Converge: Educational Opportunitiesfor People who use Mental HealthServices

Outcomes and Evidence2015-16

www.yorksj.ac.uk/converge

Outcomes and Evidence 2015-16

Report Summary

Converge offers educational opportunities to people who use mental health services. The following document sets out our outcomes for the academic year 2015-2016.

Converge offered 31 courses and provided 602 hours of direct teaching contact.

A total of 336 people (164 individuals) completed our courses.

We recorded 180 instances of support given to Converge students.

We involved 85 university students in the delivery of courses and the support of participants.

The Converge Mentor Scheme comprises nine Converge students who recorder over 100 instances of support.

32 university students were involved offering support to 65 Converge students.

Converge is committed to providing robust evidence for the efficacy of its provision; however, with such a varied and complex intervention, it is difficult to adopt one measure that would demonstrate its impact on the mental health and wellbeing of participants. Accordingly we provide a range of evidence, both quantitative and qualitative, that suggests that Converge is having a significant impact on mental health and wellbeing.

The following is a summary of our findings:

Attendance and Retention: 84.63% of people who started our courses completed. We achieved 88.03% attendance to our classes.

Evidence of Progression and Enhancement: this report provides evidence of continuing progression and enhancement through our courses.

Evaluation of a course in Sports Exercise: this report provides compelling evidence for the impact of engagement in sports exercise. Also see Appendix 3.

Highlights for 2015-16

• Converge now has courses in Newcastle and Leeds (see appendix ?)

• Converge was shortlisted for Health Service Journal Award, November 2015

• 10 Converge students have now moved on to higher education.

• Converge students now have library membership and Associate Student status through the Students’ Union.

• Over 80 Converge students performed or exhibited their work at the York St John University Create 16 Arts Festival and the Love Arts York Festival to a combined audience of over 300 people.

• Communitas, the Converge choir performed at York Minster singing a carol written by Laurie Farnell one of its members.

• Out of Character Theatre Company performed Objects of Terror at York Theatre Royal to a combined audience of 300.

• Out of Character Theatre Company perform regularly to nursing students at York University

• Converge and Out of Character gave a performance and keynote talk at an arts and health Conference in Newcastle attended by health professionals and the voluntary sector,

• We continue to work with Peter Byrom-Smith as our ‘Composer in Residence’.

• Converge has published two more newsletters and now has an editorial team which comprises of Converge and University students and staff.

• ‘A Brave New World’ soundscape was commissioned by Jorvik Viking Centre for York’s annual Viking Festival with students and staff from Converge composing the work. The soundscape was heard throughout the festival in Barley Hall.

• The International Centre for Community Music conducted primary research into our music courses at Converge (available on our website)

• Out of Character is now a registered charity

• Out of Character are also participating in workshops in conjunction with West Yorkshire Finding Independence project (WY-FI)

Attendance and Retention Figures

AUTUMN 2015 SPRING 2016

ConvergeCourse

Number ofConvergeStudentPlacesOffered

Number ofConvergeStudents

Completing

Number ofConvergeStudentPlacesOffered

Number ofConvergeStudents

Completing

Art, Drawing on Life 12 7 10 7

Art, Mixed Media 5 5 8 5

Coaching(8 x 1:1 sessions)

10 7 On-going course over both terms

N/A

Communitas Choir 29 24 33 32

Convivial Converge Conversations

Did not run in this term

N/A 8 8

Creative Writing 21 18 18 18

Dance 12 7 9 9

Ensemble 5 5 5 5

Healthy Body, Healthy Mind 10 8 20 14

Music - Improvisation toPerformance

8 6 10 10

Musical Development 20 14 9 9

Out of CharacterIn The Moment (Weds)

Did not run in this term

N/A 7 7

Out of CharacterTheatre Company (Thurs)

