Arts, Media and Cultural Mental Health

Guest editors: Erminia Colucci & Kamaldeep S. Bhui

  • Arts, media and mental health
    Editorial – E. Colucci, K. Bhui 113 – 114
  • Reflections on performance and mental illness
    Invited Commentary – M. Patsou 115 – 121
  • Introducing arts and health in Israel: How cultural factors affect the field’s development
    Original Paper – S. Schwartz, V. Marcow Speiser 122 – 137

    Cultural factors are important in determining how sub-fields within the discipline of mental health are defined and practiced. The field of arts and health in Israel is paradoxically both more and less developed than it is in other parts of the world. Tens of thousands of individuals are engaged in initiatives using the arts to humanize health care. At the same time, a holistic conception of the field of arts and health does not exist. In March 2013, the authors organized the “Arch of Arts in Health” conference, sponsored by Lesley University (Cambridge, MA and Netanya, Israel), the Rappaport Faculty of Medicine at The Technion – Israel Institute of Technology of Haifa, Israel, and the Washington, DC-based Global Alliance for Arts & Health. The conference marked the first time the field of arts health was addressed as a practical and academic discipline in Israel. The interchange between experts from Israel, the United States, Canada, the United Kingdom, Holland, Hong Kong and South Africa highlighted the importance of cultural factors in determining how the field is perceived, developed, researched and practiced. For example, Israelis working in the field primarily conceive of arts and health as an extension of creative arts therapies, and with a nearly exclusive focus on mental health. Researchers from the United States and other countries view the field more holistically, with interplay between issues of mental and physical health. The article reviews how the field differs in Israel and other parts of the world in terms of both perception and practice and suggests how cultural determinants may partially explain these variations.
  • ‘Something We All Have’ – Mental health, activism and media in the United Kingdom
    Overview – K. Bierski 138 – 148

    In the United Kingdom (UK) today, people who aim at improving social attitudes towards mental illness have developed a number of innovative campaigning strategies. In particular, they deployed a wide range of broadcast and social media in the hope that positive representations of mental health problems will lead to a thorough transformation of social perspectives and attitudes towards these issues. While transformations of social behaviours have always been on the agenda of mental illness–focused movements in the UK, regardless of their ideological outlook, the whole of the society has never been at the centre of struggle. By choice, former movements challenged, supported or demanded change from the professional, bureaucratic and political establishments that regulated mental illness and the lives of the mentally ill. For a number of reasons, which include past movements’ successes and their consequential demise as well as change to psychiatric practices, legislation and organisation of services, resistance and discord had been replaced by what could be considered as a non-contentious stance. On the basis of data collected during an ethnographic research, I suggest that it was activists’ innovative use of media, which enabled communication of such novel and overarching concerns with mental illness and health.
  • Free from pasung: A story of chaining and freedom in Indonesia told through painting, poetry and narration
    Images in Cultural Psychiatry – S. Anto, E. Colucci 149 – 167

    Thousands of people worldwide live in isolation, chained, or inside “animal cages”, naked, undernourished and often living in their own excrements because of mental health problems. This has been identified as one of the most flagrant continuing abuses of the human rights of people with mental illness, particularly in low- resource settings where mental health services are extremely scarce and inadequate. In Indonesia the term pasung refers to the physical restraint or confinement of “criminals, crazy and dangerously aggressive people”. In this article, ‘Anto’, a young man who has been kept in pasung several times, shares his personal lived experience through painting, narration, and poetry.
  • Ararat’s J Ward – A history cast in stone
    Images in Cultural Psychiatry – E. Dax 168 – 174

