History of the Project
Theatre for Living was inspired to create the initial production in 2013 because of our long and ongoing relationships inside the health sector in Vancouver and BC. We were encountering more and more patients and caregivers (counsellors, doctors, nurses, administrators) who were struggling inside the system. Professionals were less and less able to practice, in their own words, “the art of medicine” and patients were finding that receiving what feels like holistic and integrated care was also becoming more and more difficult. This situation exists across Canada and is getting worse, not better.
One aspect of the society in which we currently live and work that contributes to difficulties dealing with mental health issues is the stigmatization that goes along with declaring one is struggling with the issue at all. The issue of stigmatization is a priority for governments and private organizations alike. The Provincial Health Authority identified stigma as a major area for enhancing knowledge exchange and was important enough for Vancouver Coastal Health to bring a diversity of people together (Sept. 13 and 14, 2011) into a two-day discussion on addressing stigma called, Collaborative Change-Making. Over 120 people, many of them representing organizations, including Theatre for Living, attended this gathering.
Stigmatization and the fear of stigmatization stop people from seeking help. The stigmatization issue is itself often invisible, living underneath our conversations and professional and personal relationships. A step towards dealing with the issue, therefore, is to make stigma visible.
There is good work being done on stigmatization issues in the public realm – in families, the streets, schools. A hidden and generally ignored aspect of this issue is how the health care system itself is entrenched in beliefs, values and policies that stigmatize people. This applies not only to people who are struggling with mental health, but also to the staff that care for these individuals. This invisible layer makes effective care much more difficult, regardless of how many reports are written and how much money is invested in the area. The interactive Forum Theatre process addresses people's behaviour and human interactions at core levels, deepening the ability of the audience members and communities in finding solutions within themselves.
Participants in the Collaborative Change-Making meetings, many of them working in the mental health field, defined in numerous ways, a systemic “top-down” approach in health care as a central part of the issue of stigmatization. Their discussions named issues that included:
the artificial divide between various mental health services (silos in between programs);
how a mechanizing model of care is relying more and more heavily on pharmaceuticals;
how the health system expects patients and care-givers to conform to the needs of the system, rather than finding innovative patient-centered opportunities;
burn-out of health care workers who themselves have little or no support;
disparaging language (written and spoken) that health care professionals use to describe the people with whom they work;
…and many more.
A new and emerging language of performance targets, length of stay, product lines, deployment strategy and project management, are creating a new narrative in the delivery of health care. Business models are replacing client care models.
People spoke of dehumanization and fragmentation; of feeling alone, powerless and voiceless inside their roles as caregivers. Within their contexts they speak of being stigmatized by the health care providers, knowing there is a strong similarity between what they experience and what their client groups express regarding their experiences.
Dealing with individuals who are struggling with mental health issues can often be ‘messy’. People with mental health issues are often “non compliant”. How do we navigate a space within the system that can handle a necessary “messiness” on both sides (patient and care-giver) in which people can give and receive what is being referred to as “authentic care”?
If we agree that there are populations of clients (mental health) and health care providers who have poor interaction patterns due to stigmatization, and that these clients and providers are finding difficulty interacting in a healthy and productive manner, then we have the opportunity to experiment with new ways for these marginalized clients to access care and for the providers who work with these populations to be supported in both the health system and the larger mainstream culture.
The theatre can take statistics and transform them into personal stories; the theatre can be a true voice of people who are struggling with various aspects of the stigmatization issue; the theatre can open up the irony of the creation of 'the other' in a world where in fact there is only 'us' and in doing so, re-personalize 'the other'. Theatre for Living has a 34 year, multi-award-winning history of creating this kind of theatre.
More than that, this production, created and performed by people who have struggled with mental health issues from inside the 'system', can create a vehicle to help adapt policy and plans for social service agencies and Governments (who are willing to listen) to ensure that services are effective.
Creating the original play We initially received 191 applications from people who wanted to be directly involved in the creation and performance of this project. We interviewed 44 and then workshopped the issues with 24 patients and caregivers during a 6 day, 8-hour-a day process. Out of this workshop and a further 3-week creation/rehearsal process with the cast (all people living the issues) and a professional design team, came the final professional production.
