Given the above potential for remarkable and distinctive therapeutic and social impact, we strongly recommend that CREW be resourced to not only continue, but grow. However, rather than being treated as a ‘model’ that can be standardised, CREW needs to be recognised as a mode of engagement that requires attentive and responsive facilitation (see also Background). Thus, rather than being replicated en-masse, CREW needs to be resourced to slowly get bigger, enabling it to increasingly yet carefully touch mental health service-users and service-providers. In the short term, this could be the development of an apprenticeship approach that enables future facilitators to learn from current facilitators on a 1:1 basis, thereby increasing CREW’s capacity to work with more participants. This approach would also enable CREW to include more facilitators (and therefore participants) from a wide range of genders and ethnicities. In the longer term, CREW should be resourced to develop a facilitate the facilitator programme, allowing multiple practitioners within mental health to learn their mode of engagement through a sustained experiential and reflective process. Over time, this would build a collective of CREW facilitators that could support one another in taking CREW back into mental health services, allowing it to be accessible to as many people as possible.

As CREW continues and grows, we further recommend the following:

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• CREW continues both the sessions and the showcases – it is the combination of these that makes CREW particularly potent and unique.

• Ideally, the CREW sessions are based in a community space, physically outside of clinically-led services. If this is not possible, then CREW facilitators need to be supported to change the space they are given in ways that are conducive to their mode of engagement.

• CREW considers how to make more opportunities for more collective dialogue between participants, perhaps using this to experiment with innovative modes of peer support that focus on not only individual recovery but social analysis and change.

• CREW strengthens their participatory elements by supporting participants to become decision-makers and knowledge-producers with regard to how the programme is run. This could be done through the establishment of an advisory group of past participants – a kind of ‘CREW crew’

• The showcases continue to be community-based and accessible to the public. However, as they grow in reputation and/or size, they must remain ‘grassroots’ – that is, driven by the needs and desires of CREW participants.

• The anti-discrimination and social change potential of the showcases is recognised, resourced and used to inform mainstream mental health campaigning

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A section from an action research evaluation of the CREW programme led by University of East London

 

Creativity, Resilience, Enablement and Wellbeing – or ‘CREW’ – is a pilot art and music programme for people who have experienced distress, madness and/or mental health services in North London. Hosted by Outsider Gallery London and facilitated at Clarendon Recovery College in Haringey, from 2016-2017 three cohorts of adults and young people chose to participate in the programme through referral or

self-referral. Each were guided through weekly, one-hour 1:1 and group sessions for ten weeks before being invited to showcase the art and music that they produced to the community through an evening of exhibitions and performances.

When describing the aims and process of CREW in an interview prior to this evaluation, facilitators Ben Wakeling and Jon Hall spoke of four core elements – a responsive space, the expression of self, relationality and support, and the telling of stories – as briefly introduced below.

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Ia. A responsive space

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I think people say when you take on these...your sort of casting something in stone but you can’t really do that with creativity, you have to sort of respond to the people that are coming and how they work - Jon Hall

 

Everyone deals with their mental health very individually, so two with bipolar would be two very different people...and you throw creativity into the mix with that as well and it’s very difficult to determine, “Right that's your box, that's your box, that's your box and that ticks it all”  -  Ben Wakeling

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Ib. The expression of self

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Creating a responsive space also means “trying to put the person first” (Ben), centring their needs and desires from the first session onwards. For both Ben and Jon, part of the power of creative practice is to allow people to both explore and explode their sense of self. In terms of exploration, Ben spoke of how “generating self awareness” is a “powerful” and “scary” moment to be in but, if achieved, can help to turn things around for an individual. In terms of explosion, Jon noted how filming can allow people to “see their ‘well selves’” reflected back, and while performance can be “scary” the process allows people to “take on a new identity”, a “different option for how they might see themselves” so that “I’m not just somebody with mental health issues”. This process occurs in parallel within the art sessions – as Ben noted at the beginning of the programme, “people always say they can’t sing, they can’t draw...”.

 

Ic. Relationality and support

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Thirdly, CREW offers innovative modes of relationality and support. Happening in a community setting (rather than in hospitals), means the programme enables people to feel “back in it” (Ben) – something that is also enacted through the public showcase events. For Ben, it's also “building a relationship with someone”, “having people turn up, the same people attending sessions” that is a “measure of success”. This kind of engagement also allows for a dropping of “authoritative barriers” (Ben) that can otherwise impede the healing process, and instead inviting and respecting people’s expertise. More broadly, both Ben and Jon aim to build “a culture of peer support” (Jon). While this aspiration is at-risk of becoming institutionalised within clinically-led services, peer support has the scope to take on an innovative form within CREW given the creative nature of the programme. For example, as Jon notes, CREW can be about “setting up a way for people to talk to each other through music” – a form of “sharing”, “connecting”, “bonding” without having to use words.

 

Id. The telling of stories

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Lastly, CREW invites people to “really tell their story” (Ben) through art and music. Whether recording one’s “voice” (Jon), or being able to “hang work on the wall” (Ben), this telling not only lets people know that their lives matter (literally – for their stories are materialised into music and art pieces), but also invites people to witness, understand and shape their experiences individually and collectively, creating the conditions for empowerment.

These four elements – space, self, support and stories – enable CREW to sustain an ethical and engaged practice without imposing a standardised ‘model’ that would otherwise threaten the therapeutic and innovative essence of the programme. The evaluation that follows sought to explore how this approach affected individuals, services and the community, and in doing so makes CREW distinct from other clinical services.

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A quote from an action research evaluation of the CREW programme led by University of East London

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“Spending on therapy such as this, which has very visible results, you have an instant attraction to the general public, it raises awareness about mental health, it raises awareness of NHS funding, and it should be encouraged and this shouldn’t be the final CREW show. It’s incredible. So long live CREW, definitely” -

(BEH MHT patient)

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“You don’t necessarily have to do anything or bring anything to the table. They sort of... open your drawers and get all the pens and pencils out and paper and... it’s all inside you. They just get it out... They’ll get it out of you whether you like it or not, and then you’re really proud of what you’ve done”

- Patient. S​

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“I didn't enjoy the fact that it [CREW] was 1 hour a week. I would much rather have it as a 2 hours a week or 3 or whatever but 1 hour it does a lot of therapy but it has to do more therapy basically... It gives you the chance to get out your house you know what I mean? ...Yeah it's just the time flew past way too fast... I'm actually sad to see it go so I don't know what I'm gonna do next Friday or the Friday after that” - Patient D