    J Ward in Ararat housed some of Victoria’s most notorious ‘criminally insane’ prisoners for nearly a century. The conditions were grim and the inmates’ lives were extremely dull. Over the years a number of stone rubbings, scrapings and graffiti were created that are still visible on the walls of J Ward. These have established something of a pictorial record of inmate life and history of the gaol. The present work arose from a photographic study of the works and an attempt to classify them according to the times of their making. The earlier rubbings were probably created over considerable periods of time as the stone was worked slowly with fingers, attesting to the boredom and isolation of the prisoners. However, later graffiti were probably made when conditions improved and scraping tools were acquired. There are also initials and dates on some walls that were probably made by staff or workmen as the Ward was decommissioned. The history is of bored and frustrated inmates, over a long period, when there was little to occupy them, with changes as the Ward conditions were being improved over the 1960s and finally, with decommissioning in 1991 when the workmen and retired staff left their marks. The earlier works may be evidence of great frustration, voicelessness and boredom. Although the later-made graffiti show their part of the history of J Ward, it is the bluestone rubbings that are most worthy of note.
  • Crossing borders and inhabiting margins in Brazil: art, subjectivity, health and participation in Lygia Clark’s and Hélio Oiticica’s poetics
    Images in Cultural Psychiatry – E. Araújo Lima 175 – 188

    This paper presents partial results of a post-doctoral research conducted at TrAIN – Transnational Art Identity and Nation Research Center. This research is part of a broader study designed to investigate how the fields of mental health and art became interrelated in Brazil between the mid-19th and 20th century. Our coordinates in the construction of this investigation were various works, paths and experiments, performed by artists, patients, doctors and therapists who brought together art, madness and clinical practice. In this field of interface, Hélio Oiticica and Lygia Clark played an important role as artists who have their poetic project marked by a close proximity to the production of subjectivity, health, and social participation. Their works were very much informed by a Brazilian experience with art developed in a Psychiatric Hospital. Conversely, pathways opened by their inventions could be of interest to contemporary mental health practices.
  • Play it street smart: A street play on creating awareness about mental illness
    Research Report – S. Loganathan, M. Varghese 189 – 200

    India has a vast, diverse socio-cultural background and is a multi-lingual society. The literacy levels in general, and particularly in mental health literacy, have been found wanting, especially in rural India. The aim of this project was to enhance knowledge about mental illness in a rural population. We targeted a rural population near Bangalore, India to enhance knowledge about mental illness. We devised a script for a street play that would enhance knowledge, and shift attitudes and beliefs about mental illness. After identification of the villages in the catchment area, a professional theatre group conducted pilot shows and the script was modified in its design and content. Schizophrenia was the chosen illness. In a manner familiar to them, the theatre group who specialized in street plays staged them in various villages in the chosen catchment area. We received a positive response from the village folk that turned out in large numbers. We were able to co-ordinate, devise and conduct street plays on mental illness in a rural set-up in Bangalore, in a feasible manner, which was keeping in consonance with the local socio- cultural background.
  • Just say know: Engaging young people to explore the link between cannabis and psychosis using creative methods
    Research Report – N. Baker, C. Willinsky, K. Boydell 201 – 220

    We know substance use in adolescents experiencing psychosis increases negative outcomes, but we need youth-friendly ways to explore and share this knowledge. The purpose of this study was to understand young peoples’ experiences with cannabis while living with psychosis. A participatory approach was adopted and young people living with psychosis from early psychosis intervention clinics across Canada were trained in qualitative research methodology. These peer research assistants recruited 50 of their peers and conducted interviews and focus groups that explored the link between cannabis and psychosis. Interviews were transcribed verbatim and analyzed using thematic analysis. The lived experiences of participants’ cannabis use were characterized by their fluidity and continuum-like nature. Participants talked about their use as mercurial and context-dependent. Individual experiences with cannabis ranged from relaxing to stimulating, exciting to fear inducing, a social experience to an isolating experience, from creative and free thoughts to bizarre and disturbing paranoia. Participants discussed the role that cannabis may have played in their illness. Sharing results of this research in non-traditional ways including on social media platforms, via documentary film and with animation were identified as key to connecting with their peers. As part of a knowledge translation strategy, youth-led messages and products were generated from the findings and shared with relevant stakeholders. Using creative and participatory approaches provided insight into the experiences and perspectives of young people living with psychosis in a way that traditional research may not, especially with a sensitive topic like drug use. We suggest that there could be a more pronounced gap between the perceived range of “highs” and “lows” of their experiences versus in those in other young people. This could explain why they start and keep using, but why they often reflect that using is ultimately not helpful in their recovery process. Sharing these findings and evaluating the impact of these kinds of initiatives may help young people differentiate between symptoms of psychosis and cannabis use, and support early intervention in ways that are relatable and creative, rather than threatening or judgmental.
  • Visual arts in psychiatry – From theory to practice
    Images in Cultural Psychiatry – J. Li 221 – 227

