See me and hear me: a Photovoice study of Hispanic adolescents’ mental health conceptualization and priorities in the USA

Hispanic adolescents experience disproportionately high rates of mental health issues and face systemic barriers to accessing care, yet their perspectives remain underrepresented in research. Understanding how they define mental health is critical, as it shapes beliefs, priorities, and help-seeking behaviors. This study employed Photovoice, a community-based participatory research (CBPR) method, to explore Hispanic adolescents' conceptualizations of mental health and their priorities. Twelve adolescents (ages 13-17) from two youth centers in Greater Boston were divided into three groups. Each group participated in three meetings (a preparatory workshop, a focus group, and a feedback workshop) between June 2024 and February 2025. Participants took photographs reflecting their views on mental health, followed by reflective discussions using the SHOWeD technique. Reflexive thematic analysis was used to analyze data. Mental health was defined as the ability to feel, express, and manage emotions. Adolescents' mental health priorities were (i) self-expression and coping with distress; (ii) the role of immigrant families in adolescent mental health; (iii) the influence of peers, trusted adults, and safe community spaces in adolescent mental health; and (iv) mental health stigma. Participants emphasized creative outlets and open dialogue, while identifying cultural expectations and intergenerational silence as barriers to emotional well-being. Results underscore the need for culturally responsive mental health promotion that centers adolescent voices. Interventions should foster safe spaces for expression, validate lived experiences, and address stigma within immigrant families and communities. Intervention strategies must be multisystemic and multilayered-including family and community settings-to advance mental health equity and ensure sustainable support for Hispanic adolescents.