Creativity and Social Support in Mental Health: Service Users’ Perspectives PDF
Preview Creativity and Social Support in Mental Health: Service Users’ Perspectives
Creativity and Social Support in Mental Health This page intentionally left blank Creativity and Social Support in Mental Health Service Users’ Perspectives Roberta McDonnell ©RobertaMcDonnell2014 Softcover reprint of the hardcover 1st edition 2014 978-1-137-34547-9 Allrightsreserved.Noreproduction,copyortransmissionofthis publicationmaybemadewithoutwrittenpermission. Noportionofthispublicationmaybereproduced,copiedortransmitted savewithwrittenpermissionorinaccordancewiththeprovisionsofthe Copyright,DesignsandPatentsAct1988,orunderthetermsofanylicence permittinglimitedcopyingissuedbytheCopyrightLicensingAgency, SaffronHouse,6–10KirbyStreet,LondonEC1N8TS. Anypersonwhodoesanyunauthorizedactinrelationtothispublication maybeliabletocriminalprosecutionandcivilclaimsfordamages. Theauthorhasassertedherrighttobeidentifiedastheauthorofthiswork inaccordancewiththeCopyright,DesignsandPatentsAct1988. Firstpublished2014by PALGRAVEMACMILLAN PalgraveMacmillanintheUKisanimprintofMacmillanPublishersLimited, registeredinEngland,companynumber785998,ofHoundmills,Basingstoke, HampshireRG216XS. PalgraveMacmillanintheUSisadivisionofStMartin’sPressLLC, 175FifthAvenue,NewYork,NY10010. PalgraveMacmillanistheglobalacademicimprintoftheabovecompanies andhascompaniesandrepresentativesthroughouttheworld. Palgrave®andMacmillan®areregisteredtrademarksintheUnitedStates, theUnitedKingdom,Europeandothercountries. ISBN 978-1-349-46651-1 ISBN 978-1-137-34548-6 (eBook) DOI 10.1057/9781137345486 Thisbookisprintedonpapersuitableforrecyclingandmadefromfully managedandsustainedforestsources.Logging,pulpingandmanufacturing processesareexpectedtoconformtotheenvironmentalregulationsofthe countryoforigin. AcataloguerecordforthisbookisavailablefromtheBritishLibrary. AcatalogrecordforthisbookisavailablefromtheLibraryofCongress. For Fiona, Caitríona, Dearbhlá and Orla This page intentionally left blank Contents Preface:TheStoryofThisBook viii Acknowledgements xxiv Introduction:TheCurrentStateofPlay 1 Part I IdeasandEvaluationinCreativityand SocialSupport 1 CreativityandMentalHealth 19 2 SocialSupportandDailyStructure 42 3 ServiceUsersinPerspective 63 4 EvaluationthroughRecoveryNarratives 76 Part II ModesandMeaningsinService Users’Experience 5 ArtsandCraftsasTherapeuticResources 95 6 MusicandSongforaSenseofWell-Being 114 7 BibliotherapyandReflectiveJournaling 121 8 CreativityandSocialSupport:ACombinationTherapy 140 ConclusionsandRecommendationsforPolicyandPractice 157 Bibliography 166 Index 189 vii Preface: The Story of This Book Thathumanstellstoriesisamaximunderpinningmuchofourcultural existence. As American activist-author Rebecca Solnit has recently observed in her book of connected essays entitled The Faraway Nearby, ‘We tell ourselves stories in order to live.’ She explains that stories are navigation tools, ‘compasses and architecture’ with which we make senseofourselves,eachotherandtheworld(Solnit2013:3).Suchstories constitutemanyofthedeepestandmostprofoundaspectsofourlives. Ourverysenseofselfhascometoberecognisedinscholarlydiscourseas adynamic,personalnarrative(Peavy2006),whichbringsmetoabrief tellingofthestoryofthisbook.Nowhereismakingsenseofsomething morepoignantthanintheage-oldquesttounderstandmentalsuffering andtoforgewaysoutofcognitiveandemotionaltorment.Iinviteyou inthisintroductiontojoinmeinashortstoryofmyjourneythrougha lifeofworkingwithmentalhealthserviceusersintheUnitedKingdom andIrelandandexploringmentalhealthrecovery. Thestoryofthisbookisinfactaseriesofinterconnectedstories:per- sonal, academic, social, cultural, historical and political. My personal adventurewithitcanbetracedbacktoapointintimeafewdecadesago. Duringthe1980sand1990s,mostlyinBelfastbutwithashortLondon