As part of our ongoing ‘In Conversation’ series, we met with Kevin O’Shanahan, a Nurse Specialist in Mental Health and the Arts with Cork Mental Health Services, working within the HSE’s Cork/Kerry Community Healthcare Organisation. Kevin spoke to us about his background as a musician working in health settings, the importance of having a dedicated wellbeing hub (49 North Street) serving communities in West Cork, and the shift in mental healthcare towards a model receptive to the role of creative expression in supporting recovery.
Kevin, your role as Arts and Mental Health Co-ordinator in West Cork brings together your training as a Clinical Nurse Specialist and your experience as a musician. Can you tell me about your background and how these two worlds converged?
My music career started in the early nineties, while I was also studying Business at Waterford Institute of Technology. My passion for music grew out of the awareness of how good making and performing music made me feel emotionally. Music was also a great way of making new friends and connecting with others. When I graduated from college, I was a founder member of bands such as Ramb, who released music on Solid Records (Ireland’s largest independent label at the time), and King Kong Company. These experiences gave me an insight into how the music industry worked and what was involved in commercial music-making. I wasn’t sure this was the path for me. At this time, I was also working at Spraoi [Waterford’s Street Arts Festival]. Part of this work involved making music with groups in economically disadvantaged communities. I began to get a lot of feedback, from community workers and others, that the process of group music-making was really beneficial to people’s wellbeing.
I also had a growing interest in mental health around this time based on personal experiences. I remember wondering why no one seemed to talk about mental health and the stigma that surrounded it. From my experiences, I knew that making music together had something potentially to offer. I returned to NUI Galway to study and begin a new career in mental health nursing in 1998. I was fortunate to be selected to be a part of a European Music in Health project with Waterford Healing Arts Trust in 2006. I received valuable support from WHAT and staff at University Hospital Waterford. As musician in residence at WHAT, I also worked closely with Consultant Psychiatrist, Dr Darina Sloane, who along with a very inspiring team of nurses, helped us to articulate in more detail, the specific benefits of music-making to mental wellbeing. This informed the development of the ‘Healing Sounds’ music programme which has continued to flourish since that time.
What does the role of Arts and Mental Health Co-ordinator entail?
The core of my work revolves around a clinical focus or practice. This means working in a co-productive or collaborative way on recovery-informed mental health initiatives with inspiring people like James O’ Flynn (The Claddagh Rogues), Nora Edgeworth (Co-founder of Bantry Community Choir) and Peter Fitzpatrick (The Happiness Ensemble), amongst others.
My role also incorporates research, education, advocacy and consultancy. Collaboration with healthcare colleagues is also central. I am fortunate to have learned a lot from working closely alongside an inspiring Assistant Director of Nursing, Declan McCarthy, in developing innovative initiatives such as 49 North Street [a dedicated creativity and wellness space in Skibbereen]. I have also received tremendous support from nursing management in Cork / Kerry Community Healthcare Organisation. Previous and current Directors of Nursing, Mr. Michael Bambrick and Mr. Ned Kelly, have both been particularly encouraging.
The Claddagh Rogues was born out of a residency programme you delivered with Cork Simon Community over 10 years ago. How did the band evolve from a residency-based music project to being part of North Street’s programming?
This project began during my role as an Artist in Residence with Cork Simon Community in 2007. The Claddagh Rogues distils in song the experiences of talented individuals such as James O’Flynn, Brian Cunningham and Mags Kelly. In 2016, we received the very sad news of Mags’ untimely passing. In 2017, we released the ‘For The Record’ album in memory of Mags. Brian has gone on to become a very talented visual artist. James remains at the core of The Claddagh Rogues. I think it’s an important project because in essence it’s a recovery journey in words, music and images. The songs encapsulate James’s experiences and journey from what he would term a more custodial type of care in the older mental health hospitals to a more collaborative and person-centred way of working, as epitomised by 49 North Street. It is people like James and many others who make North Street special and keep the focus on ‘walking the walk’ of recovery in practice.
It’s quite a unique partnership, a mental health professional and service user working together over such a long period of time.