18 17 23 22

Rhythm & Percussion 12 11 11 10

Song-writing Did not run in this term

N/A 11 10

Theatre – Introduction to 15 12 Did not run in this term

N/A

Theatre – Working Toward Performance

Did not run in this term

N/A 11 8

Understanding Happiness 11 7 11 9

Understanding Happiness 5 5 Did not run in this N/A

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AUTUMN 2015 SPRING 2016

ConvergeCourse

Number ofConvergeStudentPlacesOffered

Number ofConvergeStudents

Completing

Number ofConvergeStudentPlacesOffered

Number ofConvergeStudents

Completing

Discussion Group term

Student numbers 193 153 204 183

Retention as a termlypercentage

79.27 89.7

Retention as a yearlypercentage

84.63

Publications related to Converge

Rowe, N. (2010). Bridging the Divide: Supporting people who use mental health services to enter higher education. In M. Cooper (Ed.), Changing the Culture of the Campus: Towards an Inclusive Higher Education – Ten Years On. London: European Access Network.

Rowe, N. (2011). Border Crossings: Arts and health work in a university. Journal of Applied Arts and Health, 1(3), 241-250.

Rowe, N, Forshaw, N and Alldred, G (2013). A return to ordinariness: how does working alongside people who use mental health services effect students’ attitudes to mental illness? Journal of Applied Arts and Health.

Rowe, N. (2015). Creating a Healing Campus: A Partnership between a University and a Provider of Mental Health Services. University Partnerships for Community and School System Development. (Vol. 5, pp. 119-134). Online: Emerald Insight.

Asghar, M. and Rowe, N. (2016). Learning from the unfamiliar: How does working with people who use mental health services impact on students' learning and development? Journal of Further and Higher Education. (The full article is available here)

Asghar, Mandy and Rowe, Nick (2016) Reciprocity and critical reflection as the key to social justice in service learning: a case study. Innovations in Education and Teaching International.

Pendle, A. Rowe, N. Britten, D. (2016). Coaching in a non-clinical setting with coachees who access mental health services.   International Journal of Evidence Based coaching and Mentoring 15 (1) 

Stories of Progression and Change

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Pat:

Before starting Converge I was very nervous  because I knew I was stepping out of my comfort zone. And socialising with other people. I have always found it easier and less stressful doing things on my own. The idea of mixing with others filled me with dread. I think this was because I didn’t know the people I was going to be around or what they would think of me.. In order for me to start getting myself out of this place I’d been stuck in for the last few years I knew things had to change.

I was introduced to the Discovery Hub this year and I was allocated a Peer Support Worker who would be there to support me in my next steps moving forward and helping me break down the barriers that have been holding me back for so long. my Peer Support Worker explained a bit about what they could do to help me and talked about Converge and what sort of things they offered.Having found out a bit more about Converge I decided to challenge myself and push myself into doing a short course in Rhythm and Percussion. I was determined to give the course a go and despite how I felt, and the sleepless nights I have had stressing about it, I knew I needed to challenge myself and not let my stress and anxiety define me.

A couple of weeks before Rhythm and Percussion started I met with my Peer Support Worker and they introduced me to Paul who is the course leader, so I could find out a little more about the course and help me feel less anxious when I started. I knew after talking with Paul that this was definitely the course to start with although I never admitted that to anybody. I used to have a love for music, but somewhere over the last few years I went through a tough time and I lost my love for it and even forgot how to play chords on the guitar. I was hoping now that the Rhythm and Percussion course would reignite that love I once had.

The day the course started I had a few doubts in my head but I pushed through and made it. I even managed the whole session and joined in with everyone else. I am slowly beginning to see progress with the changes I am making in life and I know that in order for me to keep moving forward I have to challenge myself from time to time and go for it. With the help of my Peer Support Worker and the Converge programme I know eventually I will get where I need to be

It's great to be part of Converge in the setting of York St John University where everyone accepts you for who you are. it's also nice to be able to be known as student as well—the title which I now live by.

Fin (Fin began as a Converge student is now a university student)

Converge gave me an enthusiasm for writing, a confidence in my work and the security that, given time, I can be a better writer. It is a debt I cannot ever repay, and these little words barely scratch the surface of what I have to say about its effect on my writing and education.

See more stories on our website

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Appendix 1

Support provided.

Converge is able to draw on a range of people to support our students:

Support and Progression worker (Full time)Occupational Therapy Student BuddiesCourse Facilitators (14 people)Peer Mentors (Converge students who have taken on a role as mentors)Converge and University staffArts Student Buddies.

