Qualitative approaches offer new and complex possibilities for mental health and suicide research. In recent years, we have gained first-hand experience of these possibilities through working on projects which centre innovative qualitative methodologies in these fields.
Suicide research, and mental health research more broadly, remains dominated by quantitative approaches and has historically neglected ‘experience’ (Chandler 2020; Hjelmeland and Knizek 2016). Professor Amy Chandler, of the School of Health in Social Science, sought to re-think this status quo through the Wellcome Trust-funded Suicide Cultures: Reimagining Suicide Research project, on which we both worked, alongside Rebecca Helman and Joe Anderson.
Suicide Cultures explored social and cultural meanings of suicide, emplaced in different communities across Scotland. The project evolved over time to emphasise ethnographic research, as well as including in-depth interviewing, arts-based methods, and document analysis. These methods helped us to explore the experiences of people who had attempted suicide, people bereaved by suicide, and professionals working with people who experience suicidality.
Within the Suicide Cultures project, ethnography offered unique insights, enabling us to engage and collaborate with diverse people and groups, many of which we would not otherwise have been able to work with. Ethnographic approaches during Suicide Cultures have allowed us to speak to individuals with complex mental health needs, disabilities, and people experiencing multiple forms of deprivation which make them unwilling or less able to participate in formal, sit-down, extended interviews. Such groups are more usually excluded from qualitative research, despite these groups being statistically at ‘higher risk’ of suicide. Shorter, repeated conversations have allowed us to gain as much or more depth of understanding from these individuals as we would have in an interview setting. Some of these conversations occurred after many months of trust-building. Building in extended ethnographic timelines enabled the embeddedness, connection, and adaptive, holistic approach that we have experienced as particularly conducive to suicide research with under-represented groups, who may have less resource to engage with research and/or good reasons to be wary of researchers. This embeddedness in communities also produced other positive impacts on the research. For example, it enabled our interviews to reach greater depth, including multiple engagements with potential interviewees, careful follow-up, and more diverse stories about people’s experiences of suicide.
Alongside and inspired by the Suicide Cultures project, we are working together on a small, Edinburgh Mental Health-funded project called Sea to Spruce: A Pilot Study of Green & Blue Space Community Groups for Mental Health Improvement. This project evolved from Suicide Cultures project findings around the importance of engaging in green (land-based) and blue (water-based)-space activities for folks’ mental health and wellbeing. This research expands beyond the focus on suicide to address broader concepts of liveability, joy, and recovery. In Sea to Spruce, we are using interviews with policymakers and green/blue space activity participants to understand beliefs around the mental health impacts of these activities and factors in maintaining these spaces. The project also uses focus groups with established green/blue space community groups to enable lively discussion of the benefits, challenges, and experiences of their activities. These encounters have led to opportunities for participant observation (a form of ethnographic work), as we have been invited to participate in the groups’ activities, including wild swimming and gardening.
Finally, and building on the theme of liveability, our wider research team, spanning the University of Edinburgh, University of Lincoln, and Mind in Camden, and led by PI Professor Chandler (Edinburgh) and Co-lead Dr Ana Jordan (Lincoln), has just launched an ambitious 7-year project. Discovering Liveability: Co-producing Alternatives to Suicide Prevention, funded by a Wellcome Trust Discovery Award, builds on years of collaborative work (including on Suicide Cultures and its Leverhulme Trust-funded sibling project, Suicide in/as Politics).
This new project will continue to draw on and expand the groundwork established across the Discovering Liveability team members’ previous work, using novel methodologies and interdisciplinary knowledge to explore the importance of alternative ways of ‘doing’ suicide research. Discovering Liveability aims to disrupt the current focus on crisis interventions for suicide, instead, centring collaborative exploration, development, and innovation in practices of liveability; shifting the lens from asking how we can prevent people dying, to considering how we can cultivate environments and societies that are more liveable. We will continue to use ethnography, in-depth interviewing, critical policy analysis, arts-based, and collaborative approaches to explore new horizons for suicide research and for considering the possibilities of liveability. Discovering Liveability will also provide lived and living experience researchers with opportunities to develop their own programmes of research, within the project.
Discovering Liveability is emphatically centred on lived and living experiences of suicide and suicidality. While suicide research has begun to engage with ‘lived experience’, this is currently not adequately embedded, and critical reflections on the meanings and definitions of ‘lived’ and ‘living’ experience in suicide prevention are relatively rare. Indeed, those with ‘living’ experiences of self-harm or suicide (where experiences are ongoing or recent) still face exclusion from research due to concerns about ethics and safety (Baril, 2023; Ansloos and Peltier, 2022). Calls for the inclusion of ‘lived experience’ in suicide prevention and research (e.g., Pirkis et al., 2023) rarely engage with what this might mean in practice – something our approach seeks to attend to.
As part of continuing to engage in long-term, meaningful, lived and living experience-led research on suicide, we are prioritising the welfare and wellbeing of our large and diverse research team. Through ‘making space’ team wellbeing sessions, peer and line manager support, reading groups, team socials and retreats, and dedicated individual wellbeing funds for project staff, we aim to build a vibrant and supportive research environment.
This rapid rundown of our research group’s most recent adventures in qualitative mental health and suicide research gives a taste of the possibilities for expanding our concepts of what mental health research looks like, who does it, and how we build supportive and long-standing teams to carry on this work.
References:
Ansloos, J., & Peltier, S. (2021). A question of justice: Critically researching suicide with Indigenous studies of affect, biosociality, and land-based relations. Health, 26(1), 100-119. https://doi.org/10.1177/13634593211046845
Baril, A. (2023). Undoing Suicidism: A Trans, Queer, Crip Approach to Rethinking (Assisted) Suicide. Philadelphia: Temple University Press.
Chandler, A. (2020). Shame as Affective Injustice: Qualitative, Sociological Explorations of Self-Harm, Suicide and Socioeconomic Inequalities. In M. Button & I. Marsh (Eds.), Suicide and Social Justice (pp. 32-49). London: Routledge.
Hjelmeland, H., & Knizek, B. L. (2016). Time to Change Direction in Suicide Research. In The International Handbook of Suicide Prevention (pp. 696-709). John Wiley & Sons, Ltd.
Pirkis, J., Gunnell, D., Hawton, K., Hetrick, S., Niederkrotenthaler, T., Sinyor, M., Yip, P. F. S., & Robinson, J. (2023). A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies. Crisis, 44(2), 85-92. https://doi.org/10.1027/0227-5910/a000902
Sarah Huque is currently a Senior Research Fellow in the School of Health in Social Science, University of Edinburgh, and Co-Investigator on Discovering Liveability: Co-producing Alternatives to Suicide Prevention. She is also the PI of Sea to Spruce: A Pilot Study of Green & Blue Space Community Groups for Mental Health Improvement and was previously a Research Fellow on the Suicide Cultures: Reimagining Suicide Research project. Her research focuses on the intersection of social justice and public health, with an interest in methodological innovation. You can contact Sarah at shuque@ed.ac.uk.
Emily Yue is a Research Fellow on Discovering Liveability and Research Assistant on Sea to Spruce at the University of Edinburgh. Emily was previously a Research Fellow on the Suicide Cultures and Suicide in/as Politics projects. She draws on decolonial and feminist approaches to data to research the intersections between 'mixed-race' and ‘suicide/ality’ in Britain. You can contact Emily on eyue@ed.ac.uk
Commentaires