The group created by Gloucestershire NHS Clinical Commissioning Group is called the ‘The Producers’. The men come from particular occupations – often tradesmen such as builders or lorry drivers.

And not only do they have similar backgrounds, but they share a similar misfortune: chronic pain. And their mental health takes the strain.   

Jason, aged 42, was a participant. After losing his ability to walk normally, he was made redundant. The Gloucester builder’s health deteriorated and his doctor advised a pain management programme at Gloucestershire Royal Hospital.

But his morale worsened and he became seriously depressed. “I was suicidal. I had no interest in doing anything and so I hid myself away,” he says. Employment looked unlikely, his condition did not improve, and the NHS pain programme – an outpatient discussion group – did nothing to soothe his condition.

So he joined' The Producers', a pilot launched in 2016, which offered an alternative antidote: making things.

Along with around a dozen other solitary men in similar circumstances, Jason took up new hobbies at a weekly meeting aiming to help them bond and develop while being productive.

Men who make

'Week after week the men take part in woodcraft and repair work. But they also make bread, socialise, and prepare and share meals together'

“The Producers is about people in a similar situation coming together to share their experience but also do stuff creatively and through that improve their lives,” explains Dominic Thomas, workshop facilitator from the charity Artlift.  

Week after week the men take part in woodcraft and repair work. But they also make bread, socialise, and prepare and share meals together. 

A loss of role

It is an unusual approach, and growing, because it yields a quite different set of results from the norm.

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“We could see where standard NHS interventions – the pain management programmes – weren’t going well enough. These are men with chronic pain and of working age, some from traditional rural environments. Due to the pain they have a loss of role as main breadwinner, leading to depression and isolation,” comments Jules Ford, Senior Programme Manager at Gloucestershire CCG. But about this group they are enthusiastic.

For workshop member, Neil, the groups helps to relieve stress and tension. “I can go home, and for two days I’m a much calmer person,” he says. “I just enjoy coming along and enjoying the company of those in the same boat. That’s immeasurable.”

The impact of pain

For most, a remedy to the physical pain is not all they’re after. The group also provides relief from the impact of pain.

“They feel bad and their marriage is on the line in some cases,” says Jules Ford.  “They have a rubbish quality of life. If being in a group lifts them out of their depression that improves their quality of life; there’s a whole knock-on effect. Their loneliness has an impact on physical health too.”

Higher recovery rate than CBT

'It is effective not just for chronic pain with depression, but for a range of other physical conditions that may affect mental wellbeing like  childhood diabetes or lung disease'

For the CCG, the way forward is no longer in question.

Studies have shown this alternative approach, known as social prescribing and concentrating on group outdoor, environmental, arts and crafts activities, is often successful for particular types of patients.

It is effective not just for chronic pain with depression, but for a range of other physical conditions that may affect mental wellbeing – such as childhood diabetes or lung disease.

“Our research on arts on prescription in the form of groups such as 'The Producers shows the recovery rate is higher than for CBT. It’s not a route that replaces the alternatives. However, its drop-out rate is lower than the IAPT psychology network. We know it works. We’re now not at the stage of whether it works, but of how to do it and who for,” explains Jules Ford.

In high demand

In addition, the CCG’s investigations show high demand for social prescribing from people with mental illness. “Around 48% of people going to social prescribing have mental health needs." says Jules.

“Some have debt and financial or housing problems; 48% are emotionally overwhelmed and really struggling. So you decide on CBT, social prescribing or anti-depressants. We’re teasing those decisions out and shifting the way we work.”

Plus, there are healthcare benefits beyond patient wellbeing: time saved for the busy GP: “20% of GP contact is heartache”, says Jules Ford. For The Producers, the outlook is good. The group has continued beyond its allotted course, and the men now run it themselves. A new group is likely to be formed, and across Gloucestershire, an alternative network of social prescribing programmes has become well established. Across the NHS, similar shifts are under discussion, so a new movement could be under way.