The following tables analyse the report given. It is important to stress the following:

a) This is only a report of support that was recorded. There will be many informal instances of support not represented here.

b) The duration of each session of support is not recorded.

A breakdown of instances of support

Support providerRecordedInstancesof Support

Support and Progression Worker 59

Occupational Therapy Student Buddies 16

Course Facilitators 12

Peer Mentors 32

Converge and University staff 17

Arts Student buddies 7

Grand Total 143

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Types of Support

Type of support Totals

During course 47

Help with Attendance 12

Outside of course 51

Performance/ ExhibitionOther

31 2

Grand Total 143

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Appendix 2

Understanding Happiness: Feedback from Converge students

We ran our first ‘Understanding Happiness’ Course this year. The course was led by a postgraduate psychology student and aimed to discuss the theories related to happiness.

The following is student feedback:

Participant responses at the end of the ‘Understanding Happiness’ course.

Q What have you found interesting / helpful?

- Working in groups. Interacting with one another- Working in groups. Making new friends- Getting away from the ‘must be positive’ rhetoric. Setting ‘appropriate and

achievable’ goals instead of shooting for the stars- Discussing what makes us happy – more of this (I think people enjoyed that - I did)- There can be a ‘positive’ side to negativity- Ideas from others’ perspectives- Debating, discussion. Accepting others discussions & points- Criticism of ‘positive thinking’- The ideas to feel better, eg running, creativity, music, writing etc- Comparing different theories of happiness and seeing how different they can be.

Eastern vs Western- What was interesting was the people talking about their feelings- Helping us to understand is very useful. 70% of arguments come from

misunderstanding- The importance of going out with friends. Listen to others but don’t judge- Shared activities and the importance of ‘really listening’ to others – what do people

really mean- Appreciation of self and others – giving a sense of identity- Finding / remembering ways to experience awe – watching stars, music,

Q What have you disagreed with or found unhelpful?

- I disagree with the idea that it’s best not to strive for happiness. I think it’s very important and lots of effort needed for a deeper happiness

- What was unhelpful for me was talking about what people had said when they are people from a long time ago

- Why!!

Q What would be good to include if the course ran again?

- Maybe a dedicated session on mindfulness early on – a lot of what was discussed related to mindfulness

- Have a written exam at the end (v informal) to ensure that everyone understands! After all, that is the class’s point!

- Meditation. Different ‘concepts’ such as ‘emptiness’

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- More small group work or one to one rather than lecture format. We’ve had good discussing

- What is your background!! Where do you come from – where are you going!!- Physical exercise and impact on happiness- More written stuff to take away about ideas of how to practically make changes- Train yourself to be happy / positive- Relationship between happiness and self esteem- The appreciation of others and acceptance of self- Personality types on happiness- Zen & mindfulness- What would be good next time is more of people writing their own [sic]- A quote / news from ‘positive news’ websites- More group work - allocate each a specific task?

Q Any other thoughts or feelings?

- Problems help us train up and strengthen for a deeper happiness- Are there simple answers to simple questions or is life too complex now?!!- It was great discussing different approaches / philosophies instead of a prescriptive

course- V good how others’ views were noted, both in history and in the classroom! It gave

us an understanding!- My thoughts about it are that I found it good when people talked about their stories- Personal freedom. Liberty!- The course does help us understand some ideas. So thank you!- We are here to be happy and not give up and settle for peanuts- Lots of good discussion. People sharing ideas openly- Positive thinking. Anticipation, prioritising, logical thinking, analysing thoughts,

recording ideas, informed decisions

Q What is happiness to you?

- Nice to have it acknowledged that a lot of Western philosophy defining happiness comes from privileged intellectuals!

- Unsustainable? Contentment: take the good with the bad & count your blessings- Comes when you don’t strive for it- An internal happiness regardless of external factors- In your childhood you have a black and white happiness – in adulthood it’s more grey

and pragmatic happiness

Q What tools can we use?

