Using Photovoice to Capture the Impact of COVID-19 on Providers’ Mental Health: Suggestions for Policy Change

Background and Purpose: There’s a growing amount of literature examining the impact of COVID-19 on community organizations and their staff’s mental health as the pandemic has impacted interorganizational operations, weakened revenue streams, and heightened service demand (Kuenzi et al., 2021) on nonprofit organizations and clinics providing healthcare services. As COVID-19 has become a prolonged crisis, the sustainability of any healthcare response is directly dependent on the health of the providers (Muller et al., 2020).

This paper captures the personal cost of the pandemic specifically from the point of view of service providers from public health non-profit organizations and healthcare centers. We used photovoice with a group of sexual health and HIV care providers to better understand the impacts of COVID-19 on their emotional and mental health as well as the impact of the pandemic on their ability to deliver care for patients and perform at their organizations.

Methods: Photovoice is a form of visual ethnography that integrates inquiry, the arts, and action that is often used in community-based participatory research (CBPR). The Black Women First Initiative is a research grant supporting the design, implementation, and evaluation of bundled evidence-informed interventions for Black women with HIV across 12 demonstration sites. All healthcare providers from Black Women First demonstration sites were invited to attend a photovoice training and practice session on video conferencing (Zoom) during the February 2022 Black Women First All Recipient Convening. Session attendees (n=11) were asked to submit photos that answered the following prompt: “How is COVID-19 Impacting You?” in preparation for the session. Three photos were selected with permission and discussed during the session. Attendees analyzed the images using the SHOWeD approach (Wang, 1997) to reflect on and to inspire health promoting policy.

Findings: Participants shared pictures that revealed their daily struggle during the pandemic. They discussed feelings of isolation, loneliness, stress and burnout that the COVID-19 pandemic has brought to their personal and professional lives. They also discussed coping processes and finding sources of hope in their personal and professional lives. Additionally, participants expressed the need for more support and open conversations about the impacts of COVID-19 in their workplaces, as well as the importance of an organizational culture and policies that prioritize staff’s mental health as well as physical.

Conclusions and Implications: Findings indicate the need for more mental health support for healthcare providers, especially during public health emergencies. Staff and providers would benefit from more mindful work environments that make space for staff members to check in and support one another, allows for breaks, and fosters community to reduce feelings of isolation. Organizational policies and culture should consider and adapt to care for the mental health of staff just as much as their physical health. A lot has been asked from these professionals, even more so in the last 3 years, yet there are still changes that need to be made in organizational policy and structure to support their mental health and their abilities to deliver high quality care to clients.