{"id":5257,"date":"2023-10-20T12:00:52","date_gmt":"2023-10-20T11:00:52","guid":{"rendered":"https:\/\/blogs.kcl.ac.uk\/editlab\/?p=5257"},"modified":"2023-11-14T12:30:34","modified_gmt":"2023-11-14T11:30:34","slug":"u-for-underrepresented-groups-in-mental-health-research-part-2","status":"publish","type":"post","link":"https:\/\/blogs.kcl.ac.uk\/editlab\/2023\/10\/20\/u-for-underrepresented-groups-in-mental-health-research-part-2\/","title":{"rendered":"U for Underrepresented Groups in Mental Health Research: Part 2"},"content":{"rendered":"<h3 style=\"text-align: right\"><em><strong>In our previous blog post \u2018U is for Underrepresented Groups in Mental Health Research \u2013 Part 1\u2019, Grace described the causes and implications of underrepresentation of LGBT+ individuals and ethnic minorities in mental health research. Now, she will discuss how these problems may be overcome.\u00a0<\/strong><\/em><\/h3>\n<div id=\"attachment_5278\" style=\"width: 294px\" class=\"wp-caption alignright\"><a href=\"http:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-5278\" class=\" wp-image-5278\" src=\"http:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo-852x1024.jpg\" alt=\"\" width=\"284\" height=\"341\" srcset=\"https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo-852x1024.jpg 852w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo-249x300.jpg 249w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo-768x924.jpg 768w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo-1277x1536.jpg 1277w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo-1703x2048.jpg 1703w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/10\/ID-Photo.jpg 1728w\" sizes=\"auto, (max-width: 284px) 100vw, 284px\" \/><\/a><p id=\"caption-attachment-5278\" class=\"wp-caption-text\">Grace, MSc Student<\/p><\/div>\n<hr \/>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<hr \/>\n<p><strong>THE POSSIBLE SOLUTIONS<\/strong><\/p>\n<p><span style=\"font-weight: 400\">As part of my placement, I recently spent time speaking to members of the TEDS study to investigate ways to improve diversity and inclusion in mental health research. This is known as Patient and Public Involvement (PPI) and provides an opportunity for researchers to involve members of the public in their research planning and study design. Below, I\u2019ve used quotes from these discussions, as well as existing research, to highlight solutions for improving representation in research.<\/span><\/p>\n<p><a href=\"http:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1477842491-scaled.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-5299 aligncenter\" src=\"http:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1477842491-1024x399.jpg\" alt=\"\" width=\"929\" height=\"362\" srcset=\"https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1477842491-1024x399.jpg 1024w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1477842491-300x117.jpg 300w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1477842491-768x299.jpg 768w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1477842491-1536x598.jpg 1536w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1477842491-2048x797.jpg 2048w\" sizes=\"auto, (max-width: 929px) 100vw, 929px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><b>1. To overcome researcher homogeneity<\/b><\/p>\n<p><i><span style=\"font-weight: 400\">\u201cSometimes you don\u2019t wanna feel like you\u2019re talking to an interviewer that has absolutely no clue, you know, what your background is and what your world kind of feels like\u201d \u2013 Female\/White \u2013 Other\/Bisexual<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400\">When speaking to TEDS twins, it was clear that researchers need to be visible allies for marginalised communities and acknowledge the limitations of their own understanding. Previous research has already illuminated the importance of cultural competence (Brown et al., 2014). This requires researchers to adapt their working style to the cultural needs, values and expectations of their participants (Argyriadis et al., 2022), and commit to the interests of marginalised groups. In conjunction, researchers from diverse backgrounds who can offer accurate knowledge about culturally sensitive topics should be hired to improve the success of research teams (Ogunkoya, 2021). Diversity and inclusion bring new and varied perspectives to the table, promote cultural competence, and produce more interesting and better-quality research. Most importantly, it increases representation for marginalised groups, builds trust between members of the public and researchers, and helps to break down the barriers in academia.<\/span><\/p>\n<p><b>2. To overcome systematic exclusion<\/b><\/p>\n<p><i><span style=\"font-weight: 400\">\u201cif you\u2019re not talking to the group\u2026you\u2019re more likely to do things and say things and create research that then actively works against that group\u201d \u2013 Gender undefined\/White\/Queer<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400\">This problem is more difficult to solve as it is linked to wider societal systems. Several methodological adaptations may be made such as providing multi-lingual study materials, using\u00a0 probability sampling (a form of random sampling which ensures that everyone from a selected population has a non-zero chance of being selected into a sample) or creating targeted recruitment strategies (as discussed further by <\/span><span style=\"font-weight: 400\">NHS England, (2023)<\/span><span style=\"font-weight: 400\">). However, PPI can be a useful tool to ensure research is relevant and accessible to people from all backgrounds, particularly those who are underrepresented in research. In PPI, researchers discuss topics such as science, research agendas and ethics with members of the public (NIHR, 2023). In doing so, the voices of marginalised groups are amplified, systematic exclusion from studies is reduced, and diverse perspectives are introduced. The TEDS twins identified many benefits of participating in PPI, including contributing to social change, learning new skills and advancing understanding of issues in their community. However, it is essential that there are substantial and tangible benefits for participants to prevent tokenistic use of their time (Haldane et al., 2019).<\/span><\/p>\n<p><a href=\"http:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1385509455.