Data Sources to Assess Whole Person Suffering
Josh Morgan
Technology, Data, & Analytics Leadership ?? | Ethical & Trustworthy AI ?? | Quality Improvement ? | Policy & Evaluation ?? | Strategic Consultation ??
In my latest blog post, I talk about ways to measure a reduction in suffering from a more whole person perspective. In California, we’re asked to evaluate subjective suffering, as described in the Mental Health Services Act. As we honor Mental Health Month, we all want to reduce suffering, but as I discuss in the blog, it’s critical to take a more whole person definition of suffering and not just focus on symptom reduction.
Focus groups, written survey responses and reflections, and progress notes are all potential data sources for Natural Language Processing (NLP) to help assess suffering. And especially in behavioral health, most of these are already collected. So what a great way to use existing data!
The Family Experiences Interview Scale (FEIS) is a semi-structured interview for loved ones to gain a more whole person understanding of their experiences. It quantifies many common data elements and can provide rich context that can enhance understanding of individual and family suffering.
Many states have implemented the Child and Adolescent Needs and Strengths (CANS), especially in child welfare and behavioral health services. The Adult Needs and Strengths Assessment (ANSA) (the adult version) is similar and increasingly popular. One of the things I really like about these tools is they give a more whole person perspective that is quantifiable. The strengths sections, for instance, provide a way to inform a more holistic understanding of people.
In my blog, I mentioned hope as a potential metric. Hope is absolutely critical in health, especially in behavioral health. There are simple tools, like the Beck Hopelessness Scale, that are validated for hope specifically. The CANS and ANSA have some items that get at this idea as well. While hope has a very strong qualitative component (so going back to narrative content as a source), it can be quantified if we want to track changes in hope. For instance, could you tell me on a scale of 1-10, 10 being the most hopeful, how hopeful you are today?
The Substance Abuse and Mental Health Services Administration (SAMHSA) emphasizes the Eight Dimensions of Wellness, which I see in alignment with this whole person suffering approach. Their Wellness Worksheets can be useful not only as an intervention, but as another data source to assess whole person impact.
The What Works Centre for Wellbeing has a series on ways to measure wellbeing. They provide a nice overview across this series that has a very holistic focus, from finances, loneliness, learning disabilities, and even employee assistance programs.
Let’s also not forget about the advantages of data integration. I’m working with several public and private agencies who are working on getting a more whole person perspective by bringing data together across departments and organizations. As we focus on social determinants of health, including non-health data can be valuable in determining whether someone is suffering or not regardless of health symptoms.
Just because some of these concepts are a bit more nebulous and complex doesn’t mean there’s not a way to get at them, both quantitatively and qualitatively. Advances in technology allow us to unlock more data and gain a more whole person view. I call that data for good!
What data sources would you suggest?
Behavioral Health Administrator, Riverside University Health System, BH Older Adults Systems of Care
5 年Josh, I appreciate your your perspective on how we as leaders can effectively improve the work culture and the impact that may yield notable opportunities.
Senior Consultant at John Snow, Inc. (JSI)
5 年This commentary and your blog post are great, thought-provoking pieces, Josh. I've been looking at some of these tools recently too, very useful to have this discussion putting them in one place. It's striking the contrast between the bias against self-report tools and the evidence that self-reported wellbeing (etc.) is a powerful predictor of all sorts of health outcomes including mortality. I wonder what you think about the potential to aggregate such information about "whole-person suffering" to look at geographic distribution since I'm sure these are community phenomena as well as individual.?
Social Worker, Program Evaluator, Doctoral Student
5 年Ironically was working on updating some CANS scales for youth I work with. New York adapted it's own to include Adverse Childhood Experiences (perhaps something worth adding to a health screening).? It's a detailed assessment and?like CANS?inclusion of not only "needs" but also strengths. ?Both the PHQ-9?and for a more detailed look the Columbia Suicide Severity Rating Scale is a good tool with some room for?narrative there as well.?