Why did we reject your paper?

The number of papers submitted to this journal has increased exponentially. This means considering papers that are likely to be of interest to our readership and that might pass peer review. This inevitably results in high rejection rates. All editors find it hard to engage peer reviewers, so we only want to send them papers likely to pass our high publication threshold, and in the last month this number was only 11% of papers. In a previous editorial we described the issues we face as editors in weeding out papers that are sham or misleading - i.e. come from paper mills or are papers with authorship for sale (Wykes & Parkinson, 2023). We try to provide reasonable timelines to a decision, especially for those papers that we consider will not ultimately meet publication threshold, so authors are quickly able to consider alternative outlets. This editorial is an attempt to help authors as they consider the journal for their submissions and specifically contains advice on what to avoid. We do hope you will read it.

When a paper is submitted to the Journal of Mental Health it goes through several administrative checks. We require information on ethical agreement and consent to use data and for reviews and trials that the protocol is published before the studies have begun. Additionally, we have a limit on the number of words in a manuscript and specific formats for references and the abstract. Even with these explicit rules we still have authors push back on these criteria, arguing that they cannot write more concisely or that no ethics committee was available. We are surprised that authors fail to thoroughly read our submission expectations prior to submission. This oversight wastes their time and ours and an inattention to detail never bodes well for a paper and most frequently results in rejection at this point in the process.

After the administrative checks the paper is considered for its potential scientific contribution to our understanding of mental health problems. Here we consider issues such as the design, the analysis and whether these components fit the aims of the study as set out in the abstract and introduction. If there is a mismatch, then the paper is rejected before peer review. Below we provide some guidance about some of the issues we have come across that could act as a checklist before submission. These issues are limited to the Journal of Mental Health but equally should be a guide for any aspiring authors. We go through these issues stage by stage.

Types of studies

We are an international journal, so we prioritise papers that are of international importance even if carried out in a single country. Studies from the global south may well have advice for those in the global north and studies that have considered different cultures in a single country might also have implications for treatments and services in other countries. We would be helped in our decisions if authors were more explicit about these links.

Replication is important in science, but when a result has already been replicated several times then we have a much higher threshold when considering whether to send a further one for peer review. This decision is because we want to add to the corpus of knowledge and so replications need to improve upon previous work by having a better control for potential confounders that was not covered in previous replications or provide some extra insight into a model rather than just repeating the study in a slightly different sample with a couple of extra assessments.

In a previous editorial we reported on our attitude to studies about COVID-19 (Wykes et al., 2021). This journal has published papers on Covid-19 and particularly on those groups whose mental health suffered the most (Geirdal et al., 2021; Lim, 2021; Taggart et al., 2021; Willis & Chalder, 2021), the consequences on services (Watson et al., 2022) and health care workers (Alsolais et al., 2021; Mayer et al., 2023; Patelarou et al., 2021; Villalba-Arias et al., 2023) as well as differences between countries (Lawal, 2021; Sapara et al., 2021). In that editorial, we advised that new submissions need to provide new knowledge. We continue to receive papers about COVID-19 and do continue to publish (e.g. (da Graca et al., 2022; De & Sun, 2023; Galanis et al., 2023; Yang & Ma, 2023)) as it is an important issue to understand, but an internet survey suggesting that people were anxious or depressed is not acceptable as it fails to substantially add to the literature even if it is from a different country or a novel group - e.g. pregnant mothers. Longitudinal, and especially cross-country comparison, studies of the effects of Covid are warranted to highlight differences not just similarities in the effects (e.g. (Durmuş, 2023). These sorts of studies may help us model the factors that might be helpful not only in the future but for different types of environmental or social effects, for example combatting the effects of loneliness (e.g. (O'Connor et al., 2023).

Review papers are welcomed to the journal as they can provide a guide to understanding gaps in the literature where new studies are needed, or alternatively they show that we have enough data and now need clinical academics to consider a paradigm shift. But if they define the area too narrowly, then they produce manuscripts with too few papers for any conclusion other than we need to carry out more research or results in a review that is so narrow that it is biased. These sorts of manuscripts are not accepted for publication. Finally, we need reviews to be up to date. If the review was completed some time ago then it will probably be out-dated given the current speed of publication.

