Very nice response to the process of building a new hospital – “Davis & Jones invited surgeons and engineers to visit each others’ places of work and explore similarities and difference…”
The result is a new work commissioned from a medical illustrator comprising a pair of images. MOVE.
Slides of a paper on failure co-authored with Dr Gemma Kearney and presented at the NSEAD/iJade conference in Liverpool.
A Literary Landscape in Russian Art at the Robert Burns Birthplace Museum in Alloway. A selection of prints and drawings by students (who have done residencies at the Pushkin Museum perhaps a little like Hospitalfield?). Quality classical drawing and printmaking skills on display from early 20th Century to present day.
Originally posted on On The Edge Research:
We’ve never been to a conference on the cultural and creative industries at a University that didn’t have someone providing a theoretical critique of the subject. On 1st October Robert Gordon University and the City of Aberdeen co-hosted an event which drew on the experiences of other energy capitals to understand cultural and creative industries development. Pacem critique, this was a morning full of insight into the sorts of strategies, policies and actions that make a difference to cities and see the arts thrive as part of their communities. It benefited from specific experience of being a European Capital of Culture (something Aberdeen aspires to) and it was a good renewal of the process of building a culture and arts development agenda for Aberdeen.
The subtitle was ‘Global Energy Cities and Cultural Illumination’ but the real point is that…
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Nemora at the Fine Art Society, Juliette Losq’ black and white ink and watercolour scenes of post apocalyptic greenworld overwhelming our cities. These paintings extend space through devices such as infiltrating a fireplace or surrounding a grandfather clock and also replacing its face. For all those attempts to question the frame and break out of the container (like the plantlife evoked in those overlooked and unplanned spaces behond retail parks) it was the framed work Scumsucker (2011) which resonated the most reminding me of the space in which John Wallace’s Cinema Sark was exhibited a year ago during the first Environmental Art Festival Scotland: the undercroft of the M6 as it crossed the river Sark defining the border between England and Scotland.
Bernd und Hilla Becher at Spruth Magers. I wonder who decided on the composition of the groups of 9 images in particular? Was it the Bechers? The groupings are very subtle.
The Nakeds at the Drawing Room. Ought to have been inspiring and provoking in the way their Abstract Drawing exhibition was. Perhaps the failure is exemplified by a success. One of the standout pieces is Fiona Banner’s block of red text on a page (a print from Arsewoman in Wonderland I think). The text is a verbal description of a woman in a porn film. The description creates a clear sense of the artist’s eye travelling over and exploring the image (presumably frozen on a screen). It’s deeply personal and distinctive. It’s in no way salacious – quite the opposite – it wouldn’t make it into a volume of erotica. But the rest was in danger of sameness failing to extend vigorously into enough different spaces of drawing the human body. The are too many pieces that feel like sketches off the studio floor – the two small pieces by Beuys feel like that, though the Warhol drawings are revealing. But there are none of Gormley’s drawings using his own semen or any Duchampian work made with naked bodies and paint. Egon Schiele is at the heart of the thinking, but in a way he dominates the aesthetic too much and the conception not enough. The aim of the exhibition, to explore the space between the nude and porn, is really interesting but the curation doesn’t really stretch it enough. Schiele obviously made work for distribution as porn, so did Turner. I wonder who else did as well?
Couple of really interesting presentations and discussions at the ESRC funded Arts, Health & Wellbeing Research Network meeting in London. Unfortunately this was the last event in the series, but I’m sure that a longer term programme will emerge, especially when it was noted that there have been some 200 participants of which approximately 50 have been Phd students.
The first interesting area was a presentation by David McDaid on health economics and how that field interacts with research and decision making. We know that decisions about healthcare are made on the basis of efficacy and cost, but McDaid unpacked some of the basics for us. He highlighted that when looking at the economics of any decision about healthcare we need to understand:
- the cost of inaction;
- the cost of action (and here he pointed out that understanding project or programme costs is very difficult and arts organisations can be quite opaque about their costs. Costs also need to include in-kind costs absorbed by partners.);
- The cost effectiveness of the action in comparison to other potential actions;
- levers for maximising value (ie how to maximise the money spent by working on uptake and participation).
In terms of the cost of inaction he highlighted three areas to consider:
- Cost of every visit to the GP (which in the figures he showed was about £45 per appointment);
- The higher cost of attending Accident and Emergency;
- The even higher cost of hospitalisation.
- In parallel with this are the informal care costs (ie how much is the family bearing factored at hours times the minimum wage), and the out of pocket costs for the individual for treatments or lost earnings.
Some really interesting challenges emerged in response to McDaid’s framing of the economics through the example of ‘arts on prescription vs. individual therapy sessions.’ Firstly, why these are presented as alternatives when in many cases they might be complimentary? Secondly why reduced contact is presumed to be good when there are circumstances where greater contact with healthcare workers is the good outcome. To which David responded, “These are all good points, but the model of decision-making in healthcare economics is simplistic.”