Theatre for Living has evolved from Augusto Boal's "Theatre of the Oppressed". Since 1989 the work has slowly moved away from the binary language and model of "oppressor/oppressed" and now approaches community-based cultural work from a systems-based perspective; understanding that a community is a complexly integrated, living organism.
Forum Theatre is an opportunity for creative, community-based dialogue. The theatre is created and performed by community members who are living the issues under investigation. Over the course of a six day Theatre for Living workshop, participants engage in very specific games and exercises that help them investigate issues at a deep level. In a mainstage production such as this one, after the workshop, the cast, production team and director then have 4 weeks to make the best art we can, that tells the truths that have risen out of the workshop process. When I say "tells the truth", I mean as true questions - hard questions - the questions for which we don't have clear or easy answers.
The resulting play is performed once, all the way through, so the audience can see the situation and the problems presented. The story builds to a crisis and stops, offering no solutions. The play is then run again, with audience members able to "freeze" the action at any point where they see a character engaged in a struggle. An audience member yells "stop!", comes into the playing area, replaces the character s/he sees struggling with the problem, and tries out his/her idea. We call this an "intervention". The other characters respond with their truth, not to "make it better", not to "make it worse", simply to investigate a shared reality. What insights do we have? What do we think? What do we learn? Who agrees? Who disagrees? In this way we engage in a creative dialogue about issues in our lives. The process is fun, profound, entertaining and full of surprises and learning.
"Theatre for Living blurs the lines between performance, political activism, playwriting, community organizing and investigative journalism, creating a deeply participatory art that flourishes inside and outside the theatre walls. Maladjusted is a thought-provoking, gut-wrenching, funny, sad and mind-broadening journey inside the hierarchical and mechanical mental health system that engaged me both emotionally and intellectually. It blew my mind."
Sally Buck, audience member
"The passion and pain and hope for change (in Theatre for Living’s maladjusted) was palpable and the real issues were held up and examined. There was no feel of a documentary or lecture though, just real emotions, real stories inspired by real people. That’s unique, important and powerful theatre."
David C. Jones, The Charlebois Post – Canada
The BC/Alberta tour of maladjusted will broaden audiences beyond Vancouver. The tour was booked over many months, bringing Native and non-Native community organizations together in every hosting community. These collaborations will, we hope, help build working relationships between the organizations and also ensure a diverse audience at each performance, that is representative of the local population. A full tour itinerary is here.
The tour will have a support person on salary throughout the rehearsals and all performances. In some Theatre for Living projects we feel that having a professional whose role it is to counsel workshop participants and cast members, if necessary, is vital to the health of the project. The work creates a great deal of natural support within a working group. Because maladjusted is about mental health and stigmatization, we feel that this is one of those projects that would benefit from a position being dedicated to support. The support person will be present in all working sessions and be available to all personnel for one on one counselling and also referral to services, if necessary.
Another important role of this support person will be to meet with the teams of local support people who will be at the events in each community. History tells us that one of the positive and concrete results of a project like this, that opens up space for dialogue about these issues, is an increase in people wanting to access services.
In the original production a “scribe” was present at each performance, notating the ideas that came onto the stage. The Scribe studied and collated the ideas from 18 interactive events and created a powerful “community action report”, available at: http://www.theatreforliving.com/past_work/maladjusted/reports_maladjusted.htm
The report contained policy suggestions for local agencies and Government. We will replicate this process in each community on the tour, so that policy recommendations that are the voice of people living the issues can be heard, notated and hopefully acted upon by local agencies.
Four of the original cast of six are back. These are: Martin Filby, Micheala Hiltergerke, Pierre Leichner and Sam Bob*. Unfortunately, Khoal Marks and Erin Arnold are unable to tour. They have been replaced by Columpa Bobb* and Christine Germano, both of whom also have lived experience of the issues in the play.
We are also touring with our Stage Manager, Dorothy Jenkins*, Support Person Charlene Hellson, and a 3-person Crew (Elisha Burrows – Technical Director, Tim Cardinal – Lighting Technical Director, Robyn Volk – Crew). Cast and full company bios are here.
*Appear through the generous support of Canadian Actors’ Equity Association.
We will once again be collaborating with SHAW on a live, interactive web broadcast, and taping of the closing night for airing on SHAW Television. This would greatly increase the reach of the project. We have done interactive webcasts with SHAW on all of Theatre for Living main stage projects for many years. The webcast will be live on March 28, 2015 here.