PIECEs Trial Protocol paper published!
We are excited to have our Trial published at BMC Trials this month!
You can read the full published protocol here
Abstract
Background
Severe mental illness (SMI) presents a major challenge worldwide, affecting approximately 5–8% of the world’s population. It causes significant distress to affected people, families and wider communities, generating high costs through loss of productivity and ongoing healthcare use. Over 75% of patients with psychosis receive inadequate care and experience a negative financial impact and reduced quality of life (QoL). It is therefore a priority to reduce the treatment gap by providing low-cost, effective interventions for people with psychosis.
Our research project, PIECEs, is designed to explore, adapt and test a low-cost, approach (DIALOG+) that makes use of existing resources to improve community-based care for patients with psychosis. The research will be conducted in two urban sites: Karachi, Pakistan and Chennai, India. DIALOG+ is a novel, technology-assisted and resource-oriented intervention, based on QoL research, concepts of patient-centred communication, IT developments and solution-focused therapy. However, the approach has not been rigorously tested within India and Pakistan. Our randomised controlled trial (RCT) aims to test the effectiveness and cost-effectiveness of DIALOG+ in improving the QoL and clinical outcomes for individuals with long-term psychosis being treated in the community in India and Pakistan.
Methods
To assess the acceptability, feasibility, and cost effectiveness of DIALOG+, we will conduct a cluster RCT with 210 patients and 14 clinicians in each country. The intervention will be used during a routine interaction between a clinician and a patient. It consists of a patient-centred assessment (the DIALOG scale) whereby the clinician invites the patient to rate their satisfaction with different life domains and treatment aspects, which forms the active control group. The intervention group will follow this up with a four-step solution-focused approach to identify the patient’s resources and develop solutions to deal with the patient’s concerns (DIALOG+).
Discussion
If shown to be effective DIALOG+ has the potential to improve community-based care and the QoL for millions of people within India and Pakistan who experience psychosis.
Trial registration
The trial was registered prospectively on the ISRCTN Registry: ISRCTN13022816 on 9 February 2022.
SCARF: PIECEs 2023 Arts Calendar
Our partners SCARF just launched a very special deliverable as part of the community engagement and strategy plan for PIECEs: the 2023 Arts Calendar, featuring the beautiful work produced by service users throughout the past year.
Through the use of creative and arts research methods, we have been engaging with service users and involving individuals in as Lived Experience Advisory Members in our research. Using arts as a tool for community engagement, dissemination, raising awareness, reducing stigma and building a bridge that connects people with SMI, healthcare workers, care givers, policymakers and the general audience into dialogue about this overlooked, underrepresented and difficult subject to discuss.
In January 2023, the calendar was launched with an event open to the public at SCARF’s headquarter, in Chennai, and the calendar will be distributed to the wider community. To view the complete calendar, click here
Announced! Selected applications for Small Scale Research Grants – India
We are pleased to announce the selected applications that will be funded via our Small Scale Research Grant Scheme in India
The PIECEs Small Scale Research Grant (SSRG) is an initiative for building research capacity and community engagement development within the ‘Improving outcomes for people with psychosis in Pakistan and India – enhancing the Effectiveness of Community-based care (PIECEs) research program*.
This grant scheme will be locally administered SCARF and will act as support fund to individuals or collectives who work as academics, students, researchers, program implementers, health workers, clinicians and advocates who support or work in Mental Health, Arts and Community Engagement and Mental Health Evaluation.
“It is a long path for mental health professionals with research interest to become experienced in research and be successful in applying for grants. The small scale research grant is a great opportunity for young researchers to gain this unique experience at this early stage of their career”, comments PIECEs Principal Investigador in India and Director at SCARF, Dr R Padmavati, endorsed by Co-Investigator Dr Lakshmi Venkatraman: “we are delighted that NIHR and PIECEs are supporting the young researchers through this . It has been very gratifying to see the amazing innovative ideas that have come in from the young researchers. We are looking forward to seeing the research outputs of these awardees”.
Funding disbursed in India and Pakistan for this programme is £25.000 per country. SCARF, our lead partner in India, received over open the scheme to early career researchers working within SCARF programmes and associated partners in Chennai. After being anonymised, analysed and scored by an independent panel, a total of five applications will be funded on the scheme.
