Exploring possibilities for a feminist ethic of collective care in suicide research

Suicide is a major public health concern, with around 700,000 people dying by suicide globally each year, and thus research to understand suicide and suicide prevention is an international priority (World Health Organization [WHO], 2021). Suicide research (sometimes termed suicidology) is a multidisciplinary field exploring suicidal thoughts, feelings, attempts, and deaths; suicide bereavement; and suicide prevention. To date, suicidology has been dominated by quantitative methods (Chandler, 2019; Hjelmeland & Knizek, 2010, 2016). Despite pioneering work over the last 2 decades demonstrating its wide-ranging potential (see Hjelmeland & Knizek, 2016; McDermott & Roen, 2016; Scourfield et al., 2012), qualitative research has tended to be positioned in mainstream suicide research as valuable only to support quantitative research, for example, in exploratory work to develop ideas, with the expectation of quantitative follow-up research (Testoni et al., 2021); it is rarely respected as the primary method of inquiry, valuable in its own right.

Yet, despite the vast amounts of quantitative research conducted, there has been very little improvement in predicting suicides (Franklin et al., 2017), and therefore the usefulness of the field's commitment to quantification has been questioned in recent years. For example, Hjelmeland and Knizek (2016) have called for a move away from the quest to quantify and predict, instead suggesting qualitative methods have the potential to deepen understandings, offering new opportunities for prevention. It has also been argued that a turn towards qualitative and critical methods of inquiry could be crucial for centring lived experiences, with potential long-lasting impacts across the field of suicide studies (Chandler et al., 2022).

Qualitative suicide research has, however, remained an emergent area. As such, there can be a lack of guidance in published research about the process of undertaking qualitative suicide research, with researchers instead borrowing from other health research areas where these discussions are more advanced (Camacho, 2016; Dickson-Swift et al., 2007; Smillie & Riddell, 2023). Although cultivating connectivity across research areas can be valuable, a central concern of suicide research is generally absent: namely, whether taking part in research will exacerbate participants’ suicidal feelings, thus increasing their risk of dying by suicide (Berman & Silverman, 2017; Mishara & Weisstub, 2005). Whenever such considerations are discussed in suicidology, they have tended to be dominated by risk mitigation approaches (Andriessen et al., 2019a, 2019b), with little engagement with feminist research methods centring mutuality and care. Furthermore, decision-making appears often to be undertaken behind closed doors: informed through departmental conventions, casual collegiate conversations, and individual intuitions. It therefore remains invisible within our research literature, hindering the development of methodological capacity for qualitative methods across the field of suicide research.

Reflections from doctoral research exploring LGBTQ+ youth suicide in Scotland

In this article, I aim to make the private consideration of ethical decision making public by sharing my reflections on the process of designing, conducting, and analysing a qualitative study of lesbian, gay, bisexual, trans, and queer (LGBTQ+) youth suicide in Scotland for my doctoral studies. I recruited 24 LGBTQ+ young people aged 16–24, living in Scotland, who had previously thought about or attempted suicide, to take part in narrative interviews. The study explored how LGBTQ+ young people made sense of suicide, what they believed had contributed to suicidal feelings and what had enabled them to survive, as well as what they believed would help reduce LGBTQ+ suicide in the future (for more information on the findings of this study, please see Marzetti, 2020; Marzetti et al., 2022, 2023).

This research was heavily influenced by the field of critical suicide studies, which draws upon queer, feminist, and indigenous theoretical perspectives to critique dominant frameworks for understanding suicide (Cesar Riani Costa & White, 2024; White et al., 2016), with the goal of transforming the suicide research landscape and placing social justice at its core (Chandler et al., 2022). An attentiveness to social justice perspectives is, I argue, crucial for the study of LGBTQ+ youth suicide, where so often there is a relationship unquestioningly assumed between being LGBTQ+ and being suicidal, without sufficient attention paid to the many varied and complex ways in which LGBTQ+ communities enact resistance, survive, and thrive (Bryan & Mayock, 2017; Jaworski, 2022). Indeed, McDermott and Roen (2016) have argued that LGBTQ+ young people experiencing suicidal feelings can be triply pathologised, through the lenses of queerphobia, ageism, and sanism. Such concerns sit within a broader landscape of suicide research in which suicidal people can be patronised and portrayed as incapable of speaking for themselves due to a perceived lack of rationality and reason (Baril, 2023), and where talk about suicide is regulated within tightly bound parameters aiming to keep “vulnerable” people safe (Ranahan & Keefe, 2021). Therefore, how to research with care requires close consideration.