- Andy Puddicombe – Headspace.com (meditation & acceptance) Also a TED talk- Writing- The ability to relate to others on the course

Other comments on course materials:

- Need to stick with the negative emotion to understand what needs to change and motivate change. Don’t deny or avoid negative experiences

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- Negative experiences often lead to positive change, seeking spirit and effort to create something better. Poison to medicine and creating value out of whatever.

- Shame is a real killer! Mistakes are OK. Being different is OK- Fleeting happiness dependent on health, wealth, relationships, age etc. Deeper

happiness not shaken by these changes- It is important to seek happiness and have purpose in our lives. Lots of philosophies

seek it.- Difference between meaning & happiness- Doing things for others. Helping friends and strangers

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Appendix 3

Healthy Body Healthy Mind: Evaluation

Martin Bond, M.Sc. - YSJActive Development Officer

Introduction

Following a previously successful Healthy Body Healthy Mind (HBHM) project, Converge commissioned YSJActive to deliver a further HBHM project designed specifically for people with mental health issues, which consisted of 12 sport/exercise sessions which were facilitated over a 6-week period from 02 March to 17 April 2015. The initial plan was to alternate between exercise and sports-based sessions. However, group feedback from the first session determined that each session would have a combination of sport and exercise. Subsequent sessions were designed based on the requests of the participants.

This report aims to provide a brief evaluation of this project.

Results

Total attendance = 126, with 18 (5 female) different participants attending at least one session. Average attendance per session = 10.5, with each person attending a mean average of 7 sessions. Three of the participants attended just one session. If these 3 participants are removed from the statistics as anomalies, then the remaining participants each attended a mean average of 8.2 sessions (retention rate = 68.33%). In contrast 1 person attended all 12 sessions.

Student volunteers

I was accompanied by four undergraduate sport science student volunteers who acted as exercise buddies to help provide support to me and the participants, as required. This will also enhance their professional development.

Film

A promotional video containing footage from one of the sessions and an interview involving me is in the process of being edited.

Final thoughts

Overall, I think the programme was a huge success with excellent attendance rates. The programme empowered participants to make their own choices with regards to sport and exercise. The programme benefitted from involving the next generation of sport/exercise professionals. Finally, the promotional video will help to further promote Converge, the university and YSJActive.

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Appendix 4

Two Converge students talk about their experience of the project.

The Art of Normality

Open days, taster course sessions and workshops, courses, enrolment, and student.

These are some of the words used by Converge and the sense of feeling like a person gaining an identity and a belonging with acceptance and no judgment.

For people who use Mental Health services, it is easy to be labelled as a “service user” and feel somewhat limited by what is available. It can feel sometimes that attending places and getting involved can feel daunting and somewhat a drag, with perhaps no sense of a future goal or motivation, except that of oneself in the aid of recovery.

Converge does not feel like that from this person’s point view.

For me, Converge gave me my identity again. It made me feel that I was a person with the possibility of growing, expanding, creating and finding the means to rebuild a shattered confidence.

You feel a part of the university, involved, taking courses, which you have formally enrolled on. Taking the advice, which is given by course tutors, encouraged to express and participate and be fully involved with the facilities and surroundings of a great university. There is a chance to push yourself, becoming a mentor to other students and even where appropriate encouraged to run your own designed workshop.

The Converge staff are friendly, helpful, understanding, non-patronising, available and “normal human beings”, meaning that you are spoken to and treated just like anybody else and any other student who is part of the university without feeling that you have been labelled.

There is a variety of courses to enrol on which are Art based, as well as new development courses in physical exercises and business studies.

So why should been enrolled on these courses be any different to anywhere else? For me, it’s all the hard work that has been put in over months can be presented with an end of term of performance and exhibition from across all the courses

By doing this you feel that there is another reason why you’re enrolled on the courses. The adrenaline, energetic, fuelled buzz, to show other people, family and friends what you can and have achieved regardless to whom you are and your own personal circumstances, is an overwhelming sense of pride, place and achievement, and the hunger to do more. At least, that’s what it feels and means to me.

Without the possibilities that Converge has to offer I would hate to think where I and perhaps many other people might be in their lives. It has breathed new life back into my bones, and perhaps, just maybe, a brighter future with new beginnings.

