IAFMHS CONFERENCE KRAKOW 2020
JUN 23 - 25
Interview with Dr. Marie-Hélène Goulet*
Student Section Editors
Ilvy Goossens, Student President | Simon Fraser University, Canada
Maria Aparcero, Student President-Elect | Fordham University, USA
Laura Dellazizzo, Student Secretary | Université de Montréal, Canada
Dr. Marie-Hélène Goulet is a nurse, assistant professor (Faculty of Nursing Sciences, University of Montréal), and researcher. Prior to obtaining a Ph.D. in nursing, she obtained a BA and MA in French literature at the University of Montréal. Recently, she completed a postdoctoral fellowship at the Faculty of Law at McGill University. Throughout her career, Marie-Hélène has held several grants and awards including the Quebec Network on Nursing Intervention Research (RRISIQ), the Faculty of Nursing Sciences (FSI), the Canadian Institutes of Health Research (CIHR), and the Quebec Health Research Fund (FRQS), among others. She was also awarded a doctoral scholarship from the Fernand Seguin Research Center. Her research interests revolve around coercive measures (i.e., isolation, restraint, and treatment orders) in mental health settings and patient partnership in research. In her program of work, she combines both quantitative and qualitative research methods.
As you will be able to read below, Dr. Goulet demonstrates a reflexivity and openness in her approach to research. She does not shy away from self-examination, which is one of the reasons why we have invited her for our Spotlight series. We are happy to have her share her story; we hope you enjoy the read.
Q: What peaked your interest in psychiatric nursing, and subsequently drove you to a career in academia?
Dr. Goulet: When I was working as a casual/nurse on call, I loved shifts on the psychiatric ward; I noticed it was based on true multidisciplinary teamwork. I saw how this can create a sense of safety and trust within teams. I also had experience as a research assistant on projects regarding seclusion and restraint reduction. When I was finally employed as a nurse, I was shocked by the gap in theory and practice on this issue. I came to the realization that the only way to make a difference on a larger scale, and not only with the patients that I was treating, was to get involved in a research career to advance knowledge about prevention of seclusion and restraint measures.
Q: Is there anything you would have liked to do differently in your career path or would have wanted to know earlier?
Dr. Goulet: I would not change anything in my career path. Each step I took provided me with knowledge that I use to this day: my master's degree in literature prepared me for qualitative analyses and the work I did as a nurse lead me towards clinical research.
Q: How did you become involved in the forensic field and the IAFMHS?
Dr. Goulet: Seclusion and restraint are (supposed to be) last resorts and are governed by very specific pieces of legislation. My work as a research assistant and as a doctoral student had highlighted a lack of knowledge of the legal framework by stakeholders, including the nurses. For my postdoctoral fellowship, I connected with Dr. Anne Crocker (incoming IAFMHS President) because she allowed me to further explore the psycho-legal aspects of coercive measures in psychiatry.
Q: What are the challenges you experienced during and/or after graduating and how did you resolve them?
Dr. Goulet: As a graduate student, the biggest challenge was maintaining a balance between my doctoral project, my research assistantships, and my involvement in different student associations and community organizations. Little by little, I had to learn to say no and choose the opportunities best aligned with my own journey. This is a sensitive challenge because the more you are involved, the more people think of you for different projects. It is easy to get scattered and lose focus. When the time came for the final sprint of writing my thesis, it was clear that those who started graduate school with me were not necessarily at the same stage as me. It was helpful to surround myself with people (in my case, cardiology students) who did not necessarily share the same research interests, but who were at the same stage as I was. For example, we set up an informal working and proofreading committee where it was possible to pass through our insecurities and have a critical first reading of our thesis before submitting it to our supervisor. We set up an informal working and proofreading committee where it was possible to pass through our insecurities and have a critical first reading of our thesis before submitting it to our supervisor.
Q: Could you share a few important moments in your career that ultimately shaped you as a woman in science, as an adjunct professor in nursing?
Dr. Goulet: The first time that I taught a class on mental health at the bachelor level, I had a major case of ‘imposter syndrome’; I felt I did not have enough experience as a clinician. However, I was amazed by the students' thirst for knowledge as well as their fear of psychiatry. I found that students needed to be reassured by getting as much knowledge as possible. Seeing that I could have a real influence on de-stigmatizing mental health (e.g., by inviting service users as guest speakers) was extremely enlightening.
Seeing that I could have a real influence on de-stigmatizing mental health was extremely enlightening.
Q: From your perspective, what are some of the challenges your field is facing?
Dr. Goulet: One of the biggest challenges in mental health, and more specifically in forensic psychiatry, is truly altering the culture of care. In my work, I have noticed that many stakeholders value recovery when, in fact, practice is more related to risk management where tolerance for disruptive behavior is very low. A challenge more specific to nursing is leadership so that nurses can deploy and exercise the full scope of their skills, such as evaluating the physical and mental condition of a person presenting signs of violence.
Q: Could you tell us about your interest in coercive measures (e.g., isolation, restraint, treatment order) and management of aggressive behavior in psychiatric settings. How did you become interested in this area?
Dr. Goulet: My research program explores coercion in mental health with the goal of preventing it as much as possible. Coercion can be exercised at different points in the patients’ care path: institutional care (including involuntary commitment), seclusion, restraint and involuntary treatment orders. I think that management of aggression is the foremost route to prevention of these coercive measures. That is why the implementation of preventive interventions is the main focus of my research. I want to ensure that the use of coercive measures remains exceptional, as stipulated by the law.
I want to ensure that the use of coercive measures remains exceptional, as stipulated by the law.
Q: In 2017, you spoke at the annual IAFMHS conference in the Professional Panel about ‘participatory action research’. Could you tell us a bit more about that?
Participatory Action Research, for me, means doing research according to my values: inclusion of all parties by teamwork between researchers, managers, clinicians, as well as people directly affected by control measures.
Dr. Goulet: Participatory Action Research, for me, means doing research according to my values: inclusion of all parties by teamwork between researchers, managers, clinicians, as well as people directly affected by control measures. Having the latter’s input on the angles to be addressed (e.g., in study interview guides) prioritizes the development of knowledge that really makes sense - for all - and thus potentiates their use. I have often asked myself “Am I truly the best person to talk about seclusion and restraints?” and have come to the conclusion that I may be well positioned to talk about the best methods to study it, but not to talk about it first-hand as experienced by those undergoing it.
Q: Relatedly, in your experience, what is the benefit of qualitative analysis over/in addition to quantitative analysis?
Dr. Goulet: Just like Participatory Action Research involves the participation of all to have a better perspective on a problem, it is important to draw from different approaches (qualitative and quantitative) to further our understanding of a specific problem. Of course, the added value of qualitative research also depends on the research question and the state of knowledge. In sum, it really is all about making sure there is consistency between the elements (e.g., research question, state of literature, population, topic) and not just a researcher's preference.
Thank you, Dr. Goulet, for sharing your reflections on your graduate and further career path and shining a light on your work on preventing coercion in mental health settings!