Arts in Health: A review of the medical literature

Dr Rosalia Lelchuk Stancoff (2004)

2.4 The effects of the arts in Mental Health- pages 24- 3


  

    This was a report done by the Arts Council, England, reviewing medical literature in order to create a national arts and health strategy to improve the work within the health care services. Dr Staricoff has taken many theories and sections of literature in order to make a 'significant contribution to strengthening the evidence base and to improving our understanding of the impact of the arts on health.'(Hewitt,pg 2). 

    I chose this report to review as, although many people can see the positive effects of arts within healthcare, without grounding evidence, it will lack the stability to grow and develop further. The chapter I decided to focus on was '2.4 The effects of Arts in Mental Health' as it contained many points and arguments that relate directly to my work and help my expand my knowledge within this field. 

   How would we describe complete health? The World Health organisation (1948) uses the term 'equilibrium' stating it involves a 'physical, mental and social well being and not merely the absence of disease'. I feel this is something that is often overlooked as we simply concentrate on a physical state of health, particularly within a care setting e.g a hospital, rehabilitation or care home. Numbers of patients are sometimes quite high with fewer staff able to focus on more social well being activities, only having time to physically take care of them. This is where outside organisations are needed with the arts playing 'a pivotal role in achieving this equilibrium' (Jamison 1994). Throughout my experience of working in care homes as an entertainer, I have found that the more art and creative activities included within a weekly program, generally, the better the morale overall within the residents. A study found that the arts within a care setting, in this instance Alzheimer's patients, increased 'self esteem' and they had a 'more positive attitude towards their family and staff',(Smith 1992). Therefore it is not only beneficial for the patients themselves, but for the families who are directly effected by a loved one having the disease, and creating a more positive working environment for the staff, thus having a knock on effect overall within the care home.
    
   'The introduction of the arts into mental health care helps the patient find new ways of self-expression and act as a vehicle for establishing communication with others' (Killick, 1999a, Killick 1999b, Alan 2000). I am particularly interested in this, as I go into a Residential unit that cares for young adults with severe Autism, entertaining them with music and dance performances. On a day to day basis communication and self expression can be difficult for those with Autism, yet the effects the performances have on the residents is so uplifting and positive to see. As they feel they are in a safe and controlled environment, they really let go, singing and dancing along the music and communicate with the carers and other residents. Speaking to the carers afterwards they comment on how much they get out of the performance sessions as the positive lift seems to last, not only for the duration of the show but for the rest of the day. It is clear to see just how much the arts can, in many instances change the outlook and general well being of a person.
   However 'it is important to note that the introduction of creative arts, such as dance and drama, music, visual arts and creative writing in mental health could have potential risk factors' (pg 25). I have encountered a few occasions, where it has been too demanding for the residents and they have become unhappy or agitated. One example was within a home specialising in care for adults with learning difficulties and disabilities. Once the music began, they became extremely excitable, which then lead to a state of agitation the onto aggression. The performance was simply too much for them to cope with, so was not actually suitable for them. Whilst on the whole these activities are undeniable effective, it is vital we maintain  'an awareness of the potential dangers of these activities.'(Dobson, 2000; Mot tram, 2003).

   Although my work with healthcare settings, is a pre set show that is for entertainment purposes, it often becomes very interactive with some residents getting up and having a dance within the performance. Hokkanen (2003) claims that ' social dancing gives patients another way of communicating, supports spontaneous activity and increases physical movements'. I find getting the residents up to dance is mostly down to the activities co ordinator, as they will lead them up and dance with them, encouraging and even helping those who are less able. I have found that the more involved the co ordinator becomes within the performance, the greater the experience the residents have. I think this is because it 'creates a supportive environment and helps the patient achieve a state of independence (Palo-Bengtsson 1998; Palo Bengtsson 2000).  The encouragement of the activities co ordinator gives the residents the confidence to the  participate in singing and dancing, enabling the most from the performance. 

    The section on 'Music intervention in Mental health' backs up many articles I have read before suggesting just how important music therapy is, yet so much more research is needed, which requires much more funding. One particular area which needs to be developed is the use of 'reminiscence therapy'- using music to help patients recall events of their life. Often after a show, particularly my 1940's World War 2, residents will chat to me about where they were at that time, going into great detail, describing all senses and sounds, and how the songs brought back those memories for them. Not only does it help them with memory but also encourages them to communicate with others by sharing those memories. 'Previous studies have indicated that music also helps Alzheimer's patients to maximise their social functions'(Glyn 1992, Sanmandham 1995), therefore if linked with reminiscence therapy it captures to aspects that will help the residents. Could this be because when they are more relaxed they are able to free their mind? Jennings (2002) states that 'it has been recently confirmed that music significantly reduces physical agitation' which makes me question whether this relaxation and reduction of agitation is the trigger for all the other things. 

   This Chapter was extremely helpful to me as it backs up so many ideas I have been looking through and create a solid grounding for all my other research. I feel the topics relate so well with my professional practice so I can continue to work and learn, with a greater understanding.