“One Image After Another”: Photographic Portrayals of Recovery Among Formerly Homeless Adults With Serious Mental Illness

Introduction: This paper discusses the use of respondent-controlled photo elicitation interviewing (PEI) in order to explore aspects of participants’ lives more easily broached via images than direct verbal elicitation alone. Research questions guiding the inquiry include: 1) how are newly-housed individuals’ experiences of recovery conveyed through photographic portrayals?; 2) how does photographic content and accompanying  narration compare with verbal-only interview data?

Methods: PEI was conducted with 18 participants in a qualitative study of formerly homeless men and women with serious mental illness. Following a respondent-controlled approach, participants were asked to take up to 18 photographs over a two week period visually portraying positive and negative aspects of their lives and subsequently narrate the meaning of the photos in a one-on-one interview.  Verbatim transcripts and 285 photographs were coded and analyzed using content as well as thematic analysis (Boyatzis, 1999).

Findings: Content analysis showed that participants took 208 photos in the community and 77 inside their apartments. Participants narrated their recovery experience along two themes. Participants who used “a slice of life” approach (n=12) concentrated on quotidian aspects of their lives whereas participants whose approach was “then vs. now” (n=6) contrasted negative events in their past to their more positive current life situation. While all of the female participants (n=4) chose a “slice of life” approach, male participants (n=14) used both approaches almost evenly ("slice of life"=8; "then vs. now"=6). More than half (11/18) chose to emphasize positive aspects of their lives in the photos, and 4/18 opted to exclude negative photographs altogether. Analysis of the transcripts revealed four themes: 1) pride in one’s community; 2) future hopes and aspirations; 3) mobility and access to resources; and 4) ontological security (the benefits of housing). Comparisons to content from earlier verbal-only interviews showed no contradictions but new and more vivid descriptions of life experiences.

Discussion: Individualized PEI offered visual and subjective portrayals of participants’ lives that complemented and deepened what was learned from verbal-only interviews. It also revealed optimistic accounts of participants’ goals and dreams, indicated their mobility in moving around the city, and gave them the opportunity to reflect on living in (and defining) their communities. Respondent-controlled PEI also proved to be valuable in empowering participants through control of the camera and their accompanying narratives. Given the subjective and intangible aspects of mental health recovery, photographs and other visual methods are an additional means of documenting its progress and giving consumers the opportunity to “show and tell” both literally and figuratively.