Written evidence submitted by Mortal Fools (CYP0107)
Introduction to Mortal Fools:
1. Mortal Fools is a drama, theatre and creative learning company. We specialise in using creative drama-based approaches to support subclinical and preventative mental health outcomes in children and young people.
2. We are based in the North East of England and work nationally. We have a strong track record of creating high-quality work with children and young people in settings including mainstream and SEND schools, and out of school provision.
3. We are submitting evidence because we have demonstrable success of a cross-sector programme design and delivery approach with potential for wide application and learning to share. We successfully trialled an approach to evaluating mental health and wellbeing outcomes in children and young people, which is replicable in a range of settings, and we have created both live and digital programmes, enabling a range of approaches and wide distribution to schools and families, in an accessible and scalable model. This work is hugely and increasingly needed, and we want to contribute our evidence and learning to this conversation.
Early Intervention Case Study: Melva
4. A creative intervention project designed by Mortal Fools, in partnership with Children North East, to support children and young people’s knowledge and self-management of worries and anxiety through early intervention.
5. Melva was originally a stage play produced in 2017 to engage new family audiences in an area of social and economic deprivation and rural isolation. Feedback from audiences (aged 5-87) was hugely positive, most strongly relating to accessibility as a high-quality theatre production, value for money and how the production gave positive new ways for children to talk about their worries and anxiety.
6. Building on this success of Melva in 2017, schools in the North East of England – specifically Northumberland - were consulted about using the stage play to create a wellbeing programme to support children’s mental health in school settings. The programme was identified by the schools as being a way to support the objectives of the 2017 Green Paper ‘Transforming Children and Young People’s Mental Health Provision’.
7. A programme was designed for children in Key Stage 2 at a sub-clinical and prevention level. It was produced in partnership with Children North East and Public Health England (with funding from Northumberland CCG and Arts Council England).
8. The programme consisted of:
- 3 x 25 minute teacher-led online preparatory activities
- School visit day, with:
- 80-minute production of the Melva stage play
- 4 x 45 minute post-show practical workshops as part of school visit
- 3 x 25 minute teacher-led online follow up activities
9. The programme aims are:
- Give positive role models of people developing their mental health
- Reduce mental health stigma by encouraging open conversation about day-to-day challenges
- Improve emotional intelligence, particularly through providing child-friendly language and vocabulary to discuss worries and anxiety (“worrits”)
- Teach practical coping strategies to deal with worry and anxiety
- Support the development of positive relationships (with teachers, parents and peers)
10. Mortal Fools toured the Melva Live creative intervention programme to 22 schools in Northumberland, Newcastle and Gateshead, and a further 10 schools accessed the programme at Gosforth Civic Theatre. In 2019-20, the programme engaged more than 2,800 children in total.
11. Mortal Fools commissioned Lesley Wood of Ubiquitous Arts to develop an impact and evaluation process using the PERMA Framework for mental wellbeing. She produced a report – which is still in draft – but some of the key findings are summarised below:
Relevance: Were activities relevant to the young people?
12. The pupil surveys distributed after the activities were scored from 1-5 with 5 being the highest score. Average scores from 1029 surveys remained consistently above 4, suggesting that pupil engagement was strong.
13. We believe that this is an indication that the activities had relevance for those involved.
15. Professional responses were very positive about the relevance of the activities both in terms of engagement and the appropriateness of the messages given: “Our school counsellor watched the whole show and felt it was completely appropriate for years 5 whilst addressing difficult subject she is going to use some of the resources when working with KS2 students. Extremely engaging and interactive sessions.”
16. The theatrical format and the quality of the production brought an element to the intervention that engaged and inspired change in pupils. In addition, the characters were relatable and a good vehicle for the messages of the intervention: “The children really enjoyed it, many of them have never seen a theatre performance before and have only seen pantomimes, so it was a great experience to see the theatre lighting and scenery. Melva was an ideal character that the children could relate to and the way she learned to overcome her “worrits” in the performance was really inspiring to the children particularly those that have anxiety. There were a number of useful strategies for calming down that Melva learned and it was fun and engaging for the children to learn these rather than being taught in the ordinary way.”
17. In total there were 947 comments to the question “What did you enjoy?” in pupil surveys, which have been filtered into the following subsets:
- Everything: These were comments in which pupils cite the whole experience.
- Mindfulness/ Emotions: These were direct comments about positive emotions or mindfulness. Comments may have also included a character name or activity.
