ATTUNE

ATTUNE was a significant arts and mental health research project led by a collaboration between Falmouth University and the University of Oxford.

Four people sitting on steps wearing jeans and trainers

Project details

Project leads Anna Mankee-Williams, Professor Minhua Eunice Ma and Professor Kam Bhui
Centre alignment Centre for Arts & Health
Start date April 2020
End date August 2025
Project website https://www.attuneproject.com/ 

The ATTUNE research collaboration explored the individual, environmental, social, economic, educational and geographical factors that influenced young peoples’ mental health.

ATTUNE aimed to understand the pathways of risk and resilience from Adverse Childhood Experiences (ACEs) to adolescent mental health outcomes. To do this, it brought together a national consortium of academic, public sector, voluntary and community sector, and charity partners. The project used participatory, arts-based research methods alongside epidemiology and health economics.

ACEs are highly stressful or traumatic events that can have a lasting impact on health and wellbeing throughout a person’s lifetime. Almost half of young people experience at least one ACE, and one in ten experience four or more. Examples can include abuse, neglect, witnessing violence, substance misuse in the family and discrimination.

Through creative, co-designed research activities with young people, ATTUNE uncovered new insights into how these experiences affect mental health, and how support services can respond in ways that young people find meaningful and validating.

Outcomes & outputs

ATTUNE’s first phase used participatory co-discovery activities to inform subsequent research.

Young people consistently expressed that traditional talking therapies often felt unhelpful or invalidating, and instead called for creative, flexible and consistent approaches.

Key outputs included:

Ace of Hearts – a co-designed serious game developed with young people and produced by Falmouth University’s game development team. Based on earlier research, it provided a private, creative space for young people affected by ACEs to reflect on their experiences through a mobile game. The game contained four themed minigames: Horse and Foal (bereavement and early responsibility), Hard Times (family financial struggles), Dial It Back (living with a disability) and Out of Shell (gender dysphoria). All were linked by a central hub, the Cosy Den, where players could personalise a bedroom space. By embedding lived experiences into gameplay, the project offered a safe, relatable way to explore sensitive topics.

Immersive final conference, Disrupting the Silence (July 2025), replaced conventional conference presentations with audio-visual soundscapes, a short film, live visual art and facilitated dialogues led by young people themselves.

Validating Voices – a public health resource for professionals and young people aged 12–24 to embed validation in everyday conversations within public sector settings. Co-created by 20 young people and 17 professionals over nine workshops in Leeds, Cornwall and Kent, it addressed ATTUNE’s finding that repeated invalidation by professionals can reinforce the harm of ACEs.

The toolkit, combining physical and online resources, helps staff recognise and act on opportunities for “micro-validations” that build trust, self-worth and safety, and ultimately show that the young person is being taken seriously.

Young people said this change in professionals’ behaviour could have a profoundly positive impact. Validation involves being curious and open about a young person’s experience and needs, rather than assuming, dismissing or delegitimising them as immature, unnecessary or attention-seeking. It also involves affirming a young person’s identity (for example, as neurodivergent or non-binary) and remembering how their past or current ACEs may be shaping their behaviour and needs.

In everyday encounters, this means professionals looking for opportunities to say things like “I believe you”, “I want to know what is going on for you”, “it is understandable that you feel that way or need these things” and “you don’t need to change to be welcome, accepted or safe here”.

Survey and focus group work showed that:

  • Both digital and in-person creative environments were important outlets for expression and wellbeing.
  • 83% of surveyed Falmouth University students saw digital tools such as apps, VR/AR games as useful for diagnosis and support.
  • Transitions, particularly from university to employment, were key stress points.
  • Choice of engagement method, whether digital or physical, was important for accessibility and comfort.

Additionally, co-design participants also anticipated benefits for professionals, including stronger relationships with young people and reduced burnout.

Impact & recognition

ATTUNE’s findings informed public health bodies, commissioners and service providers, encouraging them to:

  • Reconsider existing approaches to diagnosis and support for young people with ACEs.
  • Embed co-designed, creative methods into service design.
  • Actively listen to and validate young people’s own perspectives on what support works.

By combining art and science, and working with young people as equal partners, the project influenced how policy makers, healthcare providers and youth organisations thought about mental health interventions.

Project media

Public media for ATTUNE includes:

Introduction to ATTUNE | Research Project

ATTUNE project video
ATTUNE: Remote in Blue

Project team

The ATTUNE consortium brought together clinicians, academics, service providers, artists and young people from across the UK.

At Falmouth, the team included lecturers and researchers with expertise in mental health, wellbeing, co-discovery and co-design within creative practice.

Anna Mankee-Williams

Associate Professor, Arts and Health

Anna is an Associate Professor in Arts and Health. Anna has 22 years’ experience in the health sec...

Anna Mankee-Williams

Professor Tanya Krzywinska

Professor of Digital Games

Tanya started playing computer-based games on Usenet when working at the Digital Equipment Corporati...

Professor Tanya Krzywinska
David Prior

Professor David Prior

Pro Vice-Chancellor Research and Knowledge Exchange

I joined Falmouth as Associate Professor in Music and Sound Art in 2010. Now as Pro Vice-Chancellor ...

Professor David Prior

Dr Ruth Pethybridge

Senior Lecturer, Dance

Dr Ruth Pethybridge is a choreographer, facilitator and researcher. She has delivered dance in ...

Dr Ruth Pethybridge
Karen Brett

Karen Brett

Senior Lecturer

Karen Brett is an artist working with photography, moving image & sound who graduated with a BA ...

Karen Brett
kathy

Katharine Nicholls

Senior Lecturer

With over a decade in the Animation industry in addition to her work as a freelance illustrator, art...

Katharine Nicholls

Partners

The project included input from the following people and organisations:

  • Professor Kam Bhui CBE, University of Oxford
  • Professor Siobhan Hugh-Jones, Professor in Mental Health Psychology at the University of Leeds
  • Professor Mina Fazel,  Professor School-based mental health interventions, University of Oxford
  • Professor Nicola Shaugnessy, Kent University, contemporary performance, autobiography, applied and socially engaged theatre with specialist research interests in the neurodiverse population.
  • Dr Sania Shakoor Lecturer in Mental Health, Centre for Psychiatry, QMUL
  • Professor Daisy Fancourt, Professor of Psychiobiology & Epidemiology/Wellcome RF, UCL

  • Professor Peter Fonagy, Professor Epidemiology/Wellcome RF, UCL
  • Professor Craig Moran, Professor of Social Epidemiology, KCL
  • Professor Paul Mcrone, Health Economics, Greenwich University
  • Dr Georgina Hosang, Senior Lecturer in Chronic Disease Management, QMUL
  • Cornwall Council
  • Cornwall Partnership Foundation Trust
  • Young People Cornwall
  • Aardman Animations
  • NSPCC