The submission evaluation

What is now described is not rocket science, but it is advice that we know people who submit papers have ignored. The title and design of the study are vital to attract readers to a paper. Titles must be accurate. For example, if a title suggests that the study is a randomised control trial, but the study only compares groups of individuals over time and never makes a comparison between them, then our readers will be disappointed, so we reject that paper. A non-randomised study may be helpful even if it is only observational, but authors need to evaluate their own submissions and not over-promise.

The methods of the study need to be described so that the study can be replicated. For all studies this requires how a sample was recruited, the inclusion criteria and the number expected to be recruited as well as the measures collected and the procedure for those assessments. This information is the gold standard for any scientific paper. Yet we routinely receive manuscripts that fail in at least one of these areas.

The Journal of Mental Health publishes both qualitative and quantitative studies and for both we consider the sample size. This factor is important as generalisation depends on the study being able to adequately characterise the population it purports to represent, and just as importantly, for the study results to be replicated. Even when sample sizes look adequate, we have discovered that authors may reduce them to sub-groups in the analysis. Some of these sub-groups are extreme, like comparing men and women when there are only two women in the sample.

For qualitative analyses often the sample sizes are smaller, but we still require them to be adequately justified. If the study has a very small or a very large sample, then this needs to be explained in the context of the aims of the study and the analysis method used. Small samples in qualitative studies tend to boost any significant effects and these are less likely to be replicated. We know that pilot or feasibility studies need smaller samples, but they still need more than a few participants to reliably evaluate whether the intervention is acceptable to those with lived experience. A small sample size can be appropriate if there is a strong rationale and explanation of the limitations that this produces.

Large sample sizes in observational studies do not necessarily have scientific integrity. They are usually convenience samples collected through the internet so that the results have many limitations. We provided advice to authors of such papers in a previous editorial (Wykes, Sweeney, & Guha, 2019). Large numbers are sometimes warranted especially if we want to understand population level issues (e.g.(Virk, Doan, & Karim, 2023). However, there are limitations to this expansive approach. For instance, we have published studies on student mental health (Byrom, 2018; Dodd, 2021; Mishna et al., 2018; Worsley, Harrison, & Corcoran, 2023) that have contributed to our understanding of mental health issues and potential interventions for students. The papers we are currently receiving are generally not at all like this. They often investigate the relationships between different aspects of well-being and, although of course useful in general, this journal has mental health in the title and so we need some concentration on mental health issues. Mental health difficulties or diagnoses are not simply the opposite of wellbeing which is anyway a difficult concept to define. Apart from these definitional issues, there is the consideration of the sample limitations – students are highly educated, often of a higher socio-economic status and many do not have the same financial concerns or lack of social opportunities. The limitations sections of papers either do not mention these differences as potentially have an impact on their results or that they may limit generalisation of the results. When a sample of students is uniquely different then these differences should be adequately measured and reported in a manuscript. This level of detail will strengthen a manuscript focused on any population.

Secondary analyses of large datasets are important, and we do consider them for publication. However, authors need to demonstrate a strong rationale for the analysis, indicate that the analysis plans were developed ‘a priori’ and describe the practice or policy impact of their findings. These are characteristics that will make submissions stand out and be more likely to progress to reviewers.

Whatever the appropriate sample size is, the measures chosen should be appropriate to the sample under investigation and any variable chosen for analysis ought to be operationally defined so that we see the link between the aims and hypotheses of the study. So, if the sample is of children, then obviously the measures need to be developmentally appropriate, assessments designed for one culture cannot immediately be provided to another unless there is evidence that they will be understood in the same way.

