Professor Heidi Hjelmeland currently works at the Department of Mental Health, Norwegian University of Science and Technology.
What are your research interests?
They have changed quite a lot over the years. I started off my career as a mainstream quantitative, risk factor researcher but realised quickly that this won’t get me far in terms of finding anything useful. However, it was a slow process to change as I was involved in two large European multicentre studies, one on attempted suicide and one on attitudes towards suicidal behaviour and self-reported suicidal behaviour in many different European countries. But I realised I had to change completely from quantitative to qualitative because quantitative research can only scratch the surface. Many researchers tend to find the same risk factors over and over again and therefore the field seems to be sort of stuck in this repetitive risk factor research that is not getting us anywhere. So now I do purely qualitative research, or mostly I’m supervising PhD candidates to conduct qualitative research but I think that’s the way the field needs to go as this method allows you to take into account more of the context and explore the complexity involved in suicidal behaviour. We should stop pretending that we are going to be able to find all of the relevant risk factors for suicide and put them together into a predictive model to predict suicide. I don’t believe that is possible. I believe that we need to study suicide in a life history perspective, which means we need to have qualitative research. We need to conduct qualitative research with people who have lived experience, or have been bereaved by suicide, to tell the story of the suicide. In case of the latter, the common way this has been approached is to conduct psychological autopsy studies by interviewing one or two close relatives of the deceased person, mainly to look for psychiatric disorders. However, that is not a good approach. I have participated in three qualitative psychological autopsy studies in Norway, Uganda and Ghana and we found that if we interview five people around the same suicide, we might get five different stories about that person’s suicide. Alternatively, if we interview four members from the family we might get four similar stories, for instance, but then when you interview a close friend, it turns out that they have a completely different story. For the family members it might be important to keep up a façade, whereas a friend might have no problems revealing a family secret of sexual abuse, for example. This showed that it is important to have several voices, covering different types of relationships when conducting psychological autopsies. However, it is also important to conduct research with people who have first-hand experience, by exploring the life stories of people who have experienced serious suicidal thoughts or made suicide attempts too. This will allow us to understand more about their lives and the context surrounding the suicidal acts so that we can understand what suicidality is all about for those who are suicidal and then I think we will be better equipped to prevent suicide.
You know, you often find that the most passionate anti-smokers are people who previously smoked. Whilst I have never smoked, I was a quantitative risk factor researcher but now I find that such research has little to contribute with regard to how we can understand suicidality. Of course, we need epidemiological studies, but I really think we have more than enough risk factor studies.
What would you say are your career highlights?
The work I have been doing now for the past twenty years in Uganda and Ghana has definitely been a highlight. I have had a great pleasure to supervise PhD candidates from those countries, in which they have come to Norway for their PhD, but collected data in their respective home countries and then returned home after their PhD to continue their work. Over the years we have developed a group of strong researchers from Ghana, Uganda and Norway, and even though we are currently out of funding we have remained as a group. Wherever we have a chance we will bring each other in to our work. Even though it has been challenging in many ways but overall it has been so rewarding and I have learnt so much from them. I am incredibly proud of what we have been able to achieve with very, very little money. We have organised dissemination workshops because we need to get our research findings out there so that it can make a difference. And these workshops have not just been for students, or psychologists, or psychiatrists, or nurses, or religious leaders, for example, but once we also held a workshop in a village. We returned to a village in Uganda where we had conducted the research in order to share our findings back with the whole village. That was truly one of the best experiences I have had in my working life, because then we could see the impact of what we do. This brings me to another point that I would like to raise, which is what I refer to as Impact Factor fetishism. When you look into how this system works you can see that it can be manipulated and it is not a reliable indicator of quality. From my position I can choose to ignore that. I can prioritise getting the knowledge and findings from the research conducted by our group out to people who need to know about it. If that’s a journal or some kind of report with no impact factor, so be it. It will be important for the people who can access this work, so again, that’s something at my stage of career I can choose to do, but if you are an early career researcher then you are more likely to be pressurised to go for high impact factor journals. The problem with this is that it is often the high impact journals that have to retract published articles because they are pushing to publish quickly. It makes me feel so sad that this is where we have our focus. This publish or perish thing leads to so much rubbish research because researchers are pressured to publish a high number of articles, rather than producing quality work which will really move the field forward. Instead of repeating for the hundredth time that depression is a risk factor for suicide, developing some new knowledge is much more important.
And how about career lowlights?
