By Tim Harford and Paul Monks
Mental Health Review 2001; 6 (3): 13-16 (September 2001)
The astonishing story of Core is a story about determination, teamwork, growth, acumen, daring, imagination, care, respect – but most simply, it is a story about inclusion. Everything that Core has become, it has become because of who was included. And everything that still remains to be done, remains to be done because some refuse to be included.
We hope that our story will inspire people to be more inclusive as a natural reflex, rather than in an empty policy statement. It is in everyone’s interest, because exclusion is a two-way process. If somebody excludes me, then I miss out, but so do they. If we include each other, we both benefit.
1991: Include me
Our story begins with Paul being included in an unusual group. Seven years’ education in the arts and a spell in educational development in Africa left him moving like a nomad from studio to studio in London’s East End. He was looking for place and a purpose, but in a world of egocentric factory art which was competitive, isolating and uncommunicative.
Paul had more luck when he found studio space, no demands or expectations attached, in the decaying Victorian buildings of a disused wing of Hackney Hospital. The room might have been cramped and smelly, but it brought with it something that had been missing: an honest dialogue.
This honest dialogue came not as you might expect from art therapists or psychiatrists, but from the community of young Afro-Caribbean men whose lives were punctuated by spells on the wards. When not officially in the hospital, many chose the derelict wings as their playground. No one else wanted to be there.
The hardship and isolation they had suffered left them with little reason for pretence and deception; these were honest men. They were happy to share what little they had, be it their last fiver or their dreams and visions. And they were not only willing but also eager to include him in their lives.
1992: Include each other
As Paul’s circle of new friends grew they spent as much time making art as talking. It was perfectly clear that most were actively creative in their own right – but for some reason these activities were saved for their own time often when they found themselves isolated at home, often at night. As the friendships grew strong and full of the respect that is fundamental to any relationship, Paul was invited further into their lives.
He shared beers with Haril and met his mountain of four thousand pages of prose; he smoked with Karl, and took in his fantastic wall paintings around the flat; got to know Arthur and his fantastic computerised painting machines.
Paul’s portraits of his new friends were very simple in comparison but it was clear that being the subject of a portrait gave many a real sense of self-esteem. They saw their images made into icons and their identities elevated.
This was not about Paul descending from the middle classes into some ghetto to heal the sick and bring hope. It was a two-way process. Paul had not enjoyed painting since he was at school; even then, he had never found a purpose for his creativity. But now, he had all that. He was happy again.
One memorable afternoon eight of the group sat down together and agreed that what they were enjoying was more than just fun for themselves – it was worthwhile to others. In order to do more, they needed support and resources. They decided to get themselves formally recognised.
The process of agreeing an identity took all of five minutes. Karl was the man of a thousand ideas but they only needed the first one: the name, Core. It was agreed. As for colours, they would be the purple and gold of the 7mg silk cut cigarettes on the table we sat around. Would the logo be a pair of lips or a thumbprint? Thumbprint. It turned out that Paul was the only one never to have had them taken, and in the spirit of seeking new experience popped into the local police station, to politely ask them to take his prints. And in fact, he only had to go to two stations before somebody agreed…
Core was official.
1993: Include the workers
The hospital staff were brilliant. Not the management, nor the clinical staff: after the initial kind offer of a room, conversations with them were rare. When Core had hopes and ideas but no money, it was the auxiliary staff, the porters, the works department, and the cleaners who began to join in and help the merry little band. The service staff are the people who really know how any institution is run, and it was their humour and openness which embraced and supported unreservedly the activities Core was developing. There was a key here, an order slip there – and access to the derelict tunnels and rooms beneath the hospital.
Sid was homeless and lived in those tunnels, and when he told Core about an old radio station hidden in the hospital’s bowels, it took little persuading to liberate what remained. Now we could make sounds as well as pictures.
1994: Include a helping hand
Paul’s interaction with the “powers that could” was important but disheartening. He is white, male, and middle-class. Nobody else in Core was. It was Paul’s reassuring presence which generated confidence and support from community development agencies. Every idea generated by the Core members was perceived as coming straight from Paul. If Paul had a dream or an aspiration, that was exciting or imaginative. Coming from another member it was a fantasy or delusions of grandeur. Challenging these assumptions has been part of Core from the outset.
In the midst of this prejudice, one inclusion was definitive. It secured the continued development of Core. That inclusion was the involvement of Elizabeth Bayliss and the Community Psychiatric Research Unit. Without fear or doubt Elizabeth helped focus and fund the project, delivering three years core funding and enabling us to constitute ourselves as a charity limited by guarantee.
Elizabeth’s unit was wound up as part of an incessant restructuring of services. There would be little hope of a fledgling initiative like Core being supported today.
Core owes Elizabeth and her disbanded team a great deal.
1995: Include a wider circle
Core was growing. More patients, more friends and more artists began to frequent the studio, which was now a whole ward in a disused block. Not many left, once they had got involved. The excitement, freedom, and respect that all shared was helping each of them. Core’s members were teaching, learning and growing together. A common interest in creative pursuits was their rationale. Individual differences and hardships were understood and accepted.
