PONE-D-24-24720Conducting Qualitative Research on Acute Mental Health Inpatient Wards: Lessons from the FieldPLOS ONE

Dear Dr. Berry,,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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The study provides important insight into the subject. However, a thorough review is needed to improve the syntax and grammar of the manuscript. ==============================

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Shazia Khalid, PhD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: N/A

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: No

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The current paper presents a valuable contribution to the field of mental health research by providing detailed methodological insights and practical reflections on conducting qualitative research in acute mental health in-patient wards. The article addresses a significant gap in the literature on how to conduct qualitative process evaluations which is its biggest strength. Paper also have methodological rigour, the detailed description of ethnographic observations and semi-structured interviews, along with the challenges faced and strategies employed, demonstrates a robust and reflective approach to qualitative research. By incorporating some of the revisions to enhance analytical depth, structural clarity, and integration with existing literature, the paper would be well-suited for publication and could serve as a significant source for researchers in similar fields.

• In line 4 & 5 of Abstract, words “including in mental health care settings” should be replaced with “including mental health in-patient settings” so it may go with the title of the study.

• Incorporate a more extensive review of related literature to contextualise the study’s methodology and findings

• The sampling strategy needs to be explained, how hospitals were selected, how sample and wards were selected, which guidelines were followed.

• Specify clearly about selection of sample by using tables or flow charts so that the reader may understand it more easily

• Observation guide and interview guide should be included will clear cut points

• Reorganize sections with clearer subheadings and ensure a logical flow from one section to the next to enhance readability and comprehension. The paper could be improved with a clearer structure and flow. Some sections, such as the methodology and results, might benefit from more subheadings or a clearer delineation of subtopics to enhance readability.

• The word “such as” is used many times which shows that only some of the data is shared not all. This shouldn’t be the style to report rather include all in the form of tables or flow charts. E.g. Line no 84, 106, 139, 140, 216, 234, 320, 508.

• Use of randomization should be included in detail about which the researcher wrote in line 130

• Results of the interviews and observational study must be included in detail with tables and flow charts regarding themes generated which make sense and understanding to the reader. Provide a more thorough analysis linking specific observations to theoretical frameworks or broader themes in qualitative and mental health research.

Reviewer #2: Overall, the paper “Conducting Qualitative Research on Acute Mental Health Inpatient Wards: Lessons from the Field” provides a significant foundation for understanding the use of qualitative process evaluations in mental health care settings. The paper discusses how qualitative research techniques were adapted for acute mental health settings. This specificity is crucial for ensuring that the methods are appropriate and effective in the given context.

The use of both ethnographic observations and semi-structured interviews to supplement randomized control trials in mental health care settings is credible.

The paper offers a clear description of the approach to conducting ethnographic participant observations on acute mental health in-patient wards.

Highlighting the significance of personal and team reflective practice adds depth to the research process. It shows an awareness of the researchers' impact on the study and the importance of continuous self-evaluation.

This sis a review paper which may offer even greater contributions to the field by addressing the identified issues.

Limitations of the Research Paper

The long sentences are used in the document (line 56-59 and 65-68) it’s better to make simple and small sentence so that the reader may get benefit from the paper.

The paper doesn't talk much about the specific problems faced during the ethnographic observation part of the study, which could have offered helpful insights into practical difficulties.

Although the paper extensively covers the importance of personal and team reflective practices, it doesn't go deep into the possible limitations of this approach, missing a critical evaluation of its effectiveness.

There's limited exploration of potential biases that might have influenced the researchers' observations and interpretations, which could affect the study's validity and reliability.

The paper doesn't address how the researchers' backgrounds, experiences, and perspectives might have impacted data collection and analysis, which could affect the generalizability of the results.

The paper could benefit from a more detailed discussion on the ethical considerations and challenges encountered during the research, especially in sensitive settings like acute mental health wards.

The paper could have included a more detailed discussion on the study's implications for future research and practice in acute mental health settings, highlighting areas for further investigation and development.

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Reviewer #1: No

Reviewer #2: No

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Conducting Qualitative Research on Acute Mental Health Inpatient Wards: Lessons from the Field

PONE-D-24-24720R1

Dear Dr. Berry,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Dongmei Li

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: (No Response)

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Based on the detailed information provided about the manuscript and the authors' revisions in response to the previous feedback, here are my recommendation.

Overall, the authors have made significant strides in addressing the main concerns raised during the initial review. The improvements made to the theoretical grounding, sampling explanation, and ethical considerations greatly strengthen the manuscript.

Given these revisions and their potential contribution to the field, I would suggest that the manuscript be accepted for publication, provided that the authors address any remaining minor concerns, such as adding a brief overview of the findings to give further context to readers.

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Sadia Mushtaq

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