Paper short abstract:

Using rapid, multi-site, approaches to hospital ethnography presents a trade-off between the desire and need for time to be spent at the ethnographic site and with the data; meaning rapid, multi-site, hospital ethnography may lead to advancing breadth in knowledge, but not obtatining depth.

Paper long abstract:

Drawing on my research conducted in antenatal clinics across London, I present a critique of rapid, multi-site, hospital ethnography. In doing so, I engage with concepts of methodological agility and research pragmatism as a social scientist engaging in ethnographic research conducted at and across the disciplinary boundaries of the social, psychological, and health sciences.

Firstly, I will discuss the issue surrounding multi-site ethnography, whereby cross-disciplinarity can become an issue where, as a non-clinician across multiple clinical settings can render the researcher an outsider, a stranger, an intruder even, thus demonstrating the need – as ethnographic researchers based in hospital settings – we must become methodologically agile, adapting to both our settings and our population(s) of interest.

Secondly, I present the issue surrounding rapid ethnography, which can be intrinsically problematic when working in healthcare systems which present inherently slow processing which can delay research, juxtaposed against a phenomenally high turnover of population (both patients and staff); thus, indicating the requirement – as hospital ethnographers – to become pragmatic researchers, adapting to both our limited time at each hospital site and their changing forms.

Finally, this chapter whilst wrestling with the concepts of methodological agility and research pragmatism acknowledges time as an important factor in ethnographic research as in all qualitative research. Time is problematised in these types of ethnographic approaches as being doubly constrained – first through the rapid approach and second due to the division of a researcher’s focus across multiple hospital sites.

Paper short abstract:

Research and evaluation in arts and health is required to be more robust and demonstrate efficacy similarly to pharmacological interventions. Yet, the relationship between methods, sample size and evidence remains problematic and the relational elements of creative interventions hard to measure.

Paper long abstract:

‘Arts and health’ encompasses the broad range of ways in which artists contribute to health care and health promotion. Reflecting this complexity, the terminologies and definitions for arts and health activities are currently fragmented and disputed, with a plethora of different terms used by different groups. Furthermore, the field of arts and health is particularly vulnerable to academic dismissal and poor visibility, particularly among clinical professionals due to stark epistemological differences between the creative arts and medicine. Key to this, is a preoccupation with developing a standardised and quantified evidence base of impact, with a view to examine their potential to be ‘mechanised’/ replicated in a similar fashion to pharmacological interventions. This leads to a series of problematic assumptions about which methods and sample size are best suited to measure the efficacy of arts and health interventions which heavily rely on creative professionals as sentient agents. Drawing on observations, interviews and questionnaires with 44 participants in 17 arts and health projects (7 completed, 10 ongoing) that form part of the Health Art Research People innovation programme (HARP) and a cross-Wales online survey completed by 28 professionals and 56 participants, this paper will discuss what is being missed when we move from experiential and observational methods of assessing impact to more standardised forms of evaluation, and what methods might be best suited to evidence the relational and psychosocial agency of creative professionals who are at the heart of arts and health interventions.

Paper short abstract:

This paper presents a study of ‘tension’ - an emic theory of mental and embodied distress experienced by Gaddi tribal women. It offers an alternative approach to studying distress that begins not in the clinic or shrine but follows tension as it emerged from relations within and between households.

Paper long abstract:

In anthropological studies of mental health, ethnographers often start at the ‘clinic’ or the ‘shrine’ – seeing such therapeutic spaces as privileged sites for recruitment and knowledge production. Interlocutors are engaged through a classic set of methods such as the illness narrative or survey. Data generated by such methods is often seductively organised in the neat form of a ‘case’ or ‘cohort’; and forms of distress are classified as culturalist ‘idioms of distress’ (Nichter 1981) or ‘cultural syndromes’ (Good 1977). Though such approaches generate important perspectives on distress and healing, they sometimes risk locking their subjects in a ‘suffering slot’ (Robbins 2013), defined by their deviance or pathology. Such methods can be marked by culturalist, individualising tendencies and scale-blindness; unable to fully capture the relational, structural, intersubjective, embodied and affective terrain of distress. But what methods, if any at all, can be drawn on in their place? This paper presents insights from a study of ‘tension’ - an emic theory of mental and embodied distress that women from the Gaddi tribal community of North India experienced. It offers an alternative approach to studying distress that begins not in the clinic or the shrine but follows tension as it emerged from biomoral relations and flows within and between households in intimate economies. It shows how such a heterodox approach generates different kinds of data, that allow a more ethnographically accurate mapping of forms of mental and embodied distress, as they intersect with inequalities of gender, class, caste, tribe and race.

Paper short abstract:

A comparison between the roles 'methods' play in anthropology, allopathic research and Traditional Chinese Medicine reveals important overlaps and differences. Prospective anthropological methods, being most dependent on the active participation of the researched, should be renamed 'preparations'.

Paper long abstract:

In allopathic medical research, ‘methods’ are designed to be replicable, with the aim of cancelling out subjective bias and precipitating objective fact. Sandwiched between researching subjects and knowable objects, methods themselves are not usually thought to have any substantive, ontological reality. They are merely the means to objective knowledge. In contrast, methods, as diagnostic processes in Traditional Chinese Medicine (TCM) are important in their own right: the (variable) ways in which bodies are known are not subordinated to ‘the body’ as a knowable object. Patients of TCM often celebrate rather than criticise different methods being used to diagnose the same condition. In anthropology, broadly replicable methods- observing, participating, ‘being with’ (Driessen et al. 2021)- are valued for their potential to produce different results. Indeed, this is the whole premise of the discipline as a comparative endeavour. However, if the anthropologist often does research using the ‘same’ participant-observation methods, the success of these methods also depends on the co-participation of research participants, such that anthropologists only provide half of the methodology in practice. The always-different co-participation in, and production of, ethnographic fieldwork methods by participants is what produces the anthropological sense that life is different from one place to the next. In their reliance on the methodological co-participation of others, anthropological methods revealingly overlap with both TCM and allopathic approaches. Given that any anthropological research proposal only ever provides (at most) half of the actual methodology to be ethnographically employed, what are often called ‘methods’, I suggest, should be renamed ‘preparations’.