Self-Referral Form (Create Well mental health)

1. Create Well - mental health programme information and criteria

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This form is intended for people who would like to apply for a place on Artlift’s Create Well mental health programme.  

If you need help with this form and/or need to apply in another format, please contact us: 01452 222 726 or artlift.referrals@nhs.net. 

Please note that an offer of a place on one of our courses is subject to your providing the contact details of a health professional involved in your care, and to availability of (limited) spaces. 

ABOUT THE CREATE WELL PROGRAMME

Artlift offers non-clinical courses face-to-face in community venues as well as online.  The sessions are free, and materials will be provided. No artistic skills or talent are necessary. Visit our website to find out more: www.artlift.org. 

Our Create Well programme offers:

  • A chance to get creative and meet others (if in a group) over 8 x 2-hour sessions.
  • Creative Check-ins (one-to-one conversations) with a specially trained Artist Facilitator to help you embed and sustain creative activities.
  • Move On plans, so that you can continue to use arts as a tool and to meet up with others (if you wish) to support ongoing improved wellbeing.

CRITERIA FOR PARTICIPATION

Our Create Well programme is for adults who are:

  • Currently experiencing mental health challenges like depression and anxiety; and/or
  • Living with conditions that impact negatively on your mental health, e.g. MS or Long Covid
  • Registered with a GP in Gloucestershire
  • Comfortable in a group setting
  • Able to follow simple instructions or demonstrations
  • Committed to attending as many of the sessions as possible
  • If aiming to do an online course, willing / able to use Zoom, with a computer or tablet and quiet space where sessions can be accessed (N.B. we can support with Zoom familiarisation)

If you can answer ‘yes’ to, or are unsure about the following questions, a non-clinical Arts on Prescription service is unlikely to be suitable for you, and we would urge you to seek alternative support without delay (if you’re unsure, please don’t hesitate to call us):

  • Are you currently experiencing any symptoms of psychosis, such as delusional thoughts?
  • Are you currently feeling suicidal?
  • Are you currently struggling with addiction?

 

 

 

1. How did you hear about this Artlift programme? *

 

2. Have you been referred to Artlift in the past? *

 

3. Would you be interested in our creative dance course? *