'Poetry can be a powerful tool for young people in crisis care' | Nursing Times

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There is evidence that poetry can reduce feelings of hopefulness (Xiang and Yi, 2020), with the power and healing nature of words recognised for centuries as a helpful adjunct to formal therapies (Allen et al, 2019). Here in Greater Manchester, our CAMHS Crisis Care is using poetry as a powerful tool for young people accessing our service.

Our pathway offers short and longer term planned crisis interventions to young people, delivered by our team of mental health practitioners, occupational therapists and youth support workers. These are bespoke to meet individual needs, ensuring evidence-based interventions are accessible and meaningful. As part of this overarching ethos, we use poetry to encapsulate and reflect the journey our young people take in the six weeks they are with us.

“The tangible nature of the written poem can provide a positive memory of what is often a dark and difficult time”

We are conscious how privileged we are when young people trust us with their stories, thoughts, feelings, and emotions. We write with our patients and also use existing poetry. The sessions give young people a space to share with us their vulnerability, difficulties and inner most thoughts. Their resilience and strength shines through in the work they do.

Six weeks goes by quickly and the sessions are intense and highly demanding due to the emotional challenges posed. For our young people, creating a tangible reminder of their work feels important, if not crucial. During crisis periods, young people can struggle to see the positives in themselves, finding it challenging and uncomfortable. Through poetry we give them something they can look back on, hopefully with a positive lens.

Young people’s brief experience with a crisis service is something they are likely to carry with them throughout their adolescence and beyond. Through our work, we strive to ensure they feel seen, heard and valued. Poetry demonstrates through written words that we have met them where they are. It reflects their thoughts back to them, providing further evidence that they have been heard and understood. The tangible nature of the written poem, which we typically print and frame, can provide a positive memory of what has often been a dark and difficult time. Poetry can highlight the resilience our young people struggle to see in themselves and provide validation.

Mantra and rhythm are two elements of poetry we find young people respond well to. We often note down a short sentence or ‘mantra’ on a post-it note or card for young people to carry with them between sessions; this technique helps them feel they are ‘held in mind’ by the team and reminds them of the skills they possess to tolerate emotional distress. Rhyme feels accessible and brings a sense of playfulness and joy. The first poem I wrote, “How do I try”, was an amalgamation of the rhyming mantras generated in sessions. It was given to a young person in their last contact with the team and was incredibly well received by them and their family.

A significant proportion of our patients are neurodivergent, which is reflective of CAMHS (Crane et al, 2018). Neurodivergent young people can find it hard to identify their emotions and access emotive language (Heasman and Gillespie, 2019) and many of our patients struggle to talk openly about their feelings and show their vulnerability. I wrote a poem, ‘Talking isn’t easy’, to explore why talking about emotions can make feel people vulnerable and why at times it feels impossible. This has been used successfully in session work to help young people unpick what feels difficult and how to overcome this. This poem was also given to a young person with their discharge letter, which helped them feel understood.

As a team, we have found ways to create and use poetry specific to the individual and more generically to further conversations. Many poems consider ‘hopefulness’ in a novel way to create a therapeutic ending to a young person’s care. We are excited and passionate about continuing to explore how poetry can be embedded within our crisis care service and used along with the written word to work with and support our patient cohort.

Imogen Belcher is clinical lead, CAMHS Crisis Care Team, Manchester University NHS Foundation Trust