Yes that’s true, but I think what’s important is that James inspires in others the idea that recovery is possible, no matter how much the odds may be stacked against you. James has confronted challenges in relation to addiction, homelessness and severe mental health difficulties. His story epitomises a journey in recovery and illustrates how the arts or particularly music in James’s case can play an important role. James has also acknowledged the importance of the on-going support of The Simon Community and Cork Mental Health Services in keeping well.
The arts and mental health programme in West Cork has been running for a number of years but it’s only in the last year that North Street was established. What is the importance of having a dedicated space people can attend?
It is vitally important. It’s a meeting place. Its location in the centre of Skibbereen town means we are in the heart of the community. It allows for real integration with the community and participation in cultural events such as The West Cork Food Festival or The Skibbereen Arts Festival. It is symbolic of the many years of hard work from many people. For example, Professor Pat Bracken, our previous Clinical Director, has for many years articulated the benefits of the incorporation of the creative arts in mental healthcare. This vision has continued to be supported by our current Clinical Director Professor Marcellino Smyth and Head of Services, Sinead Glennon. Research such as the Five Ways to Wellbeing clearly outline that simple things contribute in important ways to our wellbeing. A space such as North Street has allowed us to have a home for creative, therapeutic and wellbeing worlds to meet which has led to a cross-pollination of different perspectives and from this exciting things are happening.
If you are someone in recovery and you’re working with the local community mental health services, can you just drop into North Street or do you need a referral?
People can both drop in on a self-referral basis or be referred through the Multi-Disciplinary Team.
This year, the UK government has committed £4.5million in funding to social prescribing. Do you think a social prescribing model has potential for Cork Mental Health Services?
I think there is a lot of potential. There is a growing evidence base internationally of the benefits of social prescribing programmes. Innovative work is being led by Priscilla Lynch, Head of Health and Wellbeing for Cork and Kerry, including a pilot programme in Listowel. From my own work, I think social prescribing initiatives can reduce the burden of referrals on often already overstretched community mental health teams. Most importantly such initiatives can add real benefits to an individual’s wellbeing and quality of life.
The programming at North Street is really dynamic; there are lots of things happening on a weekly basis as well as once-off events. Can you tell me about some of the initiatives?
How much space have you got! If you go to The Wellbeing Network website, you can see the variety and learn more about individual projects. We are extremely fortunate to work with so many talented professionals from a wide variety of backgrounds – just too many to name individually. Currently, Rebecca Keyser facilitates a wonderful visual art group ‘Ealaíon’ every Friday afternoon. The Happiness Ensemble are collaborating with artist Tomasz Madajczak. Our most recent additions to the programme include weekly mindful movement sessions, and that’s almost like combining a creative approach and mindfulness. We also tried a ‘pop up’ Gaeltacht during the Skibbereen Arts Festival and it was just fantastic, the people coming through and the energy around engaging in new ways with the Irish language. So we now have a weekly ‘pop up’ called ‘Fite Fuaite’ which translates as ‘Interconnected’ where people can engage creatively with the Irish language. A monthly book club, walking groups, a gardening group, in addition to a number of therapeutic and self-help groups also feature. These are delivered from disciplines as diverse as nursing, psychology, social work and, very importantly (in terms of the ethos of North Street), users by experience themselves. The support of the Cork Education and Training Board has helped to make such a diverse programme possible.
You get a real sense of the organic development of programming because it’s very much rooted in the needs and interests of the community. Has this ethos of co-production changed your perception of what arts and health practice can or should be?
My understanding of co-production is that it should be a collaborative process. I’ve been involved in arts and health work since 2005, and in recent years I began to feel in some ways that you can almost end up being over-protective about the arts and in danger of being out on your own too much, rather than working in truly collaborative ways. But what I’m learning from North Street is that actually the interactions between the different perspectives can lead people in new and sometimes unexpected directions. For example, you find you have people who come for a walking group and then maybe they want to get engaged in a creative group. So you have this almost cross-pollination of ideas between arts professionals, health professionals and users by experience. In my experience, the most authentic and high quality work happens when all perspectives are heard and honoured. The really important thing is that people feel that they can come and try activities and it’s fine if they’ re not for you; it’s about genuine choice. The door is always open, to come and go on your own terms.
