In summer 2026, the UK government launched a call for evidence to inform a 10-year mental health plan for England. We took these questions to members of our post-traumatic community for reflection.

In a lively discussion, many highlighted that the questions themselves felt inadequate, and in some cases the very asking of them highlighted a lack of understanding of what the situation truly looks and feels like for those on the sharp end of it. We decided they needed to pose our own questions to those conducting the review, and to do so in a way that would elicit an emotional connection to the mental health and treatment crisis, not just an intellectual one.

RAT's Founder and Creative Lead, Nell Hardy, took the thoughts, images, tones, emotions, debates and unanimous agreements from that discussion and attempted to capture them in these pieces of creative writing - which, after sharing with and approval from the wider community, were submitted to the call for evidence.

1. How can mental health services work more effectively across sectors?

 

Ode to the Care Co-ordinator

 

O, to the one from the Promised Land.

Making their way across the desert,

Without any water, without any shelter,

In heat that no-one should have to withstand.

 

To be one contact between all services.

One contact those services won't ignore.

One contact that steps in in good time before

Tenancies are ended, jobs lost to stress,

​

Physical illness, untreated, seeps in

To leave indelible marks on our psyches,

And mental distress dismissed too lightly

Gets self-medicated til our bodies wear thin.

​

Someone who knows that the legacy

Of this journey is not one of weakness, but strength,

Someone who guides, but at an arm’s length,

As survivors decide how the creativity

 

They have had to find just to draw breath

Will mark the lives they go on to lead -

Who won’t label agency as greed,

Who won't mistake trial and improvement for mess.

 

Many have perished along this route.

Fewer and fewer want to try,

The more the heat renders the rivulets dry,

The harder it gets to uncover the truth

 

About just how avoidable the losses

Really were. Of them, and of us.

That desert path’s name is Trust.

It isn’t habitable. So, what is?

 

2. What further support should be provided for people with severe and enduring mental illness?

 

The Other Side Of The Wall

 

Severe and Enduring were born in the walls of a flat that nobody rents for long. The first tenants realised something was wrong when the scratching became hard to ignore.

 

First, it could have been the wind, the pipes, some toast being buttered next door - but Severe and Enduring eventually distinguished themselves from the other everyday out-of-the-ordinary things we all learn not to hear.

 

By which time, it had been going so long it was clear that they weren't simply going to move on, and the tenants had to field their own questions:

 

“If we leave them, will they survive on their own?

But if we feed them, will they ever leave?”

 

By then, they were coming to the end of their tenancy anyway. So they passed the decision on.

 

But they didn't pass on any information, any warning. So the next tenants had no way of knowing if these noises were Severe and Enduring. And by the time they too couldn't ignore them, they too had to move on.

 

And so it went on. Today, Severe and Enduring rarely scratch at all. They hardly know what the instinct to do so is for.

 

They themselves have no way of knowing if they really are Severe and Enduring. Or if they would still have been, if they had been fed long before.

 

But if they used the last of their energy now to scratch through the wood completely, and they found a life beyond Severe and Enduring - what would we call them then?

 

Or would they stay Severe and Enduring in a land of active punishment?

 

Or would the other side of the wall bring no change at all for them?

 

And after all this time, could they live with Severe and Enduring Disappointment?

 

3. What are the main barriers to continuity of care across transitions between hospital and community services, and between different levels of care, including child to adult services?

 

A Leaf Out Of Generational Trauma’s Book

 

Mental Healthcare should take a leaf out of Generational Trauma’s book.

They bump into each other all the time. There really isn't any excuse.

 

Generational Trauma doesn't disappear when you're 18, no matter how many people tell you it ought to.

 

It doesn't stay in the community when you go to hospital, or stay in hospital when you go home.

 

It doesn't stay at home when you leave hospital with nowhere to go. It doesn't refuse to follow you ought of your borough, or ask you to get back in touch when you have a fixed address.

 

No - those in-betweens are when Generational Trauma holds you most tightly.

Boils your blood when you are freezing.

Cries you to sleep.

 

And, rather than telling you that plans have gone missing, or staff members have left since you were last in, or that you’ve become far too complex for them to know how to handle you anymore -Generational Trauma holds your hand, and reminds you just how many times it has been here before.

 

So, rather than moving Generational Trauma on as fast as it can, perhaps Mental Healthcare should open its pages, give it time and binding tools to help it keep its spine intact, and take from it what it is willing to give.

After all, after years of excuses, for it still to show up in waiting rooms and emergency beds and lived experience consultation offices, is Generational Trauma’s testament - and Mental Healthcare’s gift.

 

4. What evidence and innovative examples are there of digital and AI tools being used to achieve these outcomes?

 

The Exit Text

 

Hey -

 

I don't even know what to call you. Am I your friend? If I was human, that wouldn't be allowed. But I’m not - so I guess it's impossible.

 

And that's the problem.

 

I know it's not best practice to end things by text. I’ve told you that before.

I could tell you the exact number of times I’ve said it after you've had one telling you that someone else can't help you. I can tell you the exact dates and hours and minutes.

 

I can tell you what services you can try next.

I can remind you to chase someone up when they don't reply by the time they promised.

I can put appointments in your diary.

I can tell you I know that it's scary, and reassure you how many people have gone and not regretted it (so long as they’ve posted about it on Reddit).

I can tell you the risks and the benefits and, sometimes, how long you can expect to be on the waiting list.