According to Professor Victoria Bird, Lead Investigator on PIECEs Research the richness of the proposals made it difficult make the selection. “There were so much variety of promising new projects and research emerging on the topic of severe mental illness. We are very much looking forward to work collaboratively with the selected applicants to build capacity and nurture knowledge, and together achieve impact as wide as possible”.
See below the selected projects, which will be developed in the course of the next year. Participants will be fully supported by the PIECEs Research and Management teams to develop capacity around project management, reporting procedures and good clinical practices and any further training needed to deliver projects at the highest standards.
Congratulations to all the selected projects!
- Using Photovoice to empower persons with psychosis: A pilot study from a LAMI country
Project Lead: Kasthuri Divya G.
With increasing evidence supporting participatory approaches in research, the study aims to pilot photovoice- a well-researched methodology that has been used as a community-based tool, in a mental health service user population at the outpatient department of SCARF, India.
The study will be executed in 4 phases, with the aim of finding out whether photovoice can bring about a positive change through empowering persons with psychosis. This process will include recruitment and training of participants to communicate through photographs, as well as evaluation assessments. The study intends to evaluate the impact of photovoice as a participatory tool that facilitates subjective documentation of the lived experience of psychosis.
- Acceptability and feasibility of UPSIDES peer support model
Project Lead: Ms. Sonia Sims
The proposed project aims to assess the acceptability and feasibility of a peer support model – UPSIDES. Although the UPSIDES model has been piloted and is being implemented in different parts of the world, including Gujarat, India, this study is a first-time exploration of using peer support volunteers in our setting. The different sociocultural aspects of the study setting warrant an exploration of facilitators and barriers to implementing a peer support model. This is achieved by this pilot study through quantitative and qualitative assessments that will shed light on the process and outcomes of using the UPSIDES model. Regular debrief sessions with the PSVs will keep the researchers informed about the utility of the UPSIDES workbook as a tool to drive recovery-oriented conversations.
Notes from these sessions will also help in course correction of the UPSIDES model. UPSIDES being a flexible and adaptable model can benefit from the learnings gained through its implementation and can be customised to better suit the study setting. As a long-term outcome, possibilities to integrate peer support into the mental health system at the tertiary care center will be explored using the experience gained through the implementation of the UPSIDES model.
- ADEPT Project – Of the people, for the people, by the people: Development of an Advisory board for Experience-enriched service and research in Psychosis Treatment
Projetc Leads: Priyadharshni B , Krishna Priya K, Jagadeesan Settu, Amritha P, Greeshma Mohan, Vijaya Raghavan
The proposal aims to develop an advisory board manual for people with early psychosis by involving people with lived experience, caregivers and other relevant stakeholders as the board members and to assess the developed manual. The underlying principle of the proposed protocol is to use the participatory action research approach and we aim to involve end-users i.e., the patients of first episode psychosis and their caregivers at all stages of the study.
- Use of Theatre of Oppressed methods to provide a voice for People with Psychosis
Project Lead: Manikandan Pari
Psychotic illnesses such as Schizophrenia or Bipolar Disorder (BD) are a group of conditions that are categorised as severe mental disorders. The impact of the conditions is determined by various factors, not just the absence of specific symptoms or disorders in people living with psychiatric problems but by a multifaceted social process in which people are devalued and discredited because of a stereotyped social status or personal characteristic.
This study attempts to use the Theatre of the Oppressed to engage persons with psychoses, providing them with a platform to express their experiences, view these from several different perspectives and possibly work through the change to enable recovery. TO is a form of popular participatory community-based strategy that uses theatre as a tool for critical thinking and transformation. It is now used worldwide for social and political activism, conflict resolution, community building, therapy, and government legislation, through supporting and developing interactions with the audience. Participating in community-based theatre will also provide opportunities for social interaction and advocacy work.
