groups of peers and mentors. However, a major limitation involves UNM’s inability, as a relatively resource-poor institution, to find other major financing to support these efforts. Realistically, universities enjoy few sources of funding to develop and sustain such training efforts. In future programs, NIMH and other funding agencies may want to consider the challenges and successes that we have witnessed in efforts to facilitate research careers for members of minority and/or other underserved groups.
The training institutes and the partnerships forged among our mentees, mentors, program directors, and community advisory board members have offered inspiration and support for new directions of mental health research. Proposed research topics have addressed the mental health needs of minority communities and have contained elements of mental health services research at the interface of primary care. The potential effects on mental health appear far-reaching, as the partnerships and proposed research activities target racial and ethnic disparities in common and/or life-threatening mental health issues, such as trauma and abuse, depression, anxiety, somatization, post traumatic stress disorder, disorders arising from bereavement, and suicide. Educational, research, and service institutions gain several advantages by training minority faculty. These advantages include easier entry to communities with major health and mental health disparities, including a reduction in time to establish trust; community-university research collaborations that prove less difficult to form than with “outsider” researchers; opportunities to evaluate culturally based interventions and indigenous approaches to mental health; and advancement of community based participatory research (21
To our knowledge, data remain unavailable to compare our results with those of training programs that have not targeted mentees specifically from minority groups and underserved communities. For instance, NIMH has sponsored a variety of training programs, most of which have not aimed specifically to recruit trainees similar to those whom our programs have prioritized. Despite our overall favorable results, we cannot assess our evaluation data in light of similar data from other types of programs. We do not know if attempts to replicate our efforts at other institutions would lead to similar results, even though we suspect that the approaches used in the M-RISP and MEP may prove helpful elsewhere. In addition to program modifications that take into account institutional differences in resources and the pool of targeted trainees, other educational institutions may encounter varying challenges in developing and maintaining such programs without the assistance of extramural grant support. We suggest that NIMH take the lead in encouraging attempts to conduct inter-institutional comparisons among training programs, with more standardized quantitative and qualitative methods that can assess the subtle issues that we have identified as important in trainees’ career development.
How can educational programs best address the needs and aspirations of people from minority or otherwise underserved communities as they contemplate research careers? Such efforts must encourage high standards in the conceptual and methodological work that quality research entails. Based on our experiences, we believe that successful training programs also must go beyond high technical standards. In addition, these programs must provide supportive and non-threatening mentoring within networks of social support that recognize an emotional legacy of discrimination and historical trauma. Without such sensibility, programs to enhance research careers likely will replicate the patterns of failure and injustice with which we have become all too familiar.