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TEDx-Style Talk Presented at (Virtual) AAS 2020

April 24, 2020

Addressing Equity, Diversity, and Inclusion in Suicide Prevention as an Early Career Suicidologist

Transcript: Well, thank you all so much for joining me here, virtually, to talk about addressing equity, diversity, and inclusion as an early career suicidologist.

Um, before we begin, I'd like to acknowledge that although our meeting is virtual today, I'm presenting from Lubbock, Texas, which is located on the tra- traditional, uh, ancestral and unceded territories of the Comanche and Jumanos people. If you're interested in learning more about the purpose of this type of land acknowledgement, I would encourage you to look at the website of the Native Governance Center, which is


So, as I was beginning to think about the material for this talk, this Tweet showed up in my feed, and I thought that the quote from Dr. Robert Sellers was a great way to think about diversity, equity, and inclusion. Uh, the quote reads, "Diversity is ensuring everyone is invited to the party, equity is making sure everyone can dance, and inclusion is asking everyone to contribute to the playlist." Um, I got curious about this quote because I felt like I had seen it elsewhere before. So, I did some digging, and found the actual origin of this metaphor.

Um, this is Vernā Myers, a Harvard trained lawyer who now runs her own company devoted to inclusion strategy and industry. As you can see in the bottom right of this text in bold, um, she's actually copyrighted the motto or the saying, "Diversity is being invited to the party. Inclusion is being asked to dance." And yet her contribution was lost along the way from her work to the Tweet that showed up in my feed a few months ago. This just highlights for me how often women's voices, especially women of color, are omitted from our conversations in suicidology broadly, but especially about diversity, equity, and inclusion.


So, I feel very fortunate to have grown up in a family and an environment that taught me important lessons about valuing equity, diversity and inclusion. Here's an old picture of my parents and I from my high school graduation. Uh, although I can think of many ways that my family background contributed to my views on these issues, perhaps the clearest influence on my thinking was my father, pictured on the left there. 


Um, my dad was disabled throughout my life. Early on his back injuries and repeated surgeries made it hard for him to play with us the way that other dads would. Um, but he managed to figure out some workarounds.


This is a very old picture of him showing me how to use a computer way back in the 80s. As he got older, his disability worsened, and he also became visually impaired, um, having two cornea transplants, until he could no longer get around on his own or drive. And this, uh, these types of impairments and difficulties impacted our relationship in important ways.


For instance, as I showed earlier, I have photos of my dad from my high school graduation, but in this photo of my college graduation, it looks a little different. He's not there. And it turned out that on the day of my graduation, all the disabled parking spaces on campus had been occupied. And so there was no place close enough to the graduation ceremony for him to park and to be able to attend. Um, which meant he wasn't able to see me earn my bachelors. And unfortunately, he died before I received my PhD.


Navigating the world with a disabled dad meant being constantly aware of the physical accessibility or inaccessibility of everyday spaces. Curb cuts on sidewalks became necessities, and the accessibility of restaurants and hotels defined whether he could travel or even do something as simple as eat dinner out with our family. In fact, many of the places that I've lived as an adult were entirely inaccessible to my dad.


So, what does this have to do with suicidology? I shared a bit of my background to explain just some of the influences that have shaped my views today, and for the rest of my time I hope to talk a bit about the ways that I consider diversity, equity, and inclusion in my work, and to give you some recommendations about ways you can consider these factors in your own research and practice. I recognize that there are many areas in which I am not an expert, and that there is simply no way in a single talk to talk through all the complex, intersectional experiences that marginalized communities have within suicidology and more broadly in modern society. I feel so blessed that AAS's conference this year is having so many fantastic talks on these issues, and I encourage you to learn more through the other talks that we've heard yesterday and today and that will be available virtually after. My hope for this talk is just that the material will give you some things to consider, learn more about, and potentially implement in your own work.


So, we'll talk first about diversity. Going back to that metaphor from earlier, "Diversity is ensuring everyone is invited to the party." In my mind, diversity is a question of "who?" 


The most common way we talk about diversity is in our workforce. How diverse is that graduate program? How diverse is the staff at that organization? This is also something we think about in terms of recruiting participants for research studies. How diverse is your sample? Diversity is necessary, but assuredly not sufficient for equity. Often, we think about diversity as the outcome. For instance, what percentage of students in that program identify as racial or ethnic minorities? What proportion of the faculty are female? But I strongly recommend that you spend more time thinking about the process of diversity, and that's where equity and inclusion come into play.