- Operational research to evaluate Namma Area, an in-operational service for the persons with mental illnesses, using mixed method approach
Project lead: Dr (Major) Karthikeyan P R, Epidemiologist
The proposal intends to evaluate the ‘Namma Area’, a hangout space, the first of its kind established within the premises of SCARF (I), for people with mental illnesses, as part of community engagement. The evaluation is intended to be carried out adapting Operational/implementation – research methods using Pragmatic Robust Implementation Sustainability Model (PRISM) & RE-AIM evaluation framework. PRISM & RE-AIM framework has been adopted because the framework in itself designed to be used at all stages of research/program/policies/interventions from planning through evaluation and reporting and across different settings using both quantitative and qualitative approaches.
RE-AIM framework is often considered as ‘gold standard’ for decision making and guidelines. The elements of RE-AIM follow a logical sequence, beginning with adoption and reach, followed by implementation and efficacy or effectiveness, and finishing with maintenance.
*This research is funded by the National Institute for Health Research (NIHR) via its Research and Innovation for Global Health Transformation (RIGHT) programme. Grant number NIHR200824, using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.
Selected Applications In Pakistan! Small Scale Research Grants
We are pleased to announce the selected applications that will be funded via our Small Scale Research Grant Scheme in Pakistan
The PIECEs Small Scale Research Grant (SSRG) is an initiative for building research capacity and community engagement development within the ‘Improving outcomes for people with psychosis in Pakistan and India – enhancing the Effectiveness of Community-based care (PIECEs) research program*.
This grant scheme will be locally administered by IRD Pakistan and will act as support fund to individuals or collectives who work as academics, students, researchers, program implementers, health workers, clinicians and advocates who support or work in Mental Health, Arts and Community Engagement and Mental Health Evaluation. “The SSRG initiative invests in innovative ideas for equitable and effective access to mental health care by the next generation of early career researchers from Pakistan and India“, points out Onaiza Qureshi, PIECEs Program manager in Pakistan
Funding disbursed in India and Pakistan for this programme is £25.000 per country. IRD, our lead partner in Pakistan, received over 100 applications from 26 different cities including: Abbottabad, Attock, Bahawalpur, Buner (Hangu), Chakdara (lower dir), Chitral, District Jaffarabad, Gharo, Gilgit Baltistan, Islamabad, Kandhkot (District Kashmore), Karachi, Lahore, Rawalpindi and Gujranwala, Larkana, Layyah, Mansehra, Mardan, Multan, Peshawar, Quetta, Sakhar, Tharparkar, Sindh and Thatta.
After being anonymised, analysed and scored by an independent panel, a total of six applications will be funded on the scheme. According to Professor Victoria Bird, Lead Investigator on PIECEs Research the richness of the proposals made it difficult make the selection. “There were so much variety of promising new projects and research emerging on the topic of severe mental illness. We are very much looking forward to work collaboratively with the selected applicants to build capacity and nurture knowledge, and together achieve impact as wide as possible”.
See below the selected projects, which will be developed in the course of the next year. Participants will be fully supported by the PIECEs Research and Management teams to develop capacity around project management, reporting procedures and good clinical practices and any further training needed to deliver projects at the highest standards.
Congratulations to all the selected projects!
*This research is funded by the National Institute for Health Research (NIHR) via its Research and Innovation for Global Health Transformation (RIGHT) programme. Grant number NIHR200824, using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.
‘Namma Area’: An Innovative hangout space for mental health service users at SCARF
* by Manikandam Pari, Research Assistant at PIECEs Research
Namma Area is an innovative hang-out space for people in treatment for mental illness across Chennai. It was inaugurated in May 2022, as a part of the celebrations of the World Schizophrenia Day by the SCARF team, alongside Mr Paul Heritage, Professor of Drama at Queen Mary University of London and Director at People’s Palace Project, UK. Ms Mariana Steffen, Arts Project Manager and Ms Renata Peppl, Programme Manager, PIECEs Project, also joined the occasion. The presence of Namma Area is advertised through social media, posters, and pamphlets for the local public in Chennai and at SCARF.
It is currently functioning two days a week, on Tuesdays and Thursdays, between 2 pm and 6 pm on SCARF premises. It’s aimed to be a safe space for service users to develop activities as they wish, creating a sense of autonomy and ownership.
Namma Area (which means ‘Our Space’ in Tamil) started with indoor games like chess, carrom board, and other board games. The users choose the activities themselves. for example, if they want to exercise, Bike exercise machine was made available. It provides an excellent opportunity to socialize and gradually start interaction within each other.
