ISCHP

Brett Scholz is a research fellow in the Medical School at The Australian National University. His work is concerned with consumer leadership in health services and systems, and the allyship that non-consumers can engage in to create opportunities for consumer leadership. He is one of the co-editors of ISCHP’s podcast The Operative Word. He can never say no to a cup of tea.

How did you embark on an academic career? What prompted this path? The seed was sown when fellow-ISCHPer Stuart Ekberg – then a tutor for an undergrad psych subject I was taking – marked a discourse analysis paper that I had submitted, commenting that my analysis was good and that I should consider qualitative research for an Honours year project. That seed was then watered when I had the opportunity to work with another fellow-ISCHPer, Damien Riggs, during my Honours year. I realised how much I enjoyed critical research. Without being able to see and work with critical academics, I would never have followed this path.

That seed for an academic career turned into a little plant thanks to sunlight (opportunity) and nutrition (good supervision) during my PhD. I was lucky enough to work with yet another ISCHPer (and previous ISCHP Conference Chair in Adelaide in 2011) Shona Crabb.

I am really grateful to have learned a lot from Shona about how to work as a critical health psychologist in interdisciplinary spaces: I worked with her in two very different departments - Psychiatry and Public Health. I looked to her as an example of how to navigate in to different disciplines in my own career – working now as a Research Fellow in the Medical School at the Australian National University and an adjunct Associate Professor in the Faculty of Health at the University of Canberra.

I think being a Critical Health Psychologist means that we are able to form alliances across the boundaries of disciplines and universities. While I have worked in Psychology departments too, I’ve really benefited from partnerships and mentorship from people outside the discipline. For instance, Brenda Happell, whom I’ve worked with for almost 4 years, comes from a mental health nursing background and she exposed me to critical ideas about consumer leadership that have now become an important part of my research identity.

At each step along this path, key to my success has been excellent mentorship, opportunities to work together with other brilliant critical minds, and making plenty of time to rest and reflect about how to do more impactful and critical research that nourishes me. And ISCHP – having the opportunity to come together with like-minded academics is absolutely critical (pun intended) to sustaining me in academic structures that are often otherwise positivist, re-producing power imbalances, and less supportive than we deserve.

What have been the highlights of your career so far? A big component of my research programme is about consumer leadership – i.e., a health system that has leadership of consumers (and not just tokenistic participation or ‘representation’) in every stage of service planning, implementation, delivery, and evaluation. As such, being invited to keynote last year as a non-consumer at the consumer-led Service Users Academia Symposium on the topic of allyship was a highlight and a huge honour for me.

Similarly, every time I get to talk about my research and explain that most other (i.e., non-consumer) health professionals are doing a poor job of working to address the power imbalances between consumers and organisations is exciting for me. I either see people become very defensive and angry at being called out for not really putting consumers first, or I see people re-think how they can work with consumers in their own context. Challenging these norms and learning from others about how they challenge them is a highlight for me.

Can you tell us about any career challenges and how you have you tackled these? The big and ongoing challenge for my work is ensuring that universities, funders, and other stakeholders value my consumer researcher collaborators. All my publications for at least 4 years have been co-authored with consumer researchers or experts by experience. That is, people in dedicated roles because of the synergy of their research skills and their lived experiences. In my previous role, there was a consumer academic in a role that was specifically created for someone labelled with mental illness. I also co-supervise, co-teach, and co-produce wherever I can with those who have traditionally been the ‘subjects’ of research. However – as we’re all too aware – funding for teaching and research is tight. Despite the immense value consumer academics bring, remuneration is a huge issue.

The most recent project I was working on was about consumer leadership in palliative care, and so of course I couldn’t publish without co-authoring the paper with someone who had experienced palliative care. There are no dedicated positions in any Australian universities for a consumer academic in palliative care, nor was there funding available to me at the time to employ a consumer academic to work on the project with me. There were no funds at the time to pay the consumer researcher for their work. While only a small token, I was, however, able to use my research account to support them to attend and co-present at a conference.