Returning to our earlier metaphor, if diversity is having everyone at the party, "equity is making sure everyone can dance." Sometimes people confuse equity and equality, and feel that equity is achieved by giving everyone the exact same resources. But true equity is about meeting people where they are, with their own unique strengths and needs, and ensuring that they have what they need to succeed.


Equity, in my view, represents the question of "What?" Once we have a diverse group of people, what concrete steps can we take to ensure that those people can participate fully in our field? Our current situation, coping with the coronavirus pandemic, offers a specific example of this.


So, this is a headline from an article on Inside Higher Ed discussing journal article submission rates since the coronavirus pandemic reached the United States. Overall, submissions are up markedly, but almost none of this increase in apparent productivity is coming from female academics. Why might that be? This is likely due, at least in part, to the additional burden that women in academia - and more broadly - take with respect to childcare, and childcare demands have increased dramatically since schools and daycares around the country have been shut down. This is a fantastic example of why true equity requires not only having women in the field, but policies and programs that support women and other people from marginalized groups with the unique and specific challenges that they might face.


Some of you may be familiar with this image. It was originally designed by Craig Froehle in 2012, and the leftmost side is supposed to represent equality, where each person gets the same size box to stand on to see over a fence at a baseball game. However, as you can see, the shortest person still can't see over the fence, and the tallest person on the left didn't actually need the box at all. The image on the right side, in contrast, shows an interpretation of equity, where each person has what they need to be able to enjoy the game. However, some point out that this is not a fair representation of equity, because it leaves out the factors that contribute to inequities beyond simple individual differences. 


In this image, designed by Paul Kuttner in 2016, it takes a slightly different perspective. You can still see there's three individuals, but they don't differ in height. Instead, they differ in their ability to see over the fence because the ground that they are standing on is uneven, and the fence they're looking over varies in height itself. This version of the image recognizes that equity demands different resources, and different opportunities, not simply because of innate differences between people, but because of the need to account for, and correct, social, political, economic, and cultural factors and processes that disproportionately harm people from certain backgrounds.


Returning to the earlier part of the metaphor, "Inclusion is asking everyone to contribute to the playlist." That's different than ensuring that everyone can have the ability to dance. It's actively seeking out contributions, feedback, and connections with people who may be different from us. It's about the steps you take before the party even starts to make sure that everyone feels welcome and included. In my view, this makes inclusion a question of "How?"


How do we go about getting diverse stakeholders engaged with our work? How do we get our work out there to people who need and want it, even if we don't know them directly? More broadly, how do we make suicidology a leader in inclusive practice? I'd like to talk about several domains where I think that inclusion is essential and identify some key questions for your consideration as you work to factor these issues into your own practice.


First, let's talk research design. I love research, and often as an early career researcher, your ability to make major decisions in research design may be limited, either because you lack the authority to do so, or because you lack the concrete practical supports that you need to make them a reality. Often, that practical support is money. Here are some questions that I still think are important to consider as you're designing your own research, whether it's a dissertation or an early faculty study.


First, where do you get your research ideas? Did they come from the top down or bottom up? Who's deciding what ideas are important or worthy of study? How are you going to measure or assess the things that you care about?


How do you decide which measures or methods to use? Is it based on what's familiar or what's most scientifically sound? And have the measures you plan to use or the methods that you plan to use been tested, or even used, before in the – with the people that you hope to understand better? 


Next, think about who is actually going to be doing the research, from conceptualization, design, data collection, analysis, and publication. Who's going to get credit for that work? How can you make sure that everyone involved is treated respectfully and as a meaningful member of the team? How will that work be compensated, whether financially or otherwise?


Finally, in terms of all of the above questions, consider who is getting to make these decisions? How transparent is that process? How are you ensuring that these decisions are made in an equitable manner? You'll notice that I didn't talk about participant recruitment on this slide, because I think it actually deserves its own separate slide.


Researchers are often asked to think about and talk about the diversity of their samples, and often this gets narrowed down to a brief paragraph or even a single table in research output. Rather than focusing on that outcome, you'll find it easier to think about designing an inclusive recruitment strategy. 


For instance, where are you recruiting your participants from? Is it a convenient sample like a psychology subject pool? Sometimes that might be the only feasible option, but consider who is able to see your recruitment materials, and who therefore has the opportunity to participate in your research and who does not.


Think too about the methods that you use to recruit participants. For instance, much recruitment and advertising is now done online, but that ignores the reality that many people do not have computer access at home and do not necessarily have access to those online recruitment databases. Think about how clear and concrete and uh, essentially, transparent your advertising materials are. Is it intelligible to someone who's not pursuing a PhD or pursuing any kind of advanced degree? 


