I have a new crush.
I get them. Big intellectual crushes. On people who are doing really innovative work in the field of measurement.
I have a long-standing crush on Michael Quinn Patton, originator of Developmental Evaluation.
My new crush is Dr Skye Barbic, who has created the Personal Recovery Outcome Measure (PROM). I spend a blissful hour and half this week learning all about it.
The PROM questionnaire is designed for people who are recovering from mental illness. But it can be used by everyone.
In fact, I think it should be used by everyone.
The World Health Organization (WHO) defines mental health as "a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community."
Clearly we don't need to be recovering from a debilitating mental illness to be pursuing improved mental health. In fact, the WHO definition for mental health could be the definition for purpose in life.
The PROM questionnaire is designed to help anyone realize their potential and cope with stress.
It's my new favourite tool!
How it Works
The questionnaire tells a story of recovery, from the very earliest stages of the process to total wellness.
That's why all of us can use it: wellness is a goal we all share no matter where we are stating from.
This tool quantifies that which can otherwise feel amorphous. It enables a person to track their progress over time, and also enables comparison between people.
There are 30 multiple-choice questions in PROM and they are sequential.
The metaphor Dr Barbic uses to describe measurement of recovery using PROM is a 30-cm ruler. The whole ruler represents total wellness. For any of us.
Almost no one is at 30. All of us are somewhere on the ruler.
Each one of the questions, in order, represents another increment (a centimeter) on the ruler.
By completing the PROM questionnaire we end up with a score. Some number out of the highest possible total of 30 (for example, I got 24 and Matthew got 16.5).
This score enables you to track changes over time.
If you missed the link earlier in this post, you can find the questionnaire here.
After scoring, the questionnaire enables you to identify areas of strength as well as areas to work on.
Your score also refers you to an intervention opportunity as part of your story of recovery.
So, for example, my score of 24 refers me to statement #24, which is "I like the place that I live in."
I could choose to work on something else, but something around 24 might be a good place for me to start.
Dr Barbic suggested that we look at a range of options, three below and three above our score. If I go three below, I get to "I can manage stress".
That's definitely where I need to start!
Matthew's score refers him to statement #16 "I have new interests".
Are you feeling it?
I sure am.
Matthew and I have do these questionnaires, every 2 months.
Implications for People with Chronic Health Conditions
Many people with autoimmune and other chronic health conditions report degenerating mental health, whether that takes the form of brain fog, depression, anxiety, or something even more disabling.
Given that, it makes sense to track mental health recovery as well as recovery of other symptoms when engaging in n=1 experimentation for healing.
PROM also focuses on the lifestyle components of healing protocols, like sleep, stress management and supportive relationships. Things that we know we need in our lives to improve our health and well-being.
So, our mental health can improve by using PROM as a measurement and intervention tool, and our physical health can, too.
The Mental Health Epidemic
I used to coordinate a large health network with the goal of improving the mental health outcomes of children and youth.
I was curious about whether this questionnaire could be used with youth. Before I could put up my hand to ask, Dr Barbic told us that it can.
With one key difference.
She said" I hypothesize that the ordering is not the same for youth. I use the example of sleep and intimate relationships. They are not necessarily flipped….but they do not fall in the same order as adults." In other words, youth care less about sleep. But they care very much about intimate relationships.
I wrote a post awhile back called the child & youth mental health epidemic, but this 'epidemic' is not just confined to young people.
According to Dr Barbic, the "cost of mental illness to Canadian society is approximately $192 billion annually and evidence suggests that in the next two decades, mental illness will be the leading cause of disability in Canada."
And that's just one sparsely-populated country.
I think something like PROM, widely used, could reverse those trends. For us as individuals, and for entire societies.
The quality of our food matters when it comes to our physical and mental health. I struggled for decades with depression and anxiety before I started using personalized (n=1) experimentation to find out what foods and activities would enable me to heal.
As a result, I no longer eat many pantry foods. Mostly fresh vegetables and meat from happy animals. Bulletproof foods are an exception.
• Collagen, cocoa and 'brain octane' MCT oil for my breakfast cocoa;
• Chocolate fuel bars for work sprints; and
• Collagen protein bars for quick emergency fuel, especially when I'm travelling on consulting contracts. And as treats.
I've done my own n=1 experiments and these products hold up, over and over again.
I bet my health on them.