St Albans Arts on Prescription

St Albans Arts on Prescription
St Albans Arts on Prescriptio

Timescale:
Planning: October-December 2015
Contacting potential referral agencies: January-February 2016
Receiving referrals: February-March 2016
Delivery: March-June 2016

Context:
Public Health England’s Community Mental Health profile for Herts Valleys CCG indicates that in contrast to the generally good health results for St Albans there are some surgeries which are significantly above the England average for the incidence of depression.  These include one which has the highest figure for the entire CCG.

Project Aims:

  • Improving the overall health and wellbeing of those diagnosed with mental ill health by providing social prescribing via group workshops in creative arts.  
  • Providing support to vulnerable individuals by offering a safe and stimulating environment where participants can engage in activities which help to increase self-esteem, and general wellbeing and the confidence to extend their social engagement.
  • Reducing inequalities caused by mental ill health including social isolation and an inability to engage in paid or voluntary work by improving the general wellbeing of participants

Location and setting:
Referrals are drawn from residents of the City and District.  The sessions in Phase 1 took place at Mind in mid-Herts – a centrally located venue which was already familiar to some of the participants.  Mind was a project partner and prepared to offer the space at a much reduced rate.  Initially we targeted patients from city centre surgeries as resources were limited and we were concerned that if we distributed the leaflets across the district they would be taken by patients whose GPs were not familiar with the scheme and would therefore not refer them.

Description of the arts activity

In Phase 1 we delivered visual arts workshops engaging an artist via an open recruitment process with significant experience of similar groups.  She structured the sessions so that the participants experienced a range of media including mark-making with pencil and charcoal, ink (experimenting in the second week with tonal difference), collage (with a set theme of ‘trees’) and colour mixing using watercolours.  It was observed that setting a theme reduced anxiety.

Each participant was asked to select two pieces of work for a sharing event and also a favourite section from their original mark-making for a small frame we had provided.  The artist’s diary indicates that they were “very focused on searching out the section they wanted”.  If they were uncertain about what to choose “we discussed it … and others in group (sic) gave input to help”.  The artist observed how as the weeks progressed people started to encourage one another, got more confident about being able to comment on one another’s work and also more accepting of comments on what they had done.

One very positive outcome was that the group developed sharing skills around tidying up.  In week one the artist did it all but by week 9 they worked as a team “some tidying, [not just their own stuff] while other (sic) finished off their work.”

Whilst those who had been referred were waiting to start sessions we held fortnightly ‘coffee mornings’ where we met those who were interested at a coffee shop and discussed art stimulated by paintings, books or what they had seen on TV.  Some brought examples of their own work to share.  These sessions were not well attended but were valued by those who did come.

Details of the project participants

The project was designed to target those with mild to moderate stress, anxiety, depression and other conditions affecting mental wellbeing.  Participants had to be aged 18 plus and live in St Albans City and District.  

Referrals were through health professionals (GP, counsellor, psychiatric nurse or psychologist) or staff at support organisations such as Mind. It has proved challenging to develop the trust and awareness of these professionals so for the next phase we will be looking at a wider spread of referral agencies.  

The participants came from different backgrounds but the majority were already attending Mind regularly and had long term mental health challenges.  

Project management

Ethics and consent:
• Referral forms countersigned by participants consenting to taking part in the project.  Photo consent forms were also completed.
• Delivery team have enhanced DBS clearance and the Arts Team undergoes safeguarding training.
• The case for evaluation and the methods used were explained at every stage and participants could opt out although no one did.  
• Participant questionnaires were identified only by number with all information held on a secure server


Roles & responsibilities
Arts Development Manager:

  • Funding / financial management
  • Identifying referral agencies
  • Meeting potential referral agencies
  • Session administration
  • Liaison with participants Arts Development Officer:
  • Meeting potential referral agencies
  • Recruiting and managing artist
  • Session administration
  • Liaison with participants

Sessions cost £2 per week payable in one or two instalments to ensure that it did not feel like a ‘drop in’ activity.

Evaluation methods and findings

  • Session check in/check out using ‘mask cards’ showing a range of emotions
  • ‘Change’ measurement based on Warwick Edinburgh scale –completed in weeks 2 and 9.
  • Participants also set 1 group and one individual goal
  • Artist’s diary/observations
  • Case study
  • Follow ups – participants & referral agencies – not yet completed

Results and learning outcomes:

  • The check in/check out process was simplified as too many choices created anxiety.  In retrospect this evaluation method was not reliable as an individual’s external circumstances on the day might affect results.  
  • The ‘long view’ created by the questionnaire completed in weeks 2 and 9 is more reliable.  The most marked changes were in interest in other people, interest in new things and thinking clearly which links to the artist’s observations.
  • A particularly positive outcome is that one individual who has not worked since an accident several years ago is considering retraining.

 

Supported using public funding by the Arts Council England