Considering a care-full approach

The concept of care has a long history in feminist psychology dating back to Carol Gilligan's (1993) pioneering work, In a Different Voice. It is central to how feminist researchers conduct research in ways that actively resist exploitation and prioritise relationships of mutuality and care, promote power-sharing and accessibility to amplify diverse participants’ voices, and encourage reflexivity and reflective practices amongst researchers (Kingston, 2020; Oakley, 1992; Preissle & Han, 2012). However, enacting a feminist research ethic in practice is not without complexities. In Researching With Care: Applying Feminist Care Ethics to Research Practice, Brannelly and Barnes (2022) argued that caring can have patronising, ableist, and paternalistic connotations, designating people to the subject position of “vulnerable” and robbing them of their autonomy, running counter to the feminist aims motivating an ethic of care in the first place. To renegotiate this ethic of care and resist these problematic connotations, they encourage their readers to delve deeply into the politics and possibilities of care to find what they have termed “care-full” ways to practice our research. They propose that we should enact a thoughtful orientation guided by a feminist ethic of care, which they describe as “a critical approach that seeks to understand the necessity of care to wellbeing, to understanding marginalisation and identifying responsibility to remedy social injustices” (Brannelly & Barnes, 2022, p. 6). This resonated strongly with my experience of designing an ethic of care, balancing a desire to care for my participants and put in place sufficient safeguards, while also respecting participants’ autonomy and resisting further reinforcing pathologising approaches towards LGBTQ+ people experiencing suicidal distress.

This was particularly important as I experienced an intertwining of myself as the researcher, the participants in the research, and the broader area of study. Jaworski (2022) has argued that the relationality between researchers and participants does not simply exist as interpersonal rapport to support data collection, but as “a philosophical interdependence and interconnectedness that can bind researchers to their participants in relational and existential ways” (p. 49). My positionality as a person who had previously been suicidal, as a youth work practitioner working with queer young people, and as an LGBTQ+ community member who saw my participants as fellow community members meant that my investment in enacting a feminist ethic of care throughout the research process was a personal, professional, and political pursuit. It was also perhaps due to this positionality that I did not see this ethic of care as one solely flowing from individual researcher to individual participant, but rather a collective ethical responsibility flowing between researchers, research institutions, and research participants.

A litigation orientation: From procedural ethics to ethics in practice

To begin my research design, I turned towards the suicide research literature to find guidance on the practice of enacting an ethic of care when talking to participants about their experiences of suicide. However, I was surprised to find very little. The majority of research on ethics in suicide research, quantitative or qualitative, tended to focus on what has been termed “procedural ethics”: A process of convincing and educating our colleagues on research ethics committees (RECs) or internal review boards (IRBs) that our work is ethical (Guillemin & Gillam, 2004), and therefore should be permitted (Hom et al., 2017). It appeared to concentrate on assessing and managing participant risk, gaining informed consent, safeguarding, and maintaining scientific validity (Andriessen et al., 2019a, 2019b; Lakeman & Fitzgerald, 2009a, 2009b). This in part perhaps responds to ethical guidelines prompting us to mitigate possible participant harms and protect vulnerable participants (Social Research Association, 2021), and in part demonstrates a litigation orientation binding university practices (Guillemin et al., 2012). There were far fewer engagements, however, with the dynamic ethical practices woven throughout our entire research process (Boden et al., 2016), sometimes termed “ethical mindfulness” (Duncan et al., 2009) or “ethics in practice” (Guillemin & Gillam, 2004), and the potentialities for care.

