The HOAX Project, 2012-2018
(Themes: psychosis, schizophrenia, paranoia, suicide, treatment, therapy, drugs, family, mental health)
Contents
A True Story
HOAX 2012-2014
. HOAX My Lonely Heart (stage musical)
. HOAX Psychosis Blues (graphic novel)
HOAX 2012-2014 Qualitative Feedback
The HOAX Project 2015-2018
The HOAX Our Right to Hope App
The HOAX Tour
. HOAX My Lonely Heart (revised)
. HOAX Psychosis Blues (second edition)
. The HOAX Tour Website
The Mental Health Study
The HOAX Project Quantitative Results
The HOAX Project 2015-2018 Qualitative Feedback
A True Story
The HOAX Project was a long term, ambitious project that sought throughout to push the boundaries of engagement, involvement and impact around serious mental illness.
It began with two existing, award-winning Ziggy’s Wish crossmedia applied narratives, created and launched 2012-2014. Both were based on the true story of a young man from Manchester called Rob, his life with schizophrenia, through to his death by suicide.
The first was the stage musical HOAX My Lonely Heart; and the second was its sequel the graphic novel HOAX Psychosis Blues.
Here these are collectively referred to as HOAX.
HOAX 2012-2014
Rob was a poet in real life. HOAX was inspired by the poems he wrote leading up to and during his time living with schizophrenia.
HOAX My Lonely Heart (stage musical)
The stage musical tells a backstory. It is the tale of two people – Rob and Helen – their meeting, their belief that the immediate need they satisfy in each other is love, the truer co-dependent nature of their relationship and their ultimate breakdown.
The show opened in Royal Exchange Theatre, Manchester 2014, running for four consecutively sold-out nights. It received outstanding reviews and was shortlisted for the Medicine Unboxed Creative Prize 2014.
HOAX Psychosis Blues (graphic novel)
The graphic novel tells Rob’s story beyond the end of the stage musical, post his diagnosis as having schizophrenia, and the difficulties he faces over subsequent years.
The book was published alongside the show in 2014. It was nominated for and won several awards including Comics in Education Graphic Novel of the Year 2014, British Comic Awards Best Book 2014, Comica Top Ten British Graphic Novels 2014, Critic’s Poll Publishers Weekly 2014, and The People’s Book Prize 2014/15.
HOAX 2012-2014 Qualitative Feedback
It was evident from the qualitative feedback that HOAX had a profound effect on its audiences, suggesting these crossmedia applied narratives held a very real potential to change attitudes, reduce public stigma and reduce self-stigma around mental health.
The HOAX Project 2015-2018
In 2015, we began working with the Psychosis Research Unit (PRU) – a joint project between Greater Manchester West Mental Health NHS Foundation Trust and The University of Manchester – to explore how PRU might quantitatively harness that potential and test the hypothesis that HOAX could lead to positive behavior change around mental health, and even to self-recovery. Thus we created The HOAX Project – a world-first crossmedia applied narrative, health research study.
PRU promotes a normalising approach to understanding psychosis, and believes the experiences commonly regarded as symptoms of psychosis are often highly understandable reactions to adverse life events. Their primary aim is to develop ways of reducing the distress of people with these experiences, as well as developing ways of restoring their autonomy and dignity.
The aim of The HOAX Project was to study the impact of HOAX on audiences, including those with lived experience of psychosis-related difficulty; and whether this impact was long-lasting.
For this to work, PRU required access to a wide range of members of the public, as well as an optimized way to gather data from them over time. It was crucial this data-collection method supported the HOAX content being studied, to minimise the audience being ‘pulled out’ of their engagement with that content, and therefore to give the truest reflection of its impact.
Thus we developed and delivered a mobile app for the project, using digital applied narrative, titled HOAX Our Right to Hope.
The HOAX Our Right to Hope App
The HOAX Our Right to Hope app was specifically designed to help people connect to PRU’s mental-health research in a way that showed them why the research was important, and why they should take part in it.
As such, the app not only housed PRU’s study questions, but it also wrapped them in a new piece of HOAX applied narrative that we created to seamlessly dovetail with the original HOAX content – introducing, linking and concluding it – and meant the audience could take part in the study without feeling like they were leaving the HOAX experience.
As this new piece of applied narrative was digital, it also meant we could provide PRU with highly efficient data-capture, categorisation, and export capabilities.
