Børn og unge med psykiske vanskeligheder har krav på bedre systematisk udredning og behandling

Professor Robert Goodman er manden bag SDQ og DAWBA. Hans passion er at udvikle redskaber og “best-practice” modeller, der kan sikre, at flere børn og unge med psykiske vanskeligheder får:

  • hurtigere adgang til systematisk udredning,
  • evidensbaseret indsats samt
  • opfølgende evaluering.

Læs nedenstående interview med Robert Goodman, hvor han fortæller om sine livsværker SDQ og DAWBA, passionen for at hjælpe børn med psykiske lidelser og samarbejdet med Anna og James Goodman i familievirksomheden YouthinMind. Goodman kommer samtidigt ind på sine visioner for videre samarbejde med praktikere og forskere i Danmark.

Interview with Robert Goodman

Short, simple and valid measures for clinicians and researchers

Tell us about your motivations for creating SDQ and DAWBA?

If you had told me 30 years ago when I was starting my research career that I would spend a lot of my time developing measures, I would not have believed you – and if I had believed you, I might have been very dismayed to think that I was going to waste my life doing boring methodological stuff!

Having qualified in medicine and neuroscience, and finding children more fun than adults, I was set on a career in paediatric neurology, and did indeed spend a couple of years heading down that route at Great Ormond Street Children’s Hospital in London and Yale University in the USA. What I soon discovered was that many of the children I saw with brain disorders were more impaired by their psychological and psychiatric problems than by their physical disability, leading me to spend many years studying brain-behaviour links and completing a training in child psychiatry.

I would have liked to get on with my research using “off the shelf” measures, but since they weren’t there, I tried creating “minimalist” measures for clinicians and researchers that were as short and simple as possible while remaining valid.  

In the course of this, I realized that the researcher’s dreams of big discoveries often succeed or fail according to whether they have suitable tools for the job. I would have liked to get on with my research using “off the shelf” measures, but since they weren’t there, I tried creating “minimalist” measures for clinicians and researchers that were as short and simple as possible while remaining valid.  Some, like the SDQ and DAWBA, succeeded in their aim and were widely adopted. What started out as a brief diversion into methodology turned into what some people would consider a life sentence. Fortunately, I am a shy person who is very happy quietly getting on with the job of making tools for others to use in their more exciting clinical and research work.

A need for standardized help for children with mental health disorders

What do you think are the major challenges for children’s mental health today? How does your work in Denmark fit into this?

While there is a lot more to be done on refining our current diagnoses, assessments and treatments, what most strikes me is that we already know a lot more than we routinely put into practice. There are some wonderful exceptions, but I don’t think there are many parts of the world that can boast that a high proportion of children with mental health disorders in the community have rapid access to a comprehensive standardized assessment leading to well-delivered evidence-based treatment, followed by routine follow-up to establish whether they have responded well – leading on to further assessment and treatment if appropriate.

…we already know a lot more than we routinely put into practice.

If we look instead at children with leukaemia, they do much better in all these respects. The greater funding and prestige of leukaemia services is relevant, but if we are honest with ourselves, I think we will probably accept that some of the problems might be solved if we adapted our professional trainings and working patterns. I know the good will is there in our professions – but getting the details right is surprisingly hard, even in professions that are supposed to be particularly good at systemic thinking.

Developing mental health services in Denmark

For much of my working life, I have been on the lookout for inspiring models of good practice that will allow the rest of us to learn even better ways of helping children. Having had many successful collaborations in the Nordic countries, I have become increasingly convinced that these countries are particularly well placed to take the lead – and that Denmark has some unique advantages, in terms of professional training, public attitude, funding, national priorities, size and – of course – the uniquely well-developed Danish registers.

We want to catalyse change by encouraging others to think differently and think big.

After a meeting with Carsten Obel about something completely different, we decided it would be worth investing our time and effort in seeing if we two outsiders – one a foreigner and one from a public health background – could help our colleagues in a range of disciplines see how well placed Denmark was to take a global lead and unlock their creativity. We have no ready-made plan that we wish to impose on child psychiatrists, teachers, and others – we want to catalyse change by encouraging others to think differently and think big. Many busy people have given up their time to listen to us and – more importantly – tell us their own ideas. After all we have heard, we are very optimistic.

Close coorporation with family and friends has been the key to succes

You are the man behind SDQ/DAWBA and it now seems that your children are becoming equal partners. Can you tell us a bit about your team and how you work together?

We are a family venture that has benefited enormously from being able to call on the help of some very talented friends. Although I generated many of the original ideas, it has been the family and friends who have given shape to the ideas and stopped them spinning out of control. Anna (my older daughter, and an epidemiologist) has increasingly taken the lead on data analysis, publication and systematization of the websites. James (my son, and a lawyer) has taken over managerial responsibility for youthinmind as a whole, while also putting his legal training to good effect when thinking about issues such as data protection, intellectual property and consent. The third Goodman child, my younger daughter Rosa, has also contributed in a variety of ways, though we have not yet found a way to harness her main expertise in Renaissance art! This ‘family farm’ model of running a business is of course not so common in the 21st century, but we are finding it a great way to work – there are definite advantages to being able to have a board meeting at the breakfast table.

Although I generated many of the original ideas, it has been the family and friends who have given shape to the ideas and stopped them spinning out of control.

In terms of other key members of the team, Anna and I both also spend some of our time writing computer code under the expert guidance of Professor Mike Smith, an extraordinary computer scientist who is a powerhouse of ideas, techniques and enthusiasm. We feel bad not to mention all the other friends and colleagues who have played crucial roles, but they know who they are – and that we greatly appreciate their contributions.

The interview was composed by Robert Goodman, Anna Goodman and Signe Herbers Poulsen, October 2014.

Robert Goodman

  • Psykiater
  • Professor ved King’s College, London
  • Ophavsmand til SDQ og DAWBA