John Whall from Derby QUAD is the ArtWorks Alliance digital participation champion. Here he explores issues around mental capacity and creative work by participants in an edited version of a blog fromDigitalpARTicipationis…No-one wants to participate in participation designed by somebody else following a Soap Box presentation at the 2018 Engage international conference A Social Prescription.

Derby QUAD’s Creative Wellbeing programme has created strong links with local health and care services over several years.

Back in 2017, Digital Participatory Artist in Residence Kajal Patel worked with participants from Rethink Derby, local artists and other creatives. This provided a rich pool of people sharing learning and practice, from which an exhibition of participant work was developed in the context of contemporary visual art. This was a powerful process and outcome for everyone, especially those living with mental health issues.

We identified the 2018 Digital Participatory Artist in Residence programme as an opportunity to explore new ways of working with a selected participant group: inpatients from a Derbyshire Healthcare service for residents with acute mental health needs. The artist was Leila Johnson.

Our immediate challenge was the capacity question and how this affected what could, and could not, take place in relation to the presentation and use of participants’ creative work.

Section 2 of the Mental Capacity Act 2005 says that ‘a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain’.

Lacking capacity includes when your ability to make decisions is affected either:

  • permanently: which is where your ability to make decisions is always affected. This might be because, for example, you have a form of dementia, a learning disability or brain injury


  • in the short term: which means your ability to make decisions changes from day to day. This might be because, for example, you are confused because you’re on medication or because of certain mental health conditions, or you are unconscious.

Capacity Assessments establish, at that moment in time, someone’s capacity to make an informed decision about themselves. Assessments can take up to 45 minutes per patient: it’s time-consuming and may require additional staffing.

In our project, capacity related to people giving permission for their work to be used beyond the hospital. We decided that the assessment process was going to be too big an ask for the nature of the workshop engagement between our artist and residents.

This impacted on the documentation process as well as the representation of participants’ voice and creative development, as it meant:

  • No images could be taken to document the workshop
  • None of the participants’ words could be used
  • None of the work created in the workshop could be used

Leila’s work for the residency focused on falling and failing, which seemed to fit well with the concerns and issues faced by the participants. Participant engagement involved the exploration of technology and being creative with digital. The patients in residence varied and in these settings, there are often people who are very creative, although they may have difficult, negative feelings about creativity along with a sense of having ‘failed’ as artists, or potential artists. It’s important we are always aware of these potential vulnerabilities.

Initially, there was a planned element of Leila’s work which involved presenting participant comments within the exhibition space. However, because no capacity assessments were undertaken, this could not be done. So, as another theme within Leila’s work was dancers, she worked with local dancer Rosa Cisneros who used movements originated by inpatients and staff to create a dance sequence which she then performed.

This provided enough ambiguity not to be indicative of any particular participants. And with movement being a potential negative trigger, Rosa took great care in ensuring the vocabulary used was not exaggerated and was participant led.

Leila provided hands on access to 360° cameras, motion capture equipment and LED light systems. Participants were really taken back with this: not because of the equipment, but because they were being trusted to operate it.

Trust, the humanity of creativity and the up-close nature of the experience had a noticeable effect on participants. They entered the space quiet and withdrawn. They left energised, confident and excited about engaging with arts and culture further, as outpatients.

This experience has highlighted that, within arts and culture, it’s important to remember the positive impact of the act of engaging a participant in creativity, regardless of which Key Performance Indicator they fall under or whether we’ve been able to record it: we don’t need to show it to know that it’s happened.