In our recent webinar, we convened a panel to discuss how to advance mixed methods in mental health research. In this article, Dr Ola Demkowicz reflects on key themes in the original BMJ paper, the webinar discussion and suggests some calls to action for the field as a whole.
Mental health and the systems around mental health are inherently complex and multidimensional. We therefore need methods that can be used to effectively match that complexity. Mixed methods research – formally integrating both qualitative and quantitative methods within one study or project – is widely recognised as a valuable tool with which to do that.
Mixed methods have been increasingly applied in mental health research – particularly in some areas, such as nursing research and service and intervention research. Yet, they are not as well-embedded across the field as we might hope or expect, with researchers continuing to face a range of ongoing challenges and limitations in practice.
In this recent piece published in BMJ Mental Health, which followed on from a Mental Health Incubator event, we set out to reassert the importance of mixed methods in mental health research and to examine solutions to some of these challenges. The article was co-authored by Ola Demkowicz (The University of Manchester), Eleanor Chatburn (The University of East Anglia), Charlotte Archer (University of Bristol), Rhiannon Thompson (Imperial College London), and Ruth Plackett (UCL). We outline some of the core benefits and features of mixed methods research, and offer worked examples from our own research, to show some of the wide range of ways that researchers can make use of mixed methods approaches.
We suggest various pathways to advancing the use of mixed methods within the mental health research field. We advocate for:
- A shift from fragmentation to integration, pushing beyond siloed thinking and practices and exploring the building of a shared language and agenda
- Improved publication routes for mixed methods studies, including openness to practical solutions that could aid researchers in feasibly publishing engaging mixed methods outputs
- Effective resourcing, in thinking about both the training available in mixed methods research as well as consideration of practical challenges in specific projects, such as funding constraints
To further advance mixed methods research in the field, and overcome some longstanding challenges, we need active commitment from across our field and infrastructure – including individual researchers, leaders, institutions, editors, funders, and training providers.
In the webinar (you can access the recording here) we heard from:
- Ola Demkowicz, lead author of the original BMJ Mental Health piece and Senior Lecturer in Psychology of Education at The University of Manchester
- Ruth Plackett, co-author of the original BMJ Mental Health piece, Senior Research Fellow at UCL, and mixed methods Training Provider, at Methodical & Social Research Association
- Mariana Bolivar, Research Programme Lead at MQ
- Jo Ellins, Senior Fellow at The University of Birmingham
- Nagina Khan, Associate Editor at BMJ Mental Health and Senior Clinical Research Fellow at The University of Kent
- Tom Hutchinson, Senior Programme Manager at NIHR
Here, we share some of the themes and reflections that arose through our discussions…
Mixed methods for real world impact
A clear message in the webinar was that mixed methods can expand our capacity to respond to real-world complexity, to offer more relevant insights. As Mariana discussed, mixed methods work enables researchers to provide tailored, context-sensitive advice to decision-makers by integrating evidence with stakeholder perspectives and strategic considerations, and making that process robust and traceable (this can also offer more value for money!).
Starting out and building confidence across methodological borders
For researchers rooted in either qualitative or quantitative traditions, venturing into mixed methods can feel daunting. There was encouragement and valuable insights on this from several panellists. Whether your background is in statistics or ethnography, a key takeaway from Jo was to work alongside others who bring different strengths. Joining or even initially just observing mixed methods research teams – even if you’re initially focused on your primary expertise – can offer invaluable exposure to integration in action, and help us understand where the intersections are.
Panellists acknowledged that it can be daunting to think about “re-learning” or becoming fluent in a second methodological language. But as Ruth explored, being a mixed methods researcher doesn’t mean you must master every technique; it means building a good-enough understanding of the different perspectives at play, and examining how they come together meaningfully. An important step can be about breaking down the silos and language barriers between paradigms.
As in our original BMJ piece, we would signpost readers to seminal conceptual and practical texts from the Journal of Mixed Methods Research’s virtual special issues on integration and quality, respectively.
Building a mixed methods project
There was a clear reminder from the panel that a strong mixed methods project goes beyond methodology: it requires thoughtful team structures and, sometimes, shared leadership. Several panellists highlighted the value of co-leadership between qualitative and quantitative leads, noting how this mirrors the integrated nature of mixed methods.
We heard from Tom that funders like NIHR are increasingly open to these models, and are also creating more space for mid-career researchers to lead. Tom emphasized that funding panels are evolving to include more mixed methods expertise, but they’re still often topic-led, so understanding how to position your work matters. He encouraged researchers to get involved in review panels or advisory roles as a way to shape future funding guidance from the inside.
Publishing mixed methods wih integrity
Publishing mixed methods research brings its own set of challenges, and we saw several questions about this from attendees. We turned in particular to Nagina on this, who advised engaging with journals (BMJ Mental Health) early to discuss the best strategy, especially when considering twinned papers or complex designs like embedded methods. Another key consideration is to retain the integrity of the methodological integration rather than separating the qualitative and quantitative elements too cleanly – e.g., a twinned paper organised by theme was suggested by a delegate, rather than by a qualitative/quantitative split. Several useful resources were shared to guide reporting, including the GRAMMS framework, and EQUATOR Network guidance on mixed methods.
Framing your career as a mixed methods researcher
For early career researchers (ECRs), it can feel difficult to “evidence” yourself as MM, especially if your outputs to date lean toward one methodological tradition. A few practical suggestions from Jo and Ruth included writing a short narrative section in your CV or personal statement to clearly frame your mixed methods identity, even if your publications don’t yet fully reflect it. Others highlighted the importance of being opportunistic; joining teams, co-authoring, and contributing to analysis processes outside your own specialism to build up your mixed methods credibility over time.
Call to action
To wrap up the session, panellists were asked to offer a one-sentence call to action. A few themes emerged strongly:
- Training and visibility: Institutions and funders should support ECRs in developing mixed methods skills and portfolios, and researchers should use various platforms to share practical examples of mixed methods in mental health research, including challenges and learning.
- Review and publication culture: There may be a need for more mixed methods literate reviewers and journals to ensure high-quality research gets the recognition it deserves. Update the journal’s Aims and Scope to specifically mention mixed methods as a welcome and encouraged methodology. Create a dedicated section in the author guidelines explaining:
- What constitutes a high-quality mixed methods study
- Expectations for integration of quantitative and qualitative data
- Examples of acceptable designs (e.g., explanatory sequential, embedded, convergent).
- Ensure peer reviewers have experience in mixed methods so they can fairly assess both components. Allow authors to upload additional materials (e.g., coding frameworks, integration matrices) as supplements rather than fitting them into strict word limits. Encourage submissions from underrepresented settings where mixed methods are often used due to lack of large datasets.
- Equity and inclusion: Mixed methods can be used to amplify under-represented voices, including giving weight to lived experience and co-production, with transparency and accessibility at the core
We hope that researchers can use our BMJ piece, along with the reflections shared from this webinar, to guide their own mixed methods journey. We also invite both research and infrastructure teams to use these insights to initiate – or reinitiate – discussions about the role they can play in advancing the use of mixed methods in the field.
Did you miss the webinar? Access the recording here. You might also be interested in our advice pages Navigating partnership working.