Originally posted on Points of View:
The art of writing is the art of discovering what you believe.
The Ayrshire Health and Arts Blog will record and provide a place to discuss the new developments in the community and mental health facility that’s being built in Irvine and we’re excited to have the chance to tell this important story. We will be covering:
- key milestones in the construction process
- interesting developments and opportunities in arts and health/arts for health and wellbeing / social inclusion, locally, throughout Scotland and internationally
- hosting guest blogs that show the value and relevance of the arts in mental health and the health-care environment (or other related environments).
The guest blogs, so far contributed by John Fulton (Art Therapist/Principal Art Psychotherapist in South Ayrshire Psychological Services) and Donald Urquhart (one of the Arts Co-ordinators on the project), will be written by artists, mental health practitioners, architects and the community and we’d…
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Check out @an_artnews’s Tweet: https://twitter.com/an_artnews/status/526811922512216066?s=09
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.