Homelessness and Mental Disorder: Policy Considerations

Abstract

‘Photovoice’ is a photographic method that is used for several purposes (e.g. storytelling, building awareness, enhancing personal discovery), including conducting community-based participatory research (CBPR). Since its creation, photovoice has been used as a method for implementing health-related CBPR projects with people experiencing homelessness. As such, this article presents an overview of seven peer-reviewed publications regarding photovoice projects that were conducted with participants who are homeless. The goal of the review is to provide health professionals with a practical summary of the lessons learned from each photovoice project's methods and findings. Based on the literature, the review's major suggestion is that health professionals should plan and implement future projects according to the fundamental aspects of photovoice (e.g. empowerment of participants to document their community, facilitation of group discussions of photos, concerted efforts to reach policymakers).     

A Case Study Using Photovoice to Explore Racial and Social Identity Among Young Black Men: Implications for Social Work Research and Practice

This article describes an exploratory qualitative case study using a research method novel to social work known as Photovoice. This case study of the Photovoice process assesses its value as a community-based participatory research (CBPR) method with marginalized communities within social work research. Photovoice was used to engage young Black men as researchers into their own lived experience. Through a photographic and group participatory project, participants discussed how intersections of race, gender, and sexuality affect their lives and health. While this methodology has proliferated within public health literature, little research exists within social work. Photovoice represents a research well-aligned with core social work values of empowerment and social justice. This method offers our profession a participatory, action-oriented tool to inform practice and policy and does so in the voices of communities who often go unheard.     

‘Weightless?’: disrupting relations of power in/through photographic imagery of persons with intellectual disabilities

Missing in discussions of visual representations of people with intellectual disabilities are their own perspectives. Rooted in Derrida’s concern with the ‘right of inspection’ over visual representations, participatory arts-informed methodologies were used in research with people with intellectual disabilities. They critiqued and then used Photoshop to transform public photographs of labeled people. Responding to visual constructions of labeled persons as ‘weightless’/powerless, they revealed personal experiences of being denied control over their lives and representations. Yet their critiques and transformations reveal possibilities for their re-conceptualization as powerful, subverting stereotypes of labeled people and disrupting relations of power in disability imagery.     

Negotiating a third space for participatory research with people with learning disabilities: an examination of boundaries and spatial practices

The focus of this article is participatory research with and by people with learning disabilities. Drawing on discussions that took place across a series of seminars, we use the concepts of space and boundaries to examine the development of a shared new spatial practice through creative responses to a number of challenges. We examine the boundaries that exist between participatory and non-participatory research; the boundaries that exist between different stakeholders of participatory research; and the boundaries that exist between participatory research with people with learning disabilities and participatory research with other groups. With a particular focus on participatory data analysis and participatory research with people with high support needs, we identify a number of ways in boundaries are being crossed. We argue that the pushing of new boundaries opens up both new and messy spaces and that both are important for the development of participatory research methods.     

The identities and social roles of people with an intellectual disability: challenging dominant cultural worldviews,values and mythologies

Intellectual disability is commonly conceptualised as stigmatised identity with which one has to live. However, within the literature the notion of a damaged identity is contested. The aim of this research was to explore the social construction of intellectual disability, with an emphasis on the identities and social roles of people with an intellectual disability. Informed by a contextualist perspective, this research was conducted within a participatory framework. The co-researchers involved in this research were 18 members of an advocacy agency. Photovoice and conversational interviewing were used to collect data and causal layered analysis was used to deconstruct the data. Analysis of the interactions that emerged across the causal layers revealed a complex dynamic of worldviews which served to construct people with an intellectual disability as incompetent, inherently different and not quite human. For genuine, transformative change to occur, developing an awareness and understanding of social processes, such as dehumanisation, is crucial.     

The art of resilience: photo-stories of inspiration and strength among people with HIV/AIDS

Using the visual arts to aid healing is a common therapy for people with critical illness, yet the use of art to improve the lives of people with HIV is under-utilised. Eight male and 20 female participants living with HIV in urban areas of the Midwest, United States, participated in three group photovoice photo-sharing and discussion sessions, post-project individual interviews and a community photo exhibit. We used a grounded theory approach to analyse interview data and identified three key themes: (1) health and wellness, (2) fear and stigma and (3) restoring a threatened identity. Participants identified how taking photos, reflecting on and sharing them in focus groups helped them express themselves while living with and coping with HIV. Offering photography as form of expression is a way to foster strength and, consequently, improve the lives of people living with HIV. Our participants benefitted from the process of telling their story with images. They were able to express positive aspects of their lives which could be a healthy form of catharsis in and of itself. Future research should continue to investigate how participants in participatory approaches like photovoice actually do benefit from the research. Although we focused this analysis on resilience, photovoice is flexible and participants’ responses to it are varied. Additional outcomes such as impact on mental and physical health are worthy of additional exploration.     

