Written by Jed Winstanley, Honorary Research Assistant at the CARMS Project
Prior to the lockdown I had the opportunity to sit down and have a chat with Alaina Chaudhry, Sarah Evans and Orla Gleeson to find out what being a research assistant (RA) for the CARMS Project involves. Whilst typing up our conversation I thought it’d also be interesting to find out how their jobs have been impacted by the governmental guidelines put in place in response to the COVID-19 pandemic. Read on to find out more…
The CARMS Project[1] is unique in that it encompasses two types of research, known as ‘quantitative’ and ‘qualitative’. This article will focus on the quantitative arm of the project so I’d like to begin by outlining what quantitative research is. Quantitative research involves taking measures (often using questionnaires or surveys but sometimes also structured clinical interviews) of various things (such as opinions, experiences or behaviours) and generating numbers/scores to analyse in order to address specific research questions. Sarah, Alaina and Orla are researcher assistants on the quantitative arm of the project.
Sarah kicked off our conversation by telling me ‘we’re all research assistants… there’s four of us and I’m pretty new so I’m still learning the ropes… but at the minute we’re focusing on recruitment so a lot of my time (when we first spoke) was spent focusing on identifying potential participants, screening potential participants to see if the study is a good fit for them, and checking in with care-coordinators.’
We then got onto how each of the RAs studied psychology as an undergraduate and came to work within the CARMS Project:
Alaina: ‘pretty much everything I’ve done has been within mental health… it’s always something that has interested me… it kind of hits close to home because it is personal for me… before CARMS I was with Self-Help Manchester, where they have drop-in groups for people with any form of mental health problem like anxiety, depression, schizophrenia, things like that. It was just kind of like a help group where people could come and talk about their experiences. Then after that, I got onto CARMS and have been following this path for a while now.’
Sarah: ‘I’ve worked in mental health for a while, but I took a gap in the middle and I taught abroad as an English teacher. I did that for a bit so I’ve not been solely just mental health, but the last few years I’ve had previous assistant posts, support worker stuff, sort of advice phone line things as well.’
Orla: ‘a lot of my most recent work has been in mental health. I’d been at an inpatient unit working on and off across eating disorders and acute services probably for about five years for the NHS bank when I went to uni and I also worked in a few bars – I enjoyed that… my route to CARMS was a little different. I applied for the Talk, Understand, Listen for In-Patient Settings (TULIPS) trial first because that project is about looking at how they can improve access to therapy on inpatient units and that’s kind of what I was doing already at Priory Hospital Cheadle Royal, so I thought I’d give it a go. I didn’t get the interview but Katherine Berry put my name forward for CARMS… until then hadn’t really heard much about it but I did my research on it, went to the interview and absolutely love it now – which is really, really good. It’s completely different from anything that I was doing before so it’s worked out well.’
In keeping with the title of this series of blog posts, when asked what a typical day as an RA involves Orla told me, ‘a lot of chasing, organising, trying to assign participants to members of the CARMS team … then when we’re in the interview, seeing participants to finding out where they’re at and what their situation is like for them at that moment… that’s really good when we can get to that point.’
However, this was a typical day prior to the COVID-19 crisis being declared a pandemic. The UK government has since rolled out guidelines to prevent the spread of the Coronavirus. This includes the advice to stay at home as much as possible and work from home if you can so I was interested to learn how this guidance has impacted the CARMS Project.
Alaina: ‘Covid-19 and the government guidelines has completely changed the operations of how we conduct our approach and more specifically our assessments. The biggest change is that we now do our usual face-to-face assessments over the phone and this creates new challenges for us. We are no longer on the road visiting participants. We are still able to collect our data and do what we did before – the only difference to me is the way it is now conducted.
We are all currently working from home and keeping on top of communication within the CARMS team via MS Teams and Zoom. Our supervisions and catch ups are now over video calls and we have kept daily communication within the RA team.
The NHS trusts have temporarily suspended face to face contact with service users for research purposes, for both ours and the service user’s safety. We have adapted our protocols via making amendments and creating new protocols based around conducting telephone assessments. Additionally, we have included new questions based around COVID-19 to help give us a guide as to how it is affecting each individual, with the hope this information will be used to provide some context to the current information around suicidal experiences and mental health we are collecting from participants. Also, it could be used for an additional research project focused around the impact of COVID-19 on mental health, including, suicidal experiences.
CARMS has prioritised the need for constant communication and including stricter measures when it comes to collecting data.’