Think especially about the marginalized communities that have been harmed under the guise of supposed scientific research, and consider what you can do to demonstrate your commitment to ethical and inclusive research practice. In most research contexts, participants are in a situation where they experience far less power and control than the researchers, and often we don't take this power imbalance into account.


One of the major factors to consider in participant recruitment is compensation. I think we can think for a moment ourselves about what we might be willing to do for other people for free, and there might not be a lot that you'd be willing to do!


Think too about the costs that participants might face, uh, to actually be able to enroll in your study. For instance, paying for childcare, costs related to transportation, or lost wages for individuals who don't have flexible work schedules, and design your research incentives appropriately. Now, I know as an early career researcher, you may not have lots of extra money lying around, but there's a tremendous number of small grants available for early career scholars to fund this type of work.


Finally, consider thoughtfully the inclusion and exclusion criteria you use when you design your studies. It's bad science, and it's bad ethical practice, to exclude someone from your research because their participation would be inconvenient or would require extra effort from you. Think for instance about non-native English speakers. Is there a scientific reason why you wouldn't want those individuals to be a part of your study? Or is it simply because translation of measures would be onerous? What about someone who needs to use a screen reader, or who can't physically access your laboratory space?


After you've designed and run your research study, the next step is often writing up the results and disseminating your findings, and it's also important to consider how to factor inclusive practices in your dissemination. 


I know I'm not the only academic who finds themselves citing the same, uh, authors over and over. Um, but you should interrogate that question, in terms of who you're citing and who you're referencing. How do you learn about new work in your field? Is it only in the top quote-unquote journals, or are you reading more broadly? Do you give the same weight to research conducted outside of the United States as you would to American research? When you see an interesting article title, do you default to looking at the author list, or at the abstract?


More so than just the literature that's reviewed, consider how you write and present your work. We know that language matters. In my view, don't write something that you would  feel embarrassed or ashamed to have read by someone who's experienced the thing you're writing about. More broadly, interrogate that desire. Our research results and our clinical interpretations should never be something that we can't or won't share with the people who are most impacted by our work.


Once your work is available for review, whether it's an article or a presentation, consider how you're going to make sure that your work has a broader impact. Sometimes dissemination can feel like self-promotion, which can be a challenge for early career researchers, but ultimately, you're doing this work for a reason. Why would we do it if we're not going to make every effort to get that work to the people who need it or who are interested in learning more about it? This could be as simple as sharing on social media or applying for funding to pay to make an article open access. More broadly, fight for changes in our research infrastructure to break down barriers to dissemination, for instance, the norm that scientific research articles are put behind a paywall. Actively reach out to community organizations that might be interested in your work, and put in the effort to make sure that your scholarship and your expertise is serving the benefit of your community and the communities around you. 


Finally, for those who may be seeking positions in academia, consider how your mentorship and teaching can be inclusive. For instance, who you're mentoring. 


Make active plans to recruit diverse people to join your research team. Look into programs at your university that support underrepresented students in pursuing research experiences. Don't assume that only students who are well-connected or who know the implicit rules about how to get involved in research are the only ones that are worth mentoring.


Consider, too, the strategies that you use when you act as a mentor in terms of identifying your student's unique needs, not assuming that students need or want the same things that you would need or want.


In a classroom setting, consider the material that you choose to teach. Who are you citing, who are you assigning, and why? What perspectives are considered valid or appropriate for the classroom and which are not, and how are those decisions made? Consider the examples you use, even the clip art that you put on your lecture slides. Are all the images of white people? People with no visible disabilities? Consider the messages that you're sending to your students as you do this work.


There are a lot of questions to think about, and it's unlikely that any of us can account for the myriad diversity aspects of the human condition in every single action we take in this field, but we can make a commitment to pause, be thoughtful, and try harder. 


I'd like to end with a quote from Toni Morrison about power. The quote reads, "I tell my students, when you get these jobs that you have been so brilliantly trained for, just remember that your real job is that if you are free, you need to free somebody else. If you have some power, then your job is to empower somebody else. This is not just a grab-bag candy game."


Often those of us early in our careers think about the ways that we don't have power or authority or resources. And it's true that we may not be at the top of the hierarchy, but we do have power afforded to us on the basis of our status as graduate students, post-doctoral scholars, as faculty, as people with voices that are so critical to our field and to suicide prevention as a whole. So, I urge you to think carefully about how you use that power and the ways in which we can all empower others. Thank you.

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