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Insider/Outsidercollaborativepoliceandhealthresearch.Thechallengesandfacilitators
IngaHeymanPrincipalSupervisorProf.CatrionaKennedy
SecondarySupervisorsDr.SteveSmith.Dr.SheelaghMartindale
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Aim• ToexploreanddiscussthetensionsofInsider/Outsiderpositionsinpractitionerresearchthroughtheexperienceofoneresearcherwhohasgrappledwithholdingacomplexmixofhealth/police/researcheridentities.
• Thechallenges,facilitatorsandmanagementofsuchapositionwithinresearchwillbediscussedalongwiththeacknowledgementofthebenefitssuchacomplexpositionbrings.
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Professionalbackground• Lecturerinmentalhealthnursing,researcherandPhDstudent
• Adultandmentalhealthnurseinclinicalpracticefor30yearsinAustraliaandScotland
• Workedinpublichealth,mentalhealthandpoliceservices.
• Dualprofessionalinsights• Wellestablishedandvaluedprofessionalrelationshipsinhealthandpolice
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• PhDstudyoftheinterfaceandpathwaybetweenpolice,thoseinmentalhealthdistressandemergencyhealthservices
• Passionateabouttheissueandstrongdesiretobridgeagapinunderstanding
• Understoodthephenomenathroughbothprofessionallensesandinsightsintotheexperiencesofthoseinmentalhealthdistressthroughworkinginthisarea.
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Benefits• Organisationalknowledgewereinfluentialandbeneficialtothestudydesign(AlvessonandSkoldberg2000).
• Positiveandtrustingrelationshipswithgatekeeperssupportingaccesstodata,participantsandknowledgewithinbothservices-clearbenefits.
• ClinicalexperienceengagingwithPWEMDofferedopportunitiestofullyengagewithallthreeagentsinthestudy.
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StudyaimTounderstandthepathwaysandinterfacebetweenpoliceofficers,healthservicepractitionersandthoseinmentalhealthdistresswhoinitiallypresentto,andarereturnedto,policeservicesforsubsequentmanagementfollowingmentalhealthassessment.
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Whatcouldgetintheway?!• Atensiondevelopedbetweenthesubjectiveassumptionsmadeasapractitionerandtheobjectivityofbeingaresearcher
• Ethicalchallenges,potentialbiasandpossiblethreatstostudyviabilitywereaconstantconsiderationthroughtheresearchmethoddevelopmentphase.
• Becomehighlysensitiveandapprehensiveregardingthepossiblenegativeconsequencesmypracticerelationships,familiarityandassumptionswouldhaveonthevalidityofthestudy.
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Searchforapositiontomakesenseofthis…
• Challengesandopportunitiesof‘Insider’and‘Outsider’researcharewelldocumented.• Brown(1996)takesthisonestepfurtherinrelationtopoliceresearchandsuggestsfourpotentialpositions.Insider/insider,insideroutsider,outsider/outsiderandoutsider/insider.Allwithcomplexitiesandchallenges
• Foundmyselfinapositionofbeinganinsiderandoutsiderandneitherinbothservicesinvolvedinthestudyallatthesametime.
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• Insider- Canovercomebarriersofaccesstoparticipantsanddata.Insightsandgoodsubjectknowledgesupportinterpretation.Yet,perceptionofrelativepower,familiarityandpotentialbiasparticularlyinrelationtodatacollectionandanalysis.
• Outsider- Biasislesslikely.Fresheyesontopic.However,canmisinterpretdatathroughlackofsubjectknowledge.FloydandArthur(2012)suggestthatoncetheresearchhasbeencompletedandwrittenup,ethicalconcernsfadenaturallyintothebackgroundforsome‘outsiders’whichcanbedangerous
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Challengesforthisresearcher• Viewedasaninsiderbybothservices.• Forcedagreaterconsciousnessofthesituation(Moule2015).Developmentofthestudyapproachtooktime
• Casestudyapproachedallowedviewingthroughtheagentlenses
• Needfortransparencythroughoutthestudy(Latimar2003)
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Facilitators
• Viewedasaninsiderbybothservices…• Mantzoukas(2005)- biasisnotbydefinitioncounterproductiveiftheresearcher’sbiasisfullyincorporatedandapparentthroughoutthestudy.Needtoidentifymybias!
• Ethicalconsiderationshavebeenattheforefrontofthisstudystrengtheningthework.
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Findingacomfortableplace
• Ratherthanconsiderthisissuefromadichotomousperspective,thereisaspacebetweenwhichallowsresearcherstooccupythepositionofboth‘insider’and‘outsider’ratherthan‘insider’or‘outsider’.Thispositioncanbeuniqueandthusbringincreasedflexibilityandunderstandingtoexplorethe‘complexityandrichness’oftheresearch.(CorbinDwyerandBuckle2009)
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Management
• Participateinareflexiveinterviewtosupportherownunderstanding,transparencywithinthestudyandidentifyauthenticityofevidenceandethicalissues(HollowayandFreshwater2007).
• Fornon-positiviststudies,reflectionisusedtorevealtheresearcherbias,andshouldbeincludedratherthanexcludedfromthestudy(Mantzoukas2005).
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Ethics
• Studydesign- considerationsinthecontextofacomplexhumansituation
• Ethicsapproval– NHS–intensescrutiny,needforconstantjustificationandchallengeethicscommitteeswhohadlimitedinsightsintopoliceresearchandprocesses.9months.
• PoliceScotlandresearchprocessesclearerandsupportive
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Benefits
• Familiarityofprocessesandsystemswhendesigningstudyapproach
• Clinicalbackgroundtosupportscreeningtopreventharm
• Insightintovulnerability,disclosureofriskandconsiderationsofharminrecounting‘story’
• Gatekeeperbuyinbybothservices• Awelcomedstudybybothpoliceandhealth
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ManagementDatacollection
• Consciousofinterviewtechnique.Needtobecleveraboutquestioningtogetdepthofnarrative
• Easytofallintofamiliarconversationsandmovefrominterviewschedule
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Analysis
• Templateanalysisallowedforqualitychecksandreflexivity.
• Audittrail• Codingcheckingofsametranscriptswithresearcheroutwithstudy.
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Constantreflectionandjustification
• Assumptionsabouttheresearcherasadetached,objectiveobserver– arguethisnottrue.
• Constantselfreflectionandcheckingoutassumptionswithcolleagues
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Conclusion
• Researcherswithmultipleidentitiesmust considertheirinsiderandoutsiderperspectivesandmanagethisisopenly.
• Auniquepositionwhichhasbeenvalued• Ratherthanlimitthestudyithasbroughtarichnessand
depth• Ethicaldilemmasandtusslesbroughtheadaches,sleepless
nightsyetgreatlearning• Constantstrivetobetransparentandreflectivehas
strengthenthework• Sincereappreciationofthetrustaffordedtomebyservice
users,gatekeepers,policeandhealthserviceparticipants
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Thankyou
IngaHeymanSchoolofNursingandMidwifery
RobertGordonUniversityGarthdeeRoad
AberdeenAB107QG