It’s a much broader vision of creativity and wellbeing –
Yes possibly so, but the context is important and the work out of North Street centres around collaboration and transformation. In the past, I know myself I’ve been guilty of thinking whether as a nurse, musician or an arts and health practitioner, that you know best or have ‘the answer’ or solution, and I’m learning that if you wait a little bit and listen and work both with the people using the services and the staff, the programmes are often much better for it. I don’t see why a vision of creativity and wellbeing can’t include language, culture, nature, mindfulness or gardening.
What really strikes me about North Street is the partnership approach – health staff, service users, artists all working together in this very supportive environment.
Yes, we’re very keen on service users taking the lead on how North Street develops. We also want to support our colleagues from the arts and health professions and we are delighted this is happening as is evident in the programme. The health service has finite resources; there are a lot of demands on the mental health services in the day to day work. We want to ensure the creative work doesn’t become tokenistic and yet at the same time, we have to be realistic with the resources we have. We try to have open discussions with everyone involved and we find when people become more aware of the responsibilities each side has, the dialogue happens and then the creative ideas come. And then people get enthused about trying something out, like the beautiful poetry and gardening project that was conceived at North Street and realised at Perrott House – a community residence in Skibbereen.
What would need to happen for there to be a large-scale shift in Irish mental healthcare towards an understanding of the arts and creativity as something that can actively contribute to a person’s wellbeing?
This is an interesting question, because when one reflects on it in many ways it has actually happened. I don’t think the role I am in and a space such as North Street could have happened without such a shift in thinking. I find healthcare colleagues at the multidisciplinary team meetings very receptive to the potential of the arts to contribute towards recovery and wellbeing. In Cork / Kerry, there are lots of interesting developments. There is now also a Clinical Nurse Specialist in visual arts and an established arts and health programme in North Cork. The work of the Arts + Minds group in Cork city, the Iontas music programme and the wider arts and health programme at WHAT are other on-going initiatives that I have been fortunate to contribute to. I have also come across great work being driven by individuals in Wicklow, Wexford and many other counties. In fact, there seems to be so much activity now that it can be difficult to keep abreast of it all. This was not the case in 2005, when I began working in the area, so in that sense there definitely has been a national shift. We will continue to advocate from within the mental health services that recovery-informed services need to have creative and transformative spaces like North Street, where creative expression plays an important role.
Where does 49 North Street go from here? What are the plans for the future?
We would like to see North Street become even more ‘owned’ by the community and by the people who are using our services. This includes service users becoming the facilitators of the future. That for me is what it’s all about, someone who comes as a service user, then, through their work, they create their own professional skills and come back and work with us in a professional capacity. That’s real recovery 2.0 in action. James O’ Flynn is currently studying community music-making with this in mind.
We have also got strong feedback around the idea of just providing a space of no programmed group actually – just a space to talk and imagine. We are interested in starting creative projects in this way – providing the space first, rather than arriving in with the programme; let the programme come from the people themselves and then find artists to support that.
We have also had a busy and exciting year in terms of film. An Open Door, filmed in part at North Street, has been screened to acclaim at a number of mental health conferences. It was selected as part of the ‘Best of Cork shorts’ at this year’s Cork Film Festival. For the coming year, our focus will shift further towards research and evaluation. Creative methodologies such as film will be part of this process. There has been a lot of interest in response to the recent launch of Healthy Ireland’s WellBeing Network website and North Street will also continue to act as a creative hub for the network. It’s important that North Street becomes engrained within the community as a space for wellbeing, because everyone has to look after their mental health.
Kevin O’Shanahan offers sincere thanks to the many colleagues and individuals who have contributed to the development of North Street to date. Kevin would also like to acknowledge in particular the work of recently retired Senior Community Health Worker Aidan Warner who provided the leadership for the development of numerous arts and health initiatives within the HSE. This work also paved the way for developments such as 49 North Street.
For further information on 49 North Street and other community wellbeing initiatives developed by Cork/Kerry Mental Health Services visit https://thewellbeingnetwork.ie/
 See ‘Crossing the Line’, an evaluation of Kevin O’Shanahan’s residency with Waterford Healing Arts Trust: http://www.artsandhealth.ie/wp-content/uploads/2011/09/Crossing-the-line-2008.pdf
 See Pat Bracken’s perspective on Mental Health, Recovery and the Role of the Creative Arts: http://www.artsandhealth.ie/perspectives/mental-health-recovery-and-the-role-of-the-creative-arts/