Enola K. Proctor, Frank J. Bruno Professor of Social Work Research and Associate Dean for Research, George Warren Brown School of Social Work (Photo: David Kilper)

Translating Social
Research to Better Care

By Betsy Rogers

At the boundary between scholarly research and street-level practice yawns the so-called “Valley of Death,” separating the exciting promise of scientific discovery from the real-world people it aims to help. Enola K. Proctor is on a mission to bridge that chasm.

Proctor, the Frank J. Bruno Professor of Social Work Research and associate dean for research at the George Warren Brown School of Social Work, stands at the complex intersection where social work meets mental health services and research meets practice. A member of the Brown School faculty since earning her doctorate there in 1978, Proctor has focused her scholarship on mental health services and, more recently, on “implementation science,” the study of how to move research findings and the practices they inform into on-the-ground settings where they can meet real human needs.

“For a long time we thought of this as involving two primary players,” she explains. “The researchers would produce the knowledge, and front-line providers would somehow read it and magically be able to put it into practice. We now know that there are a number of organizational, policy, and contextual factors that determine quality of care. We have to look at service delivery. We really want to be able to offer the field not just evidence-based treatments but evidence-based approaches to implementing those treatments in real-world care.” This latter enterprise, Type II translation research, has become a major National Institutes of Health focus.

Indeed, Proctor’s twin commitments to mental health research and its implementation have won her extraordinary grant support from the National Institute of Mental Health (NIMH) and other grantors. Just in the last 15 years, she and her co-investigators have won some $20 million in grants. “It has to be by far the best funding support from NIH of any school of social work,” says John Landsverk, professor emeritus at San Diego State University and a Brown School senior scholar.

That National Institutes of Health support has, in turn, helped create a research powerhouse. “It has served to attract really good young scholar-investigators,” Landsverk notes. Referring to Proctor and Edward Lawlor, dean of the Brown School, Landsverk continues: “They can compete for the best and brightest, and they bring them in.”

Strengthening the foundations undergirding scholarship is a key part of Proctor’s mission. The original 1995 NIMH grant she won to establish the Center for Mental Health Services Research (CMHSR) had dual purposes—“to accelerate the development of evidence to inform social work and mental health and also to develop social work faculty capacity to conduct that research,” says Proctor, CMHSR director.

The center has succeeded on many fronts. Many Brown School faculty now review grants for the NIMH and the National Institute on Drug Abuse (NIDA). Proctor secured funding to train doctoral and postdoctoral students in mental health services, the only postdoctoral mental health program in a social work school. The center has a demanding internal peer review procedure for grant applications. It supports the necessary pilot studies. “By the time we submit an application, we have the preliminary data showing the likelihood of success,” Proctor notes.

That 1995 NIMH grant was the institute’s first to a social work school, and therein displays another facet of Proctor’s leadership in her field. “One of her most important contributions, in my view, is to demonstrate how mental health services research naturally suits social work’s professional outlook and can be used as a framework for what is truly social work research,” says Lonnie R. Snowden, professor in the University of California, Berkeley’s School of Social Welfare.

Landsverk agrees. “She has opened up the field of mental health services,” he says. Before her work, he explains, most mental health services research focused on psychiatry and psychology and their practitioners. “What her center has done is demonstrate and expand the ways in which social services, child welfare services, and services for the elderly identify and even provide mental health interventions within their own service platforms.”

These are the settings at the far end of the bridge Proctor is working to build. “She is really one of the great modern-day conceptual thinkers about how universities and schools of social work can partner with agencies in moving service delivery forward and better meeting the needs of clients,” says Joan Zlotnick, executive director of the Institute for the Advancement of Social Work Research.

“She is … one of the great modern-day conceptual thinkers about how universities and schools of social work can partner with agencies in … meeting the needs of clients,” says Joan Zlotnick.

Proctor is realistic about the obstacles. “We’re really aware of those challenges for the front-line provider who’s delivering care, the capacity of service delivery systems to implement and act on evidence so that in fact research can transform services and care,” she says. These challenges can include organizational culture, scarce resources, training capacity, data systems, and a host of other factors.

To meet them, the Center for Mental Health Services Research is forging new links with social service agencies. Its strategic partnership with St. Louis’ Family Resource Center, involving faculty consultation and vastly expanded communication about research-based practices, exemplifies this approach. “We hope these partnerships will facilitate the agencies’ ability to bring new research knowledge to bear on the services they’re providing,” she says.

For Dean Lawlor, Proctor’s unwavering commitment to bridging the gap sets her apart. “Her great strength is operating right in the middle between research and practice, taking the best of science and figuring out strategies for implementing advances in research, getting them into organizational practice,” says Lawlor, also the William E. Gordon Distinguished Professor and director of the University’s new Institute for Public Health.

“She’s really had a major influence on mental health services and delivery writ large. She’s influencing science policy nationally,” he adds. Notably, Proctor sits on the NIH Scientific Advisory Council, the first social work scholar to do so.

Closer to home, she is on the Faculty Advisory Council for the University’s Institute for Public Health and is a senior fellow at the University’s Center for Health Policy. She served on the search committees that brought Chancellor Mark S. Wrighton and Lawlor to the University.

Proctor finds serving with these groups deeply satisfying. “Any time you can work with talented colleagues to think about the future and have a small role in shaping that future, it’s just enormously rewarding,” she observes.

Her love for her work and the University permeates her conversation. She cites the chancellor’s vision, the unflagging support of Lawlor and former Dean Shanti Khinduka, the energy that Lawlor brings to the School, and the collegial atmosphere. “I come to work eager for the day and get more excited as the day goes on,” she says. “I’m doing things today that I didn’t envision a year or two ago. We are so privileged to do this work.”

Betsy Rogers is a freelance writer based in Belleville, Illinois.

At press time, Magazine editors learned that Professsor Proctor was awarded the 2009 Arthur Holly Compton Faculty Achievement Award for her work in advancing the implementation of evidence-based practices in social service settings.