On the back of McDaid’s presentation were two evaluated project case studies, one using reading with people with chronic pain, and the other using arts on prescription for people with depression and anxiety. Both were really significant, but looking at them through the lens McDaid had provided, you’d note:
- the need to focus on efficiency of delivery, maximise participation, understand operational finances and share models;
- be prepared to scale up from projects to programmes.
The afternoon presentations focused on the perceived weaknesses of two Randomised Control Trials recently published. Without trying to rehearse the details, some interesting points emerged which suggest that using Randomised Control Trial (the gold standard for evidence in healthcare decision-making) to prove the value of arts interventions is not something to be undertaken lightly.
Arts interventions need to be understood as “complex interventions” as defined by the Medical Research Council and interestingly this means that any “complex intervention” should,
- Start with a theory;
- define which ingredient(s) essential;
- include process analysis.
In terms of theory, healthcare is looking for the ‘theory of change’ that the study is going to test, but that ‘theory of change’ requires the practitioners (not just the researchers) to be very clear about their practice, and to deliver that practice in a consistent way in relation to the theory. (This clearly links to the ongoing development of a qualification in participatory practice by the ArtWorks programme in Scotland, jointly funded by the Paul Hamlyn Foundation and Creative Scotland.)
Perhaps one of the characteristics of any theory of change in the arts is the fundamentally voluntary nature of participation in that change. It’s one of the problems pointed out with Randomised Control Trials – people get selected to participate in the arts randomly. This is slightly problematic, particularly when you’re asking someone to engage in creative activity or even singing.
The point about defining essential ingredients is important – process-based work is often about context, empowerment and empathy as well as specific activity, but it’s extremely difficult to study more than one factor.
Finally the process analysis is important, on one level because that might a way to balance the attempt to define the essential ingredient, but also because timing and pattern are important in experiential work, e.g. participants are often interviewed for the baseline and then interviewed at the end of the programme, precisely the point where they might be feeling a sense of loss of an activity that had been enjoyed. Even a Randomised Control Trial is subject to such factors: not only what questions are you asking, but when are you asking them.
There was reference made to another Randomised Control Trial focused on singing, to be published imminently, which was ‘successful.’ It will be interesting to understand how this was constructed. But going back to McDaid’s point, scale may be critical because at least one really good, well evaluated, project was unable to engage with the Clinical Commissioning process simply because it’s too small (and most arts & health organisations are small even in the cultural sector, let alone in relation to healthcare).
The understanding of “complex interventions” in the medical literature bears further scrutiny and some references were suggested including Marchal (2013) (and Yin (2009) on “systematic case theory”).
Theo Stickley started the morning by offering an imagined scenario around the trajectory from the materialist understanding of healthcare that characterised the 20th Century through a transition to an holistic understanding of healthcare that could characterise the 21st Century. Whilst it’s important that the practitioners delivering arts in healthcare are well trained and professional, that they can articulate clearly their theory of change, as well as the economics of their interventions, the belief that the Randomised Control Trial is the way to prove the value might genuinely jeopardise what makes the arts distinctive from other interventions. We must become more articulate about the characteristics and values of our artforms and forms of intervention to ensure that they have equal status with the economics and the criteria imposed by the methods of research.
Only one speaker said, “and the art produced in this project was good too. We were proud of it.”
Presentations can be found here.
Linlithgow Burgh Halls – great space and a nice chance to see a range of Hopkins’ reworking of everyday objects such as maps and fabrics.
You can’t easily go and see the work that Maria McCavana and Bill Breckenridge did for the Child and Adolescent Mental Health Service (CAMHS) unit in the Gorbals. It’s not that we might not particularly want to visit a CAMHS unit. It’s not that it isn’t public space (of course it’s not a gallery, not that sort of public space). It’s real public space, public service space (NHS space) where people sit and wait whilst their children and young people attend sessions with clinical psychologists and therapists. You really can’t just wander in and have a look at the art.
This is a problem for arts and health projects. The public places in which they are often to be found aren’t public in the same way as a park or a street or even the atrium of a big hospital.
But these spaces matter. And it’s all the more important that as a professional community we are able to see what colleagues and peers are doing, hear how it works and learn from these projects.
Maria McCavana, artist, and Dr Lindsey MacLeod, Clinical Psychologist specialising in child and adolescent mental health, shared the process and results of the work in the CAMHS unit in the Gorbals and also previously at the Knightswood Centre (now demolished and therefore even less accessible). They talked about their interests and motivations as well as the lessons learnt.
This event was part of UZ Arts’ programme for the Fringe (for background on UZ see the end of the piece). Maria participated in UZ Arts’ residency programme in Sri Lanka this year, and UZ are interested in how the lessons can be transferred to artists in Sri Lanka for the benefit of the patients, families and carers. Creative Therapies, the Glasgow based art (in the broad sense) therapies organisation, provided organisational support and structure and the project was funded by the Yorkhill Children’s Foundation.
