This article looks at three recent studies that illustrate the differing approaches to developing projects for people with mental health issues.
Older, vulnerable patients
The Journeys of Appreciation Programme (Joap) is a museum and gallery partnership with NHS in-patient clinical services for older adults with mental health problems and dementia at hospitals in south London. Funded by the Maudsley Charity, the project currently works with Tate Modern and Tate Britain, the Cinema Museum, the Horniman Museum and Gardens and Dulwich Picture Gallery, all of which are in London.
The programme has been running for about two years, and involves taking patients to visit a museum and participate in a gallery workshop.
“The idea is that we have one staff member to every patient, which facilitates communication through the experience,” says Helen Shearn, the head of arts strategy at the South London and Maudsley NHS Foundation Trust. “It helps us understand the whole person.”
The experiences and activities that take place in the museum can also be brought back to the wards, which helps to enhance the hospital environment and ensure that the benefits continue beyond the visit.
The participants who take part in Joap are considered highly vulnerable. “We wanted to target people who might not normally get this sort of opportunity,” Shearn says. “During our pilot project at Tate Modern, there was some trepidation about risk assessment, but it has been very rewarding for staff to realise that it is possible to take vulnerable people to a place like a museum.”
Initial evaluation and a mental wellbeing impact assessment found that the experience brings a mutual learning opportunity. The opportunity to take part in workshops in a public space at a high-status venue such as a museum has a positive impact on participants, and has also boosted staff morale.
“One other benefit is that the work has been a catalyst effect for further collaborations,” says Shearn. For example, the Cinema Museum was selected by National Museums Liverpool to provide digital content for its House of Memories app. NHS staff were also able to access the app and dementia awareness training.
But the work is costly to run. A monthly half-day visit for about 20 people costs in the region of £1,000, with the biggest expense being backfilling staff at the hospital.
Shearn says that funding for the work will finish in about two years, and there are plans to evaluate the success of the project during that time.
“We want to integrate Joap to be mainstreamed into our care pathways as best practice,” she adds. “Hopefully it will continue as part of the trust’s service, as it has become an important aspect of people’s stay in hospital.”
Joap is the case study for the Outreach Europe project, mapping good practice in outreach with marginalised groups in museums and galleries across Europe. For more information contact Helen Shearn.
Recruitment and retention
The Arteffact project in Wales offers museum and archive-based creative sessions for people with mental health issues living in the community.
Morrigan Mason, the deputy director of Bodelwyddan Castle Trust, which is one of the founding partners in the project, says the biggest learning curve has been the recruitment and the referral process.
“At first we fell into the trap of thinking that we had to be the experts in deciding who could come, but we soon realised that we can’t make that judgement,” she says. “We had to give our referrers the right information about what we were offering and trust them to make that decision.”
Arteffact now has a project manager who is responsible for recruitment, and Mason says having a single point of contact for referrers has made the process easier.
One of the concerns that many museums face when working with people with mental health issues is the risk of disruptive – or even dangerous – behaviour.
“We’ve never had a serious incident,” says Mason. “If participants are feeling anxious or upset, we deal with these issues in a quiet space.”
Despite the fact that Arteffact works with vulnerable people – many of who might have complicated lives outside of the programme – retention has been good. Mason says the largest number of drop outs occurs between the initial booking and the first session.
Because the workshops last for 12 weeks, the museums build a relationship with participants, but sustaining that beyond the course can be difficult.
“Our vision is to have a ‘next step’ offer,” says Mason. “We have invited visitor service assistants and volunteers in to speak about opportunities at museums, but none of the participants have taken that up yet.”
NHS buy-in
In 2014, Suffolk museums and the Norfolk and Suffolk Foundation Trust ran Objects and Art in Mind, a six-week project that aimed to foster better links between the museums and the NHS. Funded by the Suffolk Foundation charity, the project involved creative workshops for participants at two museums – Ipswich Museum and Gainsborough’s House.
