Photo-Led Interview Data: Youth Substance Addiction in Assam, India, 2019-2020

Part of The Big Picture project. The data was collected between 2019 and 2020 in the city of Guwahati, Assam. With regards to this data, our use of photovoice involved photo-led/elicitation interviews in which each participants was invited to prepare for interview by taking, and/or collecting, photographs/images relevant to the topic of research. Hence the interview incorporate discussion of the images. The project data consists of transcripts and images from photo-elicitation interviews with 30 young Assamese people, 15 from resilience-to-risk (R2R) and 15 from resilience-for-recovery (R4R) group.

India has committed to implement Mental Health Action Plans and to achieve Sustainable Development Goals, two of which relate to mental health (3.4 & 3.5: National Mental Health Survey of India 2015-16). Assam, one of the states in the northeast of India, presents a complex picture around mental health, constituting an apposite region to explore risk, resilience and recovery. With relatively low mental health problems, Assam offers an opportunity to understand psychological, social and cultural resilience. However, mental health stigma in the region is high and there is an immense mental health treatment gap. Substance Use Disorder (SUD) is acknowledged as an urgent, public health problem in Assam. SUD is particularly high in metro areas (such as Guwahati) and is widespread in school-going males 14-16 years. There is a worrying level of solvent abuse amongst young people, particularly of low socioeconomic status and young age of substance use initiation (8-13 years). The prevalence of substance use within certain social groups and peer cohorts suggests that learning how young people successfully negotiate this risky context would constitute significant new knowledge. Moreover, a resilience approach attends to a full range of mechanisms enabling contextually-appropriate, tailored interventions. We worked with two groups of young people: (i) those successfully refraining from substance use despite being at increased risk (R2R) aged 15-18 years (N=15); and (ii) those in successful recovery from SUD (R4R) aged 19-24 years (N=15). Our overall goal is divided into three inter-related aims and associated research questions as follows. 1. Increase knowledge: To enhance psychological, social and cultural insights into the experience of risk, resilience and recovery with regard to youth substance use in Assam. 2. Enhance voice: To 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. 3. Inform practice: To learn if and how photovoice can be adapted in culturally-sensitive ways to enhance local mental health services seeking to prevent and treat youth substance use in Assam. Participants were invited to generate or collate photographs/images (over 7-10 days) to represent the experiences they want to share at interview around risk, recovery and resilience. Given assumed power differentials, young people may: perceive a standard interview as interrogatory; be unsure about expectations for self-disclosure; fear revelations may be used against them; feel exploited with no direct benefit to them. Photovoice minimises these risks. There is evidence that it facilitates engagement with traditionally ‘hard to reach’ populations and there is reason to believe it can be adjusted to support culturally-sensitive modes of engagement. There is growing evidence that photovoice itself can have therapeutic effects, and the photographs – with or without participant narratives – can be an effective way of documenting and increasing the impact of local interventions. Exploring protective and enabling factors around risk and recovery shed light on complex psychological, familial, social and cultural pathways to, and away from, SUD.

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