The brief for the project was focused on the users of the space, the clients, having an influence on the design of the space, actually to give them a sense of ownership. Lindsey said, “We asked young people to make their mark on the building.” The brief also asked that, “the space should be interesting, but not too interesting (ie not overwhelm the kids on the spectrum or over stimulate the children with ADHD).”
It was refreshing to hear the concerns from the perspective of the clinician:
That colleagues and teams are busy (and a project such as improving a waiting area is on top of an already full workload). Service delivery on a day to day basis is the priority.
That as a clinician, maybe more so in mental health services, you need to be very confident to entrust your patients/clients into the hands of someone outside the NHS.
That if it wasn’t some of the clinicians’ “cup of tea,” did that really matter? This led onto a really interesting discussion around evaluation.
Of course we assume that evaluation is important. But what exactly are we evaluating?
Is the space improved? Yes the space is improved, but it would have been improved with fresh paint, new carpets and new furniture. What did the ‘art’ do? Actually the art made it more specific, more interesting. The waiting room is now a nicer, more comfortable waiting room, but its also now an interesting waiting room rather than a generic one. It’s got funny bookshelves where each book fits into its own slot.
It’s got an amazing sculptural bush of individual letters sticking out in all directions (top image). The signage has been sorted out to reduce visual clutter.
But let’s be clear, you wouldn’t reproduce exactly this scheme in all the CAMHS waiting rooms across Glasgow. It’s not designed to be literally reproducible. It’s designed to be distinctive. The approach used is definitely reproducible.
Who benefits and how? The brief was drawn up through consultation with staff and users. McCavana and Breckenridge proposed a residency-based approach working with nominated patients/clients of this CAMHS unit. They did a series of workshops over an extended period. McCavana and Breckenridge designed the workshop process and all the activities, and there is a clear development from the workshops to the installed project. If I’d been involved in the workshops, I’d recognise my contribution in the space.
Like many artists interested in participatory and co-creative work, McCavana is articulate about the need to change power relations, to give voice to those who don’t normally have a voice. We’re not talking about art therapy – that’s something different. Grant Kester, one of the key writers on participation and collaboration says,
“In the most successful collaborative projects we encounter instead a pragmatic openness to site and situation, a willingness to engage with specific cultures and communities in a creative and improvisational manner … , a concern with non-hierarchical and participatory processes, and a critical and self-reflexive relationship to practice itself. Another important component is the desire to cultivate and enhance forms of solidarity… .” (The One and The Many: Contemporary Collaborative Art in a Global Context, Duke University Press, 2011, p125)
The discussion following the presentation raised some other issues, including the important role of the ‘host’ in doing this sort of residency based work. This is something that the Artist Placement Group highlighted in the late 60s but continues to be an issue. If an artist is going to work in a context, especially one where there is an existing community, it is essential that someone in that community acts as a host, doing those things a host does. This includes doing the introductions but also discretely making sure that the artist doesn’t step on toes. It means making sure that the artist is included in community activities where appropriate, but also protecting the artist from internal niggles and ongoing wrangles. A member of the audience pointed out that when this works well the host becomes a co-creator of the process.
The other subject that was raised from the floor focused on the extent to which these sorts of projects involving artists in healthcare buildings are actually patching up bad architecture. There was some feeling in the room that this was the case. Of course the specific projects that had been presented were work done in older buildings, but…
What is distinctive is the participatory and co-creative process that artists are using. Although some of the younger architecture practices also do this, the larger more established ones, particularly doing public sector work, are not. Nor would it be easy for them to, given that they are embedded in the supply chain, usually employed by the main contractor, not even the client.
What is also distinctive is the blurring of art, design and architecture. This project could have been done by a young design or interior architecture studio. It’s not the art specifically that makes this distinctive, rather it’s the turn to participation and co-creativity.
There were other good points made from the floor which I haven’t covered here, but the overriding one is that we need more presentations like this, and more time for the ensuing discussions.
UZ Arts is an international arts charity based in Glasgow. We create our own work and collaborate with artists and producers who wish to work across art forms and across borders creating work outside conventional arts venues – often in public space.
We commission artists and support the development of their work through residencies, hothouses and collaborating as their producers or co-producers. In the last 3 years we have commissioned over 60 artists in 8 countries but with more than 50% of the work being made in Scotland.
Much of the work we make or support is sited . That is to say site specific – made for a particular place or site located – made for a particular type of location.
Some of the artists we work with engage with the public either as a source of inspiration or as collaborators in the delivery of their work
Jupiter Artland – very much appreciated Jessica Harrison’s gruesome reworkings of found ceramic
mantlepiece ornaments using epoxy and nail varnish. You walk into the upper exhibition space and see what you take to be a suite of traditional ceramic figurines and it takes a moment to realise that they have been Tarantinoed. Someone else referenced the Chapman Bros.