stint,Iworkedacrossvariousmentalhealthcontexts,fromacutewards to community research, as a trainee and later as a qualified mental health staff nurse and research assistant. In the context of that work, I became aware of the story of psychiatry, in fact several versions of it. Mainstreampsychiatriccultureatthattimecouldhavebeeninterpreted asrestingonanideology,astrongbeliefthatthedisciplinerepresented anever-enlighteningprogresstowardsaneventualtotalunderstanding and control of mental illness as a bio-pathological process, one that could conceivably be arrested and restored, largely through drugs and otherphysicaltreatments. Differentviewswereevidentthough,bothwithintheprofessionand its associated disciplines, albeit in a perhaps uneasy peace and tolera- tionofeachother’sareaofexpertise.Aspermyownlimitedexperience, differences were evident across teams and disciplines, aired on a fairly regular basis. Sometimes this would be a constructive discussion, at others it would be more of a stalemate over the origins of problems viii Preface:TheStoryofThisBook ix and the best approach with certain individual clients. Disputes would arise particularly when a client was detained under the Mental Health Order, or when a doctor’s prescription of medication became an issue, or conversely when nurses believed a client should be medicated and doctors were not keen to prescribe it. This is unsurprising given the professional cultures, responsibilities and workloads involved and the oppositeideologicalpoleswithinwhichtheprofessionsandideological sub-schoolswerenegotiatingandlegitimisingtheirpractices(Luhrmann 2000). Acute admission units were largely focused on diagnosis and medication,accompanied,ofcourse,byconcurrenteffortstoempathise and support in all possible ways and with Occupational Therapyinput onweekdaysessionsaswellasSocialWorkinput.However,thepsycho- analytical and behavioural branches within psychiatry had not been eliminated, they rather operated on the fringes with a selected set of highlyspecifiedclientswhoweredeemedsuitableandlikelytobenefit fromtheseapproaches. As innovative Irish psychiatrist Dr Pat Bracken has recently artic- ulated in a debate on the usefulness, or otherwise, of psychiatric diagnosis,whileitmaybeusefulincertainsituationswhereorganicdis- ease processes are evident, most psychiatric illnesses are complex and multi-factorial. Established categories are disputable and of arguably little value to service users, and since ‘psychiatry is not neurology’, Dr Bracken maintains that it is more important to understand the meaningoftheexperiencefromtheclients’pointofview.Ratherthan diagnostic labels, a partnered process of assessment with clients and taking on their experiences and felt needs would illuminate a more constructivepathtowardsrecovery(BrackeninMaudsleyDebate2013). This debate is not new, as I have argued. What is new is that it is now public and that the psychiatrists are engaging in it openly not only withintheirprofessionalcirclebutalsowithotherprofessions,andmost crucially,withserviceusersandtheirrepresentativeorganisations.Back inthe1980sand1990s,suchapublicdebatemighthavebeenunlikely, tosaytheleast.Inpractice,fromapersonalperspective,withsomescep- ticism already developing with regard to strict diagnosis and extensive medicationofsufferers,Inonethelessparticipatedasastaffnursewithin thepsychiatricsystemand,notwithouttrepidation,didmyfairshareof medication dispensing. I hope I managed to deliver much empathy as wellassomeconstructivepersonalsupport,whichisforotherstojudge. A major preoccupation of mine at that time was an acute awareness that every patient with whom I was connected had a unique story to tell.Morethanthat,thosestoriesoftenseemedtobeastruggletowards
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