jrust July 28th, 2010
Enthusiastic CARF surveyors said on July 23, 2010 that Mirasol is light years ahead of any other program in the country. Continuing they said, that in all of their years working in the mental health field, they had never seen a program as excellent as what we do at Mirasol.
CARF, a national accrediting agency that examines and awards accreditation to more behavioral health facilities than any other agency, examines Mirasol every three years. A CARF endorsement means that a program’s policies and standards meet the highest possible criteria of excellence. An accreditation by CARF is proof of excellence in all areas of a facility.
Last Thursday and Friday two CARF surveyors arrived. Both of them were long-time inspectors. One member of the team was an RN with 30 years of experience in the mental health arena. The other was a man with behavioral health experience as a social worker but also an experienced surveyor having done surveys for CARF for over 25 years.
When the survey was over, our management team and the surveyors gather round for “The” report. The entire staff had worked for months making sure that we had everything ready. After the CARF people gave their report , my mouth was hanging open. I knew that we had an excellent program. I knew we were really good, but I didn’t imagine in my wildest dreams how good we are!
Basing their comments on our outcome data and after viewing our treatment at the units they said our treatment was like magic.
I have never wanted to play the game of outcomes. “Mine is better than yours. “ “No, mine is much better…….. “ Statistics can be manipulated and when I hear someone claiming a success rate of 92% at a year, I know it’s not true.
The team made me promise that I would share some of our numbers with our stakeholders which are all of you!
When someone enters treatment, we do quite a lot of psychological testing. Two of the most important psychological instruments we administer are the Eating Disorder Inventory-III and the Beck Depression Inventory.
I’m going to give you all of this information just as we gave it to the surveyors. It’s rather complicated but you can read the numbers – I’ll help.
The Eating Disorder Inventory 3 (EDI-III) is the third edition of a test that reports in multiple scales.
The test consists of 91 questions answered in terms of frequency of behaviors from always to never.
Reports consist of 21 separate scales; three are validity scales, four are eating disorder risk and composite scales, nine are psychological scales, and five are psychological composite scales. Results are presented as percentiles for all, anorexia, bulimia, and EDNOS diagnoses.
For simplicity of reporting percentiles of two risk scales/composite scores are used, each chosen for broad-based relevancy to Mirasol’s program, the Eating Disorder Risk Composite (ERDC) and the Global Psychological Maladjustment Composite (GPMC). In addition, the 9 psychological scales, including Low Self-Esteem (LSE), Personal Alienation (PA), Interpersonal Insecurity (II), Interpersonal Alienation (IA), Interoceptive Deficits (ID), Emotional Dysregulation (ED), Perfectionism (P), Ascetism (A), and Maturity Fears (MF).
These will all be compared for pre and post scores for the total, anorexic, bulimic, and EDNOS populations.
The information presented in the following chart is based on residents who completed the program during the years of 2007, 2008, 2009, and through June 2010.
You can readily see the differences between the pre-scores and the post-scores. But look at the post scores for EDRC for 2007, then 2008, 2009, and finally 2010. You’ll see that the scores progressively get lower – meaning that our patients are getting a lot better!
Now do the same for the GPMC.
2007 Results Pre EDRC Post EDRC
ALL (N = 22) 53.27 28.00
2008 Results Pre EDRC Post EDRC
ALL (N = 34) 54.06 21.50
2009 Results Pre EDRC Post EDRC
ALL (N = 20) 49.35 13.60
2010 Results Pre EDRC Post EDRC
ALL (N=11) 46.10 11.82
2007 Results Pre GPMC Post GPMC
ALL (N = 22) 56.55 31.45
2008 Results Pre GPMC Post GPMC
ALL (N = 34) 54.44 25.21
2009 Results Pre GPMC Post GPMC
ALL (N = 20) 49.35 18.15
2010 Results Pre GPMC Post GPMC
ALL (N = 11) 44.00 10.27
On the individual psychiatric scales, I won’t list all of them here. I’ll quote a couple:
Self Esteem – 2007 – Pre-56.5 Post – 30.6
2008 – Pre- 59.2 Post – 26.6
2009 – Pre- 47.8 Post – 17.7
2010 – Pre- 47.4 Post – 15.2
Personal
Alienation – 2007 – Pre- 53.6 Post- 31.0
2008 – Pre- 54.7 Post- 23.6
2009 – Pre- 53.1 Post- 18.9
2010 – Pre- 47.6 Post- 14.4
Interpersonal
Insecurity 2007 – Pre- 51.2 Post- 32.8
2008 – Pre- 54.0 Post- 34.4
2009 – Pre- 46.5 Post- 27.8
2010 – Pre – 40.8 Post- 14.6
I am happy to send anyone the full EDI-III report who is interested. On these scales look at the scores pre-treatment and then the scores post-treatment. Then look at how the scores are improving each year!
I also wanted to share the pre- and post- test scores for the Beck Depression Inventory. The Beck is one of my favorite tests. It’s short and very informative.
2007 Results Pre BDI Post BDI
ALL (N = 23) 34.26 18.13
2008 Results Pre BDI Post BDI
ALL (N = 34) 31.50 13.03
2009 Results Pre BDI Post BDI
ALL (N = 19) 30.42 7.89
2010 Results Pre BDI Post BDI
ALL (N = 12) 29.83 10.5
The decrease in the levels of depression as evidenced by these scores is dramatic. They display a general trend of improvement of feelings of well-being.
I invite anyone to phone me with any comments or suggestions. I’m proud of the work our staff is doing – they are truly incredible as is our treatment model!