Doing Critical Ethnographic Research on Violence in Inpatient Mental Health Care as a Service User Researcher: Reflections on Methodology, Relational Ethics and Politics by Dina Poursanidou

I am a service user researcher. Since February 2015 I have been working at the Service User Research Enterprise (SURE), a research group at the Institute of Psychiatry at King’s College London.

Real Knowledge

The uniqueness of SURE lies in the fact that all of its members are both mental health service users (ex-service users or current service users) and academic researchers.

I have a 3-year postdoctoral research fellowship and as part of this fellowship I have been conducting an evaluation of how a violence reduction programme has been implemented on inpatient psychiatric wards in London and in Devon (that is, I have been doing a process evaluation).

For the evaluation I have been using ethnography, a research approach that is well suited to the study of cultures and institutions – in my case, to the study of inpatient psychiatric wards and their cultures.

In the context of this ethnographic evaluation, I have spent  long periods of time on a number of  different inpatient wards in London and in Devon, observing what was going on in the wards, the interactions between ward staff and service users, service user group activities and key staff meetings. I have also spent hours talking informally (‘chatting’) with ward staff and service users, as well as doing formal interviews with them.

Since April 2016 (when I started the ethnography) I have been reflecting a lot on and speaking (at conferences and research meetings) about the methodological, ethical and political challenges and dilemmas I have encountered in the process of carrying out service user-led critical ethnographic research on violence in inpatient mental health care. Some of the questions I have been interrogating are:

  1. How to negotiate the need to constantly oscillate between being immersed in the settings I observed, on the one hand, and ‘making the familiar strange’ by adopting  a critical distance and problematising what could be taken for granted (including my  own lived experience and experiential knowledge of inpatient care), on the other?
  2. How can I  manage the emotional labour and profound emotional cost of using my own lived experience/subjectivity as ‘an instrument of knowing’ and understanding (expected of me as a service user researcher) in my mental health ethnography?
  3. How to reconcile the political and ethical position of being an ‘engaged’ (intellectually, emotionally, sensorily, relationally and politically engaged with the subject of my inquiry) researcher and (dare I say) a service user ally with the need to be dispassionate, detached and critically distant for a large part of my ethnographic work?
  4. How to use  my lived experience of acute inpatient care and my experiential knowledge of coercive/violent practices constructively in my ethnographic work – without being overwhelmed by the feelings associated with this knowledge , i.e. anger, grief and terror?
  5. To what extent can I claim that I have been doing ‘non participant observation’ on my study wards when I have often-albeit unintentionally on my part-been pulled into the dramas that take place on these wards, which raised acutely difficult issues of ethical responsibility for me?



The powerpoint I have attached here (Doing an ethnographic study of violence in mental health care as a service user researcher) contains my reflections on these and other questions that my ethnographic study has raised for me.