Tuesday, 3 May 2016

Artists and Patients Transform Rohallion Psychiatric Ward

Vanessa Magnone writes as an intern in Art in Healthcare and as an undergraduate student studying psychology and neuroscience:

Art in Healthcare is involved in a new and exciting project at the Rohallion Intensive Psychiatric Care Unit located in Perth, in which we are commissioning three artists to create original artwork for the hospital environment. Rohallion is an all male facility with patients from various parts of Scotland. This project will hopefully transform the environment into one which engages patients, staff and visitors mentally, while also providing a more domestic ambiance in the hospital. The human mind requires engaging stimulation constantly as it is essential for mental health. It was saddening to learn of the bare corridors and large communal areas that are home to the patients at Rohallion. When touring the Rohallion Psychiatric Hospital, I was impressed with the stunning woodwork in architecture throughout the unit, as well as the lovely outdoor spaces on the second floor. It is easy to recognise the potential at Rohallion which explains our enthusiasm for the project.
Rohallion Secure Care Unit
Interesting Research:
Incorporating visual artwork into the Rohallion Intensive Psychiatric Ward will not only enhance the domestic atmosphere, but potentially aid in the patient’s progression with internal thought processes. Some may be quite sceptical on how exactly placing artwork throughout the halls will help in the recovery of patients. The physical environment is the foundation to which recovery can take place. Research suggests that long-term reliance on a hospital style environment only erodes identity and physical and mental health. Furthermore, there are profound benefits in the processes of internal thought when cognitively engaging in artwork, (thus looking and thinking about the artwork). Researchers in the field of neuroscience and radiology at the University Hospital Erlangen in Germany conducted a study with fMRI brain imaging, as they were curious about the neurological effects of art on the human brain. They interestingly found that art evaluation improves the functional connectivity in the brain pathways of the Default Mode Network (DMN). The findings were increasingly more significant when participants actually performed an artistic activity rather than simply looking and thinking about an artwork. The DMN is a network in the brain related to internal thought processes such as introspection, reflection, daydreaming, comprehension of emotional states, and retrieval of memories. One should not underestimate the significance of art evaluation, that being simply looking and thinking about an artwork. It is amazing that many do recognise the benefits mentally ill patients, as well as staff and visitors, can gain from having artwork in their environment. (Bolwerk et al, 2014)

Focus Group Success:
We have had two focus group sessions thus far. Art in Healthcare and the artists involved in the project recognised the importance of involving the Rohallion patients in key decision making about the interior of the ward, as it is their home. The artists were passionate to gain personal input from patients that could further inspire their creation. The focus group allowed for patients and artists to interact and connect while sharing ideas about the direction of the project.

Artwork created by patient in the unit participating in the second focus group

First Focus Group
Seven Rohallion patients voluntarily participated in the focus group which was perfect for the small intimate setting we were hoping for and provided a comfortable environment for all of us to openly share. The focus group was structured with set activities, but allowed for open discussion on various topics. Patients shared their past experiences with art, discussing material preferences and subject matter interests with the artists. We couldn’t help but to first break the ice with a quick discussion on Donald Trump, which quickly got us all comfortable with each other. Artists showed their previous work to patients in a presentation, which patients and staff really enjoyed. The true success was the final art activity, “Feelings and Colour”. Patients, artists and Art in Healthcare staff joined together to participate. We passed out blank squares of paper, each having a theme written on it. Some of the themes were entitled “love”, “hope”, “hometown”, “favourite food”, “dreams”, “unhappy/annoyed”. We each filled in the blank squares with colours we personally associated with the different themes, for example, “bright red” for “unhappy/annoyed”. This creative art activity was very expressive and personalised to each patient. The nature of the art activity allowed the artists and patients to create and reflect on an equal level of skill. One patient who was quite reluctant in discussion in the beginning of the focus group was able to open up fully while engaging in this art activity with the group. He began analysing the characteristics of certain themes and further discussed his inner feelings. It showed a sense of deep thought and full engagement. It was very pleasing to see the social and therapeutic benefits artistic expression had on patients and artists. Artists found the art activity helpful as they took note of the different colours and shades used by patients, potentially inspiring their future works to be placed throughout the ward. My favourite part of the focus group, apart from engaging so close with the patients, was analysing the different colours and shades chosen for the theme of “dreams”. This category was very peculiar and quite psychological, almost asking which colours one associated with their mind. It was very fulfilling to see distinctive differences, and also patterns in shades and colours patients in the ward associated with their dreams.