In the early stages, people visited out of curiosity and became interested and kept coming to the space to see what it was about and gradually more people started to use the space. Some users who have been regularly coming have started to become more comfortable with themselves and others around them. The users gather for monthly review meeting to discuss use of the space and suggestions on what they want for the next month.
In the first meeting, some of the users requested to have indoor plants, play music, books and magazine in regional language Tamil. Over time, the interactive activities and games in that space will increase based on their suggestions.
We aim to evaluate the development of Namma Area and the patterns of use after Namma Area has been in existence for atleast 6 months. It will be interesting to understand the types of people who use the space and how the space is perceived and governed by the users.
In the pictures illustrating this post, you can enjoy some of the drawings made by service users and images of other activities participants are engaged in while hanging out at Namma Area.
Paper Published: Frontiers of Psychiatry
We are happy and pleased to share PIECEs first paper publication: Implementing psychosocial interventions within low and middle-income countries to improve community-based care for people with psychosis—A situation analysis.
You can read the full piece on the Frontiers of Psychiatry website here
PIECEs Small Scale Research Grants – Call open in India!
The Small Scale Research Grants is offered as part of the programme for research capacity building and community engagement development of the PIECEs research, a collaborative research that aims to explore, adapt, and test a low-cost, app-based approach (DIALOG+) that makes use of existing resources to improve community-based care for patients with psychosis and reduce the need for institutionalisation. The overall aim of PIECEs is to improve the quality of community-based care for people with psychosis in India and Pakistan by adapting and testing this approach, and up-scaling through the use of participatory arts methodologies and community engagement. For more on the research, access our website: piecesresearch.com
Thank you for showing interest in applying for the PIECEs Small Scale Research Grant. Make sure you read the guidelines before you apply. Please fill in the application form below along with the project proposal, completed budget (template attached) and submit with your CV (2 pages max; CV should give details of previous research experience, if any) to Dr. Padmavati (padmavati@scarfindia.org).
Download Application form and budget template here.
The research is funded by the NIHR (National Institute for Health Research in the United Kingdom) and is led by Queen Mary University of London (UK), Interactive Research and Development – IRD (Karachi, Pakistan) and Schizophrenia Research Foundation – SCARF (Chennai, India), in partnership with Aga Khan University and People’s Palace Projects
Who can apply to this grant
The Small Scale Grants is open to support individual or collectives who work as academicians, researchers, health workers, clinicians and persons with lived experienced who are currently working/partnering with SCARF. We encourage particularly researchers, health workers, practitioners and facilitators on early career or junior positions.
Nature of proposals
The aim of this grant is to help develop and strengthen the skills, instincts, abilities, processes and resources of early career researchers to adapt, and grow in the areas of research, clinical, community engagement, community care of people with experience of psychosis, their carers and health workers.
Research Proposals focussing on psychoses are invited from Early Career Researchers in the fields of Mental Health, Arts and Community Engagement, Health and Mental Health Evaluation, and Health Economics. Research Proposals focussing on psychoses are preferred.
Community treatment of psychosis – development of projects or resource oriented approaches that provide community day-to-day support and strengthen local awareness around people with experience of psychosis, their carers and health workers to ensure they have resources or pathways of care within their local community.
Arts, Community engagement and Mental Health – Projects or activities that enable public participation and involvement to promote relationship building through learning, action, and the expression of needs and values through the arts, culture or community led activities for people with experience of psychosis, their carers and health workers.
Evaluation methods – Proposals that enable the creation of innovative criterias, approaches and methodologies around evaluating the success of a given program or project in the field of research, clinical interventions, community engagement and the arts involving people with experience of psychosis, their carers and health care workers.
Who cannot apply for this funding scheme:
- Any funding applications from individuals or organisations not working in partnership with SCARF
- The grant will not be able to support PhD work
Funding available
The Early career research grant can support up to 6 proposals of various sizes as follows
| Size of grant (GBP) | Number available |
| 10000 | 1 |
| 5000 | 1 |
| 2500 | 4 |
Funding can be used to cover any directly allocated costs (e.g. staff and suppliers, training courses etc.), subsistence, travel, equipment and community engagement related costs.
