What has CORC learnt from the data? Julian Edbrooke-Childs introduces the findings ahead of his presentation on 22nd November
I'm delighted to be giving a presentation on behalf of myself and my colleague, Jenna Jacob, at the CORC forum on 22nd November, reflecting on what we've learnt from CORC research over the past five years. CORC forums are always a fantastic opportunity to hear about current work - from both the central team and from CORC member services. This year's forum has a special place in my heart because I'll be looking back on some of the research I set out to do in my very first CORC forum presentation almost five years ago when I joined - the forum was actually in my very first week on the job!
In reflecting on what we've learnt, there are some key messages that stand out for me:
- outcome measures and feedback tools provide one piece of information about a clinical picture or a picture of a service
- but the measures are only as good as the way they are used
- and understanding and addressing the barriers to collecting, choosing and using measures is still work in progress.
This is true in the context of child mental health service provision here in the UK and also universally across services, settings and countries, as we will hear in the CORC forum from international expert on routine outcome monitoring in mental health, Dr Kim de Jong.
So what will I be talking about on the 22nd?
We have been considering five main research questions, and I'd like to give you just a little taster of some of our findings in these areas.
- How can we embed best practice in routine outcome monitoring and use of feedback? We've found out when measures are more or less likely to be used, as well as some of the barriers and facilitators influencing their use in clinical practice.
- How do we best measure change in mental health over time?I'll be talking about the approach we have developed to conceptualising change over time in young people accessing services.
- What is the impact of interventions and approaches on child mental health outcomes?I will be sharing our findings about the impact of different treatment types on child mental health outcomes, as well as the effect that shared decision making can have in treatment.
- Who accesses services?An area of personal interest for me is the differences in reasons for referral and case closure associated with young people's ethnicity. I'll discuss previous work and how we're taking this forward at CORC.
- How best to reflect on evidence about practice, and challenge orthodoxy when relevant?I'll be reviewing our approach to analysing routine data from child mental health services, in light of data limitations, and in light of key questions currently of interest to us at CORC – for example the question as to how and if we can use data on expected outcomes to help manage expectations at the start of therapy.
What impact has last year's report on outcomes data had for CORC's approach to research and analysis of data?
We're particularly excited about the new approach to examining outcomes based on the approach used in the CYP IAPT national report (Child- and Parent-reported Outcomes and Experience from Child and Young Person Mental Health Services 2011-2015), where we examined recovery (or crossing clinical thresholds), reliable improvement (or change greater than that expected solely due to measurement error) and the two combined - reliable recovery. Over the past couple of years we've reworked the format of CORC member reports based on members; feedback, and you've told us that the new reports are much easier to understand and use. Now we are including these additional metrics from the CYP IAPT report in member reports - as well as the same metrics from members' data - we hope this helps services to review similarities and differences in their data with national data.
Julian Edbrooke-Childs is a CORC Research Lead, as well as being Head of Digital Development and Evaluation and Senior Research Fellow at the Evidence Based Practice Unit (EBPU). Julian is also Lecturer in Evidence Based Child and Adolescent Mental Health at UCL.