Second Focus Group
I was excited to see familiar faces at the second focus group, as 4 patients from the previous focus group were present, along with the three artists. The remaining patients unfortunately could not make it because of other commitments. Art in Healthcare brought in two paintings from the collection to discuss with the patients and artists. Patients were vocal about their personal opinions for each painting. Talking about aspects of the paintings they liked, didn’t like, or what they would have done differently led to a captivating discussion. This art activity allowed patients to learn techniques in art evaluation that will help them connect to artwork in the future. We then allowed the patients to produce a quick sketch which could be anything from a landscape to an abstract form. Robert Macmillan, one of the artists, shared with the group his distinguished approach in creating landscape paintings, which we then all attempted. I took a lot from this experience, as did the patients. The work produced by patients was extremely expressive and reflected their talent, which was quite fascinating.

Sketches by patients using pastels
Overall, the focus group sessions were successful as everyone interacted well and took something meaningful out of the experience. I do hope the focus groups further encourage the unit to create more art based groups for patients at Rohallion, as it seems to be limited. Art in Healthcare is very much looking forward to seeing the finished products of artwork that will be produced for the ward in June.

Artwork created by patient in the unit participating in the second focus group
Bolwerk A, Mack-Andrick J, Lang FR, Dörfler A, Maihöfner C (2014) How Art Changes Your Brain: Differential Effects of Visual Art Production and Cognitive Art Evaluation on Functional Brain Connectivity.

Thursday, 24 March 2016

Developing a social prescribing service at Art in Healthcare based on an Occupational Therapy model Part 3

Thursday 24th March 2016

Following on from the fourth and final art workshop of our social prescribing service for referred patients of Baronscourt Surgery, we held a Celebration Event last week, at the Surgery, with patient's artworks newly framed and hung. The event was indisputably a happy one, full of chatter, cooing at artworks and laughter with patients, GPs, Art in Healthcare staff and volunteers amongst others. The surgery, which was closed to the public for the afternoon for staff training, took on the feel of a public gallery opening, an entirely different atmosphere to the hours when open as a GP surgery. 

Four of five participants attended the event with the fifth reluctantly unwell. All seemed proud to see their artwork hung on the walls and were pleased to pose for photographs beside their work. One lady brought along cakes for the event, consistent with having voluntarily brought along biscuits and milk to each of the four workshops. She also brought flowers for myself as the project coordinator and a card for the artist, which felt a sign that she had got significant value from the workshops prescribed for her at the surgery, over and above any medicines that she might otherwise have been prescribed in the past.

The GPs attending the event, over and above our GP partner in the project, seemed considerably impressed with both the finished artworks now hanging the walls of their workplace as with the purpose of the project and questions were asked universally about 'what happens next?'. On a short term basis, while the workshops have finished, we can be assured that the patients have formed friendships throughout the project that already sees them making plans to get together for coffees and art meetups. On a longer term basis, I am working on a substantial report that will draw together the key learning from this project and serve to inform future planning for similar projects, as for contributing to funding applications that may support further art projects at Baronscourt Surgery and beyond.

Meanwhile, I am partway through my Occupational Therapy 1:1 evaluations with the patients that aim to gather key feedback on both their participation in the project and regarding the goals we set together at the outset. These sessions are also a chance for us to discuss what happens now for patients with regards to art and how they might build art and creativity into their lives on a longer term basis as a contribution to their health and wellbeing.

What's become resoundingly clear is that this project has had significant social benefits for all participants, getting them out of their homes to integrate and form friendships with previously unknown people in their local community; patients have stepped out of their comfort zones to try a new activity and realized what they can actually achieve, raising their self-esteem in the process; and participants have all expressed themselves immeasurably through the creation of artworks, many of which now hang proudly on the walls of Baronscourt Surgery for every visitor and GP to see. Now that is what I call a successful prescription for someone with enduring mental health needs. 

A full report on the project is available at: http://bit.ly/29PsIlz 

Amelia Calvert writes as the Outreach Manager of Art in Healthcare and as an Occupational Therapist.

Art in Healthcare is an Edinburgh-based charity whose mission is to enhance the health and wellbeing of everyone in Scotland through the visual arts.