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My journey to Converge

In mid-2006, I lost my mind to schizophrenia. That’s what I put on forms. It’s not fashionable to label and categorise the mentally ill, which I have found curious since I first came into contact with mental health professionals.

I did not begin the road to recovery until after I discovered I was seriously mentally ill on 21st July 2014. That is how I wound up with the Standard-setting Converge programme, via a splendid OT at Bootham called Cecille. She took me to York St. John in person.

I will get on with what is important instead. I have seen what Converge does. Folk who’ve suffered disgusting dehumanisation of the most personal kind, misery and loss, regaining a measure of their true selves. Many - some of whom could scarcely read - becoming proud of their poetry and their prose, pleased to read their work aloud in class.

Converge staff are no jobsworths either. They must be very carefully chosen, because I have not encountered many people who, despite their decency, intelligence and good intentions, are not fazed by some of us nutters: reciprocating with something or other that is not needed. The Converge staff are indistinguishable from the loons. They’re our mates and I, for my part, am indebted.

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Appendix 5

Student Research

Soul Medicine: An Investigation into the Experience of Studentson the Converge Theatre Course

Student research into the experience of 4 student on the Converge theatre course. The full dissertation is available on request. The conclusion is as follows:

This study has aimed to investigate the experience of four students on the Converge theatre course. All the participants interviewed in this study had a very positive experience on the course. Although the main aim of Converge is to offer educational opportunities to people with a history of mental illness, this study clearly shows that it offers much more than that. It gives learners the opportunity to socially interact and make friends with peers and support each other in relation to both their education and their mental health. Being around others who have also experienced mental ill health was reported to be extremely beneficial as it helped to reduce isolation and empowered participants towards recovery. Some of the more experienced group members were seen as 'role models,' as participants had witnessed how much they had changed and this made them feel more motivated and empowered to do the same.

All participants experienced an increase in confidence and self-esteem as a result of both the social environment of the course, and the theatre exercises, in particular improvisation. They also felt that they gained a higher understanding of themselves and an ability to see both their strengths as opposed to just their weaknesses. Taking part in theatre and being supported through it by fellow group members and the course tutors saw the participants' mental health and general wellbeing improve; in two cases significantly, while more subtly for the other two participants, who said that they felt the improvements would continue the longer they stayed on the course. This brings forward a suggestion for further research: a case study exploring students' journeys throughout their time on the theatre course. This could involve interviews with the participants before they started the theatre course, halfway through the academic year and at the end of the academic year, to show what they felt had changed and improved as a result of taking part in the course.

Another positive factor of the course was that it facilitated new learning and a chance to be creative for the participants, which they otherwise would not have experienced. The findings show that the participants found working together as a team intellectually stimulating, and the end performance, on the most part, was a positive goal to work towards. Being a part of an educational course at a university also evoked a sense of pride in the participants, as this was an achievement that they could tell people about in social situations outside of the course. The fact that the students were treated as equals by the course leaders, not as 'people with a mental illness,' was hugely empowering and freeing for the participants, as they had the opportunity to put forward an identity that did not involve their mental health history.

One possible improvement to the course that arose from the findings was that the tutors could be more aware of the anxiety some participants may feel towards the end performance, and regularly check with them that they are comfortable with what they were planning to do. Another improvement could be to spread the word more about the support

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available to Converge students, such as the Mentoring Scheme, the Student Buddy Scheme and the Discovery Hub. This is because fear of starting the course was identified as a barrier for prospective future students, as they may be afraid of starting something they didn't know very much about alone. Therefore, if mental health services were aware of the support that Converge can offer to new students, they could pass this information on to clients who they were thinking about referring to Converge. Knowing that this support is available could help reduce anxiety around beginning the course and would reduce the chance of people rejecting Converge because of this fear. In addition, continuing to clearly show that Converge is focused on educational opportunities as opposed to mental health could encourage people to join, as a fear of being labelled was also identified as a barrier. A further suggestion for improvement was to keep asking what the students wanted to work on, or wanted to gain, regularly throughout the course, to ensure that their aims and goals were still being met.