There was also a stark absence of consideration for researcher wellbeing (Boden et al., 2016; Mckenzie et al., 2017), accompanied by a corresponding gap in institutional provisions. Several systems were provided to safeguard my physical safety: I was asked to record research locations with a third party, carry a panic alarm, and use a safe phone system. However, despite the recognised risks of secondary and vicarious trauma in other sensitive research areas (Smillie & Riddell, 2023), the safeguarding of emotional wellbeing was understood through a “self-care” lens. Implicit within this was that although the responsibility for keeping researchers physically safe was taken as one shared between researchers and the institution, the responsibility for emotional wellbeing was seen as a private concern for researchers to take on alone (Pearce, 2020; Smillie & Riddell, 2023). This was also reflected in the relevant ethical guidelines, where in the consideration of mitigating harms to researchers, the impetus is almost entirely on individual researchers to self-care (Social Research Association, 2021).

In this article, I make the case for the importance of introducing a feminist ethic of care into qualitative suicide research, reframing ethical approaches away from prioritising risk management, towards questioning how we can meaningfully engage in care-full research practices that value the complexity and humanity of our research interactions and recognise participants as experts in their own experiences (Brannelly & Barnes, 2022). I also consider how we can recognise the need for researchers to experience care within the neoliberal university (Pearce, 2020). To do so, I reflect upon the circulation and stoppages of care at individual, interpersonal, and institutional levels when undertaking my doctoral research, to consider the possibilities for a more care-full approach to supporting suicide researchers and the participants with whom we work. I begin by exploring the practicalities of developing caring practices oriented towards participants. I then move on to consider how one may negotiate the pressure to “self-care” in neoliberal institutional contexts, and explore provisions for community care led by research institutions.

Wanting to do the “right” thing: Cultivating a care-full balance through detailed planning

Brannelly and Barnes (2022) have suggested feminist researchers can be concerned that their research is not sufficiently caring toward participants, but that such concerns become unspeakable for fear of being perceived a failure. For me, this concern was bound up in a catch-22: given my prior experiences in LGBTQ+ suicide prevention, which had often situated me in a support role within youth work settings, with friends, or within LGBTQ+ community groups, I feared that I might slip into this reflex, offering more support than was sustainable for myself or the research participants (Hesse-Biber, 2007; Sampson et al., 2008). However, I was simultaneously concerned that if I drew too far back from participants, I could painfully replicate some of the uncaring and dismissive service experiences that LGBTQ+ young people report when attempting to access support for suicidal distress (Marzetti et al., 2023; McDermott & Roen, 2016), reproducing some of the exploitative research dynamics that feminist research seeks to resist (Oakley, 1992). I was motivated by a feminist ethic of care to find balance: enacting enough care to be authentically present and responsive without over offering care in a manner that could not be maintained and that therefore could be either individually or mutually harmful. This balance became a central concern that ran throughout this research project, and has extended into my subsequent work.

This consideration is not only moral, ethical, and philosophical, but it is bound up in our positionalities and our academic identities. I saw undertaking my doctoral studies as an academic apprenticeship: I therefore did not only want to act in ways that appeared ethically “right” to me, but also to my supervisors and my institution. This sense of doing the right thing was about checking my own compass for caring against the unfamiliar institutional compass; it was not simply about asking whether I was doing the “right” thing for me and the participant, but also about asking whether I was doing the right thing for the institutional position I occupied.

To facilitate an explicit, shared understanding of how I was expected to respond to participants, I wrote detailed plans working through hypothetical scenarios that I thought would possibly present themselves during the course of the research. The plans were shared with my supervisory team, enabling us to explicitly discuss and agree upon how to practically, empathetically, and responsibly respond to participants. This process clarified and codified the details that are often left unsaid due to an assumption of shared understandings. This enabled us to be open about our expectations (Mishara & Weisstub, 2005), and explicitly discuss areas of disagreement. This was provided as an appendix to my REC submission, which facilitated further changes. For example, I planned to offer safety planning to participants who became distressed (an established practice to facilitate reflections on how one can try to keep safe from suicide that I had used within youth work settings), but although supported by my supervisory team, this was precluded by our REC. This emphasised the importance of making the specific plans as explicit as possible in order to understand what would and would not be institutionally supported.