The data analyses proposed in the methods section often has scant detail of why an analysis is being performed and how it is aligned with the hypotheses. The statistical methods may be correct but because the descriptions are inadequate, these manuscripts are a challenge to move forward to peer review. A frequent problem is a lot of tests, often correlations, which lead to concerns about Type 1 errors. For qualitative analyses a similar problem arises. The analysis methods are frequently not adequately described so it is not possible for another researcher to understand or replicate the study. A further problem we have noticed is that some supposedly qualitative research is carried out in a quantitative paradigm, like using frequencies, counts and statistics, rather than rich description of the data, without justifying this approach. Descriptions of qualitative analyses may also be inappropriate for example, stating that grounded theory was used when it clearly was not.

The results and discussion are also not immune from challenges. Manuscripts that go beyond their data in the discussion and interpretation of the findings are always problematic. Studies that concentrate on statistical analyses need to stick to the rules in their description of methods and not overinterpret small non-significant results with words like “tend towards” significance, that are then described as if they were significant changes in the discussion section. When findings are overstated, the authors have often missed other unique or interesting aspects of their data by focusing on an outcome that cannot really be supported by the current data. For example, this might occur when the authors make causal claims with cross-sectional data. In qualitative analyses we want to see a rich description of the findings, if it is thin then the results seem superficial and for the editors and reviewers, are viewed as either uninteresting or unimportant.

We publish this journal only in English, so we need the writing to be understandable. Poor grammar and odd uses of vocabulary prevent comprehension and although poor use of language is not a bar to consideration, we do advise that authors make sure that the submission is as clear as possible at the point of submission. Highly technical papers like those ones using Large Language Models and machine learning, require simplification for our journal readers. Merely doing something complex, (e.g. multilevel modelling), that adds very little to our understanding of the topic will not increase our confidence in the results. We consider the theme of the paper and the novelty and safeness of the results in our assessment. If the paper provides no new insights, then statistical complexity does not improve the chances of publication. While writing can be edited, poor writing or writing that seems rushed will affect the editors’ decisions. If a manuscript fails to adequately define variables, does not provide citations for key ideas or concepts, or is challenging to follow, then publication is unlikely.

Decisions to reject a manuscript are multiple and the above comments are often discovered at the editorial stage prior to peer review. When a paper is sent out for review, we take the views of reviewers very seriously. If they say reject, then we follow their suggestion, but we also consider whether reviewers have been generous in their assessment. A long and highly critical review may indicate rejection even if the reviewer chose to give the authors another chance. We occasionally receive requests by authors to reconsider the reviewer’s comments. Unfortunately these rarely receive a favourable change in decision and only delay the potential for the paper to be accepted elsewhere.

We also receive other forms of publication. We want to inform potential submissions of book reviews or editorials that we solicit these ourselves and rarely if ever publish ones we have not requested. One reason for rejecting unsolicited book reviews is a suspicion that the reviewers have some connection with the authors of the recommended book. Recently we investigated a claim of no connection with the author to discover, after only an elementary search, that the reviewer had co-authored several papers with that author. This highlights the issues of honesty and integrity that we require from manuscript authors. We thought this would be obvious but in our joint consideration of the reject process we have all had similar difficulties. Even with the most benevolent view of authors we now know that many do overplay their results, underestimate study limitations, and lose focus on their study aims in the papers we reject. The process of carrying out our administrative checks, the editorial and peer review all take time so we would like our authors not to slow us down by asking us directly whether we have processed the paper. When our system says ‘awaiting reviewer assignment’ you can be confident that peer review is underway, and some reviews may even have been returned Requests for further information rarely speed up the process.

The Journal of Mental Health receives many excellent papers from around the world that make a valuable contribution to our understanding and treatment of mental health difficulties. They cover all factors contributing to patient benefit including training of mental health care professionals, societal effects of international financial crises and representation in the media, as well as issues of concern for young adults (e.g. (Balay-Odao et al., 2023; Bilkay et al., 2023; Talamonti et al., 2023; Virk, Doan, & Karim, 2023). We want to ensure that we continue to receive this outstanding work so that aspiring authors can become published in our journal. We hope that close attention to this editorial will enhance their chances.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Til Wykes has been supported by her NIHR Senior Investigator Award and the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London