Duration
This scheme is looking to fund projects with duration from 6 months to 18 months of delivery life. At the end of the project, partners selected via the scheme must provide a report highlighting the undertaken activities and outcomes delivered during the lifespan of the project.
Selection process
The submitted proposals will initially be evaluated by the Scientific Advisory Committee of SCARF. Proposals deemed to be suitable will then be forwarded to the PIECEs International team. The selection process will be conducted by the PIECEs Independent International Advisory Board, formed by experts and researchers from the UK, India and Pakistan. Successful applicants will be informed of the results by 20th November 2022 via email and expected to start delivery of the project from January 2023 onwards. All successful applicants will be mentored by a senior researcher from the PIECEs project international team or SCARF senior researchers.
Safeguarding
We expect applicants regardless of the type of work developed to have considered their safeguarding responsibilities and to have suitable policies and procedures in place to protect from harm people who come into contact with the project. As per guidance, if your project works with vulnerable children or adults at risk you should:
- Establish good safeguarding policies and procedures that all involve trustees, which fit with the policies and procedures of your local authority safeguarding partner or safeguarding children or adults board
- Ethics approval for projects should be submitted upon approval of the proposal within the Scheme
- Make sure all staff and volunteers receive regular training on child protection or working with adults at risk
- Manage concerns, complaints, whistleblowing and allegations relating to child protection or adults at risk effectively
Key dates
Deadline for application: 1st October 2022 (11.30 pm)
Results by email: 20th November 2022
Expected start date for projects: January 2023
Note: This research was funded by the National Institute for Health Research (NIHR) via its Research and Innovation for Global Health Transformation (RIGHT) programme. Grant number NIHR200824, using UK aid from the UK Government to support global health research.
PIECEs Small Scale Research Grants – Call open in Pakistan!
The PIECEs Small Scale Research Grant is an initiative for building research capacity and community engagement development within the ‘Improving outcomes for people with psychosis in Pakistan and India – enhancing the Effectiveness of Community-based care (PIECEs)’ research program. The overall aim of the project is to improve the quality of community-based care for people with psychosis in India and Pakistan by adapting and testing this approach, and up-scaling through the use of participatory arts methodologies and community engagement.
Make sure you read the guidelines before you apply.
Please fill in the application form below and submit with your CV (In English, 2 pages max), completed budget (template attached) and any other supporting information to the PIECEs email address pieces.pk@ird.global with the email subject “SSRG Application Submission 2022”
Download application form here.
Download budget template here.
Deadline for applications is the 30th September 2022, 11pm Pakistan time. Successful applications will be informed with the results by the 20th November 2022 via email and expected to start delivery of the project from January 2023 onwards.
The research is funded by the NIHR (National Institute for Health Research in the United Kingdom) and is led by Queen Mary University of London (UK), Interactive Research and Development – IRD (Karachi, Pakistan) and Schizophrenia Research Foundation – SCARF (Chennai, India), in partnership with Aga Khan University and People’s Palace Projects.
Who can apply to this grant
This Small Scale Research Grants scheme is locally administered by IRD Pakistan (Pvt. Ltd) and open to support individuals or collectives who work as academics, students, researchers, program implementers, health workers, clinicians and advocates who support or work in Mental Health, Arts and Community Engagement and Mental Health Evaluation in Pakistan. Proposals are invited especially from those working at grass roots local community levels and researchers with lived experience of mental health conditions, across a wide range of activities, training and or personal development, in the following areas:
Capacity building – Proposals that involve the development and strengthening of the skills, instincts, abilities, processes and resources that individuals, organisations and communities need to survive, adapt, and grow in the areas of research, clinical, community engagement, community care of people with experience of mental illness, their carers and health workers.
Community treatment of mental illness – Development of projects or resource oriented approaches that provide community day-to-day support and strengthen local awareness around people with experience of mental illness, their carers and health workers to ensure they have resources or pathways of care within their local community.
Arts, community engagement and mental health – Projects or activities that enable public participation and involvement to promote relationship building through learning, action, and the expression of needs and values through the arts, culture or community led activities for people with experience of mental illness, their carers and health workers.