One important element of Objects and Art in Mind was ensuring that staff and volunteers were confident working with people with mental health issues. Mental health first aid training was put on, and the museums also worked closely with NHS staff to help inform the activities and evaluation.
The initiative had been turned down for Heritage Lottery Funding (HLF), but a second application for a further project was successful and in March Creative Heritage in Mind was launched with a further two museums – the Museum of East Anglian Life and the St Edmundsbury Heritage Service – with further in-kind support from the Norfolk and Suffolk NHS Foundation Trust.
The second project consists of three seven-week courses run a year. It will focus on improving the independence and confidence of participants being in the community.
Lyn Gash, the museum development manager at Suffolk County Council, says there were some important lessons from the pilot that will feed into the larger project.
“We did an awareness-raising session for staff, some participants and people from the health sector for the pilot, which was a light bulb moment as people taking part realised the impact that the museum could have on vulnerable people,” she says.
Working with vulnerable people can be an intense experience for staff, so Gash recommends taster days to address any anxiety.
“Small groups and providing quiet spaces are essential,” she adds. “But participants come like any other member of the public and should be treated in the same way. Some people are very keen to disclose their conditions, but that is for them to decide – importantly, the focus of the day isn’t on mental health, it’s on the museum experience and the creative opportunity.”
Gash says the quality of the artist is key to any work of this kind. "The museums have benefitted from working with an inspiring and experienced artist who values work with the client group – without her, the programme would never have flown."
During the pilot, the museums invited someone from the NHS trust to drop into the sessions to give their feedback and make sure everything was on track. This level of support also meant that any questions or issues could be addressed, including advice on dealing with any challenging behaviour.
One of the strengths of the projects is the buy-in from the NHS trust. Gash says that the health service is hard to break into, and although people might say yes to partnership work, you can’t guarantee they will prioritise it.
Creative Heritage in Mind was funded with a HLF grant of £39,000 and £5,000 from Suffolk County Council. The pilot project cost £5,000.
Older, vulnerable patients
The Journeys of Appreciation Programme (Joap) is a museum and gallery partnership with NHS in-patient clinical services for older adults with mental health problems and dementia at hospitals in south London. Funded by the Maudsley Charity, the project currently works with Tate Modern and Tate Britain, the Cinema Museum, the Horniman Museum and Gardens and Dulwich Picture Gallery, all of which are in London.
The programme has been running for about two years, and involves taking patients to visit a museum and participate in a gallery workshop.
“The idea is that we have one staff member to every patient, which facilitates communication through the experience,” says Helen Shearn, the head of arts strategy at the South London and Maudsley NHS Foundation Trust. “It helps us understand the whole person.”
The experiences and activities that take place in the museum can also be brought back to the wards, which helps to enhance the hospital environment and ensure that the benefits continue beyond the visit.
The participants who take part in Joap are considered highly vulnerable. “We wanted to target people who might not normally get this sort of opportunity,” Shearn says. “During our pilot project at Tate Modern, there was some trepidation about risk assessment, but it has been very rewarding for staff to realise that it is possible to take vulnerable people to a place like a museum.”
Initial evaluation and a mental wellbeing impact assessment found that the experience brings a mutual learning opportunity. The opportunity to take part in workshops in a public space at a high-status venue such as a museum has a positive impact on participants, and has also boosted staff morale.
“One other benefit is that the work has been a catalyst effect for further collaborations,” says Shearn. For example, the Cinema Museum was selected by National Museums Liverpool to provide digital content for its House of Memories app. NHS staff were also able to access the app and dementia awareness training.
But the work is costly to run. A monthly half-day visit for about 20 people costs in the region of £1,000, with the biggest expense being backfilling staff at the hospital.
Shearn says that funding for the work will finish in about two years, and there are plans to evaluate the success of the project during that time.
