The Big Picture:Adapting PhotoVoice to enhance psychological, social & cultural insights into & prevention & treatment of youth substance use in India

该项目的重点是了解印度年轻人的生活经验，围绕与物质使用障碍（SUD）有关的风险，恢复和复原力。目标是增加知识，加强青年人的声音，并通过影响政策和提高公众意识来告知实践。我们的视觉参与方法- PhotoVoice（PV）-集中了年轻人在努力理解、预防和干预印度与物质使用有关的精神健康困难方面的生活经验-在服务和政策层面。这项研究将在阿萨姆邦进行，我们将探索转移到印度其他邦的可能性。全球心理健康战略优先考虑青少年，因为他们有可能走向终身不利的轨迹。年轻人的心理健康状况不佳也是SUD的一个风险因素，儿童热线基金会报告说，在印度使用物质的人中有13%是儿童。在2015-16年印度全国心理健康调查中，阿萨姆邦的精神障碍患病率最低，因此提供了了解心理，社会和文化适应力的机会。即便如此，在阿萨姆邦，围绕心理健康问题的耻辱感很高，治疗差距巨大，印度调查的阿萨姆报告将青少年SUD列为一个紧迫的问题。我们的目标是：-增强心理，社会和文化的洞察力，了解阿萨姆邦青年物质使用的风险，复原力和恢复的经验-促进阿萨姆邦青年人对物质使用的声音，以减少耻辱，提高公众意识，并为精神和公共卫生政策和实践提供信息-了解PV是否以及如何以文化敏感的方式进行调整，以加强当地的精神卫生服务，寻求预防和治疗阿萨姆邦的青年物质使用。我们将进行照片引导的采访：（i）约15名15-18奥尔兹成功地避免了物质使用，尽管风险增加;（ii）约15名19-24奥尔兹的年轻人成功地从SUD中恢复。这些将使用专题分析进行分析，以探索围绕风险和恢复的保护和有利因素，并将揭示复杂的心理，家庭，社会和文化途径，并远离，SUD。我们对PV的创新是将其扩展到参与式电影制作。因此，参与者将被邀请制作他们的照片海报，以激发约6个简短的，以服从为重点的电影，这些电影涉及的问题以及他们认为最能解决这些问题的变化。我们还将探讨证据如何告知阿萨姆邦的心理健康政策和实践。我们将审查关键的政策文件，并与有目的地抽样的利益相关者进行约15次访谈。材料将使用框架分析进行分析。我们将举办3个利益相关者研讨会，以检查我们对概念化、实践和研究政策途径的评估的可信度，并帮助规划公众意识和政策导向的活动。关于潜在的应用和好处，我们将：-启动社交媒体心理健康摄影活动，以提高对年轻人如何管理物质使用风险的认识和理解，以保持健康;- 通过培训我们的合作伙伴组织的工作人员在设计，交付和分析PV方面加强研究能力，并支持他们推动实施，以改善服务;- 推广PV，将其作为一种低成本、易于实施的工具，最初以预防和治疗SUD为目标;- 开发一个符合ESRC的、开放访问的、教育性的和资源性的电子心理健康网站，包括关于如何提供、分析和评估PV心理健康项目的易于使用的、文化敏感的指导，通过灵活的方式，产出可以为服务发展提供信息;-与泛印度的关键决策者接触，他们能够促进产出的更广泛的服务和/或政策层面的影响，并有助于阿萨姆邦精神卫生政策的制定。

This project focuses on understanding the lived experience of young Indian people around risk, recovery and resilience in relation to substance use disorder (SUD). The goal is to increase knowledge, enhance the voice of young people, and inform practice through impacting policy and promoting public awareness. Our visual participatory method - PhotoVoice (PV) - centralises the lived experience of young people in efforts to understand, prevent and intervene - at both a service and policy level - in substance-use-related mental health difficulties in India. The research will be conducted in Assam and we will explore transferability to other Indian States.Global mental health strategies prioritise adolescents given their potential trajectory towards lifelong disadvantage. Poor mental health in young people is also a risk factor for SUD, and the Childline Foundation reports that 13% of people using substances in India are children. In the National Mental Health Survey of India 2015-16, Assam has the lowest prevalence of mental disorders so offering an opportunity to understand psychological, social and cultural resilience. Even so, in Assam stigma around mental health problems is high, the treatment gap immense, and The Assam Report of The India Survey classifies adolescent SUD as an urgent problem. Our aims are to:-enhance psychological, social and cultural insights into the experience of risk, resilience and recovery with regard to youth substance use in Assam-promote young Assamese people's voice with respect to substance use in order to reduce stigma, raise public awareness and inform mental- and public-health policy and practice-learn if and how PV can be adapted in culturally-sensitive ways to enhance local mental health services seeking to prevent and treat youth substance use in Assam.We will conduct photo-led interviews with: (i) ~fifteen 15-18 year olds successfully refraining from substance use despite being at increased risk; and (ii) ~fifteen 19-24 year olds in successful recovery from SUD. These will be analysed using Thematic Analysis to explore protective and enabling factors around risk and recovery and will shed light on complex psychological, familial, social and cultural pathways to, and away from, SUD. Our innovation of PV is to extend it to participatory film-making. Hence, participants will be invited to make a poster of their photos to inspire ~6 short, resilience-focused films on the issues at stake and the changes they feel could best address them. We will also explore how evidence informs mental health policy and practice in Assam. We will review key policy documents and conduct ~15 interviews with purposefully-sampled stakeholders. Material will be analysed using Framework Analysis. We will hold 3 stakeholder workshops to credibility check our assessment of conceptualisations, practices and research-policy pathways, and to help plan public awareness and policy-directed activities.In relation to potential applications and benefits we will:-launch a social media mental health photographic campaign to raise awareness and understanding of how young people manage risks around substance use in order to stay well;-strengthen research capacity through training staff in our Partner Organisations in the design, delivery and analysis of PV and support them drive implementation where it will improve services;-promote PV as a low-cost, easy-to-implement tool initially targeting prevention and treatment of SUD;-develop an ESRC-compliant, open-access, educational, and resource e-mental health website including easy-to-use, culturally sensitive guidance on how to deliver, analyse and evaluate PV mental health projects, through to flexible ways that outputs can inform service development;-engage with key decision-makers pan-India who are able to facilitate wider service and/or policy level implications of outputs and contribute to the development of an Assam State mental health policy.