Photovoice as a promising public engagement approach: capturing and communicating ethnic minority people’s lived experiences of severe mental illness and its treatment

• Published in: BMJ open quality Vol. 8; no. 4; p. e000665
• Main Authors: Halvorsrud, Kristoffer, Rhodes, James, Webster, George, Francis, Joy, Haarmans, Maria, Dawkins, Natalia, Nazroo, James, Bhui, Kamaldeep, Cooper, Patrick, Harris, Patrick, James, Verona, Ogowewo, Oghenekome, Stephens, Anthony, Thorn, Jacqueline, Annette, Martin, Duruk-Ferreira, Nulifer, Pandey, Manisha
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 01.11.2019; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Healthcare quality improvement; Holistic medicine; Mental disorders; Mental health; Minority & ethnic groups; Patient-centered care; Patient-centred care; Post traumatic stress disorder; Quality control; Quality improvement; Short Report; Systematic review; Workshops; Patient-centred care; Healthcare quality improvement; Mental health
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2019-000665

Correspondence to Dr Kristoffer Halvorsrud; k.halvorsrud@qmul.ac.uk Problem Mental health related stigma, within widespread discrimination and exclusion,1 inhibits many from seeking help.2–4 Moreover, conventional therapeutic methods relying on the spoken word only may not elucidate the full range and nuances of lived experiences.5 6 The use of photography alongside narratives (photovoice) can provide a powerful means for ethnic minority service users and their carers to communicate these experiences, with photographic displays to a broader audience contributing towards destigmatising mental illness. Post-it notes provided a simple, unstructured and anonymous feedback method after each workshop/exhibition, revealing how photography was seen as an accessible and creative means to communicate priorities, while exhibition delegates overwhelmingly agreed that photos and captions were well displayed to communicate mental health narratives (see table 2). Table 1 Key characteristics of photovoice participants Location, n (%)  London 12 (57.14)  Manchester 9 (42.86) Stakeholder identity, n (%)    Service user (currently or former) 19 (90.48)  Carer 2 (9.52) Age, mean±SD    (n=18 responses) 47.06±12.90 Gender, n (%)    Male 9 (42.86)  Female 11 (52.38)  Other 1 (4.76) Ethnicity, n (%)    Black African 4 (19.05)  Black British 2 (9.52)  Black Caribbean 5 (23.81)  South Asian 5 (23.81)  Other Asian 1 (4.76)  Arab 1 (4.76)  White and Asian 1 (4.76)  White Other 2 (9.52) Reported diagnoses (eg, International Classification of Diseases), n (%)    Schizophrenia 4 (23.53)  Bipolar disorder 4 (23.53)  Schizoaffective disorder 1 (5.88)  Personality disorder 2 (11.76)  Post-traumatic stress disorder 1 (5.88)  Severe depression 3 (17.65)  Obsessive-compulsive disorder 1 (5.88)  Substance misuse 1 (5.88) Returned camera with photos, n (%)    Yes 16 (76.19)  No 5 (23.81) Table 2 Project feedback and statements Rated feedback (on 5-point Likert Scale) from delegates at public exhibitions ‘Overall I found this event a useful experience’ Mean±SD=4.44±1.00 23 of 25 respondents (92%) either ‘very strongly’ or ‘strongly’ agreed to this statement ‘The photos and captions were well displayed to communicate the narratives of lived experience of mental health and its treatment’ Mean±SD=4.48±1.12 23 of 25 respondents (92%) either ‘very strongly’ or ‘strongly’ agreed to this statement Themes and supporting participant statements Creative and empowering method 'We talk about these things all the time and are told to write these things down but to take photographs like these is better – it helps us to concentrate and focus on what matters. Because when you look at the picture, the picture is always there for you … and then you can share to people about it.