- Activities/ Workshops: This relates to comments that directly cited an activity or workshop content.
- Engaging Factors: Relates to comments on engaging factors such as “it was fun” or “That they all taught me something”.
- Characters: Relating to specific characters or the characters as a whole.
- With others: Comments citing shared experience or helping others.
- Negative: Negative responses.
The volume of the responses suggest that pupils were engaged with the activities and the characters indicating that the delivery methods were relevant to them.
Relevance: Were activities relevant to the teachers?
19. Surveys completed by the teaching staff suggest that the resources were relevant. In some cases, the resources have offered new approaches to working with pupils: “One girl in my class has anxiety issues and I've had numerous conversations with her about the way her brain has a negative voice and a positive voice. She loves talking about it in those terms and it helps her to verbalise how she is thinking more.”
20. When asked what they have taken from the sessions, one school described several tools that they have taken from the activities: “The use of role play, and the dial from 1-5 to show different levels of emotion was great. Teachers will also use the rubber chicken and breathing exercises where you blow out on your hand. Teachers and teaching assistants were also inspired and will use the games Fortunately- unfortunately and the circle game where you say “it was even worse when…”. The performance also taught teachers the importance of teaching children simple practise, like scrunching and thinking of three things that they can see, hear and smell, as a way to calm down.”
21. It is important to remember that Melva is made of several elements and the play that itself is an important resource: “Melva is simply the best drama intervention I have ever seen, you have to give your school over to the vision of Melva for the day, but the rewards are instant and long lasting.”
22. One school commented that this supported the work that they already did, and that this had been a benefit.
Relevance: Were the activities relevant to the purpose of the programme?
23. Teacher comments suggest that pupils were very engaged by the activities and that activities have supported areas like mindfulness and managing anxiety: “The children loved the characters being in their classrooms it caused lots of laughs and excitement. The children found figures hilarious. It was also good for the children to have male actors and facilitators that were so funny and engaging (like Gideon] It inspired the boys.”
24. Talking to the characters was significant in this process. Pupil responses on what they have enjoyed rated the interaction with the characters highly. This was also confirmed by teaching staff: “Children like the engagement with the characters and discussing the scenarios with them they learned techniques to control their breathing and tried to let go of worries.”
25. Comments from professionals indicate that not only the resources but the steps and process of delivery had made a significant contribution to supporting methods of understanding wellbeing: “I thought this was a very accessible medium to introduce children to the cognitive model and dealing with anxiety. The children found it very entertaining and the workshops followed on logically from the performance giving the children a chance to practise the methods that Melva learned to reduce her anxiety.”
26. Qualitative data from 1029 pupil surveys offer a range of techniques to manage “worrits”. Many of these relate to the names of the characters or a particular activity recommended or taught by the character
27. Popular choices of activity included using:
- breathing exercises,
- finger tapping
- doing something fun to distract yourself
- going for a walk or taking part in an activity
- talking to others
- being kind
28. As the programme focusses on areas of wellbeing this aligns itself well to the NHS five steps to mental wellbeing:
- Connecting with other people - Pupils often mentioned connecting with others through conversation or by sharing a worry.
- Being physically active - Many of the coping mechanisms suggested related to being physically active, going out walking, taking part in exercise etc.
- Learning new skills - Potentially the activities that pupils have taken part in are new to them in terms of learning. However, a baseline was not set with this and so it cannot reliably be confirmed
- Give to others - This was cited a number of times as the area that people enjoyed. However, this intervention is predominantly about helping oneself.
- Be mindful - Meditation and breathing exercises were cited as areas of enjoyment. Pupils also frequently identified being calm or calming themselves as being important.
29. In our opinion the data suggests that the majority of pupils have benefitted from activities that support wellbeing and have engaged with the intervention and the characters making them relevant to the programme.
Effectiveness - Did the programme have the anticipated outcomes?
30. It was anticipated that the programme would support young people to improve their own wellbeing and to understand ways in which they could manage their stress and anxiety.
31. Looking at the data relating to the question “When you get a Worrit, what will you do?” we have looked for themes in the responses. Where a response may fall into more than one category, we have looked for the dominant theme.
32. The responses broadly fell into:
- Comments: which related back to characters rather than giving a solution which could be controlled by the individual responding, for example “Ask for help from Grandpa Pebble or the goat”.