“We want to integrate Joap to be mainstreamed into our care pathways as best practice,” she adds. “Hopefully it will continue as part of the trust’s service, as it has become an important aspect of people’s stay in hospital.”
Joap is the case study for the Outreach Europe project, mapping good practice in outreach with marginalised groups in museums and galleries across Europe. For more information contact Helen Shearn.
Recruitment and retention
The Arteffact project in Wales offers museum and archive-based creative sessions for people with mental health issues living in the community.
Morrigan Mason, the deputy director of Bodelwyddan Castle Trust, which is one of the founding partners in the project, says the biggest learning curve has been the recruitment and the referral process.
“At first we fell into the trap of thinking that we had to be the experts in deciding who could come, but we soon realised that we can’t make that judgement,” she says. “We had to give our referrers the right information about what we were offering and trust them to make that decision.”
Arteffact now has a project manager who is responsible for recruitment, and Mason says having a single point of contact for referrers has made the process easier.
One of the concerns that many museums face when working with people with mental health issues is the risk of disruptive – or even dangerous – behaviour.
“We’ve never had a serious incident,” says Mason. “If participants are feeling anxious or upset, we deal with these issues in a quiet space.”
Despite the fact that Arteffact works with vulnerable people – many of who might have complicated lives outside of the programme – retention has been good. Mason says the largest number of drop outs occurs between the initial booking and the first session.
Because the workshops last for 12 weeks, the museums build a relationship with participants, but sustaining that beyond the course can be difficult.
“Our vision is to have a ‘next step’ offer,” says Mason. “We have invited visitor service assistants and volunteers in to speak about opportunities at museums, but none of the participants have taken that up yet.”
NHS buy-in
In 2014, Suffolk museums and the Norfolk and Suffolk Foundation Trust ran Objects and Art in Mind, a six-week project that aimed to foster better links between the museums and the NHS. Funded by the Suffolk Foundation charity, the project involved creative workshops for participants at two museums – Ipswich Museum and Gainsborough’s House.
One important element of Objects and Art in Mind was ensuring that staff and volunteers were confident working with people with mental health issues. Mental health first aid training was put on, and the museums also worked closely with NHS staff to help inform the activities and evaluation.
The initiative had been turned down for Heritage Lottery Funding (HLF), but a second application for a further project was successful and in March Creative Heritage in Mind was launched with a further two museums – the Museum of East Anglian Life and the St Edmundsbury Heritage Service – with further in-kind support from the Norfolk and Suffolk NHS Foundation Trust.
The second project consists of three seven-week courses run a year. It will focus on improving the independence and confidence of participants being in the community.
Lyn Gash, the museum development manager at Suffolk County Council, says there were some important lessons from the pilot that will feed into the larger project.
“We did an awareness-raising session for staff, some participants and people from the health sector for the pilot, which was a light bulb moment as people taking part realised the impact that the museum could have on vulnerable people,” she says.
Working with vulnerable people can be an intense experience for staff, so Gash recommends taster days to address any anxiety.
“Small groups and providing quiet spaces are essential,” she adds. “But participants come like any other member of the public and should be treated in the same way. Some people are very keen to disclose their conditions, but that is for them to decide – importantly, the focus of the day isn’t on mental health, it’s on the museum experience and the creative opportunity.”
Gash says the quality of the artist is key to any work of this kind. "The museums have benefitted from working with an inspiring and experienced artist who values work with the client group – without her, the programme would never have flown."
During the pilot, the museums invited someone from the NHS trust to drop into the sessions to give their feedback and make sure everything was on track. This level of support also meant that any questions or issues could be addressed, including advice on dealing with any challenging behaviour.
One of the strengths of the projects is the buy-in from the NHS trust. Gash says that the health service is hard to break into, and although people might say yes to partnership work, you can’t guarantee they will prioritise it.
Creative Heritage in Mind was funded with a HLF grant of £39,000 and £5,000 from Suffolk County Council. The pilot project cost £5,000.