Reflections on moral care when conducting qualitative research about suicide in the United States military

Abstract

Critical suicidology (White, Marsh, Kral, & Morris, 2016 ) offers a critique of positivism as the mainstream rhetoric of scientific research. In this article, the authors add a critique to the moral detachment of scientific inquiry (Wilkinson & Kleinman, 2016 ) in suicidology. They provide a discussion at the intersection of theory and research when considering moral care of all stakeholders in the implementation of suicide research toward the development of more humanitarian policies and program alternatives. The authors reflect upon their experience of conducting an Interpretative Phenomenological Analysis (Finlay, 2011 ) on suicide in the U.S. military.

Putting Suicide Policy through the Wringer: Perspectives of Military Members Who Attempted to Kill Themselves

“…Our work was completed to identify other ways military mental health policy leaders can respond to individuals and apply insider knowledges to the ongoing transformation of mental health policy and its practices, lacking in their internal practices. The core of our research centered on the investigation of secondary information from existing transcripts capturing the collaboration with seven military service members who offered accounts of their lived experience centered upon what was helpful in moving toward wanting to choose life after being identified as suicidal in the military system [7]. The participants included seven individuals, three women and four men ranging in active duty service from two years to over 20 years.…”

“…Suicide is viewed as caused by mental illness [2,3]. This understanding then creates a context for military policy and the way service members are treated to evolve from a hierarchical expert position of mental health researchers and mental health providers without input from the members seeking help [4,5,6,7,8]. The goal of our research was to take a different approach, agreeing with and responding to the Air Force Surgeon General’s call [9] that for continued transformation of military medical policy and services, it is vital and critical to ensure that the perspectives of those with experiences in our medical system are legitimized and considered in ongoing production of knowledge informing policy transformations.…”

“…Our work was completed to understand ways military mental health policy leaders can respond better to individuals and apply insider knowledges to the ongoing transformation of mental health policy and its practices, now lacking in their internal practices. To this end, secondary information—historical transcripts of individual interviews with service members who shared their experiences when identified as experiencing suicidality from prior research completed by Tirzah [7] were revisited for further analysis.…”

“…While understanding suicide from the medical perspective has no doubt saved lives, it has inadvertently created a circular loop in the continued national and military policy responses of suicide as being largely understood in the context of mental health pathology controlled and privileged by mental health professionals requiring continued mental health problem solving [4,5,6,8], overlooking other perspectives, in this case service members’ perspectives of military mental health policy and suicide prevention efforts. Military leaders recognizing the lack of voices of those who have lived experience and are most able to inform what would be helpful in our internal military policy transformations, asked us to collect their experiences as an initial step to resolve this [7].…”