In Gloucestershire, The Music Works has been working with young people and teachers in two schools to co-create a music programme to use music as a coping strategy to improve mental well-being. The programme was specifically targeted to young people experiencing low- to medium- level mental health difficulties and who are believed to be at risk of self-harm. In this blog, one of the four music leaders, Misha Law, shares some of her learning and a few tips from her experience of the programme. In the next blog in this series in January 2018, project manager Anita Holford will share some of the overall learning about the programme, and the final evaluation report
About Music Minds
Music Minds is a music-led approach to reducing mental health issues in teenagers with a focus on self-harm, body-image, eating disorders and stress. It is being piloted by Gloucestershire-based community music charity, The Music Works, and has been part of a wider programme of cultural commissioning work in Gloucestershire - looking at alternative approaches to the medicalised model of health. The work is part of the Arts Council England-funded Cultural Commissioning Programme, for which Gloucestershire has been selected as one of two UK pilot regions (the other is in Kent). Funding has come from Youth Music, NHS Commissioning Gloucestershire, Gloucestershire Healthy Living and Learning, and Make Music Gloucestershire, the county’s music education hub.
The Phase 1 pilot consisted of four ten-week programmes, two in each of two schools, each involving groups of up to 15 students in year 9, plus ‘universal’ (whole school or whole year) presentations/talks and taster days; the Phase 2 pilot consists of one continuation programme in each school, one with year 9s and the current one with year 8s, both adapted following feedback from young people and teachers. Running alongside this, there has been a programme of one-to-one work in hospital education, with young people who aren't able to attend school because of their mental health problems. The music sessions are led by young people's interests but largely involve songwriting, singing and music technology.
About the young people
Most of the young people who are taking part have been identified as having some issues which put them at risk of escalating mental health issues, whether that is difficulties at home, social issues, bereavement, additional needs etc.
This is the third time I am delivering the programme together with another TMW music leader and each time we have learned, changed and adapted it based on our experiences and feedback from the young people. At the end of each Phase there has been a focus group with young people: this is no just ‘consultation’ or ‘feedback’: we’ve asked them to help us to shape the programme for the next time, and explained that we need their help to make it better and more effective for other young people in the county. They’ve responded well, giving us lots of useful insights and suggestions.
One of the main changes that I have found to be most successful is making sure that the group sizes are small enough so that we can really give time to each pupil and build the relationships. This not only makes the experience for everybody more meaningful, but it also means we are able to build trust and get to know the young people on a deeper level. This in turn means we are able to tailor the music making activities to the individual, which is more likely to result in them continuing making music after we leave. We’ve found that a ratio of maximum six young people to one music leader is optimum: we work in pairs, so at the start we worked with larger groups but in the final cohort we’re working with 12 young people.
Is it a music programme?
One of the things I have found difficult and yet very important to grapple with is how we bridge the gap between this being a mental health programme and a music programme. This programme is designed to be both, but how that translates into real terms is an ongoing question. For example, one young person had been very quiet and at one point, rolled their eyes and said, "Do we have to talk about how we are feeling?". It took a while to realise that what she needed was just to sing! However, another young person needed weekly one to one time to speak about some very difficult and dark feelings. It was our job to listen, not judge and to help her translate these feelings into lyrics. This young person came to see me the other day and said "You literally saved my life last term. Literally!”
During the initial pilot the young people had an assembly delivered by a mental health and self harm expert, Satveer Nijjar, followed by a taster day with TMW leaders. This meant that the premise of the programme being a mental health intervention was set up from the start. As a result of feedback from the young people we decided to change it so that they have a day’s workshop half way through the programme which includes the talk/assembly, this time from ‘The Self Esteem Team’, a team of mental health speakers for schools set up by ex-government mental health tzar Natasha Devon. We’ve discovered a downside to this change, which is that we are not able to relate back to the assembly and therefore introducing the mental health side of things lies entirely with the music leaders who do not have the expertise that the specialist mental health workers have in communicating around more fragile issues.
What knowledge and support do music leaders need to deliver a mental health programme?
Delivering a mental health programme comes with its own challenges for music leaders. As a registered music therapist I am aware that my training has given me a lot of tools in terms of theoretical thinking, as well as self care when working in some really difficult and emotionally challenging circumstances. When taking on a programme like this we need to be able to manage holding and being along side very difficult feelings without letting them take us over, but equally without shutting them down. Some advice on managing this:
- Factor in time to talk with your co-leader about what has affected you.
- Ask advice if you feel overwhelmed by a situation. Talk it through, don't carry it by yourself.
- Have a named person at the school that you can encourage the young people to talk to, or who you can pass things on to if you're worried.
- Be aware of your own 'stuff' (for example, something someone tells you might trigger a memory/experience or something else for you that will impact on how you are able to support that young person. Talk about it to your colleague, or to someone you trust.. but be as conscious as possible to what might be going on and why)
- Don't take work home with you.
- Learn about what you can and can't do in terms of helping that young person. i.e. sometimes you'll just have to sit with sadness and that will be all you can do.
For more on this, see the blog Working with at risk young people, do we really have the right support and skills?
Some practical thoughts on delivering the programme.
Take time. It takes time for a group to form. Take time to get to know them, for them to get to know you and each other and be patient that this might not be immediate. I found that 'the bits around' the session, such as talking about their weekend, or just chatting casually as they arrive really helped in building trust and relationship. It felt very important, especially in the school environment, to be genuinely really interested in who they are, what they bring and what's going on for them in their lives.
Expect people to take time. Remember that it might take a while for a young person to open up and show you who they really are and what's really going on.
Be alert to moments to connect. Be alert all the time for opportunities to connect with the young person and make space for those moments. It can be easy to get caught up in your own agenda as the music leader to get the song done, or finish the recording and although these are important things, it might mean you miss the moment that young person wants to talk or share something.
Use group bonding activities. Spend time establishing the group getting to know everyone, chatting about music they like, don't like etc and also playing games at the start of sessions. Simple things like, two things that are true about me one thing that isn’t, or body percussion, really help.
Write a group song by picking a theme. This is best if it has come out of discussions with the group, or has been suggested by the group. If everyone is finding it difficult to come up with something, suggest some possible themes and see if the group responds. Be a 'yes' person to their ideas.
Make time to talk and reflect with your co-worker. Working together with another music leader it's important to establish how you work together. This is difficult to do during the sessions as the pupils need all the attention they can get. Work to your strengths. Make sure there is time for reflection after the group, and/or before the next group. Flag up what you noticed about how the different group members are doing.
Questions to ask when reflecting:
- What worked well for the group?
- What didn't?
- How did each individual seem?
- Did you notice anything particular about how each person was? Were they struggling? What might have been going on for them if they were struggling?
- If someone was difficult in the session, why might that have been? What else could be going on for them in that group? Or outside? What could we do next time to help that person engage/open up/ feel more included/ get what they need.
- If someone made you feel uncomfortable in the session, or angry.. why might that be?
Be flexible. Make sure to be flexible within the session to be able to respond to the young persons needs at that time. This is obviously easier in one to one sessions or with just a couple of pupils, but harder to do in a group of 10-12.
Continuously reflect on the music/mental health balance: One of the things I found difficult was to walk the line between 'being alongside' them, allowing space for discussion, opening up, emotional connection, and having specific aims of songwriting/ group work and developing musical skills. As I mentioned earlier, again it is the question of bridging the gap between mental health support and musical product/focus. I think reflecting on this from session to session is important in terms of getting the balance right.