In terms of the lowlights, it is so incredibly difficult to get funding for the type of research I do, it’s an uphill struggle all the time. I think the absolute worst thing is that there is so much resistance from the people in power toward some new insight or critical thinking. I think that’s a problem with this field. They really don’t want to have their own truths questioned, and they use their power. This can be journal editors, research managers, or funding agencies, and I have seen so much of this since I have started writing critically. It is incredibly difficult to get published, and you can see it from the reviewers’ statements and the editorial decisions, the reasons they use to reject your work are completely absent of scientific argument. It’s all about politics, power and vested interests. I have actually published an article about that (which was covered at a netECR journal club). I have had various reactions to that article. I knew it was going to be controversial, but we had a rare opportunity because of a special issue focused on critical suicidology to get a piece like that published. So, I took the opportunity and thought, OK some people may hate me for this, or think I am stupid or whatever, but so be it. I don’t care anymore. It is important to show people what is going on and most of the reactions have been positive.
As academics we should be having open debates to hear the viewpoints of people who disagree with one another, both at conferences or in journals. But those in power do not want that, they shut it down and in my view that is not just unscientific but also unethical.
The times I have been involved in debates, I have had some unpleasant experiences, people have so much to defend so when they run out of arguments they start attacking the person instead of arguing their argument, so that became very, very unpleasant. The team on my side of the debate tried to approach it in a bit more of a light-hearted manner, but the other side were so serious and started attacking the person instead of the argument. So then I regretted being involved.
But I think we need to hear more of these discussions, both in journals and at conferences. Because I am sorry to say, but at conferences it tends to be the same old men, saying the same old things. I have been arguing about that for years. When I was Vice-President of IASP I was involved in the planning of two conferences and I argued that we should have more women. I mean there are so many clever, brilliant women working in this area, we should be aiming at 50:50. But this was seen as impossible; because others felt people would expect to hear from the same old men. I said no. I don’t. I want to see more courage from conference organisers to invite not just more women to present, but also newer faces. Perhaps people maybe from outside this field who can offer a viewpoint from a different perspective. Not just the same old, same old. And I am not talking about one particular conference, but this seems to be the pattern across most conferences with few exceptions.
What advice would you give to early career researchers working in suicide and self-harm research?
That is a tricky one, because of course I would like to say “Please start working to change the field. Please skip all this repetitive work, and predictive models that are never going to work anyway, and look to qualitative work, which also allows us to take the cultural aspects on board”. But I realise that this is very easy for me to say because I have a permanent position as a Professor, and I fully understand the need to be strategic at this stage of your careers because you might struggle to get a job, or get funding. So I can’t say that. That can’t be my advice, as much as I would like it to be.
I do understand that people need to have jobs and research funding, so my best advice would be to do whatever you need to do at this stage, but to try to be creative and look for ways to smuggle in some qualitative component as part of your project which will help to advance our understanding of suicide.
That aside, the key thing I would advise everyone to do, is to question well-established truths. Even though that may sound obvious, as that should be part of our duty as researchers, there are powerful forces working to prevent that in order to keep the status quo and retain their power.
This is why I feel unable to give advice which could destroy peoples’ careers before they have even got started.
What are the key things you look for when hiring ECRs?
One is passion. I don’t want someone who just wants a PhD and doesn’t care about which area it is in. I want someone who is passionate about the field. The second thing I look for is a critical mind, someone who is able to question well-established truths, or question my ideas and thinking. This isn’t something I just want, it is something I expect. It is your job as a researcher. In our group this is something that we do with respect so that even if we have different viewpoints and really vivid discussions, sometimes with a high temperature, we can then all sit down and have lunch together afterwards. It doesn’t affect our relationship. This is the way it should be.
What would you describe as essential to your wellbeing?
To have some form of support, because there can be some tough times in academia. Speaking from my own experience, I really hit a wall and then I needed to take a year out. This was because of all the pressure and resistance at all levels so to have some support is just essential. If it hadn’t been for the critical suicidology network we have formed, with members across the globe working together to change the direction of suicide research and prevention, I probably wouldn’t still be a suicide researcher. I am so fed up with all the resistance towards new thinking and all of the different strategies that are used to keep you out. So to have a forum or group that you will get support from no matter what you say or do, that is so essential. So with your network of ECRs if you can be that for each other, be there for each other in tough times, I think that’s crucial. All of the competition in research, fighting for the same funding and grants, it can be really difficult. So to have a group of colleagues, who understand, can support you and be there for you is essential. I couldn’t do this work without that.
Interviewer: Donna Littlewood (@donnalittlewood). Donna has a PhD in psychology and is a Research Associate at the NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester (firstname.lastname@example.org).
Cover Photo: Hovedbygningen (NTNU) sett fra Gamle bybro on Wikipedia.