I think back to a recent interview with a national mental health research funder. In the interview I was told that my research was “so left-field it was out of the stadium” and that I would have intense trouble trying to convince funders to support research into exploring racially inclusive approaches to Patient and Public Involvement. My approach and my research were torn apart in 90 minutes of critique. Ultimately, this critique had the potential to be constructive. However, it lacked compassion as I felt disillusioned and devalued within health research. I felt as though my approach was maligned and, talking about racial inclusion with four white academics, I felt marginalised.    

Introduction 

After I published my first article, an introduction to myself, my research interests, and my community work, I began thinking about a way to structure the subsequent series. Through discussions with friends and my brilliant mum, we finalised a plan which brought together reflection and action through a values-based approach to research. 

As such, my pieces will be structured around a particular value: how it relates to my experiences, how it presents in mental health research, and how we can use such values to reflect upon and shape our practice. As with all concepts, such values are open to interpretation. This is openly welcomed and encouraged in your engagement with this piece.  

In this article I will be reflecting on the value of Compassion in my approach and experiences of mental health research. 

Contemplating compassion 

I have the privilege of being an Amritdari (initiated) Sikh. Born and raised in a household which centres its reflection and action upon the Sikh Dharam (faith), values-based discussions were commonplace during my upbringing. As someone who is naturally curious I have always questioned the possibilities and limitations of these values, including how they are often reduced to platitudes and phrases and how in some cases ‘values-speak’ is weaponised against the most vulnerable and disenfranchised. For much of my upbringing this led to me feeling disillusioned with such concepts and ultimately cynical about their place in the world.  

However, I recognised that the world we live has a tendency to identify, co-opt, and regurgitate the language of social change, leading to its recalibration to serve the status-quo. Although this is disheartening, the battle for meaning is not lost. As such, I started using my faith-based foundations to reassess and reconstitute my approach to values and their place in my daily practice. 

While entire books can be written on definitions of compassion, I will try to keep mine succinct. Alongside my immediate family, the first Sikh Guru, Guru Nanak Dev Ji, and their steadfast approach to naming and acting upon social injustices alongside the writings of bell hooks and Leah Lakshmi Piepzna-Samarasinha have been foundational to me. In my understanding, compassion means seeing the joht (divine light) in all and ensuring that our interpersonal relationships are reflexive, understanding, and founded in hope. However, my compassion is also aware of structural and systemic inequities as well as the wholesale change needed to work towards compassion-based systems and infrastructure.  

My compassion emphasises a critical compassion and a compassionate critique to work towards a better world for all.

Presenting compassion in mental health research 

Compassion in mental health research can open possibilities, partnerships, and potential to make change. While mental health researchers may be motivated by a range of factors the case for compassion is there for all.   

Interpersonal compassion in mental health research 

Many activists and advocates I have worked with in lived experience, patient and public involvement, and user-led movements are actively challenging the status quo and established ‘ways of doing’ mental health research. Traditionally seen as ‘outsiders’ in research spaces, these individuals and communities have been compassionate and critical in their approaches which are ultimately aiming to work towards mental health research which is equitable, accessible, responsive and reflective to those it serves.  

I have also worked with mental health researchers, especially those who do not identify with survivor and user movements, who show consistent compassion in their interpersonal engagement. This is particularly true of those who work in open, transparent and reflective ways with those who have lived experiences of mental health challenges. As such, these researchers may experience additional pastoral responsibilities which go beyond their work remit. However, despite this, they are still able to work collaboratively towards positive research experiences and outcomes across the team. 

In these instances, interpersonal compassion in mental health research can help to forge lasting relationships, it can enable active and open listening to ensure all team members feel welcomed, and it can facilitate effective communication amongst all parties. Interpersonal compassion in mental health research may present as patience, pastoral care, sharing time and resources, as well as communicating intentionally with all involved.