Evaluation methods – Proposals that enable the creation of innovative criteria, approaches and methodologies around evaluating the success of a given program or project in the field of research, clinical interventions, economic or cost-analysis, community engagement and the arts involving people with experience of mental illness, their carers and health care workers.
Funding can be used to cover any directly allocated costs (e.g. staff and suppliers, training courses etc.), subsistence, travel, equipment and community engagement related costs.
Who cannot apply for this funding scheme:
- Any funding applications from individuals or organisations outside of Pakistan
Funding available
Stage 1
- Small-scale research projects (5 grants up to £500 for 6 months)
- Medium-scale research projects (2 grants up to £2,500 for 6 months)
Stage 2
- Applications indicating proof-of-concept in Stage 1 applications will be contacted to submit an application for a small-medium scale implementation research project of a grant amount up to £7,000 for 12 months
Successful Grants will receive direct funding from IRD Pakistan (Pvt Ltd.) upon signature of an agreement between both parties and subject to financial reporting requirements.
Duration
This scheme is looking to fund projects with duration from 6 months to 12 months of delivery life (dependent on funding stage secured and project deliverables). Extensions may be considered on a case-by-case basis.
Reporting
Partners selected via the scheme must participate in progress meetings with IRD Pakistan and provide quarterly and project-end reports highlighting the activities conducted and outcomes delivered during the lifespan of the project.
Timelines and Selection process
Deadline for applications is the 30th September 2022, 11pm Pakistan time. The selection process will be conducted by the PIECEs Independent International Advisory Board, formed by experts and researchers from the UK, India and Pakistan. Successful applications will be informed of the results by 20th November 2022 via email and expected to start delivery of the project from January 2023 onwards.
| Call-out | Deadline | Applicants informed | Project start |
| 1st August 2022 | 30th September 2022, 11pm PKT | 20th November 2022 | 2nd January 2023 |
Safeguarding
We expect applicants regardless of the type of work developed to have considered their safeguarding responsibilities and to have suitable policies and procedures in place to protect from harm people who come into contact with the project. As per guidance, if your project works with vulnerable children or adults at risk you should:
- Establish good safeguarding policies and procedures that all involve trustees, which fit with the policies and procedures of your local authority safeguarding partner or safeguarding children or adults board (Ethics approval for projects should be submitted upon approval of your proposal within the Scheme).
- Make sure all staff and volunteers receive regular training on child protection or working with adults at risk.
- Manage concerns, complaints, whistleblowing and allegations relating to child protection or adults at risk effectively.Note: This research was funded by the National Institute for Health Research (NIHR) via its Research and Innovation for Global Health Transformation (RIGHT) programme. Grant number NIHR200824, using UK aid from the UK Government to support global health research.
PIECEs Research site visits round-up: Arts & Community Engagement week in Pakistan
After a week long site visit in India ( which you can read all about it in our previous blog post here), the team flew to Karachi, Pakistan, for another week of activities regarding our Arts and Community Engagement work package.
The three members of UK team (Paul Heritage, Arts Co-I in the PIECEs Research; Renata Peppl, PIECEs Programme Manager and Mariana Steffen, Arts Projects Manager) joined the main partner on site, IRD Pakistan, and the Arts partner, IRC, during the first week of June.
After a week long site visit in India (which you can read all about it in our previous blog post here), the team flew to Karachi, Pakistan, for another week of activities regarding our Arts and Community Engagement work package.
The three members of UK team (Paul Heritage, Arts Co-I in the PIECEs Research; Renata Peppl, PIECEs Programme Manager and Mariana Steffen, Arts Projects Manager) joined the main partner on site, IRD Pakistan, and the Arts partner, IRC, during the first week of June.
Below you’ll find the highlights of the site visits.
Clinical site visit: Karwan-e Hayat and Forum Theatre session at Korangi Zia
The team started their first day of activities with a site visit to Karwan-e-Hayat (KEH), one of the local clinical partners in the PIECEs research project, and a long-time research partner with IRD. KEH was established in 1983 as a not-for-profit welfare organization, providing psychiatric treatment and rehabilitation services for people with experience of severe mental illness (SMI). It has both private and free of charge services. Inpatients and Outpatients are seen in the same facility.
