A picture worth more than one thousand words: A 30-year review of photovoice representation disparities in psychiatric research.

This 30-year review of psychiatric research with Photovoice examined the demographic representation and adherence to action and advocacy goals. Diagnostic and Statistical Manual of Mental Disorders, fifth edition and previous research informed search terms; the search year began in 1992 when Photovoice was created. Fourteen studies met the criteria: original peer-reviewed journal articles, written or translated into English, conducted in the United States, and described exclusively as Photovoice with at least 50% of participants meeting the diagnostic criteria for severe mental illnesses, internalizing disorders, or substance use disorders. Participant social identities (race and ethnicity, economic position, gender), psychiatric diagnoses, and policy-related steps were documented. Results revealed that schizophrenia spectrum disorders were most represented in Photovoice (33.33%), whereas most substance-related and addictive (11.51%), depressive (13.49%), bipolar (8.33%), anxiety (4.76%), and trauma or stressor disorders (3.57%) were less studied. Obsessive-compulsive and related disorders were not represented. Major U.S. census-defined minoritized racial and ethnic groups were nearly, if not entirely, absent. An ethics and social-justice approach to collecting and reporting thorough demographic data (Call et al., 2023) was also lacking. Nearly three quarters of studies initiated the action and advocacy component of Photovoice to mobilize collective change, though what happened next regarding policy outcomes was not well-examined. Results also revealed the emergence of augmented Photovoice (28.5%), which supplemented or integrated Photovoice with behavioral or therapeutic interventions. This study illuminates significant disparities in participant representation, points the field toward a post-Photovoice examination, and provides recommendations for leveraging augmented Photovoice among all three tiers of a public mental health model. (PsycInfo Database Record (c) 2025 APA, all rights reserved).