Personal Recovery Outcome Measure

Measuring RecoveryLast week Dr Skye Barbic presented on the Personal Recovery Outcome Measure (PROM) at Island Community Mental Health.

The PROM questionnaire is designed for people who are recovering from mental illness. But it can be used by everyone.

The World Health Organization (WHO) defines mental health as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

Clearly we don’t need to be recovering from a debilitating mental illness to be pursuing improved mental health. In fact, the WHO definition for mental health could be the definition for purpose in life.

How it Works

The questionnaire tells a story of recovery, from the very earliest stages of the process to total wellness.

That’s why all of us can use it: wellness is a goal we all share no matter where we are stating from.

This tool quantifies that which can otherwise feel amorphous. It enables a person to track their progress over time, and also enables comparison between people.

There are 30 multiple-choice questions in PROM and they are sequential.

The metaphor Dr Barbic uses to describe measurement of recovery using PROM is a 30-cm ruler. The whole ruler represents total wellness. For any of us.

Almost no one is at 30. All of us are somewhere on the ruler.

Ruler

Each one of the questions, in order, represents another increment (a centimeter) on the ruler.

By completing the PROM questionnaire we end up with a score. Some number out of the highest possible total of 30.

This score enables you to track changes over time.

If you missed the link earlier in this post,  you can find the questionnaire here.

PROM questionsRecovery

After scoring, the questionnaire enables you to identify areas of strength as well as areas to work on.

Your score also refers you to an intervention opportunity as part of your story of recovery.

So, for example, a score of 16 refers you to statement #16 “I have new interests”.

You could choose to work on something else, but something around 16 might be a good place to start.

Dr Barbic suggested that we look at a range of options, three below and three above our score.

PROM questions 2Implications for Youth

I was curious about whether this questionnaire could be used with youth. Before I could put up my hand to ask, Dr Barbic told us that it can, but that a youth version is currently under development.

One example: Youth don’t care about sleep. But they care very much about intimate relationships. So those statements (#5 & #29) may need to be adjusted in a tool developed for youth.

She’ll have more information in April.

Comprehensive Children’s Mental Health Indicators

It’s a wonderful thing when you find a paper that proactively answers your specific research question!

Creating Comprehensive Children’s Mental Health Indicators for British Columbia is a paper like that.

Our Question

What data sources are available and what criteria should we use to select comprehensive indicators to track the mental health of young people in the capital region over time?

This Paper Answers:

The Data Sources used to select indicators for this study can be found on pages 16-18 and the indicators on pages 19-22.

But the whole paper is worth a read. Or two.

Here’s just a little of what this paper offers:

“Mental health—or social and emotional well-being—is fundamental to human development and essential for all children to flourish. Yet at any given time, an estimated 14% of children (or 800,000 in Canada) experience mental disorders causing significant symptoms and impairment, exacerbating matters, clinical treatment services still reach fewer than 25% of these children despite substantial public investments in health care. Meanwhile, there are almost no investments in programs that could address determinants and prevent problems. Consequently, mental disorders unnecessarily persist throughout the lifespan, with adverse outcomes ranging from reduced educational and occupational chances to increased mortality. The associated economic burden is now estimated to exceed $51 billion in Canada annually, urgently underscoring the need to better address mental health starting in childhood. To address children’s mental health adequately, a new comprehensive population health approach is needed—promoting healthy development for all children and preventing disorders in children at risk, in addition to providing effective treatment for children with established problems and disorders.”

“Canada urgently requires a population health approach to children’s mental health—promoting health and preventing disorders, in addition to providing treatment. Underpinning this approach, indicators could enable population monitoring, thereby informing ongoing public investments.”

“Strategically, monitoring could also raise public awareness about the importance of children’s mental health—understanding that ‘what gets counted, counts.'”

“A population health approach for children’s mental health—promoting health and preventing disorders, in addition to providing treatment—requires a correspondingly broad framework encompassing concepts central to the social and emotional well-being of the entire population of children. Therefore we propose a comprehensive framework that covers: major developmental stages; determinants and contexts; mental health status and related developmental domains; and a wide range of intervention approaches.”

Population Health Framework for Children's Mental Health
Gratitude to Charlotte Waddell, Cody A. Shepherd, and Alice Chen from Simon Fraser and Michael H. Boyle from McMaster for all the work that went into this project and for reporting the results so we could learn from them.

A comprehensive system for monitoring early childhood development

The late Dr. Clyde Hertzman, past director of the Human Early Learning Partnership at the University of British Columbia, and a leader of the pan-Canadian Early Child Development Monitoring Network, describes a proposed system for monitoring early childhood development & it’s determinants.

This system includes 5 elements:

  1. Population measures: measures that are taken of all children at a given point (such as at birth, 18 months or Kindergarten). An example includes the Early Development Instrument ‘EDI‘.
  2. Longitudinal Studies: random samples of children that begin at or before birth and intensively track influences and outcomes for individuals;
  3. Administrative Data Linkages: Bring together birth, health and education data (shared measurement~!)
  4. Social Indicators: ‘baskets’ of variables of social factors that effect children’s development, including socioeconomic and social capital factors
  5. Early Child Development program and policy databases that track all of the public investments that are made by a society into early childhood