See Me and Hear Me: A Photovoice Study of Hispanic Adolescents' Mental Health Conceptualization and Priorities

Background and Purpose:

Hispanic adolescents experience high rates of poor mental health, sadness, and hopelessness—key indicators of depression—and low access to mental health services, yet their perspectives on mental health remain underexplored. Understanding how they conceptualize mental health is essential, as it shapes their beliefs, priorities, and patterns of care-seeking, informing strategies to reduce depressive symptoms and enhance service engagement. To drive transformative change, social work must center the voices of those it serves and employ innovative, collaborative, and community-engaged methods to translate research into practice and policy. This study uses Photovoice, community-based participatory research, to answer the research question: How do Hispanic adolescents define mental health, and what are their priorities?

Methods:

Nine focus groups with 12 Hispanic adolescents aged 13 to 17 were conducted from June 2024 to February 2025. Adolescents were recruited from two youth community centers that provide life and vocational skills in the Greater Boston area. As part of the Photovoice methodology, participants were asked to use cameras to visually capture their’ perceptions about the research question. This study included five phases: 1) Initial focus groups (n=3), where the project and cameras were introduced to the youth. 2) Photograph taking, where adolescents took photographs over a week. 3) Second focus groups (n=3) were conducted using SHOWeD technique (e.g., what you see, what’s happening) to reflect on the photographs. 4) Third focus groups (n=3) where the research team and the participants provided a summary of the findings, conducted member-checking validation, and discussed potential places for photo-exhibition. 5) Conduct a photo exhibition in the community library to raise awareness and create change. We used thematic analysis to analyze the findings.

Results:

Findings revealed that this group of Hispanic adolescents define mental health as complex, unique, and unconfined to a condition, place, or person. Through thematic analysis, we found five themes that summarize the way in which mental health permeates all aspects of adolescents’ lives: 1) At the individual level, adolescents discussed their sense of self, personal growth, and coping skills. 2) At the relational level, parents, siblings, friends, and adults were discussed as both sources of support and stress. 3) At the cultural level, adolescents discussed the vicissitudes of living within immigrant families, including cultural negotiations, language, and stigma about mental health. 4) At the contextual level, youth community centers, neighborhoods, and the impact of “higher powers”—meaning things not in adolescents’ control—such as immigration laws and school policies, were identified as essential to their mental health. 5) The role of trusted adults in the youth community centers as sources of mental health support was highlighted.

Conclusions and Implications

With its expertise in ecological systems, social work is poised to improve the mental health and well-being of Hispanic adolescents—who make up 25% of the total US population under 18. To effectuate tangible change, social workers are required to invest in and advocate for developmentally and culturally responsive practices that can lead to effective policies that target the entire ecosystem of Hispanic adolescents.