the numbers. It helps explain why people do things. It also usually
scores lowest on the accepted hierachy of evidence because of the high
degree of unpredictability in replication of good results. Whereas
quantitative methods in mental health lead to robust answers that are
replicable they are often useless for clinical decisions and
commissioning of services.
Commissioning services and writing national clinical guidelines in
mental health must be a nightmare. I remember the tone of Dame Carol
Black's voice as she despaired at the quality of research (and I assume
the small effect sizes) in mental health at a conference a couple of
years ago. She's got a solid background in physical medicine but
probably had little contact with mental health research until she took
on one of the leading government roles in mental health in the UK. The
quantitative methods and medical science that had provided such useful
answers for physical medicine with significant effect sizes for
treatment couldn't deliver the same results in mental health. But then
behavioural and emotional control is a different kettle of fish to medicine.
I'm on a thought process at the moment about how suicide in
schizophrenia (and BPD) can be treated. Knowing the completed lifetime
suicide rate is up to 10% for sz and up to 20% for BPD is about as
useful as a chocolate teapot. My personal experience elucidates more
however it is still just a single case study (of the highest quality).
In a previous post I'd looked for research to help me help a suicidal
doctor. I came across lots of quantitative stuff in my cursory search of
the literature using Google Scholar. It gave me very little insight into
what it's like being a suicidal doctor. It seems the preference for
research is to find out percentages instead of find out truths.
The search for the truth is so much harder to find and to fund.
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