To conclude, it is evident that both the social side of the Converge theatre course and the learning, knowledge gaining side has had a positive impact on the participants' lives both inside and outside of the course. The findings of this research imply that although Converge is not therapy, it is therapeutic in many ways. This supports the researcher's initial rationale that groups like Converge should be more accessible and widespread, and theatre and arts in general is an effective, alternative way of improving people's mental health and wellbeing. As Shaun McNiff puts it, "Whenever illness is associated with loss of soul, the arts emerge spontaneously as remedies - soul medicine," (1992, page 1).

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Appendix 6

Student research:

Facilitators and obstacles to participation in a community choir:a survey of choir members’ perspectives

Susie Wright

Summary

Research aim

Communitas, a York community choir, was established in 2008 as one of the arts courses offered by Converge. Its 50 members comprise York St John University students and staff and Converge students. A growing evidence base supports the correlation between singing and improved health and wellbeing in a diverse range of social groups (Bailey and Davidson, 2005; Livesey et al., 2012; Judd and Pooley, 2014). In the light of this evidence, a research study was designed to identify the facilitators and obstacles to participation in this health-enhancing occupation. It was hoped that the results would helpfully inform leaders’ approach to promoting attendance and engagement in Communitas.

Method

Sample: 38 Communitas members present at the rehearsal on 2nd December 2014.

Data collection tool: an original questionnaire posing both open and closed questions

Data analysis: closed questions generated quantitative data, which were analysed using descriptive statistics. The qualitative responses to open questions were analysed thematically according to Braun and Clarke’s (2006) six-stage model. The two sets of results were synthesised.

To reflect the values of Converge and challenge the stigma attached to mental health problems, questionnaires were distributed to all choir members present at a rehearsal and results were not categorised according to mental health status.

Results and conclusions

38 people completed the questionnaire. The equal gender split in the sample was notable compared to the widespread female bias in choirs. Over a third of respondents had never sung in a choir prior to joining Communitas, which attests to the choir’s successful integration of beginners. The most common factors hindering participation and engagement in Communitas were found to be tiredness, work commitments, mental health problems and anxiety. The most supportive factors were reported to be the setup of Communitas (including the rehearsal time, location, and the absence of musical notation), good health, social support, personal attributes and skills (including organisation skills, focused attention, and attending to one’s health). Consistent with previous studies, respondents were most motivated to participate in Communitas by the sense of community, learning opportunities and positive emotions.

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Limitations

This study does not represent the experiences of those who have not overcome obstacles to joining, people who have left the choir, and members absent at data collection. However, it helpfully identifies past and present difficulties affecting the participation of current members which may reflect challenges experienced by those who have been unable to join Communitas.

References

Bailey, B. A. and Davidson, J. W. (2005) Effects of group singing and performance for marginalized and middle-class singers. Psychology of Music [Internet], 33, pp. 269–303. Available from http://pom.sagepub.com.ezproxy.yorksj.ac.uk/content/33/3/269 [Accessed 24th October 2014].

Braun, V. and Clarke, V. (2006) Using thematic analysis in psychology. Qualitative Research in Psychology [Internet], 3 (2), pp. 77-101. Available from http://www.tandfonline.com.ezproxy.yorksj.ac.uk/doi/abs/10.1191/1478088706qp063oa [Accessed 24th October 2014].

Coleman, L. (2013) An Investigation into the Experiences and Perspectives of Members of a Community Choir. Unpublished BSc (Hons) dissertation. York St John University.

Judd, M., Pooley, J.A. (2014) The psychological benefits of participating in group singing for members of the general public (2014) Psychology of Music [Internet], 42(2), pp.269-283. Available from http://pom.sagepub.com.ezproxy.yorksj.ac.uk/content/42/2/269.full.pdf+html [Accessed 28th October 2014].

Livesey, L., Clift, S., Morrison, I., Camic, P. (2012) Benefits of choral singing for social and mental wellbeing: qualitative findings from a cross-national survey of choir members. Journal of Public Mental Health [Internet], 11 (), pp. 10-26. Available from http://www.emeraldinsight.com.ezproxy.yorksj.ac.uk/doi/pdfplus/10.1108/17465721211207275 [Accessed 27 October 2014].

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