It is important to note that, although detailed planning enabled a clarity of expectations and provided a framework for reflections in advance of a situation arising, it did not mean that I knew the “right” thing to do or say. Research engagements are almost impossible to predict, and therefore plans cannot be followed rigidly (Boden et al., 2016; Brannelly & Barnes, 2022). However, the act of explicitly discussing detailed plans allowed us to formulate a framework within which to work (Preissle & Han, 2012). Through these discussions, I was able to build confidence that we had a shared understanding of procedural ethics, enabling me to focus on responding to participants within an agreed framework of empathy and care. This both supported participants’ wellbeing and reassured me of the parameters within which I should be working.

Practices of care designed with participants in mind

Facilitating an easy “no”

The informed consent process is an essential part of any research engagement, but it has been argued that particularly in qualitative research, given the interpersonal relationship between researcher and participant, withdrawal can be difficult (Duncan et al., 2009). In advance of the interview, I spoke to participants to discuss what participation involved, checked they fulfilled the inclusion criteria, explored the support available to participants if they were upset after the interview, asked if there were any adjustments that could be made to the interview process that might make it more accessible or comfortable, and provided an opportunity for participants to ask me questions. In practice, participants also used this conversation to tell me a little bit about their experiences of suicide and why they wanted to take part in the research, often beginning to develop rapport. As such, I was very conscious that the interpersonal relationship, which can complicate participants’ ability to withdraw from a research study, was also beginning to develop prior to the interview itself, and that this might complicate participants’ ability to say no to taking part in the research in the first place.

Therefore to try and make saying no as easy as possible, and to remove the pressure of a live setting, participants were not asked to confirm whether they wanted to proceed with their participation during the initial phone call. Instead, I finished the conversation by offering to send participants more information about the study, and encouraging them to discuss taking part with anyone in their life they felt it would be helpful to talk to; I then sent a follow-up email a week later and although many (24 participants) did agree to take part, in some way, I was reassured that some participants told me that, on reflection, they had decided not to.

Locating the interview: Research budgets as essential

Once participants had agreed to an interview, in the spirit of power-sharing, I gave them the choice of where and when they wanted to meet. None of the participants wanted me to visit them at home, with most sharing their housing with family, friends, or peers. I offered to host interviews in my office and pay participants’ travel costs, or alternatively to travel to participants and hire a small meeting space (e.g., in a library, college, or community centre) in a location of their choosing. The travel and venue hire were only made possible through the provision of a research budget included in my doctoral funding, and although, at first, I conceptualised this as being lucky, I now see this as an essential part of the research process without which this research would not have been possible, and therefore suggest that research councils and institutions must take the inclusion of such budgets seriously. Without research funding, I would have only been able to interview people who were geographically close to me, which would have been a massively prohibitive barrier to including a diverse group of participants.

Balancing openness and structure in narrative interviews

I designed semi-structured, narrative interviews, with an arched trajectory that aimed to finish on a positive note (Rimkeviciene et al., 2016). We began with gentle warm-up questions, before moving towards topics I foresaw as being more upsetting, exploring times of suicidal crisis and discussing what had contributed to suicidal thoughts and feelings, and finishing with topics that were positively focussed, such as what had kept participants safe from suicide and what they believed would reduce LGBTQ+ youth suicide in Scotland in the future. The questions were designed to be broad and open, balancing providing a focus, so that participants did not feel lost, with an openness to facilitate the sharing of experiences that participants felt were important to their stories of suicide. This enabled me to learn about experiences participants felt were important that I had not foreseen and therefore would not have directly asked about (Burgess-Proctor, 2015; Riessman, 1987).

