David Mosse

Background: Suicide is a leading cause of death for autistic people, but it is inadequately explained by theories derived in non-autistic populations. Autistic people’s perceptions of the factors underpinning suicidal experiences are vital for guiding conceptual understanding, risk assessment, and policy and clinical practice toward preventing suicide. Methods: We recruited 1369 autistic participants for an online survey designed through consultation with autistic people. Participants were 326 cisgender men, 718 cisgender women, and 325 transgender or gender-divergent individuals, ranging from 16 to 89 years old. We asked them to rate the importance of 19 contributing factors to their suicidal thoughts and feelings and to enter their own explanations of additional factors if desired. Alongside thematically analyzing this qualitative data, we examined whether ratings of contributing factors differed by age and gender and whether ratings statistically predicted levels of lifetime suicidality. Results: Loneliness, feelings of worthlessness/failure, hopelessness, and mental illness were the highest rated contributing factors to suicidal thoughts and feelings, particularly by autistic women and sex/gender minorities; ratings also differed by age. Qualitative responses indicated the complexity of suicidality, wherein autistic status influenced both the nature of the stressors (e.g., societal stigma) and cognitive-emotional states (e.g., feeling disconnected through feeling different to others) that participants identified. Greater perceived importance of bullying, difficulties accessing support, and past trauma characterized participants with experience of suicide plans or attempts. Conclusion: While some of the experiences and mental states identified by participants resembled those identified in non-autistic groups, the psychological profile of autistic participants and their experiences of marginalization appeared to heavily contextualize expressions of hopelessness, burdensomeness, worthlessness, loneliness, and entrapment. Autistic people vary with regard to the factors perceived to underpin suicidality. However, associations between suicidality and the perceived importance of bullying, trauma, and inability to access support highlight the necessity of societal and systemic change to prevent suicide.

Open Dialogue is a rights-based approach to psychiatric crisis response with growing global uptake. Over the last five years, it has been subject to a large-scale randomized controlled trial (RCT) within the UK's National Health Service. While the trial researchers have emphasized the need for more evidence to inform policy, many practitioners involved in the trial have been lobbying for Open Dialogue's immediate rollout across the country. Drawing on 24 months of clinical ethnography, we suggest this tension reveals moral dimensions of mental health care that are not adequately accounted for in evidence-based psychiatry.

When Open Dialogue diversifies internationally as an approach to mental healthcare, so too do the research methodologies used to describe, explain and evaluate this alternative to existing psychiatric services. This article considers the contribution of anthropology and its core method of ethnography among these approaches. It reviews the methodological opportunities in mental health research opened up by anthropology, and specifically the detailed knowledge about clinical processes and institutional contexts. Such knowledge is important in order to generalize innovations in practice by identifying contextual factors necessary to implementation that are unknowable in advance. The article explains the ethnographic mode of investigation, exploring this in more detail with an account of the method of one anthropological study under way in the UK focused on Peer-Supported Open Dialogue (POD) in the National Health Service (NHS). It sets out the objectives, design and scope of this research study, the varied roles of researchers, the sites of field research and the specific interaction between ethnography and Open Dialogue. This study is original in its design, context, conduct and the kind of data produced, and presents both opportunities and challenges. These are explained in order to raise issues of method that are of wider relevance to Open Dialogue research and anthropology.

Caste is a complex ontological construction. Despite several anti-caste movements and constitutional provisions, caste exists in the Indian psyche as part of everyday life. Even in the advent of globalization, caste continues to foster social and economic inequalities and exclusion in newer forms and perpetuates violence. The available research on caste-based stigma and humiliation provides a limited understanding as it deals with Dalits only; and ignores caste-Hindus (upper-caste) agency. Based largely on qualitative data collected at an intense three-day workshop, including two Focus Group Discussions and a year-long ethnography, this article illustrates the micro processes of everyday life experiences of caste-based stigma and humiliation among university students, academic staff and administrative staff. It explores subtle and overt caste discrimination, prejudices and stereotypes existing in the spatial morphologies of Indian higher education, its perpetuation on campuses and its impact on students’ psyche. It highlights the dearth of scholarship in this area of caste identity and stigma; and proposes nuanced questions for future research to understand why universities in India are turning into places of social defeat for Dalit and OBC students. The article argues the basis of caste discrimination and humiliation in universities is not the same as it exists in other social institutions. Instead of asserting conclusions on this matter we set out justifiable lines of inquiry. There are two issues that this article examines: first, how students in Indian higher education evolve strategies for coping with threatened identities. Second, what structural repair in higher education is required to heal the wounded (caste) psyche?

This introduction sets out the significance and scope of current research on Open Dialogue, an alternative approach to psychiatric crisis and serious mental illness that reorients psychiatry from its conventional diagnostic to a dialogical approach. The article establishes the context for contributions to the Frontiers Research Topic, ‘Open Dialogue Around the World – Implementation, Outcomes, Experiences and Perspectives.’ It explains why this is a good moment to bring together international research on Open Dialogue as the approach expands across countries, sites and services. The different designs and methodologies of Open Dialogue research are indicated, as well as the scale and focus of studies. These range from comparative surveys, organisational studies and randomised controlled trials to those examining therapeutic processes and bringing ethnographic, phenomenological and philosophical perspectives to bear on Open Dialogue.

"Monique Nuijten and the ‘hope-generating machine’ in the time of Covid-19" published on 30 Oct 2020 by Wageningen Academic.

Donor‐funded development NGOs are sometimes portrayed as co‐opting, privatizing or depoliticizing citizen action or social movements. This much is implied by the term ‘NGOization’. Alternatively, NGOs can be seen as bearers of rights‐based work increasingly threatened by tighter regulation or substitution by corporate social responsibility models of development. This article engages critically with both perspectives. It traces the role of NGOs and their funders in agenda setting, specifically in bringing the previously excluded issue of caste discrimination into development policy discourse in the form of a Dalit‐rights approach in Tamil Nadu, south India. The authors explore the institutional processes of policy making and NGO networking involved, the alliances, entanglements of NGOs and social movements, and the performativity of NGO Dalit rights. But at the same time, the article illustrates how NGO institutional systems have constrained or failed to sustain such identity‐based claims to entitlement. In Nancy Fraser's terms, the article explores success and failure in addressing ‘first‐order’ issues of justice, that is rights to resources (in this case, land), and in tackling ‘second‐order’ injustices concerning the framing of who counts (who can make a claim as a rights holder) and how (by what procedures are claims and contests staged and resolved). This draws attention to the important but fragile achievements of NGOs’ discursive framings that give Dalits the ‘right to have rights’.

This chapter explores some issues and dilemmas involved in undertaking ethnographic research within rural development organizations. These reflections derive from experience working as an anthropologist within rural development in different organizations in India. The chapter focuses on the way in which social research is undertaken by actors in and for development organizations – both 'aid workers' and those the aid organizations are attempting to help – and in the way that research is used by the actors themselves in support of their own ends. After explaining something of the context of my own interest in social research in development projects, the chapter examines some recently popularized participatory research methods. It also revisits some of the problems and dilemmas of attempting social research within organizations, and in particular the difficulty of balancing the demands of engagement in development agencies with critical analysis of their institutional processes.