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Developing a play representing the multifaceted concepts of mental illness, treatment and “wellness”

23 November 2015

In this weeks post Katy Hopkinskatyhopkins1   talks about her unique experience of working with two theatre companies to shape the script of a play about mental health.

Over the past week I have had the pleasure of working with two award winning theatre companies, HOAX and Luminary Theatre to explore the multifaceted concepts of mental illness, treatment and “wellness” through a series of interactive workshops involving academics, clinicians and members of the public. This was a dynamic and exciting two-way process of communication. In the words of one workshop participant, a mental health professional, “ever since I left the Hysterical R&D Workshop I have been seeing the world with a new perspective”.

The workshops’ primary aim was to refine the script of a darkly comedic, absurdist, play about mental health, “Hysterical“, by playwright, Karis E. Halsall of Luminary Theatre in collaboration with HOAX . Together with academics, clinicians and people with experience of mental health difficulties we built a picture of “ideal” and “actual” journeys through the mental health system. These informed the second draft of the script, which was iteratively refined throughout the week. We used multiple facilitation methods, drawing on theatrical techniques to explore the use of vulnerability on stage and understand how this relates to the concepts of mental health and “wellness”. katyhopkins3

The week began with an unrehearsed reading of a first draft script to a mixed audience of mental health experts, followed by a feedback session in which we drew out audience responses using a bottom-up approach, aiming to get their views without colouring them with our own. Interestingly, many of the issues the creative team had identified were also picked up on by the audience, and some very excellent suggestions for improvement were made.

Two intensive workshops followed, exploring the core themes of the play with different groups of people (academics and clinicians on one day, members of the public with lived experience of mental health problems on another). We sought views on “wellness” and “illness”, diagnosis, barriers to seeking help and how to empower mental health service users to take a more active role in their treatment. We were fascinated to note the different, but complimentary perspectives from service users, clinicians and academics. Mental health practitioners in particular expressed a strong desire for more collaborative practice, but a lack of knowledge or confidence to implement it. Service users expressed a similar desire, feeling unheard or uninformed, but not knowing how to access information. One suggestion that arose was a mental health “MOT”; a brief but regular mental health check (similar to screening programs for sexual health or cancer), delivered with the understanding that everyone has a “mental health”, whether “well” or “unwell”. Other suggestions that stood out were upskilling Learning Support Assistants, Community Health Workers and others who engage with the general public on a daily basis to talk about mental health. The production of simple leaflets with easily digestible information about mental health treatments (medication and psychological therapies) and their pros and cons (similar to those available for contraception) was also suggested.

The final day featured a rehearsed reading of a second draft script, refined based on learning from the preceding workshops. The audience included academics, clinicians and members of the public, some of whom had attended previous workshops and some who had not. We were really pleased to note that the audience picked up specifically on, and praised the importance of, aspects of the script that had been refined based on learning from the workshops. For example, the nuanced portrayal of the mental health nurse was commended, as was the strength of the parallel drawn between western and tribal approaches to mental health. Both of which were constructively criticised following the first reading.

Thus grounded in clinical and academic knowledge as well as lived experience of mental health problems, this project is a unique attempt to create a piece of theatre that has a reach far beyond the usual theatre going audience. “Hysterical”, carries strong themes questioning societal concepts of mental health and wellness as well as traditional gender roles. The team also plan to curate visual art exhibitions at various points in the project, which may include items produced by audience members during or after the performances, and a program of outreach will run alongside the play. Ideas from the R&D process have given us a strong steer on what these might look like, although we are still collaboratively designing them. katyhopkins2

The creative team have high hopes for the project, aiming to be a vehicle for destigmatisation, knowledge transfer, and opening a two-way dialogue between academia, mental health workers and the public. We hope to secure Wellcome Trust funding for the further development of the project including additional performances, and a more intensive program of outreach and evaluation.

A preview of the play will be shown at the Vault Theatre Festival in February 2016, and the show will travel to the Brighton Fringe later next year. Contact Katy for more information katherine.hopkins@ucl.ac.uk or visit theHysterical website.

 

 

 

Does poorly reported research make treatments look good?

7 May 2014

Nick Freemantle and Greta Rait publish an editorial in the BMJ on a meta-analysis which found that in the cutting edge field of stem cell research in heart disease the more discrepancies found in a paper the greater the improvement in outcome.  On average, trials with many errors show improved ejection fraction, while trials with no errors find no benefit. What should we make of this?

Find the paper here

The authors work with PRIMENT Clinical Trials Unit, a partnership between the UCL Research Department of Primary Care & Population Health, Division of Psychiatry and the Department of Statistical Science.