Mental health consumer voice through an ethical filter: a mixed-methods case study in a rural setting

The focus of this research was to evaluate the impact of a specialized inpatient mental health service in rural South Australia. A mixed-methods design included the collection of qualitative data via phone and face-to-face interviews with consumers, carers, non-government community partners, and interprofessional health workforce affiliated with the service. An online survey derived from the interview data was developed, and anonymous feedback option was collected from consumers and a standardized measure for health status included. Quantitative data included de-identified records for mental health inpatient admission, transfers, inpatient days, diagnosis, and rurality. This research methodology case study summarizes the ethics approval process, which included Aboriginal Health Research Council approval and two additional University Human Research Ethic Committees (HRECs), and considers the methodological implications of the need to protect patient and stakeholder privacy while also attempting to minimize selection bias. The complexities of contract research arrangements and how these may jeopardize collaborative research partnerships will be discussed, as will the conflicting priorities of university and government in regard to the dissemination of research findings, timeframes, and research rigor. This research case study has a rural context; however, the experience and conclusions are generalizable.