To manage participants’ expectations during the interviews and to facilitate the sharing of researcher–participant power in the interview space, I designed paper-based visual aids to communicate the overarching interview questions (see Figures 1 and 2). The interview questions and paper-based resources were shared with three established charities working in the research area prior to the interviews, to gain feedback, and amendments were made accordingly. Participants were provided with the resources in advance of the interview, and although most made little use of these, some reported finding them helpful in managing their anxieties about the interview, and two participants used them extensively, planning what they wanted to cover so as not to “miss out” anything important. The paper-based resources also gave participants objects which they could use to diffuse the intensity of the interview, for example, by playing with, moving, or writing on them, which was particularly appreciated by a participant who found eye contact difficult.

OPEN IN VIEWER

Figure 1.

Paper-based resource: “topics we will cover in the interview.”

OPEN IN VIEWER

Figure 2.

Paper-based resource: “reflection wheel”.

Making space for sadness

As suicide researchers, a key concern is the possibility that we might do harm to our participants, triggering or intensifying suicidal distress. I was fortunate to have participated in extensive training courses on the subjects of suicide, self-harm, and safeguarding through my youth work role, and it was in this youth work setting that I had also been able to put my learning into practice, which I hoped would stand me in good stead to translate my skills across sectors into the research interview. Throughout the interview, I was careful to look out for any verbal or non-verbal cues that participants were becoming distressed, and respond accordingly, as a first response, offering a break. In addition, to close each interview, participants were offered a sheet signposting organisations that provide support on some of the topics covered in the interview (mental health, suicide prevention, LGBTQ+ support, and youth organisations). Further to this, I also offered participants a phone call with me in the weeks following their interview to discuss any further thoughts, feelings, or questions they had. This was not offered as a support call, but rather as an opportunity to debrief from the interview once the participant had had time and space to reflect upon it.

Although most participants appeared comfortable throughout the interview, some became upset when talking about their experiences. One participant, Ayla, cried twice during an interview: firstly, while talking about her mother's response to her coming out, and secondly, when describing her own suicide attempt. Responding to this, each time, I offered her a break in the interview, which she gladly accepted. During the breaks, we turned off the recorder, got some air, had some “small talk,” and I reassured her that she did not need to continue with the interview. However, as has been reflected more widely in suicide research (for detailed exploration of this, see Ranahan & Keefe, 2022), Ayla was motivated by a hope that in sharing her experiences, she would be able to help others, and therefore she wanted to continue. To respond to Ayla's desire to continue while also maintaining an ethic of care towards her, I discussed reshaping the interview with her to focus on what had helped her stay safe from suicide rather than reflecting on her experiences of suicidal distress and the issues and experiences that had contributed to her suicidal feelings—an approach that has been suggested as one way of making interview practices trauma-informed (Alessi & Kahn, 2022). Ayla felt that this would be helpful, and so we proceeded with this reshaping.

This process of taking time out to de-escalate participants’ distress and re-establish consent to participate in the research was reassuring to me because I viewed this as the participant prioritising her needs, taking time and space for herself. It also allowed us to discuss what she was finding distressing and to reshape the topics of the interview accordingly, which fitted neatly with the plans that I had made with my supervisors. However, other interview experiences did not fit quite so neatly with these procedural ethics. For example, during an interview, one participant, Sophie, began to cry when talking about the death of her childhood girlfriend by suicide. When I offered a break, however, she refused, saying she was “just emotional.” Although I was concerned that telling the story had upset her, she wanted to continue to talk without taking a break, and so we continued. However, I was left with some residual concerns after the interview, questioning whether this had been the right judgement call. To me, this experience raised questions about the complexity of negotiating participants’ emotions while engaging in research on emotional topics such as suicide: balancing respecting their autonomous right to choose to participate with the need to safeguard them from any possible harm that the research could induce (Lavis, 2010).

