Institute of Global Health Innovation

*CONTENT WARNING – eating disorders, mental health, loneliness*

Dr Lindsay Dewa is an Advanced Research Fellow in Mental Health at the Institute of Global Health Innovation, Imperial College London

We all experienced COVID-19. Being socially isolated from those we loved was really difficult for most of us, and had a real impact on our mental health and wellbeing such as loneliness. 75% of mental health disorders start before the age 24, and young people were already going through challenging transitions: from school into employment, college and university, and maybe new relationships. But then COVID-19 struck and these transitions were made all the more difficult. Everyone had different coping strategies but eating-related coping strategies and having a good social connection with others were quite common. These are both highlighted in my research (Dewa et al 2021a, 2021b). 

 

“I truly believe connection in any form is so powerful and so important, no matter if it’s digitally or physically, we all need to stay connected to each other.” – Dylan

 

I was approached by a film production company, Inner Eye Productions, in December 2020 to make a film capturing the essence of the research, but also to use the same co-production principles applied in the research. We won funding from the Burdett Trust and West London NHS Trust and set to work with young people (aged 16-23 at the start of the project) to make a film drama in just over a year! All had lived experience of the pandemic, and some had experience of mental health difficulties.

Making a film involves three main stages:

1. 1. 1. Pre-production (planning)
      2. Production (filming)
      3. Post-production (editing, colour grading and visual effects)

Planning with young co-producers

In the pre-production stage we used research studies, including the CCopeY study, and the young co-producers’ own experiences of COVID-19 as a jumping off point for discussion and to refine our film idea. Disruption, poor mental health services, problems associated with housing and poverty, eating disorders/disordered eating and social connection came through as clear themes highlighted by the young people.

 

“My favourite part of the process was definitely creating the storyline. It was such a stimulating process and our ideas were bouncing off each other. With the help of the expert film producers, I definitely feel we included all the key ideas we wanted to based on the issues we had come across ourselves during COVID and this shaped our plot. Who knows when another such enriching opportunity will come again!” – Simi

Coping with COVID-19 as a young person

The young people, together with West London NHS Trust research lead Samantha Scholtz and our film director Chris Godwin, decided that our story should be centred around the experience of a young man with an existing eating disorder, who would share his experience of using eating disorder behaviours to cope during COVID-19. The character’s experience was made worse by poverty and disconnection with his close friends, who he was unable to see because of COVID-19 restrictions. It was really important to all of us that we had a diverse cast, and created as authentic a story as possible.

We met a total of five times to create the story detail and sign off on the storyboard, casting and script. We also agreed the title: “Nexus”. Everyone was listened to and we took forward the young co-producers’ ideas and incorporated them in the content. I made sure that everyone had a voice and I noted down all the comments and feedback along the way.

 

“Working on this film was a huge creative outlet for me, in a time where I was still very much feeling the effects of lockdown. Getting to work alongside other like-minded and creative young people was so much fun. Talking about the issues that we all faced and then putting them into art was really therapeutic”. – Dylan

 

Getting on set

In the production stage, there were five days of filming and our young co-producers Simi, Aliyyah and Dylan came on the film set! They got to experience working behind the scenes with myself and the film director, the art of direction and behind the cameras (my dog Baxter was even part of the set keeping the crew company!).

Dylan was cast as an extra in a shop scene and we found the experience so much fun!

Once the director said “Cut!”, the filming was complete…

But we still had a way to go. We were all involved in the editing process, watching the draft film and deciding what scenes to cut, keep or edit. It was interesting that we all listened to each other and came to a consensus on the final scenes. We met twice more to organise the film poster and premiere.

Why co-production with young people?

My research is almost always co-produced with young people with experience of mental health difficulties. This means working together in partnership – notably sharing power and responsibility throughout all stages of the research. I love co-production! This style of working prompted the film production company, Inner Eye Productions, to contact me and express interest in a new collaboration to make a film using my approach. I was so excited – this was a new one for me!

I had already been working with a diverse group of young people from across the UK to co-create public engagement events. These events were an after-school event series called “A New Tomorrow” providing practical support of how to improve young people’s mental health, and an innovative co-produced online conference that featured research that examined the impact of COVID-19 on young people’s mental health, but also meaningfully involved young people. From this group, I invited people to be part of our film project, Nexus.

This co-production process is innovative, engaging and has made sure the young people have had a sense of ownership in the film, but also that it offers an authentic voice. Four young people co-produced our film drama Nexus – Aliyyah, Dylan, Pelumi and Simi – from concept and idea generation, to filming, editing, completing the film, and getting it ready to show.

 

“I work for an anti-poverty charity in Teesside called Thrive, so I see the challenges people in my community face daily. Getting the storyline about poverty and the digital divide in the film was one of my goals as I wanted to give my community a voice. Lockdown really highlighted issues that were already there, so I felt it was really important to show that not every young person is digitally connected and how isolating that can really be.” – Dylan

 

 

This project is a collaboration between Imperial College London, InnerEye Productions and West London NHS Trust. We hope that this film can raise awareness of the complexities of the impact that COVID-19 and isolation can have on eating disorders in young men. We hope it can influence change in policy and practice within mental health services, and strengthen the need for good quality digital connections.

“I hope that this film gives a better understanding of the impact that isolation can have on a young person, and how complex and multifaceted mental health can be. I hope it inspires young people to reach out to someone if they need help.” – Dylan

 

Where can you see Nexus?

We have released a film trailer which you can watch on YouTube and are holding a small in-person premiere screening of the full 20-minute film at the British Film Institute on 7 December 2022.

In the new year, we are planning an online premiere for wider dissemination and discussion. Watch this space!

 

*Update – 3rd March 2023*

‘Nexus – the power of connections’ is now available to watch online.

If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, on 0808 801 0677 or beateatingdisorders.org.uk