Moving From Data To Information: The Critical Role of Research & Evaluation in Mental Health . A Presentation to the Missouri Mental Health Commission R. Paul Thomlinson, Ph.D. Burrell Behavioral Health June 10, 2010. Data Never Speak for Themselves.
A Presentation to the Missouri Mental Health Commission
R. Paul Thomlinson, Ph.D.
Burrell Behavioral Health
June 10, 2010
The beginning of wisdom is to recognize our own ignorance.
We no longer live in the era of Galen: pointing to the opinions of a wise man will not suffice.
Numbers do not stand alone—the history of science shows us that scientific knowledge is not absolute, that it all involves uncertainty.
The result of scientific research and statistical analysis is not “unadorned and irrefutable fact”– it is an act of interpretation, and then more interpretation.
“Numbers do not lie, but they have a propensity to tell the truth with intent to deceive.” (Eric Temple Bell)
Source: Ghaemi (2009)
Every truth…is an error that has been corrected (AlexandreKojeve).
The expert sharpshooter does not become so in the absence of good data, properly reported and reasonably interpreted.
Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness.
Question: Do social and emotional skills or cognitive abilities better predict school readiness?
Answer: Results of a study of 122 preschoolers in SW MO show that the Devereux Early Childhood Assessment (DECA) provided better prediction than the DIAL of which children did well in Kindergarten. However, Math Skills in combination with DECA Self-Control scores explained more than either factor alone.
So what? Mayor’s Commission Summit, Ready to Learn project, ECHO project all focusing on early childhood SEL.
Thomlinson, et al. (2008)
Question: What measurable factors best predict one-year mortality among CHF patients?
Answer: The BSI scales significantly related to outcomes were the anxiety scale with mortality (rpbs=-0.40, p=.03), and the phobia scale with treatment continuation (rpbs=-0.39, p=.03).
So what? Significantly more attention paid to screening for psychological problems in cardiac rehab; increased referrals for psychological intervention for CR patients; and ongoing outcomes evaluation for CR by Burrell.
Question: To what extent can we identify PSD using non-invasive QEEG readings?
Answer: Among older CVA patients (with and without depression), significant correlations were found between left frontal QEEG asymmetries (greater power) and both the Beck and Yesavage depression scales.
So what? Strong collaboration with neurology department; increased sensitivity to PSD and corresponding referrals to treatment; awareness of availability of electrophysiological method with aphasic stroke patients.
Ulam & Thomlinson (1998)
Question: What factors predict/explain which patients keep and which patients miss their BH appointment when referred by their PCP?
Answer: Among those who DNKA, financial, transportation, administrative, increased stress, previous experience with BH, and motivation were identified as barriers; those who attended identified a specific problem, had encouragement of another, and linked medication access to appointment.
So what? Strong collaboration with family practice; introduced change readiness and improved distress management at time of referral into residency protocol.
Reust, Thomlinson & Lattie (1999)
What is so? It should be as easy to schedule a patient for an evidence-based health educational program as it is to schedule a lab test or an x-ray. Burrell funded this $100,000 demonstration project.
So What? Chronic Disease Self-Management Program participants showed dramatic health status improvements (SF-36), and reduced utilization.
So What? Protocols put in place to screen and refer asthma patients to adult asthma education program (Lorig model), with 3 certified educators, for which NOAH won a Missouri Quality Award for improved process and outcome (improved health status, reduced ER utilization).
So What? Timely developmental screenings for children were identified as an area in need of improvement, and resources were deployed to provide screening schedules and information on financial help with screening to all new parents with babies delivered in the system.
So What? Physician-led discussion groups on a variety of health topics, including a group for parents of children with ADHD. Evaluation showed substantial reductions in parental stress (validated PSI) over 6-months follow up.
So What? Patient self-care manuals provided to 1000 providers and 1000 patients through collaboration with Cox Health Plans, with good uptake rates (over 50%) and reduced health care utilization over 6 months.
So? Even though our relationship to Cox has changed, the health educator who managed NOAH from the start continues to provide these and a wide array of other educational interventions. Thomlinson, Schaible & Stanley (2000)
Question: What are the significant aging benchmarks for women, and how do these perceptions relate to health behaviors and concerns?
Answer: A study of 1000 indicated that there is significant variability in placing aging benchmarks, healthier/more educated women place “aged” benchmark much later in life, and those who do not fear aging reported excellent health and health habits significantly more often than those who fear aging.
So What? Established significant research collaboration with prominent local family foundation; informs our MFH proposal for older adult mental health.
O’Reilly, Thomlinson & Castrey (2003)
Led to convening of the “Changing Tomorrow Today” prevention conference in our community, attended by over 200 community leaders.
Led to Community Foundation of the Ozarks taking action in the following ways: instituting a biennial Community Focus report to track such “red flags and blue ribbons”; issuing the “Grantmaker’s Challenge for Children,” resulting in $1 million grant to a community collaborative (ECHO Project) involving Burrell, Community Partnership, schools, and Missouri State University.
Thomlinson, et al. (2004)
Meriweather & Thomlinson
Thomlinson, Maples & Rimel (2004)
Thomlinson, Maples & Rimel (2004)