Photovoice as a Tool for Social Justice Workers

Abstract

This article considers the use of Photovoice as a tool for social justice workers. Photovoice is a technique that affords diverse populations of oppressed individuals the opportunity to take social action by raising awareness in the community and with policy-makers through use of a photographic process. The theoretical underpinnings, goals, and uses of Photovoice are reviewed in relation to social work contexts and values. In addition, the inclusion of empowerment theory and group work literature is explored as a natural expansion of the current theoretical underpinnings. Photovoice is a prime example of participatory research, assessment, and social action. The relevance of Photovoice to social work theory and practice is considered and possibilities for use as an integrated practice tool are explained.     

‘I know,I can,I will try’: youths and adults with intellectual disabilities in Sweden using information and communication technology in their everyday life

This study introduces how technology and humans are part of relationships that influence agency among people with disabilities. It aims to focus attention on the use of, and access to, information and communication technology (ICT), and agency among youths and adults with intellectual disabilities. The study draws on empirical research conducted with youths and adults with intellectual disabilities, as well as staff at a day centre. It shows that by drawing upon interests, previous experiences, and cooperating in ICT activities the participants’ agency changed. Also, it shows how disability is relational and how it can be influenced by ICT. An interdisciplinary approach is adopted to interpret the findings and to explore: How do people of different ages with intellectual disabilities experience the use of ICT in their everyday lives? Are people with intellectual disabilities able to influence their level of activity by using ICT? And if so, in what ways?     

‘I walk from trouble’: exploring safeguards with adults with intellectual disabilities – an Australian qualitative study

People living with intellectual disabilities have a right to be safe from abuse and neglect and have a right to be included in the decision-making process determining safeguards that will affect them. However, the research evidence that could underpin good professional practice in terms of co-producing safeguards against abuse and neglect directly involving people with intellectual disabilities is largely missing. This article, based on qualitative research involving semi-structured interviews conducted during the first half of 2014, seeks to strengthen this evidence base. It reports on the prevention strategies identified by 12 adults with intellectual disabilities about how to stay safe and compares these with the findings of similar research. The article suggests that a comprehensive safeguarding approach comprises both life course-focused safety training and access to assisted decision-making. The article argues that given the plethora of risk situations encountered by people living with intellectual disability, assisted decision-making should take the form of a co-creation process that is situation specific and grounded in everyday life.     

Visual metaphors of living with brain injury: exploring and communicating lived experience with an invisible injury

Brain injury can affect cognitive, emotional and physical functioning – consequences that pose challenges to understanding survivors' perspectives on their lives. Furthermore, the injury may be invisible, even clinically, causing additional confusion for affected individuals, family members, co-workers and clinicians. The present study used photovoice with adult brain injury survivors so they could communicate their lived experience. Participants took photographs, discussed them, and selected some for captions. Half of their selected images are visual metaphors that foster a multifaceted view of brain injury with room for negative as well as positive aspects of their experience. Photovoice provided opportunities to communicate a personal voice during group discussions and in study binders, and a group voice in outreach products. Visual metaphors became vehicles for voice as participants used photovoice to make visible their brain injuries and their efforts to wrestle with the impacts and discover new purpose and meaning in life.     

Youth leadership program for changing self-image and attitude toward people with disabilities

Society has a negative attitude toward people with intellectual disabilities or psychiatric disabilities. It is well documented that they are subjected to prejudice, stigma, and negative attitudes (Di Giulio, 2003 ; Finger, 1994 ). Professional literature indicates that information about disabilities and encounters with persons with disabilities can change negative attitudes (Carter, Hughes, Copeland, & Breen, 2001 ; Krajewski & Flaherty, 2000 ). This study accompanied 164 9th-grade students from various junior high schools throughout Israel. Half of the students participated in an integration program for changing attitudes toward persons with disabilities, and the other half served as the control group. The research examined the existence and the degree of relationship between participation in the program, changes in attitudes toward people with disabilities, and self-image. The research findings pointed to a positive change in attitudes of the participants of the program in comparison with the control group, resulting mainly from personal contact with people with disabilities. No relationship was found between levels of self-image of the research group and attitudes toward people with disabilities.     

