Voices of mental illness through the prism of photography

Today's NHS mental health services are stretched, and private therapy remains an expensive and often inaccessible option. As a result, many of the 1 in 4 adults in the UK who suffer with a mental health problem each year [1] find their own ways to navigate their experiences. A project like South East London Photography (SELPh) could have great benefits for many people as a way of doing this. 

What is SELPh?

SELPh runs a free group for people in the community recovering from mental illness or currently suffering from depression or anxiety. The group aims to reduce social isolation, low self-esteem and mental health stigma, and to encourage expression of feelings and experiences through photography. It is based on photovoice; a participatory action research method in which individuals photograph their everyday experiences [2, 3]. In doing so, they have a voice to communicate issues important to them and effect change.

Over the duration of the project (usually seven weeks), group members take photos each week on a co-agreed mental health-related theme and discuss these during group workshops. Selected work is displayed at a final exhibition, an important platform for the group members to share their experiences and promote issues they care about. SELPh is delivered by the Health Inequalities Research Network (HERON) and is funded by the Wellcome Trust.

Whilst SELPh is not formal therapy, the nature of the group means that many comparable principles are involved. For example, building alliance; goals for the group are set, a series of photographic tasks are assigned, and bonds are formed between group facilitators and members [4]. Within boundaries set during the first session, the group facilitators work flexibly with the group to make sure the project suits their needs. Members have control over the weekly themes and creative approach. The group establishes itself as a non-judgemental, person-centred space in which members feel accepted. Some benefits of SELPh are also similar to those of group therapy. For example, group members realise that they are not alone in their struggles, have the opportunity to offer support to others as well as receive it, and develop an understanding of how they relate to and interact with others [5]. 

Facilitator reflections

In the summer of 2019, myself and two colleagues Zoe Chui (PhD candidate) and Dr Cerisse Gunasinghe (Post-Doctoral Research Associate and Counselling Psychologist) facilitated a SELPh group; I took on the lead role. As I was new to both SELPh and group facilitation, I decided to also participate in the project as a group member; taking and sharing photos. This experience took me by surprise in how powerful it could be. I couldn't think of another time in my life where I have had such a framework in which I could consider my own mental health. Each week brought a new topic: physical health, community, dreams, identity. It was challenging to look at myself through the prism of these elements, yet liberating to explore as abstractly as I wanted through photography and talk about openly with the group.

There was a sense of unity in the group that has strengthened week by week. The group grew into a cohesive and secure environment in which members felt able to share very personal thoughts and experiences. The conversations generated each week by photos were thought-provoking. Lastsummer's group was diverse in terms of age, gender, ethnicity and mental health diagnosis. I have no doubt that this has enriched conversations and allowed the group to hear different perspectives. At certain points over the project, the sense of solidarity in the room was palpable as the group considered certain impacts of mental health. Even when conversation diverged from the theme, the boost the group gained by simply having an accepting space to chat was unmistakeable. We held a final exhibition of work by the SELPh group at Peckham Levels in South London in November 2019 to facilitate a conversation about local mental health.

SELPh is by no means a substitute for therapy; but it can be a great way for people to cope with, reflect on, and share their experiences. Having a different medium through which to communicate was very powerful. With mental health, words are often non-existent or insufficient.

SELPh goes online with our Covid-19 project

In March 2020, the government put in place 'lockdown' measures in response to the Covid-19 pandemic. This meant that we had to postpone our planned SELPh projects. Like many other organisations, we were disappointed to not be able to bring together our group members. Therefore, we have worked to create an online project for people to use photography to explore, express and reflect on how Covid-19 has impacted them. This project launched in June 2020 and is open to all over 16 years of age and living in the UK. For further information on this project or to take part please visit our website www.selphgroup.wordpress.com, and follow our Instagram @selph_online. 

Future directions

Due to demand, we are planning to facilitate multiple SELPh courses per year in future (when possible). Any organisations or groups interested in collaborating with us to run a future SELPh project are welcome to contact us. We will also be publishing a toolkit to enable groups to run their own photovoice projects.

To keep in touch with details about this, or for more information about any of the above, please contact us at [email protected]. 

Hannah Harwood

Research Assistant at King's College London and lead co-ordinator of SELPh

[email protected] 

References

[1] McManus, S., Meltzer, H., Brugha, T. S., Bebbington, P. E., & Jenkins, R. (2009). Adult psychiatric morbidity in England, 2007: results of a household survey. The NHS Information Centre for health and social care.

[2] Baker, T. A., & Wang, C. C. (2006). Photovoice: Use of a participatory action research method to explore the chronic pain experience in older adults. Qualitative health research, 16(10), 1405-1413.

[3] Wang, C. C. (2006). Youth participation in photovoice as a strategy for community change. Journal of community practice, 14(1-2), 147-161.

[4] Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, research & practice, 16(3), 252.

[5] Yalom, I. D., & Leszcz, M. (Collaborator). (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY, US: Basic Books.