How can children's mental health research be effective

03/30/11 Dawn Morgan Elliott
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At last week’s 24th Annual Children’s Mental Health Research and Policy Conference in downtown Tampa, WMNF’s Dawn Morgan Elliott spoke with several mental health professionals about how research can grow from an idea to a viable strategy in dealing with children’s behavioral issues and mental illness.

“We who are providing services in the field of children and families are being asked to prove that what we’re doing works.”

Robert Lieberman is the Executive Director of the Southern Oregon Study and Treatment Center. Lieberman is also on the Steering Committee for the Building Bridges Initiative, a nationwide workgroup that sets guidelines for organizations and families working to successfully treat behavioral health issues in children.

“There’s a lot of models out there, an increasing number of models that have been researched. They go through a number of steps to get approved to be evidenced based. In other words, the evidence shows that these models work."

But not all researchers agree about which methods of research are most productive when enacted in the real world.

"There’s some issues with those models because they’re validated in a research setting, not necessarily in communities around the country. So we looked at some of those issues, and then we looked at kind of another aspect of this work, which is practice-based evidence, and that’s when folks in communities find programs that work in their community and they evaluate them. They have some objective data. And so basically what we’re putting out to the field and to policy makers is the research projects are great, and these field-based projects also have an important role."

Dr. Madeline Lee is a postdoctoral research fellow at Washington University in St. Louis. She presented a poster of her dissertation, an evidence based study that questioned why social service organizations seek high levels of certification. She wanted to know if an agency’s accreditation actually leads to higher quality care.

“Trying to figure out how and if it makes a difference for clients being served at these agencies, if they become accredited and that’s what I mean by building an evidence base.”

Did you follow a handful of organizations?

"I did. I did a multiple case study of five children’s mental health agencies. So they were providing different services, like residential care, group living, emergency shelter, outpatient mental health services, counseling.”

Is part of the reason behind accreditation so that all facilities will have a certain conformity or standard in care?

"It’s supposed to be, like, above and beyond licensing standards, which are really the minimum and that's all that is required of these agencies to basically be in business, but accreditation really is going above and beyond that."

Who accredits the accreditors?

"That’s a very interesting question. There is no larger body that oversees the accreditors but in other fields, like in education, there is. There are accreditors by region and then there’s a higher someone else who oversees that. Not in the social services."

And now how would your research trickle down to a parent looking for a facility? If they see a hospital or facility with a certain accreditation, is it safe to assume that facility is up to snuff?

"That is kind of how some of these agencies wanted to use accreditation. They wanted to signal distinction, you know, let the field know that they are meeting these high quality standards. Now there’s no research on the consumer end, if consumers are looking for that accreditation status when they try to decide on which agency they are going to go to.

"My dissertation is really just exploratory, very foundational. So trying to link the practice with the research and the policy, and that’s about really trying to figure out if accreditation does makes a difference, you know like on the client level. I think that was the third question I asked in my dissertation.

"My third aim was about if the agencies felt like accreditation made a difference, you know, what kind of impact they think accreditation had on the quality. And I think that’s still a question that we need to answer with some rigorous evaluation."

When Miami social services agency Little Havana wanted to find out if they were meeting their own organizational goals, they contracted Leslie Pagan, a researcher at the University of South Florida.

"What we were looking at this year was how they developed their formal and informal networks. So like how many contacts they may have had with a formal provider like social services or the police department. Or informal networks would be something like how many family members or neighbors they communicate with and they work with so that they could get out of like crisis situations. What we were looking at was how many connections it took on average to get those people to a healthy place.”

And how did Little Havana pan out?

“In this case what we were finding was that they were doing more than they had set out to do, and that they were being more successful than they had originally hoped. So that’s very good because that means that the money was being put to good use versus sometimes in organizations they kind of have some fall backs and then, you know, some of the money's kind of wasted and lost. But in this case, it turned out that they were doing very well with what they were hoping to do.”

Full disclosure, this reporter briefly worked at USF’s Florida Mental Health Institute, in an unrelated research study.

Previous WMNF News Mental Health Research stories:

Interview with Luanne Panacek, Children's Board CEO

24th Annual Children’s Mental Health Research & Policy Conference

23rd Annual Children’s Mental Health Research & Policy Conference

Links to more information:

Research & Training Center for Children's Mental Health

Building Bridges Initiative

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