Robert Penfold, PhD

Robert Penfold

“I do research designed to improve real-world mental health care.” 

Robert Penfold, PhD

Senior Investigator, Kaiser Permanente Washington Health Research Institute

Biography

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:

  • A Targeted Approach to a Safer Use of Antipsychotics in Youth (SUAY), a $10 million, five-year National Institutes of Health clinical trial that is developing and testing new ways to support clinicians and families in choosing safer treatments for behavioral disorders in youth age 5 to 17.
  • Assisted Identification and Navigation of Early Mental Health Symptoms in Youth. A National Institute of Mental Health (NIMH)-funded clinical trial designed to increase the early identification and treatment of youth with mental health symptoms and complaints.
  • Automated Outreach for Depression, a NIMH-funded study to decrease premature dropout from depression treatment.
  • STAR Caregivers—Virtual Training and Follow-up, a National Institute on Aging funded clinical trial to improve the behavioral and psychological symptoms of dementia and reduce caregiver burden without the use of antipsychotic medications.

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.

Research interests and experience

  • Mental Health

    Children and adolescents; anti-psychotics and anti-depressants; bipolar disorder, and depression

  • Health Services & Economics

    Comparative effectiveness; consumer-directed health plans; patient outcomes; costs of chronic illnesses; Medicare and Medicaid 

  • Biostatistics

    Space-time surveillance;  interrupted time series analysis

  • Alzheimer's Disease and Related Dementias

Recent publications

Evers S, Hsu C, Gray MF, Chisolm DJ, DolcĂ© M, Autio K, Thompson EE, Ervin E, Quintana LM, Beck A, Hansell L, Penfold R. Decision-making among adolescents prescribed antipsychotic medications: Interviews to gain perspectives of youth without psychosis or mania. Clin Child Psychol Psychiatry. 2022 Jun 12;13591045221105197. doi: 10.1177/13591045221105197. Online ahead of print. PubMed

Goger P, Zerr AA, Weersing VR, Dickerson JF, Crawford PM, Sterling SA, Waitzfelder B, Daida YG, Ahmedani BK, Penfold RB, Lynch FL. Health service utilization among children and adolescents with posttraumatic stress disorder: a case-control study. J Dev Behav Pediatr. 2022 Jun-Jul 01;43(5):283-290. doi: 10.1097/DBP.0000000000001041. Epub 2021 Nov 23. PubMed

Penfold RB, Carrell DS, Cronkite DJ, Pabiniak C, Dodd T, Glass AM, Johnson E, Thompson E, Arrighi HM, Stang PE. Development of a machine learning model to predict mild cognitive impairment using natural language processing in the absence of screening. BMC Med Inform Decis Mak. 2022 May 12;22(1):129. doi: 10.1186/s12911-022-01864-z. PubMed

Rossom RC, Penfold RB, Owen-Smith AA, Simon GE, Ahmedani BK. Suicide deaths before and during the coronavirus disease 2019 pandemic: an interrupted time-series study. Med Care. 2022 May 1;60(5):357-360. doi: 10.1097/MLR.0000000000001700. PubMed

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

 

New findings

NLP_Natural-Language-Processing_1col.jpg

Research roundup on natural language processing and machine learning

Using doctor's notes to learn about drug reactions, dementia, and cannabis use.

Research

Teenagers outside walking up stairs with backpacks to school

Addressing the crisis of youth suicide in America

Rob Penfold, PhD, writes about suicide trends in children and adolescents and what researchers are doing about them.

Prescription overload

Senior adult sitting with glass of water in one hand and  holding medication in other hand

Deprescribing: Less may be more

Dr. Sascha Dublin explains why sometimes not taking medications may be a safer and healthier choice. 

kpwhri in the media

Esketamine: How to assess new antidepressant’s efficacy

Bloomberg Businessweek, Feb. 5, 2019