- Mindfulness techniques: These ranged from taking time to think, breathing activities through to yoga and meditation. We have listed mindfulness techniques separately from the techniques learned from the workshop although they do overlap.
- Personal attitude: This included areas like “being brave” and “laughing it off”. In general, the comments related to areas linked to resilience.
- Physical Activity: Comments described physical actions which might be taken for example “go for a walk” or “read a book”
- Connection with other people: This included asking people for help, helping others or just sharing space with people. Comments related to a range of people including parents, siblings, teachers and friends.
- Activities from workshops: These tended to be broader comments such as “Use what I have learnt today to get rid of the bad Worrit” or related to a specific activity or game “Do what Feggis showed us or the rubber chicken”
- Negative comments: There were a small number of comments from pupils that suggested that they had difficulty managing “worrits” For example “Get upset because I worry about a lot of stuff to turn out good and fun”
- Not counted: Some of the comments in the data sample consisted of symbols for example a question mark and sometimes an incomplete sentence.
33. In total 911 comments were received. Of the responses the most common responses to what people would do if faced with a “worrit” were:
- Mindfulness techniques
- Personal attitudes to manage the “worrit”
Making connections with other people.
34. A breakdown of responses indicates that of the responses given 89.3% related to practical techniques to manage “worrits”.
35. It was anticipated that the intervention would provide young people with a toolkit of activities around wellbeing. The responses suggest that this has happened to a high degree.
Effectiveness - How did the activities contribute to the impact and outcomes?
36. The play workshops and lesson plans were used as the only vehicle to deliver the activities. Pupils regularly refer to the characters and the activities as the place they discovered techniques to support them managing “worrits”
37. All of the data collected and analysed shows clear links between the activities, the performance and the characters.
38. Previous examples demonstrate the high level of connection that the pupils had with the characters and the significant levels of engagement, this is also supported by teacher comments: “The level of intensity from some children exemplified a deeper than expected understanding of the programme messages, and it was pleasing to see the level of confidence the experience awoke in them to discuss and tackle some of the issues raised. The quality of the production was amazing and the production value even more so. I was so pleased to invest the time of the school into a purposeful and truly magical experience for the children that had impact from the minutes they walked into the immersive Theatre.”
Effectiveness - What helped or hindered the intervention?
39. There have been no follow up conversations with Mortal Fools Team, teaching professionals or pupils and so it is not possible to fully answer this area. However, teaching staff have mentioned that some pupils were too excited to take on board information. Comments suggest that this was a very small number.
Impacts - What unexpected impacts have there been?
40. Overall teaching staff have commented on how the intervention has exceeded expectation and also the reaction of pupils: “I was pleasantly surprised at how many ideas the children had when it came to recognising emotions and thinking of ways to calm down feel better. I was pleased that the year six children still very much enjoyed the characters and the activities [they weren't too grown up for it yet]”
41. One teacher commented on “How clued up the students were about mental health before but they still managed to learn something.”
Future plans for the programme:
42. Mortal Fools have since developed an interactive, online storytelling game which continues the Melva story and is available for schools to use in the classroom or at home as part of their approach to remote learning. The game has a strong focus on relationships, as well as reiterating the key objectives learning points form the Melva play.
43. Supported by the Cultural Recovery Fund, Mortal Fools are now in the process of creating a digital capture version of the Melva stage play and the four accompanying workshops, which together with the storytelling game will form a new Melva Digital Programme to be available for national distribution from September 2021.
44. To enable a holistic approach to mental health provision for children, Government should make funding available to support cross-sector collaboration and multi-agency approaches to supporting children and young people’s mental health
45. Teachers are not experts in mental health education. Schools need resources to use in their work with CYP, together with training in managing mental wellbeing for themselves. Suitable providers of this exist, and Government should consider how to support schools accessing this provision, especially for mental health leads in schools.
46. Investment in prevention and early intervention measures is critical in CYP successful recovery following the pandemic. Government should consider what practical resources can be made available to schools - both financial and practical - that will support schools to do this.
47. Government should source and share resources and training providers with schools that offer fun, accessible methods to support children’s mental wellbeing. They should consider what exists that can be quality-assured for schools rather than expecting each school to research what is available independently.
48. Government should consider supporting further research into the impact of increased mental wellbeing on key indicators like pupil attendance, engagement and educational attainment.
Evidence prepared by:
Projects Producer – Mortal Fools
Data analysis by:
Creative Director - Ubiquitous Arts