Homeless Youths’ Interests in Social Action via Photovoice

Engaging homeless youth in services is challenging. Novel methods are needed to better retain and empower this population. Photovoice, an innovative form of community-based participatory research, facilitates participants’ use of photography to document their everyday lives and struggles, while advocating for social change. This study examines, among 22 homeless youth, whether and why youth would be interested in participating in Photovoice activities, the types of social issues youth would be motivated to explore, and homeless youths’ opinions about committing to a longer-term, group-oriented project. Photovoice may represent promise in engaging marginalized and difficult-to-retain populations.     

In the Frame: photovoice and mothers with learning difficulties

This paper presents the results of a photovoice project involving mothers with learning difficulties. Photovoice is a technique that challenges the established politics of representation by putting people in charge of how they document their own lives. The authors describe how the project was carried out and the problems they encountered. Analysis of the content of the mothers' photo albums in the context of their own personal stories throws light on both their individual lives and their collective experience. The results challenge discriminatory views of the women as different mums.     

Mobile technology in inclusive research: tools of empowerment

Inclusive research is an accepted approach when conducting research about individuals with disabilities. No studies have been published to date on using mobile technology to support people with intellectual disabilities as researchers. An inclusive research team of researchers with intellectual disabilities and academic researchers used mobile technology to support research skill acquisition. They conducted 15 joint research training sessions, followed by 10 research meetings. In order to discuss the experience of using iPads to support researchers with intellectual disabilities, the authors used a multiple-case study approach. Findings included the challenges and successes of mobile technology implementation. In conclusion, the iPads enhanced participation opportunities for the researchers with intellectual disabilities not only in the research, but also in other areas of their lives. This also brought to light the vulnerability of women with intellectual disabilities and the lack of control they often experience in their lives.     

Life histories as counter-narratives against dominant and negative stereotypes about people with intellectual disabilities

The history of intellectual disabilities is largely a story of discrimination and social exclusion portraying people with intellectual disability as abnormal and inferior. This article describes a particular methodological approach to inclusive life history research with a small group of women with intellectual disabilities in Iceland. The article documents how, through a four-year collaborative research process, the life histories became counter-narratives to dominant historical beliefs and stereotypes. In addition to the personal empowerment of the women and the construction of a collective memory, this project has also resulted in public sharing of their stories through speaking up and giving presentations, and thus potentially also changing the historical memory.     

Using participatory and creative methods to facilitate emancipatory research with people facing multiple disadvantage: a role for health and care professionals

Participatory and creative research methods are a powerful tool for enabling active engagement in the research process of marginalised people. It can be particularly hard for people living with multiple disadvantage, such as disabled people from ethnic minority backgrounds, to access research projects that are relevant to their lived experience. This article argues that creative and participatory methods facilitate the co-researchers’ engagement in the research process, which thus becomes more empowering. Exploring the congruence of these methods with their professional ethos, health and care professionals can use their skills to develop them further. Both theory and practice examples are presented.     

Changing the method of working with homeless people: a photovoice project in Italy

In Italy, many organizations are experimenting with the Housing First (HF) model to promote a change in how they work with homeless people. This change creates some difficulties, especially in promoting freedom of choice in people involved in the HF programs. This study explored the definition of “home” in homeless people’s points of view. The study participants were 5 homeless men involved in a HF program called “The Road Home” implemented in the city of Padua. Data were collected using Photovoice, a photographic method based on participatory action research. During the project, the participants took photographs to illustrate their definitions of “home” and then engaged in a critical dialogue about the images represented in the photographs. The results of the study showed that occupants identified the home as being related to family, friendship, cohabitation, and hope for the future. The Photovoice project provided an opportunity to promote discussions that revealed the true needs of the people involved, and in the meantime, it brought a change to the program and to the community, in addition to promoting the HF model in the community.     

How do adults with intellectual disabilities use Facebook?

Social networking sites have potential to support social relationships and self-determination of people with intellectual disabilities. However, to date, this issue has received little research attention. To help address this need, we conducted an online research survey to reach adults with intellectual disabilities who use Facebook and to include their voices about their online experiences, challenges, and preferences. We used mixed methods for data collection and analysis. Results from 58 respondents indicated that they use Facebook much as non-disabled users do to connect with family members and real-world friends. At the same time, the respondents reported challenges such as privacy setting and literacy demands. We discuss these findings and how to make social networking sites more accessible for users with intellectual disabilities.