    Psychiatry is both a science and an art. However, in China biological psychiatry is still overly dominant, and cultural psychiatry is too often ignored. Scholars rarely study psychiatry from the perspective of art, despite the close relationship between art and psychiatry. In this paper I describe briefly the relationship between art and psychiatry, and share the stories of the patients with mental illness, as seen through the lens of their art. Art opens up a world of beauty for those whose worlds are darkened by mental illness. In contemporary psychiatry, insights from the humanities and the arts serve to enrich our understanding of the mind as we treat the brain. For this reason, mental health staffs need to have a basic knowledge of art in order to better understand the mind of patients, so as to provide better mental health services for them.
  • The Madness Hotel: the ‘uses of disorder’ as a route towards individual and social transformation in applied theatre practices in mental health
    Research Report – J. Evangelista 228 – 241

    This paper identifies a number of key characteristics of the Madness Hotel, a local government-funded applied theatre project for mental health in Brazil. In my analysis, the Madness Hotel draws on “the uses of disorder” as a catalyst to resisting oppressive social systems, and establishing democratic, inclusive – and therefore transformative – modes of intervention. In this paper it is contended that the Madness Hotel is able to use ‘disorder’ specifically because applied theatre practices in Brazil are left ungoverned and mostly marginal to public policies. In contrast, UK applied theatre practices have become increasingly over-governed and dictated to by mainstream public policy. Here, transformation is less about “repairing the social bonds” produced by social inequalities, and more about adapting and conforming individuals to society. In this more instrumental approach to applied theatre, where over-governance prevails, success is defined primarily by the ability to generate pre-determined and quantifiable outcomes. As such, applied theatre projects are compelled to become excessively ‘ordered’, and key aspects of their ability to be democratically transformative – participation, playfulness, unpredictability and dialogue, which are difficult to quantify and measure – become unnecessary luxuries. As these qualities are removed, the transformative potential of applied theatre becomes severely compromised. This paper concludes that the Madness Hotel is effective because it embraces the ‘uses of disorder’ not as a luxury, but as a necessity. Therefore, the example of the Madness Hotel can inform alternative approaches to UK applied theatre practices beyond the field of mental health, as a route to foster democracy and social transformation.
  • The role of art in the amelioration of mental health problems: Vignettes from Pakistan
    Case Report – B. Hussain, M. Khalily 242 – 248

    This paper explores how art can ameliorate mental health problems. We present two interview-based vignettes from the Islamabad/Rawalpindi city which illustrates the therapeutic role of artwork in helping two individuals understand and cope better with their psychiatric problems. The contents of these two vignettes were examined in the context of artwork through which the two individuals attempted to comprehend their psychiatric problems while using art as a therapeutic intervention. They depicted their artwork gradually over time as they improved and minimized their psychiatric symptoms. They functioned independently and coped with their psychiatric problems.
  • Developing socio-cultural technologies for mental health interventions in São Paulo, Brazil: Interface of arts, health and culture
    Research Report – E. de Castro, E. de Araújo Lima, E. Alvarez Inforsato, R. Monteiro Buelau 249 – 265

