Over the last number of years there has been growing interest in the use of community-based participatory research (CBPR) for preventing and controlling complex public health problems. Photovoice is one of several qualitative methods utilized in CBPR, as it is a participatory method that has community participants use photography, and stories about their photographs, to identify and represent issues of importance to them. Over the past several years photovoice methodology has been frequently used to explore community health and social issues. One emerging opportunity for the utilization of photovoice methodology is research on community built and social environments, particularly when looking at the context of the neighbourhood. What is missing from the current body of photovoice literature is a critique of the strengths and weaknesses of photovoice as a method for health promotion research (which traditionally emphasizes capacity-building, community-based approaches) and as a method for revealing residents’ perceptions of community as a source of health opportunities or barriers. This paper will begin to address this gap by discussing the successes and challenges of using the photovoice methodology in a recent CBPR project to explore community perceptions of the built and social environment (with the ultimate goal of informing community-based chronic disease prevention initiatives). The paper concludes with methodological recommendations and directions for future research.

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Aim Youth mental health is of paramount significance to society globally. Given early onset of mental disorders and the inadequate access to appropriate services, a meaningful service transformation, based on globally recognized principles, is necessary. The aim of this paper is to describe a national Canadian project designed to achieve transformation of mental health services and to evaluate the impact of such transformation on individual and system related outcomes. Method We describe a model for transformation of services for youth with mental health and substance abuse problems across 14 geographically, linguistically and culturally diverse sites, including large and small urban, rural, First Nations and Inuit communities as well as homeless youth and a post‐secondary educational setting. The principles guiding service transformation and objectives are identical across all sites but the method to achieve them varies depending on prevailing resources, culture, geography and the population to be served and how each community can best utilize the extra resources for transformation. Results Each site is engaged in community mapping of services followed by training, active stakeholder engagement with youth and families, early case identification initiatives, providing rapid access (within 72 hours) to an assessment of the presenting problems, facilitating connection to an appropriate service within 30 days (if required) with no transition based on age within the 11 to 25 age group and a structured evaluation to track outcomes over the period of the study. Conclusions Service transformation that is likely to achieve substantial change involves very detailed and carefully orchestrated processes guided by a set of values, principles, clear objectives, training and evaluation. The evidence gathered from this project can form the basis for scaling up youth mental health services in Canada across a variety of environments.

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