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

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. 2021 May 4:S0890-8567(21)00276-8. doi: 10.1016/j.jaac.2021.04.010. Online ahead of print.

Richards JE, Hohl SD, Segal CD, Grossman DC, Lee AK, Whiteside U, Luce C, Ludman EJ, Simon G, Penfold RB, Williams EC. "What will happen if I say yes?" perspectives on a standardized firearm access question among adults with depressive symptoms. Psychiatr Serv. 2021 May 4:appips202000187. doi: 10.1176/appi.ps.202000187. [Epub ahead of print]. PubMed

 

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. 

research into action

Blood-pressure_pic_Healthy_Hearts_study_-_1_column.jpg

Healthy Hearts Northwest helps small clinics improve care

A new study shows how a little supplemental support can result in big gains, especially in managing patients’ blood pressure.

kpwhri in the media

Esketamine: How to assess new antidepressant’s efficacy

Bloomberg Businessweek, Feb. 5, 2019