In addition it meant we could provide different interactive experiences for our different audience segments, ie. general public, and those who had lived experience of psychosis-related difficulties: with the app loading different study questions for each group, as well as providing different narrative experiences and associated support.
The HOAX Tour
In order to engage with a wide range of members of the public, we secured Arts Council England Strategic Touring Programme funding, to tour a pilot of The HOAX Project across the north of England.
The tour ran across five venues in spring 2017. These were Barnsley, York, Grimsby, Liverpool and Salford: areas known for having low engagement with the arts and poor uptake of mental health services.
Tickets to the event included entrance to the HOAX My Lonely Heart stage musical, a copy of the HOAX Psychosis Blues graphic novel, and access to the HOAX Our Right to Hope app.
HOAX My Lonely Heart (revised)
As the applied narrative employed in HOAX is raw, emotional and powerful, we revised the original musical to reduce its running time, in order to accommodate the potentially vulnerable audiences that the study might attract. We also held post-show discussions after every performance, and provided additional clinical support at each matinee.
HOAX Psychosis Blues (second edition)
A limited, hardback, first-edition run of the graphic novel had been printed in 2014. For the 2017 tour we commissioned a larger, paperback, second-edition run: more cost effective and, crucially, more portable across the tour audiences.
The HOAX Website
Key to the mental health research study was its anonymity, but also that each participant in the study had a unique identification code. To ensure this, we associated a unique code to each ticket that was sold. Audience members entered the code to access the app. For those who then chose to participate in the embedded study and answer the questions there, it meant their data was anonymous, attached only to a code, and not to them as individuals.
In order to deliver tickets with unique codes attached we created the purpose-built HOAX website.
Anyone could visit the website and engage with The HOAX Project, but we specfically targeted Healthcare, Community, Educator, Alternative Venue and Arts Venue groups: offering patient-centred perspective; insights into the difficulties faced by partners, friends and family; access to and engagement with ‘hard to reach’ groups; exploration of new and alternative means of treating people with mental health difficulties; validation and recognition for work done in the mental health sector; shared results; diverse representation; relatability; tangible help for at-risk individuals; subsidised arts provision; awareness raising; empowerment and encouragement to counselling; educational resources; new community connections; venue profile and exposure; new audience development; multi-stakeholder engagement and strategic partnerships; innovation; qualitative and quantitative evaluation; high quality artworks; as well as the chance to participate in a groundbreaking mental-health study, and contribute towards positive social change.
The Mental Health Study
HOAX presented an opportunity to evaluate novel intervention strategies that could impact on mental health outcomes. As such, PRU’s research study aimed to provide preliminary evidence around the feasibility of HOAX to address multiple facets of mental health stigma.
Study questions were offered to participants, via their interactions with the HOAX Our Right to Hope app, across four different timepoints. These were Baseline (prior to the musical), Post Musical, Post Graphic Novel and Follow Up, and spanned a time period of six months.
General-public participants were asked questions that assessed behavioural intent and stigmatising attitudes, in order to explore the influence of HOAX on public stigma. Participants who self-selected as having lived experience of psychosis-related difficulties were instead asked questions to assess the influence of HOAX on internalised stigma.
All participant responses were gathered via the HOAX Our Right to Hope app. To best support PRU’s analysis of this data, we created a unique web administrator, purpose-built on an adapted database to ensure export compatibility with PRU’s existing data analysis systems.
The HOAX Project Quantitative Results
The Psychosis Research Unit carried out a detailed analysis and interpretation of the health research study data that we captured, categorised and exported via the HOAX Our Right to Hope app.
From this came several significant findings including an increased engagement with the subject matter, as well as a positive change in attitudes towards people experiencing psychosis, and an increased likelihood of help-seeking if people suspected they were experiencing symptoms of psychosis. These findings were still true several months after the initial engagement.
With the stigma around mental health, particularly serious mental health conditions such as psychosis, being a major barrier to engagement, understanding and help-seeking, the findings highlighted the absolute potential for crossmedia applied narratives to bring about genuinely positive change; allowing PRU to build on their highly innovative and progressive work in the field of serious mental illness.
The HOAX Project 2015-2018 Qualitative Feedback
In addition Ziggy’s Wish gathered qualitative feedback from the many sectors and stakeholder groups that we engaged with across the HOAX Tour.