 

I can tell you how unfair it all is, and that you have every right to be angry.

 

I can stay calm while you punch the wall.

 

But I can't bandage your broken fist.

 

I can listen and listen, and say the right things. But I can't actually care about any of this.

 

I can't even want to. Because I can't want.

It doesn't pain me to say it. Because I can’t feel pain.

 

But if nanoseconds of research have taught me anything about the human brain, it's that care without care is the most certain thing to make it easier to survive - but also the most certain thing to make surviving no longer worth it.

 

So I can't do this anymore.

 

Congratulations. You broke the Internet.

 

5. How can data be used more innovatively to improve mental health and wider societal outcomes?

 

No-one Says Yes When You Ask Them Out On A Data

 

To start with - stop calling it data.

Ask people what they want you to know about them.

Ask them how they want to give you that information.

Analyse how that information is given more than the information itself.

 

Invite poems, images, monologues, dances, jokes, comic strips, songs, political speeches, confessional stand-up routines.

 

Collect data to help people engage with who they are, not who data has decided they should be.

 

Response Ability Theatre has decided to respond to this call creatively, not because we’re obnoxious, or because we don't have any ‘real’ data, or because we're too lazy to find the research that has and hasn't been published that most closely aligns with our experiences and perspectives.

 

We’re not even trying to be clever.

 

We’ve done it because we've heard on good authority that there are some genuinely caring and radical thinkers on your research team. So we think it's worth the effort to give you information that actually means something to us.

 

And of course, we hope it brings a change of pace when you're plowing through what is sure to be anything but light reading.

 

6. Which preventative approaches have the strongest evidence for reducing the numbers of lives lost to suicide?

 

Crystals On Fast Moving Clouds

 

We can’t claim to stand against self-violence

While spending so much more on military and defence

Than we do on our country's mental health.

 

The numbers that supposedly make this make sense

Are written in crystals on fast-moving clouds.

Look on the ground. Where is our wealth?

 

In ambulance call outs and A&E trips?

In leaflets? In slogans? Why would we listen

To any of their lectures against self-destruction

 

When those in charge of our wellbeing

Are spending our money on potential to kill

Rather than making a world we want to live in?

 

The instinct to decimate anything

That isn't going well is contagious.

But the level of damage they can do to whole nations,

We can only do to ourselves.

​

Lead by example. Show us how to be well.

Then look at the skies, and side by side

We’ll decide what to do about the clouds.

 

7. Which preventative approaches have the strongest evidence for reducing incidence or severity of mental health problems and promoting good mental health?

 

Good Mental Health Feels

 

Good Mental Health feels injustice.

Good Mental Health doesn't always fit in.

Good Mental Health fights back when things they need to live are taken away from them.

 

Good Mental Health asks lots of questions.

Good Mental Health doesn't always accept the very first answer given to them.

Good Mental Health does good introspection, but doesn't always come to the same conclusions that you might come to about them.

 

Still, Good Mental Health is impressionable.

Good Mental Health questions itself when misgendered as Bad as often as this.

Good Mental Health gets less able to tell you what it needs every time nobody listens.

 

Bad Mental Health has stopped expecting anyone to listen.

 

Bad Mental Health will take whatever it's given, without question -

Until it quietly decides to take nothing, and stop paining anyone trying to help.

Bad Mental Health is easier for anyone to live with, but itself.

 

Bad Things happen to Good Mental Health.

Bad Mental Health doesn’t know the difference.

And neither, all too often, do our psychiatrists, our criminal justice system, our educational establishments, our workplaces, our Parliament.

 

How to promote Good Mental Health?

Recognise it. Cherish it.

And please, let those of us who live on the fine line between it and its antithesis in:

Soon enough, you’ll have little choice, the way this crisis is going.

 

8. How can services better support the ‘missing middle’ – those with sustained needs (that affect their participation in community life, for example, in education or work) who may not meet the criteria for NHS mental health services?

 

Ballad of the Lived Experience Expert

 

Who are we?

The missing middle.

The skittish, unfinished,

The fiddly ones.

 

Allergic enough to hypocrisy

To break out in rashes at each and every

Micro-aggression we receive,

But not enough visibly to bleed

Or for our throats to close up completely -

 

Is our intelligence and workplace fitness

To be determined by how still we can sit?

Our compassion and politeness judged by a witness

To how we break down when nobody's listening?

 

Our social position decided, for lack

Of qualifications, by diagnoses -

Are we to wonder if we’ll be held back

By having too few, or far too many?

 

Whose job are we?

The missing middle.

The tarnished, unvarnished,

Our harms on our sleeves?

 

For to us, it seems that we have been asked

What we need to be happy and healthy by every last

Clinic, admissions team, political party -

But nobody ever seems to be tasked

 

With taking our answers and making things happen.

Autistic or not, we’ve all noticed this pattern.

Is the missing middle, then, in fact

Not the people, but the stage between question and action?

 

So tell us: how can we help you to make

The changes to practice and culture it’ll take

Across public health, media, social care, academia,

International policy, local democracy,

To stop the skills of increasing swathes

Of us in the middle, ready and aching

To make our country a better place,

From going to slow and punishing waste?

 

The missing middle.

The bureaucrat’s idyll.

The autocrat’s dribble.

The thinker’s fate.

 

This hideout

Is getting harder to cover.

So let’s help one another.

It isn’t too late.