- Tools & Materials
- Research Projects
As MHRN investigators, we often hear from academic researchers hoping to study new psychotherapies or eHealth interventions in our healthcare systems.
At our recent MHRN investigator meeting, we were discussing the challenges of evaluating mobile health tools in real-world healthcare systems.
Our MHRN Suicide Prevention Outreach Trial offers outreach and support interventions based on patients’ response to item 9 of the PHQ9 depression questionnaire. We reach out to patients who reported thoughts of death or self-harm “more than half the days” or “nearly every day” at a recent visit. This threshold for outreach is based on our previous research showing that those patients reporting frequent suicidal thoughts have an approximately 2.5% risk of suicide attempt over the following year. Now, several of our MHRN health systems are using the same threshold (a score of 2 or 3 on item 9 of the PHQ9) to identify patients needing additional assessment and follow-up.
My colleague Ursula Whiteside and I have an ongoing discussion (or maybe even debate) about “Zero Suicide”, the name of the comprehensive program developed by the National Action Alliance for Suicide Prevention. “Zero Suicide” is a bold, aspirational name. My reservation is not about the aspiration, but about the accountability.
One of our new MHRN research projects, led by Rob Penfold at Group Health, will implement and evaluate a program to curb over-prescribing of antipsychotic medication to children and teens. The program focuses on youth prescribed antipsychotics for non-psychotic disorders – especially attention deficit disorder, oppositional defiant disorder, conduct disorder, and depression.
Can persistent outreach reduce the risk of suicide attempt in people who report frequent thoughts of death or self-harm? Our MHRN Suicide Prevention Outreach Trial is testing the effectiveness of persistent outreach programs, using decision support software built into the electronic health record.
It seems half of the papers in mental health research describe the co-occurrence of misery; so much so that there could be a new journal devoted to this scientific genre "The Journal of Job". But that's devoid of hope. Perhaps the NIH Precision Medicine Initiative (PMI) offers some hope.
In Rob Reiner’s classic film Stand By Me, 11-year old Vern asks his more mature friend Teddy, “Do you think Mighty Mouse could beat up Superman?” Teddy scornfully replies that “Mighty Mouse is a cartoon. Superman is a real guy!” Vern counters that “It would be a good fight, though!” In our field, the most enduring (and most tiresome) epic battle is “Can psychotherapy beat up antidepressants?” Even though those two heroes ought to be on the same side, ardent fans can’t help pitting them against each other.
My colleague Evette Ludman and I were recently discussing the long-overdue movement to engage with patients and other stakeholders in all aspects of health research.