LAUSR

Over the past six decades, protections for the mental well-being of human participants in research have been included in national and international research ethics guidelines. Moreover, supporting mental health in the workplace has become an increasingly important focus in global public health given evidence of the role of job stress in the development of mental health issues.1 Despite efforts to protect the mental well-being of human research participants and the workforce in general, the research community has so far failed to provide recommendations to protect the mental health needs of the research workforce. Specifically, the research community has neglected to formally recognize that the research process can have important implications for the mental health of research staff, including research assistants, analysts and students.2–6 We have also overlooked the need to provide guidance for appropriate supports to minimize harm. These oversights may disproportionately impact research teams based in lowand middle-income countries because in many of these countries, large burdens of untreated mental health disorders exist and public mental health infrastructure and mental health-care provision has widespread limitations.7,8 Research, especially but not exclusively qualitative research, requires deep engagement with the topic matter, the lived experiences of participants, and the moral and political consequences of the findings. For many research projects, such involvement may mean significant emotional and intellectual effort is expended by research staff to engage with topics such as domestic violence, suicide and rape, which can lead to intense feelings of distress, shame, guilt, burnout, outrage and hopelessness.2–6 Moreover, this distress may be dealt with using negative coping strategies such as emotional numbing, avoidance or substance abuse.3,5,9 The emotional burden of research is likely to be heavier for individuals who are a member of the community that they are studying.4,5 Some research staff, including those working in local communities, may experience magnified risk as the result of ongoing societal adversities including classism, racism and sexism. Other relevant stressors include personal safety risks while working in the field6 and pressure to complete work quickly and to a high standard. One of our coauthors, a research assistant on a study based in South Africa, shared: “I know I often felt ill-prepared in such situations and I dealt with it by becoming emotionally numb but felt guilty and shameful for being so, but it was the only way I knew how to cope because the work had to be done, targets needed to be met. Thus, I placed my own humanity – or morality or ability to connect, feel, relate to someone – on the backburner in favour of the work that needed to be done.” Despite the mental health risks associated with the job responsibilities of research staff, the broader cultural and economic contexts in which many global health studies are based may prevent them from speaking about their distress. In many lowand middle-income countries, the low availability of mental health-care services is compounded by high levels of mental health stigma. In Nepal, for example, the limited mental health workforce and tightly connected social network of psychosocial workers can make it challenging to maintain confidentiality. In many regions of the world, these challenges are exacerbated by the lack of basic employee benefits and unsupportive workplace conditions experienced by research staff in fieldwork and research settings. The temporary and transient nature of employment contracts in research studies can preclude employees from accessing crucial health-care benefits such as trauma counselling and long-term psychotherapy, limit their opportunities to develop relevant skills, and create a sense of prolonged job insecurity. All these factors combined may stunt career progression. Lead investigators often oversee global health studies remotely and depend on local staff to coordinate daily research operations without direct supervision, which may prevent investigators from implementing the necessary mental health protections to shield study staff from poor working conditions, limited benefits and other occupational hazards. Researchers have begun to highlight the educational and career disparities that result from unsupportive work environments and power imbalances in various aspects of global health research, including unequal access to training and publishing opportunities as well as barriers to gaining research independence.10 These entrenched disparities are well-known predictors of lower job satisfaction, decreased productivity and adverse mental health outcomes.11,12 Another co-author based in Nepal describes: “High demand of job obligations, insufficient salary and benefits, poor working conditions, and the lack of operational guidance on mental health of the research staff in the countries like Nepal pose a mental health risk.” Professionals in clinical fields and practice-based professions such as psychology, social work and health care have recognized and responded to these risks by developing supports such as distress prevention toolkits to prevent clinicians from experiencing vicarious trauma, post-traumatic stress disorder, depression and/or anxiety.12 However, despite the multifaceted mental health risks faced by research staff, little guidPsychosocial training and support guidelines for research staff Raquel Burgess, Andrew Wooyoung Kim, Lindile Cele, Seema Khadka, Kripa Sigdel & Ashley K Hagaman