Orla: ‘everything has changed a lot however we are keeping going and have been given the go-ahead to start recruitment again (which was put on hold). We’ve had to change how we gain consent from participants – to be able to do this remotely. I think overall it’s good that we are able to do most of our work from home and on the phone but it’s nothing like face to face!’
I noted a consistent theme whilst discussing their roles as RAs to be a clear enjoyment of meeting with service users and following along their journey throughout the CARMS trial. Alaina said, ‘I really like seeing people… being out there in the community, having really different days and having those full interactions with people. And I like it more when people are so happy when we’ve left them… it’s nice to see that they’ve enjoyed the interaction as well… it’s something that may be really, really positive for them. That’s a good part of it.’ Orla added ‘You speak to people about some really difficult things and they might find it quite hard…. But then they’re like thank you so much for listening to me, not asking questions… just letting them share their story I guess. And you forget how much of a positive impact that can have on someone regardless of how much they’re going through.’
We also spoke about the challenges of working as an RA and Alaina told me, ‘you have to be so organised because we’re essentially managing our own time… we’re picking appointment times and trying to spread it through the day then finding enough time to come back and do our admin things on top of seeing, calling and emailing people… so you do have to be on top of it.’ Orla explained this further, ‘it’s a bit of personal development in managing your own time and being on top of what you can do and how you’re feeling with it as well… because if you’re feeling overwhelmed, it’s going to be very hard to sit down and talk to someone about difficult things’, then went on to briefly describe the differences between a research role and a clinical role:
‘I think I found the organisational aspect challenging to start off with coming from a place where you work in a service and you do your groups at a certain time every week, day in day out… sometimes the group module might change, but overall nothing much changes. Whereas here, you don’t know what your day is going to be like, you don’t know if you’re going to get cancelled on three times, you don’t know if everyone’s going to turn up… so you have to be really on it with the organisation.
I think at the start I was trying to book too many people in ‘cause you don’t want to let people down and not see them as soon as you can but then there’s no time to do all the files, and everything goes on… so you’ve got to really be managing your own time and making sure that you’re not bending over backwards to see people when you can see them the week after… you can like spread it out so that you can be more there for the appointments I guess and you end up getting more done… I do like it managing your own time because it’s different but it’s also been a challenge.’
The differences between a research and a clinical role in the vast arena that is mental healthcare is something that Sarah mentioned when I asked whether the RAs had learnt anything about themselves since becoming an RA, ‘I’ve never had a research position before and everything I’ve done prior has been clinical work… so a difference between a clinical role and a research role is like when you’re sort of sat there with somebody that is distressed and upset and you want to do all the interventions that you know, and you think, ‘Oh, I could help you with this’… but actually, as a researcher, you have to really step back from that… that’s been that’s been hard but also an important lesson in terms of unbiased research.’
Alaina expanded on this and alluded to the emotional impact that working in a research position can sometimes have, ‘one of the hardest parts of the job is you’re going in to see someone asking them to tell you exactly how they’re feeling, exploring their suicidal thoughts, things like that and then you are just eventually leaving them… as much as you kind of try and have a bit of a chat with them there’s always that kind of thought in the back of my head that I’ve just kind of made them think about distressful things.’ Orla offered that, ‘setting expectations from the offset with service users and how it’s going to be and how much you can and can’t do is quite important’ then went on to say, ‘I’ve never worked in the community before and I didn’t realise how much people can be living with and not be in hospital and be kind of managing at home. I didn’t really realise it before I started this job.’
We concluded with the RAs briefly telling me how they like to relax and unwind outside of work. Orla enjoys ‘the pub, pub quizzes… and a bit more recently swimming… I found that it clears my head quite a lot and so quite enjoy that.’ Sarah likes ‘Japanese anime, sci-fi novels and astronomy’ and Alaina likes nothing more than ‘going home and putting Netflix on.’
I’d like to thank Alaina, Orla and Sarah for taking time out of their busy schedules to help me out with this blog post!
See you next time for ‘A Day in the Life of… A CARMS Qualitative Research Assistant’: Leanne Cook tells me all about the qualitative research she has been working on as part of the CARMS Project.
References:
[1] Gooding, P.A., Pratt, D., Awenat, Y. et al. A psychological intervention for suicide applied to non-affective psychosis: the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial protocol. BMC Psychiatry 20, 306 (2020). https://doi.org/10.1186/s12888-020-02697-8