Summary of the impact

Academic staff (who are also artist practitioners) and clinical colleagues have engaged in a collaborative project which has explored the effects of anti-depressant medications. The collaborative arts/science practice explored these interests through creative, patient led, artistic expressions of change alongside conventional, reductionist measures of changing depressive symptoms. Early findings suggest that this work can make a useful contribution to the range of support available to mental health service users, and may also have a contribution to offer in the field of public health, reducing demands on acute services. The initial outcomes led to an invitation to bid for further funding in FACT's Healthy Spaces programme.

Underpinning research

Dr Liggett has been collaborating with artist Karen Heald since 2006. In 2009 Heald was awarded the Stiwdio Safle award (Arts Council Wales) which involved a residency in an acute inpatient psychiatric unit at Glan Clwyd Hospital N. Wales. Liggett was invited to co-facilitate the painting workshops and to make collaborative works based on their shared theoretical interests and experiences of working in the hospital. The Ablett residency gave artists, Heald and Liggett, the opportunity to converse with patients, and staff allowing them to further explore art and science collaborations and theoretical notions of 'in-between-ness.' Out of this work, Visualising the Invisible was an exhibition that they co- curated at Glyndwr University as part of the Wrexham Science Festival in July 2010. The exhibition featured patients and artist's individual and collaborative artworks consisting of images of numerous small paintings on gesso board, a selection of photographs and several experimental short films. The films were presented as projections onto walls and on specific objects, such as the medical screens. The exhibits displayed rhythms, colours and trace, communicating ideas that the patients have been unable to articulate in the spoken word but expressed through their artworks. There were both therapeutic and collaborative elements in the production and editing of the art works.

In further research in collaboration with Dr Richard Tranter, consultant psychiatrist, Prof. Robert Poole, Professor of Mental Health and GP surgeries, Heald and Liggett proposed new perspectives into the effects of anti-depressant medications. Scientists know that antidepressants subtly alter the way people perceive emotional stimuli around them, altering people's social behaviours, on a level that people are not consciously aware of. Through arts/science research the collaborators are interested to explore if patient changes are reflected in the way people express themselves and respond to their environment, prior, during and post antidepressant medication. The collaborative arts/science practice explored these interests through creative, patient led, artistic expressions of change alongside conventional, reductionist measures of changing depressive symptoms (Beck Depression Inventory) producing sophisticated fusions of art/science. The aim of the study was to help understand some of the effects of antidepressants and how people recover from depression. This work was set in the context of a rapidly expanding knowledge of how the brain processes emotional stimuli, how these processes are affected by depression, and how these processes change in response to treatment. People with depression show characteristic changes in the way they perceive the world around them, particularly the way they interpret emotional stimuli, for example interpreting facial expressions in others. To inform future directions of research in this area this innovative art/science collaboration explored experiential changes during treatment with antidepressants. In addition to the aims of the psychiatrists, the artists were keen to explore the role of preverbal language and creativity for patients navigating the "in-between-ness" from depression to recovery. This was informed by concepts of preverbal language and `in-between-ness' and `psychological resonance'.

The work has been disseminated through exhibitions and performances (e.g. Videoformes film screening and live performance event in Trinty Church, Salford live streamed to Maison du Peuple, Clermont-Ferrand, France (15th March 2012); Film to Change, A selection of short films on the subject of mental health - White film screened as part of the Film to Change series Albert Room, Leeds Town Hall (16th November 2010) and conference papers (e.g. Claiming Creativity: Art Education in Cultural Transition (21 - 24 April 2010) at Columbia College, Chicago, USA, ESA Research Network Sociology for the Arts, University of Lisbon, Portugal `European Society or European Societies' (2 - 5 September 2009)

References to the research

http://www.addocreative.com/portfolio/in-between-ness/
http://in-between-ness.co.uk (in particular, `about' and `links')
http://www.elia-artschools.org/images/activiteiten/29/files/elia-biennial-vienna-programme.pdf (page 19 of programme)

Further details are available on request if required.

Details of the impact

Betsi Cadwaladr University Health Board

BCUHB commented: `This research is an integral part of the Betsi Cadwaladr University Health Board's Arts in Health & Wellbeing programme. The research activity supports health outcomes resulting from arts interventions and provides evidence towards further development and funding of this work to the benefit of patients and families.' The project was not designed as a trial of therapeutic intervention; it has been an investigation of changes in emotional processing during antidepressant treatment, using artist expression as a qualitative measure. An unexpected finding is that involvement in the creative part of the project seems to have had an impact on participants' sense of well-being. It would be valuable to test this finding replicating the work in a larger sample using different artists, and BCUHB would value this opportunity when resources allow. The interim findings suggest that type of intervention can make a useful contribution to the range of support available to mental health service users, and may also have a contribution to offer in the field of public health, reducing demands on acute services.

[source a]

Foundation for Art and Creative Technology (FACT)

FACT (Foundation for Art and Creative Technology) is a leading media arts centre, based in Liverpool. Offering a unique programme of exhibitions, film and participant-led art projects, it uses the power of creative technology to inspire and enrich lives. As a centre for research and development, FACT works with partners across the creative industries, health, higher education and arts sectors to develop multi-disciplinary projects exploring the relationship between technology and culture. FACT's Healthy Spaces programme is based on the belief that artists can play an intrinsic role in the creation of healthy spaces using digital arts and new media, with artist interventions encouraging health and wellbeing within spaces - whether physical, imaginary or emotional. FACT delivers this work in a number of ways; for example through participatory projects, commissions for waiting rooms, in-hospital commissions and online resources.

Liggett and Heald attended a FACT presentation outlining future plans including research in the field of Human Futures - Health, Work, Citizenship, and had the opportunity to talk about their own work in the field of arts interventions and their impact in mental health. Liggett and Heald wrote a proposal through TIN (Talent Incubation Network - PARC NW) and were invited to present ideas to FACT outlining how they would like to collaborate with them. Staff were interested in the themes and approach they were taking and invited Liggett and Heald to work with them in the future. Liggett and Heald are currently working on a research proposal for further funding through the ARHC in collaboration with FACT.

The researchers aim to contribute to FACT's Healthy Spaces programme and to FACT's belief that `artists can play an intrinsic role in the creation of healthy spaces using digital arts and new media.' The proposed project will contribute to the public mental health message's `five ways to wellbeing', through connecting people, encouraging activity through encouraging a heightened awareness of one's environment, encouraging learning through art and giving something back to the community through creating artworks in the public realm.

The project will advance and test the findings from the previous research by:

• Engaging outpatient service users in the creative process via non-linear videos. These could be patients who are suffering from major depression but are treatment resistant or who decline to take antidepressant medication.
• Disseminating the `dream' films from the In-between-ness project through creative installations, e.g. projections on to objects / buildings or in institutional spaces that constitute in-between places such as waiting rooms, alleyways, etc. The films will be those made by people suffering from depression and also the artists leading the project.
• Developing a website / smartphone application to enable service users suffering from depression to engage in the project. An interactive model will integrate one-to-one participation with online engagement in creative activities.
• Providing an opportunity for a PhD candidate to work with FACT's Healthy Spaces programme.

[source b]

Sources to corroborate the impact

a) Head of Arts Therapies and Clinical Operational Lead / Arts in Health & Wellbeing Programme Manager, Betsi Cadwaladr University Health Board

b) Research and Innovation Manager, FACT