Reflecting back on this interview (and others in which participants had been emotionally moved), I have questioned my own interpretations of participants’ emotions. At the time of the interviews, I was concerned that the presence of emotional pain, distress, or agitation during an interview signalled possible harm to the participant caused by taking part in the interviews. I was also concerned that not pausing the interview, albeit at the participant’s request, was somehow a failure to adhere to the care-full approach I aspired to take. However, subsequently, I have revised this interpretation, concluding that suicide is an emotional topic involving expressions of despair, rage, and frustration, amongst many others, and that these emotions will at times become visible during the research process.

I now reflect on the urges I experienced to pause the interview and de-escalate distress, when the participant wished to continue, as a learning moment about my own internalisation of the value of research interviews as emotionally neutral spaces. I take a relational approach to acknowledge the intertwinement of my own emotions with the participants’. As such, I offer that, in the moment, such experiences could be disconcerting or even distressing to me as a researcher, as I understood Sophie's distress to be in some way reflective of a failure on my part to keep her safe from harm. However, on reflection, I see this distress as equal to the humour or matter-of-fact attitudes that other participants conveyed: just one expression of the many emotions associated with talking about experiences of suicidal distress. I now interpret being present alongside this whole range of emotions, acknowledging participants as experts in their own experiences and respecting their autonomy to choose to participate, as a key part of caring in ways that actively resist paternalism and patronisation, and embrace power-sharing.

Practices of care designed with the researcher in mind

As I hope the example from Sophie’s interview has illustrated, researchers’ and participants’ wellbeing cannot always be separated from one another: my capacity to respond to Sophie was intertwined with my own understandings of what researching with care meant in this situation, and reflecting upon and revising my understandings of what this meant was essential to my development as a researcher. In work seeking to unpack a feminist notion of care in health research, Brannelly and Barnes (2022) have argued that too often our research education focuses on methods and methodologies, and does not consider our capacity to enact care-full research as part of this. I argue that this is particularly the case in neoliberal institutions that fail to cultivate an ethic of care towards their researchers, for example, relying on early career researchers to produce high-quality research under tight time pressure, poor working conditions, and precarious contracts, prioritising productivity over researcher wellbeing (Pearce, 2020). This lack of care flowing from institutions to researchers (both supervisors and supervisees) acts as a complication to the researchers’ capacity to enact care-full research practices, such as deep engagement and involvement (Heney & Poleykett, 2021), and can leave researchers with a sense of dissatisfaction and worry (Brannelly & Barnes, 2022).

Perhaps it is somewhat unsurprising that, within this context, I had failed to mirror the clear and detailed plans I had created for responding to participants’ distress with plans for maintaining my own sense of wellness. However, I was almost immediately alerted to the emotional impacts of this work and the need for opportunities to process them when, as I began reviewing the primarily quantitative literature on the prevalence of LGBTQ+ youth suicide, I also began to dream about suicide. Although previous research had warned me that “feelings’ residues” from conducting suicide research could present in one's dreams (Boden et al., 2016), I was surprised by the ways that the anonymous deaths that I was reading about were finding their way into my dream world. This was perhaps in part prompted, as Coles et al. (2014) has warned, by my inability to help those I was reading about, instead being forced into a passive role.

To process these feelings’ residues, I turned to the literature for advice, which suggested keeping a reflective diary (Boden et al., 2016; Rager, 2005). I approached this journaling with enthusiasm, but I quickly felt lost. I had not kept a diary for years, and without an established practice, the blank page was intimidating. Not only this, but I had picked up an “I’m fine” impulse: where my first urge whenever asked how I was, was to respond that I was fine. This was perhaps owing to what I understood to be a “hidden curriculum,” in which the higher education sector's prioritisation of productivity over wellness had taught me that to be taken seriously as an academic professional, I needed to self-manage my emotions and embody an emotional neutrality.