Enabling compassion centred infrastructure 

However, compassionate mental health research does not cease at an interpersonal level. Mental health research systems, too, must enable the development of compassion-centred infrastructure which require longer term strategic and deep thinking. Interpersonal compassion is unfortunately not enough when tackling the bigger and knottier issues which face mental health research: demanding deadlines, disempowering funding models, selective methodologies, and one-dimensional views of preferable research outcomes.  

Working in such systems can also harm the potential for interpersonal compassion presented in mental health research. Demanding deadlines can constrain the time and patience needed to develop fruitful relationships in mental health research whilst perpetuating exploitative practice between research teams and those being ‘researched’. Disempowering funding models can limit the types of expertise to be included in a research team, potentially impacting remuneration for lived experience/user-led input and plaguing those relationships into one of resource constrained extraction. Finally, all of these systemic issues can perpetuate exclusionary mental health research practices which further disenfranchise those who have already experienced multiple forms of exclusion.  

Overworked researchers, inadequate systems, and looming deadlines can create fatigue, reduce reflexivity, and dampen the spirits of those involved with research. This ultimately creates a vicious cycle in which interpersonal compassion is lost and compassion-centred infrastructure becomes ever distant. The world constantly demands more of us, but at what cost? 

A plea for compassion across mental health research 

Compassion is easy to talk about and much harder to practice. We can display interpersonal compassion but still work within systems that are far from compassionate. I have found that when I work in challenging systems, it is harder for me to be patient and interact compassionately with others. To put it bluntly, I, like many, become too tired to be properly present and go that extra mile. 

However, in such moments, compassion can present a moment of hope, of change, of potential. I have found myself taking a moment before meetings to stop, breathe, reconnect with myself. Using my internal support, learnt with my family and faith, I try to recalibrate and be present in whatever comes next. Our world will try to extract our labour, our energy, our imagination, and our capacity for compassion. In mental health research we have an opportunity to redirect compassion back into our approach, our practice, and our lives more widely.

My recommendations 

To students who may feel dismissed or disillusioned, connect with your peers and other research staff who may have faced similar challenges. Look both within and outside of your institution for spaces which are nurturing and uplifting. Look to platforms like The Mental Elf which supports research communities and read books like Sara Ahmed’s ‘Complaint!’ which is a powerful exploration of navigating power in higher education.  

Research and support staff may hold additional extra-role pastoral responsibilities and often have to pick up the pieces from the consequences of systemic research issues. As well as fighting for adequate working conditions and pay, research and support staff should have access to supported spaces, networks, and skills which can help them navigate and change mental health research for the better. Recently the Wellcome Trust shared some fantastic opportunities for innovative mental health research focusing on issues from cell, to society, and to systems more widely. 

To funders who shape the landscape for knowledge creation in mental health, you have the biggest opportunity to shift research culture and enable the development of compassion-centred infrastructure. Traditional funding mechanisms demonstrate bottlenecks when it comes to user involvement, translation, and implementation of key findings. We must think differently and be bold in our research funding. Organisations like Lankelly Chase and the International Alliance of Mental Health Research Funders are two groups attempting to do things differently in mental health funding. 

The question of compassion is there for all, no less those across the mental health research landscape. This question is central to how we advance mental health research alongside those who have been consistently disenfranchised. Unless we enable the development of compassion-based infrastructure we will be unable to make sustainable change. Through reflecting on our research systems as well as interpersonal relationships, let’s work towards a mental health research landscape which is dynamic, conscientious, and uplifting to all.

I will use bimonthly posts to share my honest thoughts on PhD life for someone whose work spans several areas. I am lucky to be supported and supervised by three inspirational figures, Professor Trish Greenhalgh, Professor Kamaldeep Bhui and Dr Nayanika Mathur.  

If you have any questions, please post a comment below, or you can email me on: shuranjeet.takhar@phc.ox.ac.uk

Photo credits

• Photo by Mona Eendra on Unsplash
• Photo by Eddi Aguirre on Unsplash
• Photo by Tim Mossholder on Unsplash