If health faculties in universities remain reluctant to create roles dedicated to employing consumer researchers, tackling this issue requires continued chipping away to ensure funding applications explicitly include lived experience researchers, or consumer researchers are a part of every authorship team. I will be continuing to look for more opportunities so that this kind of co-production is not just tokenistic and that it is meaningful and redresses power imbalances.

Enjoying a break for tea in Tokyo. Every time Brett has a paper accepted for publication he treats himself to a matcha latte.

Can you tell us a bit about your role and experiences in ISCHP? Ever since being introduced to ISCHP in 2011 when we hosted the conference in Adelaide, it has been such a source of strength, inspiration, and pleasure for my work. Currently, I’m co-editor, along with the brilliant Britta Wigginton and awesome Ally Gibson, of The Operative Word (you all will have subscribed I’m sure, but if not: https://anchor.fm/theoperativeword). Four issues of the first volume of the podcast have been published, and the remaining 2 issues will be published in March and May. It’s been such a privilege working on the podcast, and to talk with ISCPHers about their work in a more in-deph and probing way.

What are you currently working on? My overarching research programme is about ensuring that consumer leadership can be embedded into the structures of health systems and services. This is important not only because policy now requires consumer influence at all stages of health system and service planning, implementation, delivery and evaluation, but also because services produced by consumers and systems that meaningfully (and not tokenistically) co-produce with consumers are safer, more relevant, and lead to higher quality outcomes.

Most of my publications have looked at consumer leadership in mental health. Currently, I’m extending this work in two new directions:

1. Consumer leadership in palliative care. It has been such an interesting move for me to come and look at (the lack of) consumer leadership in palliative care. The field ostensibly cares deeply for consumers, but in practice I see a lot of paternalism, excuses not to involve consumers, and a system that reproduced hierarchies that keep consumers out. Recently, I was very troubled to read an article that had no consumer co-authors listed but that referred to consumer co-researchers throughout the article. Claiming to collaborate on research but to not actually publish together seems exploitative at best. This, sadly, appears to be par for the course. Still, it’s exciting to be part of the revolution.
2. The last couple of years, I’ve supervised a number of projects about allyship to the consumer movement. Even though as critical health psychologists, we’re not part of the metropole of psychology, we still have power and influence. If we use this influence to redress power imbalances, that would be considered allyship. This could be something on a big scale (such as creating a research centre that has a majority of roles dedicated to lived experience researchers), something small (such as making sure the meeting agenda item dedicated to the consumer representative on your project is not the last item that inevitably gets pushed aside), or something transformative (such as what one of my PhD students and fellow ISCHPer Stephanie Stewart is doing with her doctoral research being driven by an expert group of consumers).

(If you’re interested in allyship – watch this space for a call for papers in Qualitative Research in Psychology on allyship or get in touch if you have any questions!)

Who/what inspires you and why? I’m inspired by people who take joy in the small things. I find this really important given the pressure of the kind of work that we do. But taking a moment to, for instance, really enjoy a cup of tea, or to call a friend makes so much of a difference to the way that we experience time. We should do this more.

Savouring a bowl of steaming lat na in Bangkok.

What is the piece of work you would like to accomplish and be remembered for by the academic community? My work on consumer leadership is slowly shifting practice in terms of valuing lived experience. I’ve seen people’s resistance to co-production of research with consumer researchers shift, and have been pleased to be part of bringing this revolution from mental health to other health disciplines. This won’t be particularly fast – after all the first consumer academic position in Australia was established more than 20 years ago, and you can still count on your hands the number of dedicated positions for consumer academics across the country. Nonetheless, I’m proud to be part of the wave. Working on these sorts of issues with my brilliant research collaborators is a huge privilege. I hope I’m remembered by the academic community as someone who always fought to redress the power imbalances between consumers and non-consumers in the health system.