A turning point came after attending a third-sector training on secondary and vicarious trauma, which encouraged reflections on our personal “warning signs,” which I translated into my everyday journaling practice to give it a little more structure. I reflected on the behaviours, feelings, and activities that I engage with and experience when happy and well, and the same for when my mental health deteriorates. Through these reflections, I identified indicators of my personal wellbeing, which formed the basis of my reflective journal, allowing me to check in with how I was in concrete ways, for example, thinking about my eating, drinking, sleeping, and socialising habits. This prevented me from defaulting to a statement of everything being “fine” if it was not. It was important for me to begin this process of reflecting before I started my research interviews, to establish this as a habit rather than starting too many new things at once. However, the more I engaged with journaling practices, the more I found that awareness alone was not enough.

Balancing self-care with the need for collective, community care

Although reflective journaling helped me to be aware of when and how my mental health and emotional wellbeing were affected by the research, I also had to implement a range of self and collective care practices that could respond to those emotional effects. I limited myself to one interview per day and ensured that this would be followed by the possibility of a social online or in-person activity, to give me the opportunity for distraction. I also ensured that, while interviewing, I had a simple dinner already prepared to minimise my household labour (which I called an “emergency freezer plan”). In addition to this, as I often conducted my research interviews outside of conventional working hours, as evenings and weekends were most convenient for participants, I used journal writing along with playing a song I had selected to create a boundary-marker around the start and end of the interview, this signalled to me when I was in and out of “work mode.” Although such practices might sound trivial, I found them to be essential structures to place around my doctoral research experience, which I found could otherwise become unwieldly and overwhelming, spilling over into every free moment.

Although individual self-care practices were helpful, given the emotional demands of working so closely with suicide every day, to complement them, I sought out opportunities to replicate the debriefing and reflective practices that I had found beneficial in previous roles, which have also been recognised as important for supporting researchers undertaking emotionally sensitive research (Boden et al., 2016; Dickson-Swift et al., 2007; Smillie & Riddell, 2023). It was important to me that peer support be organised within a non-hierarchical group of colleagues who had established, comfortable working relationships, to facilitate sharing our experiences and embracing our vulnerabilities (Pillay, 2023). Our reflective practice meetings occupied a separate function to research supervision meetings, which, as Camacho (2016) has suggested, are not always the place to discuss the emotional impacts of undertaking qualitative research, and instead are often more focussed on the procedural elements of designing, managing, and undertaking research projects, such as recruitment, progress, and writing.

As I was the only doctoral researcher doing suicide research in my department, I contacted three colleagues who were conducting qualitative research on other emotionally sensitive topics to try and facilitate mutual benefit from sharing. We met regularly during our research (both while undertaking interviews and analyses) to talk through challenges we were facing. The flat hierarchy within the group enabled us to be open and honest about mistakes and challenges. To complement this, we also arranged for someone to be available via phone or text for the time directly after interviews to facilitate immediate debriefing and peer support, taking care to maintain participants’ anonymity. This was extremely helpful for me and allowed me to immediately process the interviews I undertook, in which disclosures of suicidal feelings were expected as an inherent part of the research process.

The transformational potential of ethics in practice: How to introduce a care-full research approach into institutional ethics

The development of practices designed to support both research participants and researchers was a reflexive and relational process in which I worked between research literature, interdisciplinary conversations with other researchers, and the established practices of the youth work sector, to construct my own approach. Undertaking this process required self-awareness and foresight of potential challenges, relying on my previous experiences, both personal and professional, and a proactivity to seek out solutions. However, I argue that rather than relying on individual researchers to navigate these research challenges alone and find their own ways to implement practices of care towards themselves, their peers, and participants, research institutions could take the lead and create structures of support to facilitate engagement with care-full research practice. In doing so, they could transform the research relationship, demonstrating a depth of understanding of the intertwined relationships between researchers and research participants, not only recognising caring for researchers as important in its own right but further contributing to an ethic of care towards research participants. I will therefore conclude this article by suggesting some starting points for considering the types of support that could be fruitful (this is not a comprehensive list of suggestions, for this, see Smillie & Riddell, 2023).

