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

Hispanic adolescents conceptualized mental health as the ability to feel, express, and manage emotions.

• This definition emerged from Photovoice sessions with 12 adolescents ages 13-17 from two youth centers in Greater Boston.
• Data were analyzed using reflexive thematic analysis.
• The SHOWeD technique was used to guide reflective discussions about participants' photographs.
• This conceptualization differed from clinical or diagnostic framings, centering emotional experience and expression.

Self-expression and coping with distress was identified as a primary mental health priority by Hispanic adolescents.

• Participants emphasized creative outlets and open dialogue as important coping strategies.
• This theme emerged as one of four major priority areas identified through reflexive thematic analysis.
• Participants took photographs reflecting their views on mental health, which anchored discussions about self-expression.

Immigrant family dynamics were identified as significantly influencing Hispanic adolescent mental health.

• Cultural expectations within immigrant families were identified as barriers to emotional well-being.
• Intergenerational silence was specifically named as a barrier to mental health expression and help-seeking.
• This theme represented one of four major mental health priority areas identified by participants.
• Mental health stigma within immigrant families was highlighted as a particular concern.

Peers, trusted adults, and safe community spaces were identified as important influences on Hispanic adolescent mental health.

• This theme emerged as one of four core mental health priorities from the Photovoice discussions.
• Participants were recruited from two youth centers in Greater Boston, suggesting community spaces were already part of their support structures.
• The findings underscore the need for multisystemic and multilayered intervention strategies including family and community settings.

Mental health stigma was identified as a key priority and barrier for Hispanic adolescents.

• Stigma was identified both within immigrant families and broader communities.
• This was one of four major mental health priority areas identified through analysis.
• Addressing stigma was highlighted as a necessary component of culturally responsive mental health promotion for this population.

The study employed Photovoice, a community-based participatory research method, with 12 Hispanic adolescents divided into three groups.

• Participants were ages 13-17 from two youth centers in Greater Boston.
• Each group participated in three meetings: a preparatory workshop, a focus group, and a feedback workshop.
• Data collection occurred 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 the resulting data.

Hispanic adolescents experience disproportionately high rates of mental health issues and face systemic barriers to accessing care, yet their perspectives remain underrepresented in research.

• This disparity and research gap provided the rationale for the study.
• Understanding how Hispanic adolescents define mental health is framed as critical because it shapes beliefs, priorities, and help-seeking behaviors.
• The study was designed to center adolescent voices as a corrective to this underrepresentation.