The 'inverted case study' – methodological innovation using a realist approach to research mental health policy and service delivery for 16-25 year olds in a comparative context in Australia and the UK

This paper explores the methodological approach undertaken in a PhD research project conducted at the University of Birmingham and University of Melbourne, looking at mental health policy and service delivery for 16-25 year... [ view full abstract ]

This paper explores the methodological approach undertaken in a PhD research project conducted at the University of Birmingham and University of Melbourne, looking at mental health policy and service delivery for 16-25 year olds in the UK and Australia. The paper seeks to describe and explain the approach taken during the course of this research as an innovative method of social enquiry.

Youth mental health issues and the debate about service provision have received increasing public interest and policy attention. This research is timely as there is an increasing interest in mental health and youth in both the UK and Australia. Due to its comparative nature, the study offers insight into the different strengths and challenges posed within each system.

The study took place in six case sites (three in the UK, and three in Australia) during 2013-2014. The design adopted privileged ontology, and identified laminated strata (based on the work of Bhaskar and Danermark, 2006). Using the identified laminated levels, qualitative research was conducted at each strata in order to explore the generative mechanisms operating within the six case sites. The design was developed in response to the challenge presented when a classic case study research design did not fit the multi-layered, multi-site approach needed in order to answer the research questions posed. The idea of creating this model was that through interviewing along the strata, a rich and textured understanding of the open system would be developed in order to facilitate answering the research questions. In this way, the context of the whole system and an understanding of critical realism was embedded in the research design, and then operationalised as a framework for social enquiry. As it was designed, the model allowed for comparison not just between cases (as with classic case study research), but also enabled comparison within cases at laminate level. The research conducted included analysis of policy documents relevant to each of the case sites, and thematic analysis of 219 interviews undertaken with policy makers, managers, front-line staff and young people, who were accessing services from across the six case sites. Results from this analysis will be presented to illustrate how the design worked in a live research context.

This paper represents the first time the model itself will be presented at a conference as a completed piece of work, including accompanying research findings and results. The presentation seeks to encourage debate about how qualitative research may be used to answer complex research questions, as well as to explore the embryonic idea of an ‘inverted case study’ approach.