Ethics must go beyond the ethics form. Supervisory teams should explicitly discuss ethical decision-making in practice to make expectations and responsibilities clear, easing researchers’ concerns about doing the right thing and facilitating care-full treatment of participants. One way of doing so would be working through hypothetical likely scenarios; for example, if your research subject is youth suicide, a productive hypothetical discussion could be how to respond to a participant’s disclosure of an adverse childhood experience. This will enable the development of a shared understanding between researchers, which can then be shared with RECs and IRBs for further feedback and provide a procedural framework that guide researchers’ ethics in practice.

Research budgets are not a luxury. An essential part of conducting research underpinned by a feminist ethic of care is ensuring participation that is free, accessible, comfortable, and confidential, enabling a diverse range of participants to take part. Particularly when working on sensitive topics, such as suicide research, participants should be offered a choice about the location of a research activity to facilitate full participation. This may necessitate paying for travel, small venue hire to ensure confidentiality, and reimbursement for participants’ time and labour. Furthermore, as discussed earlier in this article, a key part of feminist research is a recognition of and respect for the expertise that is developed through lived experience. Consequently, coproduction has become increasingly central to feminist health research, which again requires adequate funding. Therefore, research funding applications need to include budgets that facilitate this.

Reflexivity and relationality are key. Methods training should provide opportunities to reflect meaningfully on the practicalities of a feminist ethic of care, including providing structured opportunities to practice reflexivity. This should not only consider ethical commitments to participants but also make clear the institutional provision of care for researchers. A prioritisation of care over risk management would represent a radical shift across all research areas, but particularly within suicide research, where discussions of care have tended to be outside of our methodological literature, remaining somewhat hidden in interpersonal conversations and conventions.

Researcher care must be institutionally supported. Although researchers may have existing practices and professional support structures, each research project creates new and different demands that they will need to find ways to navigate. Rather than promoting an approach to researcher care that relies on individuals proactively recognising their needs and independently seeking to fulfil them, the institution should be proactive in providing a comprehensive overview of the support on offer that researchers can make use of, and should support research teams to consider how to create research environments underpinned by a feminist ethic of care that recognises self and collective care as integral to the research process, and not as an individual indulgence.

Collective care as a culture shift. When working on emotionally sensitive topics, such as suicide, research teams should be encouraged to set aside time, space, and resources to facilitate reflective practice and peer support. It may be useful to offer a range of frameworks for facilitation to help research teams find what is right for them.

Consider including external professional support in grant applications. Principal investigators and supervisors could consider including therapeutic support or clinical supervision in grant applications to enable external debriefing and support that may exceed what peers and colleagues are able to provide.

Points 4–6 should not be considered as something that is only offered during research activities such as interviewing, surveying, or conducting focus groups, but instead should extend throughout the entire research process, from design to writing up.

However, it is perhaps worth reflecting that although these suggestions might act as starting points to guide feminist research practice, they also speak to the broader need for a cultural transformation. For example, working with Point 4 must go beyond stand-alone provisions, such as a one-off mindfulness course, and meaningfully engage with the realities of working within the neoliberal university. This would require grappling with some of the complexities of what it means to develop care-full working practices within neoliberal institutions that prioritise productivity over a well workforce. These may not be easy considerations and are likely to further indicate the need for structural changes to mitigate some of the precarity experienced across the higher education sector, but particularly affecting early career researchers (Pearce, 2020). However, consideration of such complicated challenges, from structural transformations to the potential for everyday care-full practices, should be tackled collectively. It should involve everyone involved in the research process, starting at an institutional rather than individual level, with the ultimate aim of cultivating a more caring and compassionate research environment.

Conclusion

This article is a contribution to the emerging field of qualitative suicide research. In it, I have made explicit the research practices that often remain invisible, implicit, and thus unknown. Central to the research practices discussed in this article is a feminist ethic of care, which I have argued should push beyond the procedural and consider how our ethical praxis can centre care rather than risk. A key part of this care-full approach is seeing our ethical commitments not simply as safeguards provided by individual researchers to individual participants, but rather as a relational practice constantly circulating between researchers, research institutions, and research participants.