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-5300 aligncenter\" src=\"http:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1385509455-1024x676.jpg\" alt=\"\" width=\"665\" height=\"439\" srcset=\"https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1385509455-1024x676.jpg 1024w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1385509455-300x198.jpg 300w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1385509455-768x507.jpg 768w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1385509455-1536x1014.jpg 1536w, https:\/\/blogs.kcl.ac.uk\/editlab\/files\/2023\/06\/iStock-1385509455-2048x1352.jpg 2048w\" sizes=\"auto, (max-width: 665px) 100vw, 665px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p><b>3. To overcome mistrust<\/b><\/p>\n<p><i><span style=\"font-weight: 400\">\u201c\u2026but I think realistically, looking at the state of the world, if we want it to get better, we have to find the-, have the difficult conversations.\u201d\u200b \u2013 Female\/Black\/Heterosexual<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400\">Developing equitable partnerships through PPI is essential to building trust between researchers and marginalised communities. Researchers in positions of power must commit to continually addressing the power imbalances between the \u2018researcher\u2019 and the \u2018researched\u2019 (Scholz et al., 2021). This is necessary to change the negative perceptions of researchers within the eyes of potential participants. This can be supported with outreach work to better understand the community\u2019s desired outcomes, provide education about the risks and benefits of participating in research, and gain endorsement from influential community stakeholders who can advocate for the research in their communities.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In summary, to ensure that research is representative to all, researchers must develop cultural competence, practice active allyship and create equitable partnerships through PPI and outreach work to help amend relationships between researchers and marginalised groups. The most important place to begin this work is by creating greater diversity in researchers themselves, something that is a priority within the EDIT lab.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong>References<\/strong><\/p>\n<p><span style=\"font-weight: 400\">Argyriadis, A., Patelarou, E., Paoullis, P., Patelarou, A., Dimitrakopoulos, I., Zisi, V., Northway, R., Gourni, M., Asimakopoulou, E., Katsarou, D., &amp; Argyriadi, A. (2022). Self-Assessment of Health Professionals\u2019 Cultural Competence: Knowledge, Skills, and Mental Health Concepts for Optimal Health Care. <\/span><i><span style=\"font-weight: 400\">International Journal of Environmental Research and Public Health<\/span><\/i><span style=\"font-weight: 400\">, <\/span><i><span style=\"font-weight: 400\">19<\/span><\/i><span style=\"font-weight: 400\">(18), Article 18. https:\/\/doi.org\/10.3390\/ijerph191811282<\/span><\/p>\n<p><span style=\"font-weight: 400\">Brown, G., Marshall, M., Bower, P., Woodham, A., &amp; Waheed, W. (2014). Barriers to recruiting ethnic minorities to mental health research: A systematic review. <\/span><i><span style=\"font-weight: 400\">International Journal of Methods in Psychiatric Research<\/span><\/i><span style=\"font-weight: 400\">, <\/span><i><span style=\"font-weight: 400\">23<\/span><\/i><span style=\"font-weight: 400\">(1), 36\u201348. https:\/\/doi.org\/10.1002\/mpr.1434<\/span><\/p>\n<p><span style=\"font-weight: 400\">Haldane, V., Chuah, F. L. H., Srivastava, A., Singh, S. R., Koh, G. C. H., Seng, C. K., &amp; Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. <\/span><i><span style=\"font-weight: 400\">PLOS ONE<\/span><\/i><span style=\"font-weight: 400\">, <\/span><i><span style=\"font-weight: 400\">14<\/span><\/i><span style=\"font-weight: 400\">(5), e0216112. https:\/\/doi.org\/10.1371\/journal.pone.0216112<\/span><\/p>\n<p><span style=\"font-weight: 400\">NHS England. (2023). <\/span><i><span style=\"font-weight: 400\">Increasing diversity in research participation: A good practice guide for engaging with underrepresented groups<\/span><\/i><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">NIHR. (2023). <\/span><i><span style=\"font-weight: 400\">What is Patient and Public Involvement and Public Engagement? \u2014NIHR School for Primary Care Research<\/span><\/i><span style=\"font-weight: 400\">. https:\/\/www.spcr.nihr.ac.uk\/PPI\/what-is-patient-and-public-involvement-and-engagement<\/span><\/p>\n<p><span style=\"font-weight: 400\">Ogunkoya, S. (2021). <\/span><i><span style=\"font-weight: 400\">Improving the Experience of Community Mental Health Services for Black, Asian and Minority Ethnic People in Tower Hamlets, Newham and City and Hackney<\/span><\/i><span style=\"font-weight: 400\">.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In our previous blog post \u2018U is for Underrepresented Groups in Mental Health Research \u2013 Part 1\u2019, Grace described the causes and implications of underrepresentation of LGBT+ individuals and ethnic minorities in mental health research. Now, she will discuss how these problems may be overcome.\u00a0 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&#8230;<\/p>\n","protected":false},"author":218,"featured_media":5299,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[248],"tags":[],"class_list":["post-5257","post","type-post","status-publish","format-standard","has-post-thumbnail","category-a-z"],"_links":{"self":[{"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/posts\/5257","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/users\/218"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/comments?post=5257"}],"version-history":[{"count":6,"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/posts\/5257\/revisions"}],"predecessor-version":[{"id":5452,"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/posts\/5257\/revisions\/5452"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/media\/5299"}],"wp:attachment":[{"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/media?parent=5257"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/categories?post=5257"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.kcl.ac.uk\/editlab\/wp-json\/wp\/v2\/tags?post=5257"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}