Survivor research – navigating a publishing barrier: a case study

Abstract

Survivor research refers to those people with lived experience of psycho-emotional distress undertaking a unique type of research that results in any societal change. Survivor research is an anathema to an academic community in that it is often biasedly seen as of a lesser integrity. There is a growing population of survivor researchers who form the Survivor Research Network to support those people to research and publish. However, gaining acceptance by peer reviewed journals remains problematic. This current issue article addresses the challenges of anonymous peer review by those who are not peers of survivor researchers. I present a case describing how reviewers from four journals chose to reject an article by a survivor researcher. The evidence is presented among views of notable survivor researchers who work in this field, also mentioning the wider challenges to all researchers seeking publication.

Keywords:

• publishing challenges
• anonymous peer review
• reviewers’ comments
• survivor research
• peer-led research
• mental health

Introduction

Survivor research provokes a unique paradigm: equality between researcher and those service users and carers/patients/other people that are involved in the research, empowers those taking part in research and as a result brings about a social change (Beresford 2020). In the UK, the Survivor Research Network (SRN 2021) is well established (Ormerod et al. 2018), and since the end of 2020, research support meetings on zoom enable survivor researchers to be supported. Whether survivor researchers’ outputs reach the public domain via peer reviewed journal articles continues to be challenging.

Background

I became a survivor researcher in 2013, being a member of IMPACT group of disabled service users and carers, at the University of Worcester, following invitation by this group’s facilitator. With ethics approval for several projects, I participated in focus groups, researching the perspectives of undergraduate health and social care students, IMPACT members, and university staff. I also produced/collaborated in the literature searches/reviews, research analyses, and write-ups/submissions of articles. These concentrated on the voices/views of people and were published in several peer reviewed journals. Simultaneously, I worked, part-time, as an intentional peer support worker (IPSW) in inpatient mental health services and successfully published an article on patients’ voices with two co-workers (Rooney, Miles, and Barker 2016). Hopefully, all these publications considered together may influence others to expand, and/or improve their practice, and/or even change social policy, therefore benefiting disabled people.

At the beginning of 2021, I joined the SRN zoom support meetings which are most interesting and later discussed the faltering pathway to publication of an article I had written. This reported on twelve psychosocial educational courses on two mental health rehabilitation/recovery units/wards giving patients’ views of such courses. Feedback about the article from SRN members during a zoom meeting involved the use of such words as ‘interesting’ and ‘exciting’. The reaction was unanimous, I should continue to attempt to find a journal which I continue to do. The raison d’être for the article was to benefit future patients in recovery services where activities/education are provided that may change mindsets (meaning: individuals’ ways of thinking/opinions). In this context, disabled people who suffer mental distress, may be supported to increase their knowledge to overcome societal adversity in the future.

Literature review

Many people who are survivor researchers have written about the benefits, achievements, and challenges of their involvement in research. For example, Russo (2012) reviewed progress of user/survivor-controlled research in the UK and provided two case studies from Germany which demonstrated that such research was possible outside mainstream academic institutions. Boxall and Beresford (2013) suggested an equal role for service user researchers in peer review of social work articles and Rose (2017) further suggested sources of knowledge and understanding for user-led and survivor research hoping this would result in both new outcomes and scholarship within critical theory.

Kalathil and Jones (2016) edited a number of papers from a special issue of a journal from service user/researchers’ perspective named ‘Unsettling disciplines: madness, identity, research and knowledge’, while Carr (2019, 7) gave a candid personal reflection of being a survivor researcher academic, and suggested that ‘mental health service user researchers who work in universities become activists and use their social connections and power to help others in the mental health service user and survivor movement thus making things fairer’.

Sweeney and Beresford (2020, 1192) made several observations regarding the bias that articles reviewers see in the inherent methodology of survivor researchers, observing that ‘mainstream journals are unlikely to publish qualitative, survivor-generated experiential knowledge that challenges not just dominant epistemologies, but often the taken-for-granted knowledge base’. Most recently, in a recent editorial for a special issue of articles about Patient and Public Involvement (PPI) in research, Faulkner and Chambers (2021) acknowledged that there was improvement in approaches to PPI, however, they concluded that further progress is needed.

Any author submitting their research to peer reviewed journals may have challenges with reviewers and editors. Nickerson (2005, 662) recommended that editors provide specific reasons for their decisions. They argued that

What [authors] do not want is an action letter that tells them that the manuscript is unacceptable but leaves them without a clear understanding of what the editor considers its major defects to be or helpful guidance regarding what to do now…authors want specifics regarding problems they see and, when feasible, concrete suggestions for fixing them and for otherwise improving the presentation. (Nickerson 2005, 662).

