Professor Kamaldeep Bhui, from the University of Oxford, is one of the leads of the MARCH network’s Special Interest Research Group (SIRG) Interdisciplinary Research Methods.
His research priorities include multimorbidity, ethnicity, health inequalities, complex interventions. I had a chat with Professor Bhui to pick his brain about the merits of interdisciplinary research, the challenges that researchers can face in this realm, what network ecosystems can offer and where we go from here.
I sat down with Kam to get his take on why interdisciplinary research is so important, particularly when addressing structures of inequality. Kam provides his thoughts on how the UK research landscape could change for the better, and where go from here.
JJ: Professor Bhui, thank you so much for finding the time to sit down with me. I want to dive right in. You chair a March network SIRG called ‘Interdisciplinary Research Methods’. Why is interdisciplinary research important?
Kam: Okay, so when you’re talking about mental health you inevitably are considering something interdisciplinary straightaway. Because the drivers of mental illness are so multifaceted – they can be social, psychological, biological, environmental, geographical, political etc. And so you have to be thinking of all of those spheres of influence and drivers, and need to be working with people who are experts in the various fields.
Outside of research and in practice, mental healthcare is already inherently interdisciplinary. You’re working with nurses, psychologists, social workers, support workers, and you’re dealing with housing agencies, welfare, police etc. I am interested in ethnic minorities and inequalities, people who are more likely to be criminalized through mental health issues and come through the criminal justice system, and one of our projects – which is trying to reduce the use of the Mental Health Act in minorities – involves the police, social workers, communities, carers in psychology, nurses etc. So interdisciplinarity is inevitable in the real world. And therefore the research should reflect that really, if it’s ever going to be useful in the long term.
J: You are the director of the Synergi Collaborative Centre, whose mission is to ‘reframe, rethink and transform the realities of ethnic inequalities in severe mental illness and multiple disadvantage’, and you have spoken about this work at a meeting of the SIRG. Within this context – inequalities – why is interdisciplinary work particularly important?
K: I think because inequalities, a bit like mental illness in itself, are driven by multiple structures, political factors and health problems. And if you do research in isolation, it has to be implemented into a real world setting where, as we’ve already touched upon, interdisciplinarity is essential.
But more than that – we partly fail to tackle inequality because we conceptualise the problem in the wrong way. And so empirical work around improving understanding of what is driving inequalities is needed. And therefore interdisciplinarity is a way of exposing revealing issues that we wouldn’t otherwise spot.
J: So by all accounts, it seems like you are of the opinion that interdisciplinarity is a vital tool in the research world’s arsenal. That seems to be the growing consensus amongst the researchers and funding bodies who I’ve spoken to. So what is stopping more of it happening?
K: Well, the short answer is that it is not an easy thing to do. What makes interdisciplinary research so important also makes it difficult – everyone’s coming at this from different perspectives and backgrounds.
This means that there are different vocabularies – does ‘mental health’ refer to emotional wellbeing, contentment or absence of mental illness? – different measures of success and outputs, different traditions of how work is undertaken in research and practice, and even the distinction between the two.
People from different backgrounds and experience will naturally have different motivations and be interested in different parts of the work and therefore have different incentives. And getting around these requires time, patience, personal relationships and the creation a very organic synergistic process. And it requires the constant sort of negotiation of positions, identity, power, resources. All of these things go into it on a constant basis.
J: Clearly, there is significant complexity when it comes to working in a truly interdisciplinary way. It seems like this appreciation of its merits is fairly new – is the system, the industry, the institutions set up for this kind of thing?
K: First of all, I want to state that the system we have in place, whilst flawed, does incredible work and produces some amazing research – just to get that in there.
But with interdisciplinary work, from a funding perspective, most calls come from a single research council – and there is a problem where people see research in a particular paradigm and there are even differing ideas of what research is. So MRC will be interested in trials whereas ESRC will be interested in quantitative data with a different level of depth. And you often see calls from the British Academy or ESRC saying that they want a Humanities and Social Sciences Department doing this work. So in the way things are structured, there is already a disciplinary divide. A step in the right direction would be more cross council funding calls, more collaboration at the funding council level which can then trickle down to the researchers.
J: And how about the measurement of such projects? Some concerns have been raised over different preferred outputs from funders and universities, as well as worries of interdisciplinary work not appearing ‘focused’ enough to fit into some of the more prestigious and highly regarded journals.
K: It’s true that each discipline has its own understanding of what a good output is, where it should be and what format it should take. And this partly stems from what people have been incentivized to views as useful academic activity. And unfortunately, it seems like high impact journal publications will continue to be seen as the gold standard of outputs by various institutions.
But these same gold standards reflect problems that exist within the research industry because of poor research integrity. They drive practices which aren’t egalitarian, which aren’t progressive, which aren’t inclusive. And that creates real difficulty with interdisciplinarity because on the one hand you can have a humanities scholar who is saying that they don’t really care where the output is published or by whom as long as it is in the public realm so practitioners can learn about it, versus an academic who is saying ‘I need it in this high impact paper because if I don’t get 4 of these every 4 years then I’ll get the sack’. If the entire reward structure is set up in a way which values those journals above other outputs, then that is a real problem.
And the institutions themselves are judged on these outputs which determines the level of resource they receive. So the whole system is incentivized for each group to operate in its own paradigm and own metrics. And that works against interdisciplinarity.
J: Could more research networks be a solution here? By connecting different people from different disciplines who might investigate things and produce different outputs, and then for all of those outputs to be seen collectively as fruits of the networks labour?
K: Possibly, but it depends on how they are evaluated. I think that the real value in networks are as stimuli to the system, making collaborations and creating capacity and allowing the conditions in which other things can happen. A network can be very valuable in providing these things, but it rarely translates into a linear, easy to identify pathway, which means that it’s hard to value in reports and the such. So there is a need for more network grants, but it’s hard to see their outputs in such a concrete way as you would see from a research project.
J: So there are clearly real challenges when it comes to interdisciplinary work, but also real benefits to be had if we can figure out ways to get around those blockers. So where do we go from here?
K: I hope that acknowledgement of both the importance of interdisciplinary work and of the challenges it presents will lead to some level of restructuring in the way things are funded and evaluated.
Part of what’s working against all of us is the total resource budget for doing this sort of work. In the UK it is good, but it’s negligible compared to the US or Canada, and probably poorer than some of the European countries. And the lack of diversity in research works against it too. We need to develop new models of accountability and academic function and progression. The Wellcome Trust have at one level come closest to getting rid of all those hierarchies and wanting people to publish in their own way, in any open access journal or lower impact journal and just have it in the public domain.
But in terms of the council’s themselves, it’d be fabulous if they did more interdisciplinary work. It’s almost like I think there needs to be a different way of funding a team of interdisciplinary people – the USA has a good model, where they identify a problem and then fund a team to solve that problem. I think we’re coming at things in a slightly more amateurish and less ambitious way. And if we can identify the biggest problems and get some big teams working on them together – and properly resource them – then that’s probably going to lead to the answers. If it was a space agency problem, like ‘how do we get to the moon’, suddenly money appears out of thin air. But sadly, that isn’t the case with mental health. It’s so familiar that there often seems to be no sense of urgency. And that needs to change too.
Professor Kamaldeep Bhui works out of the Department of Psychiatry at the University of Oxford. A big thank you to Kam for sharing his time for this interview.