Imagine giving someone a camera and asking them to tell their story through images. The narrative shifts from words alone to something more powerful—visual, tangible, and deeply personal. This is the essence of Photovoice, a participatory research method that merges photography with storytelling, empowering individuals to share their lived experiences. Developed by Wang and Burris in the 1990s, Photovoice serves as a tool for community engagement, fostering dialogue, bridging gaps in understanding, and inspiring action. By enabling individuals to document their realities, it elevates marginalised voices and presents compelling visual narratives that demand attention and change (Hanna & Hanna, 2023).

In mental health research, Photovoice has gained prominence as an approach that uncovers deep insights into lived experiences. One study highlighted how participant-produced photographs captured the stigma, struggles, and recovery journeys of individuals with mental illness (Han & Oliffe, 2016). This demonstrates the transformative potential of Photovoice—not just in research, but as a means of advocacy and system-wide change. The SHINE Project—Strengthening Health Systems by Addressing Community Health Workers’ Mental Well-Being and Agency—integrates Photovoice to document the realities of Community Health Workers (CHWs). Through this method, CHWs become active participants rather than subjects of research, using photography to illustrate their daily experiences. A picture of an empty clinic, an overburdened health worker, or a rare moment of camaraderie among colleagues tells a story that words alone may struggle to convey. By capturing these moments, CHWs highlight their challenges, their resilience, and the systemic changes required to support their mental well-being.

My life feels like this tree — tired and worn from the daily struggles of work and home. But I still have hope. Just like the tree grows new leaves after a tough season, I believe better days will come for me too. – Farida, Female, Barisal

This participatory approach strengthens advocacy efforts by ensuring CHWs’ voices are heard in discussions with policymakers and health system stakeholders. The images they produce serve as evidence, making the case for more supportive policies, better working conditions, and mental health resources within the healthcare system.

However, it’s important to remember that every step of the photovoice process—from building rapport to sharing the findings—shapes the quality and impact of the outcome. Photovoice is not simply about taking random pictures; —it’s about seeing the world through the eyes of those who live in it. Imagine a group of participants gathering in a small room, some hesitant, others excited, holding cameras or smartphones in their hands. Their mission? To tell their own stories, in their way. Here’s a glimpse into how it was done:

Implementing photovoice in SHINE: a step-by-step process on how to implement photovoice in mental health research

1. Setting the stage: Start with a purpose

The orientation begins with a conversation. Not a lecture, but a dialogue—where laughter, concerns, and curiosity mix. In this stage, researchers inform the participants- co-researchers- about the project goal, and CHWs discuss their role in shaping its outcomes. Participants express their hopes, concerns, and the hidden realities they want to bring to light. Trust-building is crucial—Photovoice is not about perfect images but meaningful storytelling

2. Finding the storytellers

Participants are chosen based on their lived experiences within the healthcare system. A diverse group, considering factors such as age, gender, and geographical location, enriches the collective narrative.

3. Learning the art of seeing

Before stepping into the field, participants engage in hands-on practice. This is a good time to inform them about the ethical considerations of taking pictures. Some are familiar with photography; others hold a camera for the first time. They discuss angles, lighting, and framing, but most importantly, they explore what makes an image speak. Every shot has a purpose. A discarded prescription slip, a quiet street at dusk, a waiting room filled with anxious faces—each image carries a message.

4. Capturing everyday realities

CHWs document their daily experiences over a set period, capturing the struggles, triumphs, and nuances of their work. These images provide raw, unfiltered insights into their mental well-being and professional challenges.

5. Analyse together- bringing stories to life

When the CHWs reconvene, they sit in a circle, sharing their photos one by one. Participants explain the significance of their photos, providing context and depth. Themes and patterns emerge as participants and researchers collaboratively interpret the photographs. This shared process ensures the findings remain authentic and representative of diverse community voices.

6. Turning images into action

The final phase involves using these visual narratives for advocacy. CHWs decide how their stories will be shared— whether through community exhibitions, policy forums, or digital campaigns. The images become powerful tools for influencing decision-makers and advocating for systemic improvements in mental health support for CHWs.

Photovoice is more than just a research method – it is a tool for empowerment, advocacy, and change. By integrating Photovoice into the SHINE Project, CHWs are given a platform to voice their realities in ways that demand attention and action. Their stories, captured in powerful images, illuminate the urgent need for mental health support and systemic reform within community health systems. Through this approach, the SHINE Project not only amplifies CHWs’ voices but also paves the way for a more responsive and supportive healthcare environment.

Written by Obaida Karim and Semonty Jahan

References:

● Hanna, L., & Hanna, L. (2023, November 16). Photovoice as a research method for community development. Applied Worldwide | Making Sociology Count. https://appliedworldwide.com/photovoice-as-a-research-method/

● Strack, R. W. (n.d.). What is Photovoice: a brief summary. In University of North Carolina Greensboro. Retrieved December 19, 2024, from https://communityengagement.uncg.edu/wp-content/uploads/2019/11/What-is-Photovoice-A-Breif-Summary_Strack-Dec-2017.pdf

● Skovdal, M., & Rumi, Sk. R. Ullah. (n.d.). Photovoice guidance: 10 simple steps to involve children inneeds assessments. Save the Children. https://bangladesh.savethechildren.net/sites/bangladesh.savethechildren.net/files/library/Photovoice_needs_assessment_guidelines_full_report_0.pdf

● Han, C. S., & Oliffe, J. L. (2016). Photovoice in mental illness research: A review and recommendations. Health:, 20(2), 110-126. https://www.jstor.org/stable/26652338