Wednesday, 17 February 2016

Developing a social prescribing service at Art in Healthcare based on an Occupational Therapy model Part 2

Monday 8th February 2016

Today we held the first art workshop for patients referred from Baronscourt Surgery as part of our pilot social prescribing service based on an Occupational Therapy model. I met patients at the Surgery along with the artist, Leo du Feu, before we walked with them over to the venue at Piershill Community Flat (PCF). 6 out of 6 patients who were registered turned up, a 100% improvement on the first time we ran the workshops when, despite apparent interest from patients to get involved, no one actually showed up. We had to go back to the drawing board about what might have represented barriers to access for patients and decided people needed to understand more about what was involved and the 'why'. This is how we came to introduce the Occupational Therapy aspect of the project - an informal Art Assessment in which patients would hear more about the project and have the chance to set goals for themselves, hereby taking a clear responsibility for their own health and well-being progression. Unfortunately, one of the patients didn't follow through and actually attend the workshop at the last minute but, she had at least set out to attend it, which was a massive step in itself. 
Image from the first Baronscourt workshop with participants using pastels

The ten minute walk was surprisingly helpful as an extra part of the process, giving patients and artist the chance to informally meet each other and chat, out of the context of the Surgery and before the context of sitting together in the 'art room'. Inevitably there was an air of anticipation amidst all patients and I could sense distinct social nerves that no one knew each other. However, the walk played a clear part in reducing these nerves and people seemed in a more relaxed frame of mind by the time they arrived than when we'd met at the surgery. Sunshine on the walk helped too!

I left patients at PCF in the capable hands of Leo with whom I had discussed previously the key goals and points to note regarding each patient. This meant that both artist and patient were more prepared than either party ever had been for our workshops and I sense this made a significant difference. Leo reported afterwards that the workshop had gone really well, that there had been a lot of conversation, a lot of creativity and a lot of interest in art in general. 

We are very grateful to our two lovely volunteers from Art in Healthcare, Beth Hadshar and Vessela Ivkova, who supported Leo in the workshop and greeted patients with big smiles when they first arrived at the PCF. With thanks also to Alistair McIntyre for hosting the workshop on behalf of the PCF and for providing essential teas and coffees to patients on their arrival!

Image from the first Baronscourt workshop with participants using pastels
Three workshops remain, followed by a Celebration Event, followed by a 1-1 OT Art Evaluation so there's work to be done in assuring the project is a success and in measuring the outcomes. However, we're confident that the building blocks bringing us this far have moved Art in Healthcare significantly along the journey of service development and we're realising that we're able to contribute a great deal more than we ever envisaged as an arts and health charity through using quite a different approach. We feel we're getting to the bottom of exactly how and why the arts can be so beneficial for health and the role that both primary care and artists can play in this, coming at it from two completely different contexts but with one unifying goal.

Amelia Calvert writes as the Outreach Manager of Art in Healthcare and as an Occupational Therapist.

A full report on the project is available at: http://bit.ly/29PsIlz

Art in Healthcare is an Edinburgh-based charity whose mission is to enhance the health and wellbeing of everyone in Scotland through the visual arts.

Wednesday, 3 February 2016

Developing a social prescribing service at Art in Healthcare based on an Occupational Therapy model Part 1

PART 1: Wednesday 27th January 2016

Today I sat in a clinic room as an Occupational Therapist at Baronscourt Surgery seeing patients referred from the GP. Essentially I carried out OT Art Assessments with each patient, inviting them to get involved in a series of art workshops that aims to improve their wellbeing through, a) the social experience of a group, b) having the chance to express feelings and emotions through art as a means of non-verbal communication and c) opportunities to improve their self-confidence and learn new skills.

Image from one of Art in Healthcare's previous art workshops for VOCAL carers organisation

I set goals with the patients about what they each might gain from the experience, ranging from, 'To leave each workshop with a smile' to 'Embrace range of creative opportunities as a long-term hobby potential', ie a range of social and creative goals.
This feels a big step along the way for Art in Healthcare in terms of mainstreaming art and the therapeutic qualities it holds through embracing the social prescribing model. It is also a big step for myself as an Occupational Therapist in terms of unifying the value I hold of creativity with my passion for supporting and giving care to others.

Artwork created in one of Art in Healthcare's previous art workshops for VOCAL carers organisation

I'm really looking forward to hearing how the workshops go next month with artist Leo du Feu and to see what artworks the participants create for display at the surgery in the long term. Meanwhile, we are grateful to Baronscourt Surgery and particularly to Dr Thomson for enabling this opportunity.

Amelia Calvert writes as the Outreach Manager of Art in Healthcare and as an Occupational Therapist.

A full report on the project is available at: http://bit.ly/29PsIlz

Art in Healthcare is an Edinburgh-based charity whose mission is to enhance the health and wellbeing of everyone in Scotland through the visual arts.