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User involvement and co-production are imperative to the design, delivery and evaluation of service provision. This chapter provides a brief introduction to these concepts as they relate to mental health, addiction and dual diagnosis. This occurs through an exploration of models of user involvement, particularly, Arnstein’s ladder of participation and MHERs engagement continuum. This is followed by exploring the benefits of user involvement at both a micro and macro level. Co-production – as the highest form of participation is also introduced followed by how these concepts are noted within policy. These concepts are imperative to the creation of a recovery-orientated service that meets the needs of the whole person and their supporters.

Food insecurity is a major public health concern, especially for refugee families. Despite the growing population of refugee families in the USA and the harmful effects on youth’s health and well-being, there are limited qualitative studies exploring food insecurity among US refugee adolescents. The use of community-based participatory research and photovoice can highlight the strength of gathering and sharing underrepresented and disadvantaged group experiences. The purpose of this study was to understand adolescent refugee's food insecurity perspectives and experiences, with a nutrition and food access focus. Three main themes and nine subthemes emerged around the role that food security plays in a healthy, thriving community. The main themes included food must be more accessible in school; importance of food access in one’s community; and food access and creating a vibrant community. Implications regarding how to apply these results with community and school-based food programs are discussed.

This study followed a phenomenological research approach to understand the experiences of refugee youth and what constitutes healthy food access in a community. Data analysis was conducted using Braun and Clarke’s (2006) thematic analysis to ensure that data saturation was met (Guest et al., 2006).

The thematic analysis of the photovoice methodological approach revealed three main themes and nine subthemes around the role that food security plays in a healthy and thriving community. These themes are as follows: food must be more accessible in school; importance of food access in one’s community; and food access and creating a vibrant community.

Funding resources limited the duration of meeting in which we could meet and discuss the photo’s students were taking. Second, consistent with phenomenological studies, the sample size was small. However, common sample size for studies using a phenomenological approach ranged from 5 to 25 (Creswell et al., 2007), which is in alignment with this study. Next, while participants did receive training in the SHOWeD method, the photography training was limited to only one hour. Despite the limited training, participants felt they had sufficient knowledge and skills to take the necessary pictures.

This study provides important policy implications for school-based food programs, such as food pantries and free or reduced school meals, and how it plays an important role in refugee youth’s well-being and education. Based on feedback from the study participants, many school-based food programs were considered not available or easily accessible, and that youth and their families were often unaware of programs available to them. This study revealed the important role schools can play in ensuring food security among refugee youth and their families as well as for refugee youth to reach their full potential equitably.

This study used a creative research approach that integrates photovoice as a means to elevate the voices of a marginalized populations. This approach has been identified as one of the most culturally appropriate method when working with refugee children and youth (Pieloch et al., 2016). Second, the study included having multiple meetings, that recruited from previously established partnerships. This form of community building and activism elevates participants voices (Catalani and Minkler, 2009). Finally, this study used a cycle of photography and discussion and held a final public photo exhibition for both the participant’s community and its influential leaders (Catalani and Minkler, 2009; Evans-Agnew and Rosemberg, 2016). The results of this study have important policy implications for schools and communities.