1996: Include the members
Core has always been run collectively. It has members, not “users”. Five years after inception it had grown and needed a formal process for making sure this continued. Core Council was born. The Council meets every two weeks to discuss an agenda set by all members, so airing concerns and generating new ideas is genuinely collaborative.
Core’s board of trustees includes the chairman of the council, and the majority of the board are members. As members grow in confidence, they’re encouraged and supported to seek opportunities for themselves elsewhere, but to also give something back to newer or less able members by sharing their experiences and skills. Approximately half the paid positions at Core are now held by individuals who have had direct experience of being sectioned, of life in the psychiatric system – and of the opportunities Core has given them. This is total integration.
Making sure that services are focused on the needs of “users” of the mental health system is the subject of a lot of hand-wringing in interminable papers and reports. There is a good deal of tokenism and not much action. We find this odd, because it is not difficult to do if the will is there. If “users” are involved at every stage of conception and delivery, only then will they be truly included. It’s not rocket science.
1997: Include the stars
Life drawing is a fantastic exercise in its own right, but stick a famous face in front of the easels and you will find a class will swell from eight to twenty eight. We saw this in Core’s “Paint the Stars” sessions. Over the course of a year, a gaggle of comedians visited the Core studios to sit and have themselves painted.
The involvement of stars has helped take the work of Core far beyond our immediate neighbourhood: when famous names are patrons at the bottom of your letter head, and when they turn up to give gigs or donate art – this goes a long way to gaining the interest and respect of people who might otherwise not have heard about the work.
But this is not a simple publicity-seeking exercise. Core’s special guests seem to receive as much as they give. As with so many visitors, they become seduced by the environment at Core: the supportiveness, the integrity, the honest and open dialogue. These relationships have continued to flourish, including famous artists, musicians, and media stars. At some Core events you can see famous faces in the crowd, bopping away on the dance floor or laughing with the members. Their names are not on the bill; they are not performing: they’re just there to have fun with everyone else.
1998: Include the press
Most people involved in receiving or delivering mental health care would agree press coverage is negative. The media seem to be fond of stories that perpetuate the myths and stigmas associated with mental health. Core has been very successful in generating very positive, sympathetic coverage from both local and national media. Good news can be interesting, too, and most papers like to share inspiring stories as well as depressing ones.
We are afraid that the reason so many health stories remain negative is that it is a convenient way of maintaining the power of certain vested interests, and securing funding to through scare stories.
We think that there are more imaginative and more positive ways to include the press.
1999: Include business
Strange as it may seem, Core receives no funding from the local health trust, and so it has taken to generating its own income. Core Design was established in response to repeated requests from organisations wishing to use the imagination and creativity bursting out of Core. With the support of Rose Albrow and East London Business Alliance, and now Social Enterprise London, Core has built a successful business arm, Core Design. Working increasingly with the members, Core Design offers design to print solutions for clients from all sectors: voluntary, government and private. Contracts are won on quality and competitiveness and not through sympathy. The profits from these activities are used to fund the organisation’s primary activity of providing training, support and opportunities in the arts for those who have been classed as having severe and enduring mental health problems.
2000: Include the investment banks
More chief executives and managing directors from City firms visit Core than do psychiatrists. Many more, in fact.
As the net of inclusion grew it was almost inevitable that Core should look to take advantage of its geographical proximity to the City of London. Enthused and excited with what greets them, they are willing to host art auctions and black-tie dinners, not only to raise money for Core, but to also introduce their staff to life outside the city.
One of the things which has particularly struck the corporate financiers is the employment environment at Core. Core seems to be able to earn tremendous commitment from its staff, and has a retention rate of nearly 100%.
2001-2006: Include the future
The Core All Stars Festival was a three day event in London starting on 31st May. It aimed to bring together anyone interested in creativity and mental health from anywhere in the country, with the freedom to join in, in any way from dance workshops to scenario building. The focus of the festival was “Creative Visions for the Future of Mental Health, 2006”.
Using the “scenario” techniques developed by Shell International and used to help rebuild post-Apartheid South Africa, Tim and his colleague Fran Monks created a safe forum for discussion and the breaking down of communication barriers. Scenarios are simply stories about the future, and as well as bringing intellectual insight they can be very powerful ways of communicating. After the scenario sessions several participants confided in us that for the first time, they had felt able to share certain personal experiences.
We plan to publish the scenarios and a full conference report soon; but it is worth bringing out one element here. One scenario, “Stained Glass Window”, described a future with very limited resources for the mental health system but a more tolerant and inclusive attitude. The other scenario, “Cash Injection”, explored the possibility of ample health funding which is largely channelled at constraint and control. Given the choice between money and inclusiveness, most conference participants seemed to prefer inclusiveness.
We hope that our readers take at least three points away with them.
First, nobody should be surprised that a progressive, successful organisation can best be described in terms of who is included.
Second, attacking “social exclusion” did not just benefit those labelled as “socially excluded”. Some of the people who gained most were people regarded as being integrated and successful members of society: like the top businessmen, celebrities, and Paul himself.
Third, social exclusion, and mental health problems, can be successfully overcome with imagination, common sense, and an accepting attitude.
Who will be included next?