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Qualitative Methods: An Example

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Qualitative Methods: An Example Program Transcript

NARRATOR: Dr. Sreeroopa Sarkar's research study is an example of qualitative research. Its design was made particularly interesting because of cultural questions and decisions that guided the design process. Listen as she explains.

SREEROOPA SARKAR: Today, I'm going to describe two research studies that myself and Dr. Bonnie Nastasi of Walden University have carried out for promoting mental health among the schoolchildren in the South Asian countries of Sri Lanka and India. These two studies were formative in nature and it aimed at assisting the mental health needs of the adolescent school students in these two countries and resources available to them to deal with any kind of mental health issues.

The first study was initiated in Sri Lanka. We wanted to test the model in a similar culture. So as a native of India, I wanted to extend this study on the model that we developed in Sri Lanka and wanted to test it in a similar culture in the neighboring country of India. We expected that India and Sri Lanka has many similarities in cultures.

I'd like to share with you why we decided to carry out these two studies in two different cultures. We have been involved in a sexual risk prevention project with the youth in Sri Lanka. And during our interviews with the young adults, many of the mental health issues that came up such as suicide, alcohol and drug abuse, and so on– for example, suicide rate among the adolescents in Sri Lanka was very high. That was also the case for adolescents in India.

Sri Lanka has the highest rate of suicide in the world. And the rate of suicide among the adolescent population, particularly between the age of 15 to 18, is highest in India. We also found out that drug and alcohol abuse is on the rise in both cultures and there are also incidents of gang activities or criminal activities, community violence, that were affecting the adolescents and the young adults in both countries.

We started looking into the literature and we also found that there is very limited emphasis on mental health issues in both cultures. There are also very limited resources available. For example, in Sri Lanka, there are only 19 psychiatrists available for a population of 20 million. There are also misconceptions as well as widespread ignorance about mental illnesses and mental disorders. And there are also cultural stigmas about mental illnesses in both of these cultures.

In this background, we decided to initiate our first study in Sri Lanka. And for conceptualizing mental health for the purpose of our study, we used three theoretical frameworks. One was Bronfenbrenner's ecological developmental framework, which emphasizes on the role of ecology in influencing a person's

Qualitative Methods: An Example

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development. We also used personal and environmental factors model, which emphasizes the importance of personal factors as well as environmental factors in influencing a person's mental health. And the third framework that we have used was the primary prevention of mental illnesses through promotion of personal social competencies.

So based on these theoretical frameworks, we generated six major mental health constructs or variables that are related to mental health. First was the culturally valued personal and social competencies. The second construct was social stressors as viewed by the adolescents in that culture.

Third was what kind of coping strategies that the youth utilized to deal with major mental health problems and stressors. Fourth was what kind of social resources that are available to the youth to deal with mental illnesses. Fifth was personal and family history that makes an individual vulnerable to mental illnesses. And the last was socialization practices and agents that influences a person's development.

We realized that using a qualitative research method would be very effective in this formative research stage. We have decided to use the ethnographic research tradition because we were trying to understand mental health from the perspective of the people from two different cultures which are very different from the cultures that we see in the United States. We wanted to learn about the culture from the perspective of the people of the culture. We wanted to get a definition of mental health as the people from that country defined it– how they viewed mental health, how they viewed different mental health problems, what kind of attitudes they have toward mental health. So we felt that ethnographic research method will enable us to get a very culture specific definition of mental health.

We conducted focus group interviews with the schoolchildren. We started with open ended questions and based on what kind of responses we are getting– for example if they wanted to discuss a particular topic, we also wanted to focus on that particular topic and discuss it with the children in detail.

I'll give you an example. When we were conducting interviews with them and we asked them about social stressors, many of the children were very vocal about academic pressure. And we wanted to explore that issue in detail and we asked them more questions about academic pressure. And we found out that there are several factors such as rigorous examination system in the country, high level of competition, parental pressure for academic achievement, as well as lack of opportunity for identity creation were identified as major stressors by the children.

Another example would be when asking females students about social stressors in India and Sri Lanka, girls talked a lot about sexual harassment and molestation that they encounter in everyday life. So we were very interested and asked them

Qualitative Methods: An Example

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more questions about that and we wanted to discuss it in detail. We found out the girls are regularly teased by boys on the streets and they're also molested frequently in the public transportation by men. They identified that problem as a major social stressor for them. We expected that the findings from these studies will help us developing a culture specific survey questionnaire and an intervention tool that we can use with a larger population of adolescent students in both of these countries.

I'll give you some of the examples of our findings. Some of the characteristics of personal social competencies as defined by the adolescents in that culture included honesty, hard work, ability to balance between work or play, and respect for elders. Social stressors as viewed by the adolescents included poverty, academic pressure, sexual harassment, family violence, fights between the parents, and divorce of the parents. Some of the coping strategies that they described included crying, pouting, isolation, listening to music, or seeking support from family members, from parents, and from friends. Social resources available to the adolescents included seeking support from family, friends, or seeking support from private tutors who particularly helped them in their academic needs. Interestingly, students never discussed getting any kind of support from professionals such as psychiatrists or psychologists.

Based on our findings from both of these research studies, there are several implications. First, the findings from these studies suggested a strong need for mental health services for the adolescent school students in both of these countries. Secondly, based on the qualitative data as well as our intervention data, we expect to recommend to the policymakers of the country several things. We expect to recommend them that they may explore the opportunity for integrating personal/social competency promotion or life skill training to the children in the schools, such as how to deal with stressors. It will teach them resiliency or it will teach them how to seek support when they are having some kind of mental health problems.

One of the challenges that I personally had to deal with while carrying out this research was keeping out my personal biases. I am a native of India and am very familiar with the culture of India as well as Sri Lanka. So when I went out there and I was carrying out interviews, I had to make sure that my personal biases doesn't interfere with data collection or data interpretation. And I think that's important for any qualitative researchers to remember, that we have to be careful. We have to be aware of any kind of personal biases that we bring in with ourselves into the research.

In closing, I would like to say that, as we expected, qualitative research was found very effective for this particular study. We found a very culture specific definition of the major mental health constructs that we were looking into. And based on the definition of this construct, we were successful in developing a culture specific instrument for collecting data as well as we developed an

Qualitative Methods: An Example

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intervention program that we implemented in Sri Lanka. We hope to do the same in the future in India with the qualitative data that we have collected there.