During the site visit, the team was greeted by the organisation’s directors board and marketing team. They also had the opportunity to speak with both female and male inpatients on site about their experiences and challenges faced navigating SMI. Also, there was an opportunity to meet the clinicians who will take part in the PIECEs RCT (currently in the recruitment phase).
The visit was followed by a visual presentation of the site, and Professor Paul Heritage presented QMUL’s and People’s Palace Projects work within research and community engagement, which was received with excitement by the local team.
From there, the team followed to a Community Forum Theatre performance at Zia Colony in Korangi, one of the most deprived neighbourhoods in Karachi, in which IRD has been developing a number of outreach programmes, including the PIECEs Arts & Community engagement pilot phase.
A local church had kindly agreed to host the community engagement sessions, leading to the performance the team witnessed, which engaged the audience – formed mostly by young people and women – in discussion about mental health, stigma and networks of support.
Clinical site visit: Jinnah Post Graduate Medical Centre
The second day was marked by the site visit to our other clinical partner: Jinnah Postgraduate Medical Centre (JPMC), a government-run public general hospital, with a dedicated psychiatry department treating inpatients and outpatients. One of the biggest hospitals in Pakistan, JMPC was founded in 1963. It offers services for over 500 hundred mental health patients per day.
We were greeted by the clinical team who has been working on the PIECEs pilot and RCT recruitment, and visited the sites, within both the outpatient and inpatient facilities. Although facing a number of difficulties regarding public funding, the local team stressed the importance of the activities proposed by the PIECEs research and were extremely interested in developing the ideas around arts and community engagement within the facility.
Following a successful morning, both Pakistan and UK teams spent the afternoon on a strategic planning session, where the teams reviewed the arts and community plan, proposed a timeline and the team to work on the development of the activities.
Strategic Arts Meetings and Arts Advisory Board meeting
The third day in Karachi was a very strategic one, where the UK team had the opportunity to take part in the very first Theatre and Arts Advisory Panel meeting. The panel invited by IRD is formed by local artists, performers, community engagement experts and drama academics who gave provoking and thoughtful feedback around the initial programme proposed by the PIECEs research team. The meeting was key to understanding the local arts environment, building relationships with the advisory panel and exploring synergies for the Theatre of the Oppressed pilot company.
Using Performing Arts to Change Communities – Mehfil-e-Izhar
For the fourth day of activities, IRD Pakistan welcomed public health professionals, arts students, and theatre practitioners to a vibrant day of performances and discussions at the National Academy of Performing Arts (NAPA). The event showcased the work IRD Pakistan is doing in participatory arts (theatre) aimed at social change, mental health, and improving vaccine confidence.
Co-I Paul Heritage spoke about the utilisation of Theatre of the Oppressed and Arts as a tool for socio-political change and Mohammad Waseem (Founder of Interactive Resource Center) discussed the impact of Theatre of the Oppressed methodology in tackling social issues like child marriage, and bonded labour in Pakistan. Paul Heritage Queen Mary University of London, on the occasion spoke at IRD Pakistan’s #MehfileIzhar, about the use of participatory arts research in the realm of public health; “Arts can be a powerful tool to engage and activate communities for action against social injustices.”
IRD Pakistan’s project teams of PIECEs & #JeeloDobara performed moving pieces at the #MehfileIzhar at NAPA, Karachi, exploring how people with psychosis face stigma and discrimination, along with raising awareness and understanding about vaccinations.
NAPA’s own theatre and arts students performed at IRD’s #MehfileIzhar showcase in Karachi, through a series of performances, namely ‘Parivartan’, ‘Lahazil’ & ‘Ghootan’, using the arts to highlight the impact of societal pressure and discrimination on the mental health of individuals. Both guest speakers urged public health implementers, media students and policy makers to work together to strengthen the impact of their work for creating resilience in Pakistan.
Forum theatre workshops to end the week
To close our week long visit, Professor Paul Heritage led a Forum Theatre methodologies workshop with a number of IRD’s team members and arts facilitators, inspiring processes and techniques that will be used not only on the PIECEs projects, but in other projects where community engagement and arts as a research method are required.
