Duke University Medical Center has launched a program that offers minority psychologists, psychiatrists and social workers training and support for innovative mental health research in a wide range of areas, from pharmacological interventions to isolation among Latino high school dropouts, to depression among African-American adolescents.

Duke secured a large grant from the National Institute of Mental Health (NIMH) to fund the three-year fellowship, the Partnership for Excellence in Mental Health Interventions Education and Research (PREMIER). The program comes at a time when minorities are substantially underrepresented in clinical research.

NIMH has made increasing numbers of minority researchers a priority: In 2001 it requested proposals for minority-focused training programs and sought to divide $2.5 million among eight or nine new programs.

A growing program

In response, Duke quickly proposed PREMIER, a three-year fellowship aiming to host one or two minority clinical research fellows the first year and add three more each year after. In 2002, the first year of PREMIER's five-year grant, NIMH gave the start-up program $157,603, a total program director David Steffens, MD, says is two to three times larger than what he would normally receive for a general training grant. While other bigger research programs with more fellows have, accordingly, bigger NIH grants, PREMIER's initial funding is remarkable, Steffens says, because it allows Duke to use some $20,000 for extra training expenses per fellow. Most training programs of this type can only use $3,850 per fellow, according to NIH.

"What made this particular grant attractive was that [NIMH] had the resources to allow for funding beyond the traditional fellowship," Steffens says. "We were encouraged to include extra money to pay for trips to meet with mentors outside of Duke."

With those extra funds, participants receive mentoring from 20 faculty members at 15 institutions around the country, as well as from 40 Duke researchers working with the program. Participants also get focused seminars and the option to earn a master's degree in clinical research at Duke. With funding re-evaluated each year of the renewable five-year grant, Steffens allowed two more fellows to join PREMIER this year and still has enough funding for a fourth to join.

Mentoring for fellows

Two of the current three fellows are psychologists who say that a key program benefit is its "role mentors"--minority faculty members who advise participants on the challenges of building research careers focused on minority populations.

"Everyone is very supportive in talking about issues that come up when you study ethnic and racial differences, such as other researchers who might not understand or think it's important," explains one of the two, second-year fellow Elvia Valencia, PsyD, who's researching Latino high school dropout rates.

The other psychologist fellow, Alfiee M. Breland-Noble, PhD, adds that, "Sometimes doing research on people of color is hard because there's not a lot of research to pull from. The challenge becomes being able to articulate the importance of the topic [to other researchers] without having this vast body of prior research. It's harder to be a trailblazer, but with the support of PREMIER, I feel I can talk openly about issues and strategize to be that trailblazer."

As invaluable as the mentoring, says Breland-Noble, is what she learns from other minority fellows with different academic backgrounds and research interests. She wants to become a community-based researcher to increase participation in clinical care and prevent depression in African-American adolescents, so she'll likely need to collaborate with social workers and psychiatrists.

"This is my first experience in a medical setting with MDs," says the first-year fellow. "But there is extreme collegiality. It has been great for my professional development."