    The Laboratório de estudos e pesquisas Arte, Corpo e Terapia Ocupacional at University of São Paulo develops teaching, research and assistance activities connected to the public policies concerning mental health, humanization and culture, introduced in Brazil from 2000 onwards, contributing to the quality of services offered to the community. This article presents a panorama of these actions, informed by the social movements surrounding the de-institutionalization of ‘madness’ and the rights of disabled people, which constitute a new field of practices in occupational therapy. Focusing on the complex demands of the target population and the expansion of their socio- cultural participation, the main methods for monitoring and evaluating these activities are through qualitative research, with the aims to build local knowledge of occupational therapy oriented by creative actions and clinical, artistic and cultural references. The strategies developed increased the access of this public to artistic and cultural experiences in the city territory and contributed to the construction of life projects, forms of participation, living together and the production of subjectivity. Nowadays, socio-cultural technologies have been configured in concordance with the importance of building contemporary proposals for people deprived of their life networks.
  • Playing in the space between art and therapy
    Research Report – S. Delshadian, A. Wasmann 266 – 284

    In setting up a new art therapy service at i-psy we were given a unique opportunity to create a program aimed at psychologically strengthening clients by using art for personal growth. This includes cultivating clients’ identities as artists, alongside their individual clinical, therapeutic treatment aims. ‘i-psy’ is an intercultural psychiatric organisation in the Netherlands, specialised in treating clients from diverse cultural backgrounds. The program, which we have called the open atelier (or open-studio) program, culminates in an annual exhibition of our clients’ artwork in a commercial gallery, based in central Amsterdam. The art therapy staff organise this event together with experienced art curators who select clients’ work to a professional standard. Supporting a transition from the social role of client to artist can be healing for many patients, and art in this form becomes a catalyst for social change. By connecting these two worlds, the gallery becomes a space to promote transformation, transition, encounter and psychological well-being through art.
  • Musical progressions: A multi-modal approach in healing from bipolar disorder
    Research Report – P. Sharma 285 – 297

    This self-narrative examines the various engagements that changed this researcher from being an ill person to exploring her musical and creative self. This article follows the method of autoethnographic inquiry in which evidences from personal history, which coincided with 18 years with bipolar disorder is shared from internet sites by the researcher, where such links are in a public domain, for anyone to access. In this span of time, she worked with many aspects of music, to the point that from a state of emotional chaos there emerged an order. Examining creativity as an idea and corroborating from Dabrowski’s theory of positive disintegration, this article illustrates how the current researcher is no longer someone living with a serious mental illness, but a person who got healed and became an artist, researcher and entrepreneur. While some of this is ascribed to the divergent thinking that is attributed to bipolar disorder, she explicates how one musical engagement led to another and brought about her recovery, though none of it had started with a therapeutic goal. What constitutes recovery in mental illness is also elaborated.
  • About field notes and art: Santa Claus’ suicide
    Research Report – C. Estellita-Lins, A. Moreno, V. Miranda, H. da Rocha Neto 298 – 310

    Visual anthropology and visual studies became sensitive to recent developments in contemporary art. Springing from ethnographic tradition, health qualitative research (suicidology focused) shows growing interest on image production. Research problems have been aroused on these overlapping frontiers. This paper describes an unintended experiment performed collectively – the construction of a strange Christmas tree inside the office during fieldwork research at an emergency facility, motivated by Christmas time. This tree sprouted spontaneously from team immersion in stressful fieldwork. The entire décor reminded the gap between Christmas symbols and suicidal behavior – simultaneously putting them together. The bizarre iconographic object (including a hanging Santa Claus) produced amazement and turmoil among research team and colleagues who shared the working environment. The suicide Christmas-tree allowed focus on the “transformation” of field notes into rituals and artwork. The circulation of iconographic references seemed more relevant than the image production itself. It materialized a theme for reflection, discussion and shared construction of preventive practices in suicidology that might challenge the relationship between art and psychiatry.