Recruiting youth consumers for suicide research: A mental health clinician's dilemma

Abstract

Background This thesis investigated the perceived barriers among mental health clinicians towards introducing research participation to young male consumers presenting with suicidal behaviours. The need for the present study arose from an earlier study which sought to explore consumer perspectives of the influences of social media on self harm and suicidal behaviours. Following the very low recruitment of consumers in the original study, the thesis was modified to proactively explore the clinical barriers to consumer recruitment. Suicide researchers’ understanding of recruitment and retention of mental health consumers is in its infancy. Little consideration has been given to understanding factors that hinder participation of young male consumers in research from a clinical perspective. Increasing participation of young male consumers has been compounded by the absence of literature identifying specific age and gender related barriers. A selective literature reviewed the qualitative evidence on barriers to participation in research. Critical analysis of literature has highlighted there are numerous complex barriers to participation in suicide research and offers insights into factors influencing clinician decisions to support recruitment of hard-to-reach groups. Method Using a face-to-face, semi-structured research interview 13 clinicians involved in the original study were recruited and interviewed. This method and resultant thematic analysis was applied to explore the complex issues which impeded data collection with consumers in the original study. Findings Findings illustrated that factors impacting on clinicians’ decisions to collaborate and subsequently recruit consumers to the study were complex and multi-faceted. The themes identified were related to contextual, disciplinary and relational influences on clinical decision making. Contextual influences included a lack of consensus on research priorities within integrated teams, multiple priorities for clinicians and the perceived complexities of engaging users of mental health services. Disciplinary influences discussed a variety of perspectives on risk and these were identified as being a prominent factor on influencing decision making. Relational influences on decision making illustrated the value that clinicians placed on relationship development, and developing partnerships between universities and clinical services were as important to clinicians as the inter-personal relationships between clinicians and individual researchers. Findings also highlighted a potential role for universities in providing leadership and support to enable clinical services and consumers to form effective partnerships. Conclusions This thesis provides a useful explanatory model for why recruitment failure can occur in studies involving clinicians as intermediaries in recruiting consumers to suicide research. Specific barriers to the successful implementation of the original study were identified and the outcomes of this study enhance understanding of the complex social processes of recruiting a clinical sample of young men. The findings from this thesis can also be used to inform the development of future research partnerships between universities, clinical services and consumers.