'Working in the field of arts and health creates new opportunities to engage with people who would not otherwise have access to quality art experiences.'
Kildare County Council’s Arts Service interprets arts and health as arts practice that takes place within any healthcare context (acute, primary, respite, rehabilitation and mental health care) and can impact on anyone who enters the facility. The potential for arts activity in this setting is diverse and may consist of environmental enhancement, site-specific commissioned artwork and participation-focused work. A distinction is made between arts and health practice and other practices such as arts therapy, community arts in health and medical humanities.
Local distinctiveness is a key element for each local authority, with different priority areas being shaped by the surrounding cultural infrastructure (or lack of). While many local authorities do not have dedicated staff or an arts and health strategy, each arts service engages in a range of arts in context programmes. They may not consider initiatives such as a participatory arts programme with older people, or commissioning an artist who is exploring illness, to be ‘arts and health’.
It could be argued that arts and health as a practice is not the responsibility of a local authority and rather is the responsibility of the Department of Health and the HSE. Given that arts and health programmes can involve patients, clients, service users, carers, staff members, visitors or the wider public, I see work in this area as an important opportunity for arts engagement by the local authority. The NESF 2007 report on ‘The Arts, Cultural Inclusion and Social Inclusion’ (1), states that ‘in terms of legislation local authorities are the organisation given most responsibility for broadening participation and access’. I feel strongly that quality arts provision is an entitlement of all citizens. Working in the field of arts and health creates new opportunities to engage with people who would not otherwise have access to quality art experiences.
The framework for ‘(Continue to) Make Inroads: An Arts Development Plan for Kildare Local Authorities 2012:2016’ (2) was built on five key roles for the arts service – Curator, Mentor, Broker, Respondent & Inspirer. In the plan, we set out our responsibility as ‘curator’, defining our role as caretaker: which includes our duty of care. This operates on a number of levels. Firstly, a person may not want to be labelled through their association with those programmes, for example a person availing of an arts programme via mental health services. This is a key consideration when producing promotional and documentation material. Secondly, we need to manage the expectations of participants. Due to resource limitations, many arts and health programmes are relatively short term. It is important to signpost participants to further opportunities provided by other agencies, or independently. In Kildare, a partnership programme with the HSE (particularly the Health Promotion Department) has assisted in this transition.
Kildare County Council was the first local authority in Ireland to employ an arts and health specialist (3) in 2007. An arts in health strategy was published in 2009. The strategy prioritised:
- Supporting the continuing development of the arts programme in Naas General Hospital
- Promoting and facilitating access to and participation in arts initiatives for users of mental health services
- Developing arts provision for older people
- Supporting arts programmes and training for service users and staff of intellectual disability services
The publication of the strategy was a strong statement to other agencies working within healthcare contexts of our commitment and willingness to work with them to develop a sustainable arts and health programme. While the strategy was warmly received by the public, we were asked why programmes around intellectual disability were included in the document. Although Kildare County Council recognise arts and disability as a distinct practice, it was felt that the arts and health specialist was best placed to take on this work as part of her portfolio.
The post of arts and health specialist has now ceased (due to the local authority staff embargo). Kildare County Council now works closely with the Kildare West Wicklow Community Addiction Service Ltd. to support the employment of an arts and wellbeing specialist for Co Kildare. The ‘wellbeing’ title is informed by current international best practice and trends. The World Health Organisation’s definition of health is ‘state of complete physical, mental and social wellbeing not merely the absence of disease or infirmity’ (4) and reflects a holistic view of society and health.
As mentioned earlier, the local authorities forthcoming arts plan was built around five key roles – Curator, Mentor, Broker, Respondent & Inspirer. These roles describe very well how we work in the arts and health field – negotiating between services and agencies, advocating for and nurturing best practice, professional development opportunities for artists and augmenting existing arts provision. In this plan, a distinction has been made between ‘arts and health’ and ‘arts and disability’. The local authority commits to engagement in both areas.
Over the course of this plan, our arts and health programme will include working with Barretstown, which is a specially-designed camp that provides therapeutic recreation programmes for children with serious illnesses and their families. In conjunction with Helium, the local authority is offering training, mentoring and placement for artists to work with children experiencing serious illness in the camps.
Reflecting on our work since 2007, there has been a lot of shared learning between healthcare and the arts service. There is a greater expectation for evidence based approaches and quantitative data from health care professionals. While the local authority has been satisfied with qualitative evaluation for arts programming to date, there is scope to adapt more rigorous evaluation methods to the wider arts programme, and vice versa.
In May 2011, I was admitted to Beaumont Hospital with suspected Multiple Sclerosis. Up until that point, I had never been really ‘sick’, had barely been in hospital and even then my longest stay was a five day stay in a maternity hospital – but that wasn’t proper ‘sick’. Of course, this was a life changing experience, in all sorts of ways. What I didn’t expect was how it would change my perspective about my work and specifically, in the field of arts and health. I realised I had considered arts and health as something for other people.
I had previously talked about ‘environmental enhancement’ in hospital settings without really interrogating the rationale for it. Waiting on an MRI scan in Beaumont, I developed a real affection for the stitched birds in the framed textile artworks dotted around the corridors, willing them to make it all okay. It is only on reflection that I can see that I thought of artworks in hospitals from a visitors perspective only and not as a patient. Over the last year, words like ‘patient’, ‘sufferer’, ‘survivor’, ‘service user’, ‘carer’ and ‘wheelchair user’ have taken on a whole new (sometimes terrifying) meaning.
At the Bealtaine conference in Dublin in May 2012, Francois Matarasso commented that ‘ageing concerns us all. At least we can hope so, because the only alternative to ageing is dying young …’ He says that ‘…older people are [considered as] somehow other … they are just us in twenty years time’. This comment resonated with me and reinforced my thinking that arts and health is for and about everyone, including me.
Lucina Russell has been the Kildare County Council Arts Officer since 2000. She has initiated a number of long-term arts development initiatives including Laban-based dance training, which has a significant national following. She managed the appointment of an Arts in Health Specialist, the first of its kind in local authorities in Ireland. Kildare County Council has an extensive arts and health programme, particularly in the field of older persons and mental health.
(1) NESF (2007) ‘The Arts, Cultural Inclusion and Social Inclusion’ NESF Report 35, pg 40
(2) Due to be published in September 2012
(3) Initially the title of the post was Arts ‘in’ Health specialist. The title was changed to Arts ‘and’ Health as it better suited the post.