Dealing with Ethical Concerns in Suicide Research: A Survey of Australian Researchers

Abstract

Given the increasing trend in suicide mortality and its burden on individuals, families and communities, ethically sound research is crucial to improve the prevention of suicidal behaviour. However, few studies have looked at the experiences of researchers in obtaining ethics approval for their studies. This study addressed this gap by investigating researchers’ experiences in obtaining ethics approval and how they dealt with the concerns raised by ethics committees. Respondents were recruited from September to November 2018 through the Australian Suicide Prevention Research Leaders Network, and 33 respondents (35%) completed the study survey, comprising forced-choice and open-ended questions. Respondents most commonly reported concerns from ethics committees regarding potential harm to participants and researchers’ responsibilities to participants within the context of intervention and evaluation studies. Most researchers modified their ethics application and/or consulted with their ethics committee to reply to the concerns raised. Most respondents perceived the impact of the modification as positive or neutral. The study concludes that researchers may anticipate potential concerns of ethics committees. Improved understanding of how ethics committees work and dialogue between researchers and ethics committees should sustain the quality in suicide-related research.

Ethical issues and practical barriers in internet-based suicide prevention research: a review and investigator survey

“…Unique issues were also identified; for example, the assessment and management of risk, appear to be more complex in internet-based intervention studies compared to face-to-face studies, particularly where the amount of contact between participants and the research team or a third-party mental health professional is limited. Interestingly, issues relating to safe storage of data or participant competency to consent did not emerge as prevalent themes; this contrasts with the literature regarding online and suicide prevention interventions more generally [14][15][16]32]. A key finding of this study relates to the limitations associated with adequately managing participant risk, which typically involves collecting participants' contact information together with information about other mental health or medical professionals involved in their care.…”

“…In Phase Two, lead and senior authors of all studies identified during Phase One were invited to participate in an online survey. Following Andriessen and colleagues [14,15], researchers who participated in the survey will be referred to hereafter as "respondents"; "participants" will refer to the participants of their studies.…”

“…The ethical and practical challenges associated with suicide research are well-documented, with vulnerability of the population, the potential for adverse events, competency of participants to consent, and researcher liability among some of the key issues [11,12]. Studies that have consulted with research ethics committee members and researchers have therefore unsurprisingly found that research ethics committees, when reviewing applications to conduct research, are particularly concerned with potential risk of harm to participants posed by the research procedures or intervention (including their potential to induce distress or suicidal ideation) and researchers' ability to respond in the case of distress or risk [13][14][15]. In order to navigate the ethical and practical issues, and anticipate or address the specific concerns of research ethics committees, researchers in suicide prevention often implement strategies such as excluding participants who are deemed to be at particularly high risk or employing strict safety protocols that may deter some people from participating (e.g., due to privacy concerns) [10,[14][15][16].…”

“…Studies that have consulted with research ethics committee members and researchers have therefore unsurprisingly found that research ethics committees, when reviewing applications to conduct research, are particularly concerned with potential risk of harm to participants posed by the research procedures or intervention (including their potential to induce distress or suicidal ideation) and researchers' ability to respond in the case of distress or risk [13][14][15]. In order to navigate the ethical and practical issues, and anticipate or address the specific concerns of research ethics committees, researchers in suicide prevention often implement strategies such as excluding participants who are deemed to be at particularly high risk or employing strict safety protocols that may deter some people from participating (e.g., due to privacy concerns) [10,[14][15][16]. Participants at elevated risk for suicide are also commonly excluded from intervention studies targeting other mental health conditions, such as depression [17,18].…”

Ethical Concerns in Suicide Research: Results of an International Researcher Survey

“…The scant research studies on this topic have revealed a core tension (Andriessen et al, 2019; Lakeman & Fitzgerald, 2009a). While the need to conduct suicide-related research is widely acknowledged (World Health Organization, 2014), the thresholds used to balance ethical issues may differ between researchers and research ethics committees.…”