Comer and Schwartz (2014) discussed vituperative (meaning: bitter and angry insults) feedback from peer reviewers using socio-psychological examples. They argued that such feedback damaged the dignity of authors and caused humiliation. Indeed, Gerwing et al. (2020) analysis of professional practices in peer review practices found that 41% reviews contained at least one incomplete, inaccurate, or unsubstantiated critique.

Choice of journals

Four journals (A-D) were successively approached with submissions over more than 12 months; if there were reviewers’ comments following revision requests, with an invitation to resubmit, this was undertaken. One article is considered in this commentary and it remains unpublished.

A special issue of journal A requesting user perspectives seemed a good fit, and submission of the article during August 2020 resulted in a revision request; the article was then rejected. Journal B was chosen as it is a generalist journal that specialises in mental health and was desk-rejected on initial screen. Journal C was chosen because it often favours articles on peer support, while a revision was offered for further peer review, this was not followed-up. Journal D was chosen because it was suggested by an editor of Journal C and it fitted the educational aspects of the paper; this was rejected following a resubmission.

Peer reviewers’ comments

There was much confidential feedback from seven anonymous reviewers across the four journals. I organised these into themes: (1) insufficient description using evidence-based criteria for rationale, lack of contextualisation, educational models, and assessment of courses; (2) inaccuracies and confusion around definitions, methodology and comment; (3) insufficient critique and acknowledgement of limitations; (4) ethical considerations, and (5) vituperative feedback.

Almost all comments were written in the negative and to resubmit I gleaned from these negative comments an approach which I believed reviewers sought. In summary, justification for theme (1) was from reviewers of journals A and B, while theme (2) encompassed five out of the seven reviewers’ comments and theme (3) resulted from Journal D’s reviewers comments. Theme (4) was due to not passing a desk screen for journal C, which was not challenged, while theme (5) was most manifest by a cascade of negativity by two reviewers from journal D. including the use of inaccurate information; theme (5) was interspersed within other journals reviewers’ comments.

Following receipt of journal D reviewers’ vituperative comments, my feelings were like a time following first attempting internal scientific writing, returned rejected, and covered with destructive remarks, in red ink, more than forty years ago; this time I had given up.

Conclusions

Reviews need to be specific and include suggestions for improvement, rather than sweeping criticism. Journals allowing for two, or more, revisions are commended, however, to reject an article, following a second revision with new, unexpected vituperative themes, sometimes inaccurate in content, as suggested happens by Gerwing et al. (2020), is unacceptable. The last reviewer from Journal D destroyed my credibility, finishing a cascade of negativity with ‘not clearly written’ chiming with the vituperative feedback described by Comer and Schwartz (2014). I am a qualified, experienced teacher in further and higher education with 16 years scientific, and ten years humanities research and publishing experience.

This commentary results in more questions than answers: was the article peer reviewed by survivor researchers? Or, were these reviewers others from academia, defending and conserving their narrow research beliefs and output spaces, therefore assessing this article as illegitimate? Is the reviewing process unbiased? Are survivor researchers being discredited and undermined by their anonymous academic reviewers? Serial rejection is disheartening.

Sweeney and Beresford (2020, 1192) suggested that ‘what has been (or will be) produced through survivor research is (or will be) fundamentally flawed on account of our identity. These rejections are at times presented angrily, with implicit or explicit personal attacks. This complicates our access to funding and publication, preserves the status quo regarding who has the right to study whom, and stifles methodological innovation’. Such researchers face multiple challenges in recognition of their work, in addition to non-acceptance of a manuscript. These include access to literature in a chosen field of study, the education of skills in: analysis, academic writing skills necessary to be of acceptable standard for peer review, and crucially sources of income and research funding within and without an academic institution.

May I repeat a conclusion of Sweeney and Beresford (2020, 1193): ‘Once our knowledge is consistently judged on equal grounds, rather than narrowly through our identity, our position in the research landscape will be more secure. Until then, academic research will continue to privilege knowledge that contains and controls the people the research intended to benefit’.

Acknowledgements

Many thanks are due to Dr S E Carr for making most constructive criticism and the anonymous reviewers of this commentary.

Disclosure statement

No potential conflict of interest was reported by the author.