Robert Penfold, PhD, is a health services research and health policy expert whose work focuses on developing and testing strategies to optimize behavioral health care delivery and patient outcomes—particularly in children and adolescents. His research addresses practical issues, such as how to reduce unnecessary use of antipsychotic medications in youth. He also studies the effects of cost-control policies on how clinicians deliver care, how people use care, and how those changes can promote or worsen their health.
Dr. Penfold is a co-investigator in the Mental Health Research Network (MHRN), a resource for studies on mental health conditions ranging from autism to postnatal depression. He leads the MHRN’s child and adolescent scientific interest group. He is also investigating reasons why similar patients receive different mental health treatment, such as different medications, depending on where they live or receive care.
His other recent and ongoing projects include:
Dr. Penfold has extensive experience gathering and analyzing information from large health databases, including those of Medicare, Medicaid, and the Health Care Systems Research Network’s Virtual Data Warehouse. These data and analyses allow rapid information sharing among Kaiser Permanente Washington and participating sites, which improves patient safety and timely access to effective, cutting-edge therapies.
He has also conducted several novel pragmatic clinical trials using the Epic electronic health record system.
Before joining KPWHRI in 2010, Dr. Penfold held research and teaching positions at Nationwide Children's Hospital in Columbus, Ohio; the Winnipeg Regional Health Authority; the Manitoba Centre for Health Policy; and most recently, at Harvard Medical School in the Department of Population Medicine and Harvard Pilgrim Health Care Institute.
Children and adolescents; anti-psychotics and anti-depressants; bipolar disorder, and depression
Comparative effectiveness; consumer-directed health plans; patient outcomes; costs of chronic illnesses; Medicare and Medicaid
Space-time surveillance; interrupted time series analysis
Simon GE, Shortreed SM, Rossom RC, Beck A, Clarke GN, Whiteside U, Richards JE, Penfold RB, Boggs JM, Smith J. Effect of offering care management or online dialectical behavior therapy skills training vs usual care on self-harm among adult outpatients with suicidal ideation: a randomized clinical trial. JAMA. 2022;327(7):630-638. doi: 10.1001/jama.2022.0423. PubMed
Penfold RB, Whiteside U, Johnson EE, Stewart CC, Oliver MM, Shortreed SM, Beck A, Coleman KJ, Rossom RC, Lawrence JM, Simon GE. Utility of item 9 of the patient health questionnaire in the prospective identification of adolescents at risk of suicide attempt. Suicide Life Threat Behav. 2021 Jul 31. doi: 10.1111/sltb.12751. [Epub ahead of print]. PubMed
Penfold RB, Johnson E, Shortreed SM, Ziebell RA, Lynch FL, Clarke GN, Coleman KJ, Waitzfelder BE, Beck AL, Rossom RC, Ahmedani BK, Simon GE. Predicting suicide attempts and suicide deaths among adolescents following outpatient visits. J Affect Disord. 2021 Jul 1;294:39-47. doi: 10.1016/j.jad.2021.06.057. [Epub ahead of print]. PubMed
Chavez LJ, Kelleher KJ, Beck A, Clarke GN, Penfold RB. Trends over time in antipsychotic initiation at a large children's health care system. J Child Adolesc Psychopharmacol. 2021 Jun;31(5):381-386. doi: 10.1089/cap.2020.0190. PubMed
Penfold RB, Hilt RJ, Schwartz N, Thompson EE, Robb AS, Correll CU, Newton D, Rogalski K, Earls MF, Kowatch RA, Beck A, Yarborough BJ, Crystal S, Kelleher KJ. Development of a symptom-focused model to guide the prescribing of antipsychotics in children and adolescents: results of the first phase of the Safer and Targeted Use of Antipsychotics (SUAY) clinical trial. J Am Acad Child Adolesc Psychiatry. 2022 Jan;61(1):93-102. doi: 10.1016/j.jaac.2021.04.010. Epub 2021 May 4. PubMed
Models that are easier to explain, use could have better uptake in health care settings.
The HCSRN conference is a venue for collaborative work to improve health and health care.
Using doctor's notes to learn about drug reactions, dementia, and cannabis use.
Rob Penfold, PhD, writes about suicide trends in children and adolescents and what researchers are doing about them.