Café Photovoice: A Participatory Approach to Program Evaluation in Community Mental Health in the United States

Photovoice is a participatory research method where facilitators give cameras to research participants to graphically represent their lived experiences with photos, so they can explore and share their perspectives on health, family, community, and their futures. Used with a variety of populations worldwide, Photovoice relies on photography, discussion, writing, and outreach to investigate experience and collaborate for change. Within the healthcare setting, research participants can take on an active role in choosing which photographs to utilize and develop their captions to illuminate their lived experiences pertaining to healthcare access and quality of care, and can contribute to decision-making in meaningful ways. This chapter examines the use of Photovoice as part of a program evaluation of an integrated health intervention within a community-based mental health center. During this bilingual project, called Café Photovoice, participants were guided in taking photos to document their “lived experiences” with mental health and/or substance use treatment and services. An important goal of the project was to gather consumer perspectives and experiences related to getting and maintaining health and community services in a Certified Community Behavioral Health Center (CCBHC). In this chapter, we outline the recruitment, content, and facilitation of Café Photovoice sessions implemented in 2021–2022. We provide details of precautions we took to maintain safety during the COVID-19 pandemic, as well as the adaptations made to promote access to technology, and the application of the U.S. National Standards for Culturally and Linguistically Appropriate Services (CLAS) Standards to meet linguistic and cultural needs. We discuss our approach to data analysis, highlight examples of our research themes, including recovery, comprehensive treatment services, and support, and explain how these relate to consumers’ quality of life. Lastly, we describe how the photographs and emergent themes became a growing photography installation in the CCBHC and a virtual gallery. As part of our program evaluation, Café Photovoice has enabled consumers of a CCBHC to use photographs and storytelling to provide a more specific and contextualized view of how they experience their mental and physical health. This has opened a window for consumer engagement and provides important access to stakeholders and the public to understand how some consumers experience community mental health services.