Psychosis research off the page and onto the stage

In Conversation with … Diana Jefferies PhD

Lecturer in the School of Nursing and Midwifery at the University of Western Sydney

By Alison Houston

Dr Diana Jefferies still finds it surreal that what she admits could once have been a dry academic research paper has taken on a life and personality of its own.

It was a meeting at last year’s Annual Arts and Health Conference with Taimi Allan, the CEO of mental health charity Changing Minds, involved in arts-based health promotion projects, that married Diana’s research into perinatal psychosis to the arts, resulting in the one-woman play Mockingbird.

Diana, a lecturer in the School of Nursing and Midwifery at the University of Western Sydney and a registered nurse with 25 years clinical experience, also has a PhD in English literature, but said she could never have foreseen the path her research would take.

“I still can’t believe it’s actually happening,” Diana said.

Mockingbird is a black musical comedy aimed at building awareness of perinatal psychosis and mania today by portraying what it was like for women admitted to mental health facilities with this diagnosis over the past 100 years.

“The conference really opened up a lot of new avenues and has been very important in showing how arts-based therapies can make a difference to people,” Diana said.

“The stories of the women I had researched were very academically written on the page, and would go to a very limited audience.

“Putting those stories into a play, those women come off the page and are given a body and voice, which is a far greater emotional experience.

“It shows how this sort of research can make a real impact on the world.”

With the help of writer and actress Lisa Brickell, Mockingbird was created as a series of 4-5 vignettes – an amalgam of 10-12 of the women’s experiences which Diana had researched.

Diana had examined the historical healthcare records of these women, highlighting the similarities and improvements in pre, post and peri-natal mental healthcare from 1885-2001.

She explained that although not publicly discussed, and often unrecognised even among the medical fraternity, 1-2 women in every 1000 will experience perinatal psychosis. That’s 600 women every year in Australia.

“I’m currently speaking to women who have had this experience in the past 10 years, and part of the problem today remains the lack of awareness regarding this condition,” Diana said.

“The mothers know something is wrong – psychosis involves sudden mood swings, hallucinations, confused thinking – but because people don’t realise when it is occurring, or are not correctly diagnosed until it is very severe, the woman often has to be admitted to a psychiatric hospital, where she is separated from her baby.

“Those mums want to be heard. They want the condition to be recognised, and they don’t want to be admitted to a psychiatric ward.

Diana said because so little was known about the condition, even maternity staff often didn’t recognise it, or really understand the woman’s needs.

“There is still a stigma that people don’t want to mention the word ‘psychosis’ in case it upsets someone,” she said.

While these women’s suffering is nothing to laugh about, Diana said by approaching their stories through black comedy it was easier for audiences to identify with them rather than being overwhelmed and unable to relate.

“It is better to make people laugh as well as cry for them to become really involved in a subject,” she said.

“This is all about getting the message out there into the world and to create change.

“I can get my papers published in as many nursing journals as I like, but it won’t have the same effect as bringing those stories to life for an audience.”

She hopes Mockingbird will bring about a new understanding between maternity and psychiatric divisions so that mothers can be given appropriate and timely treatment.

“This is a real illness that people need to recognise and start thinking about the best way to look after these women,” Diana said.

It’s hoped that when the play is performed in February, research surveys on the audience will quantify exactly what the play’s impact is.


Forget the 3Rs, young people need the 4Cs

In Conversation with … Jim Rimmer
VicHealth Mental Wellbeing and Arts senior project officer
As today’s younger generation grapples with an era of unprecedented change, we need to rethink our preoccupation with school subjects as vocationally linked and turn our attention towards “the 4Cs of 21st century learning – critical thinking, communication, collaboration, and creativity”.
That’s according to Jim Rimmer, the Mental Wellbeing and Arts senior project officer for the Victorian Health Promotion Foundation (VicHealth).
He said such a confluence of factors – economic, technological, social, and environmental transformation – was “unchartered territory”.
 “Many young people will navigate these changes successfully but, for a growing group, these challenges are being acutely felt,” he said.
“Limited opportunities to succeed in education and employment, limited literacy, lack of stability in family and among friends, and absence of positive identity and self-esteem are being experienced by young people now. The impact on their mental and physical wellbeing is devastating.”

Studies have shown that the old adage of Australia being ‘The Lucky Country’ no longer rings true for many young people.
“One in eight are lonely, one in four report limited access to social support when needed and, as a result of these factors and others, over 75% of all serious mental health problems start before 25 years of age.” Jim said.
In 2015 VicHealth commissioned the CSIRO to provide a clearer understanding of the challenges and opportunities facing Victoria’s youth.
Their report, ‘Bright Futures: Megatrends Impacting the Mental Wellbeing of Young Victorians over the Coming 20 Years’, identified resilience as an important asset for success not just locally but nationally, and globally.
As a result, Jim said, VicHealth had adopted an ecological view of resilience assets where communities and organisations, family, friends and key influencers all played an important role, in addition to individuals.
“Building resilient communities fosters good health, prevents illness and benefits everyone,” he said.
Creativity, he said, was the key to navigating this future of rapid social change and finding purpose and meaning.
“If we think of creativity as conceiving original, useful ideas that overcome challenges and take advantage of opportunities, then it is core not just to work but every aspect of our lives,” Jim said. 
“The arts help us to familiarise ourselves with the intricacies of the world, to experience the perspectives of others, and to critique our dreams, aspirations and fears.”
Given this, our education system must stop marginalising the arts as simply an extra-curricular activity.
“It was mentioned in a recent Americans for the Arts blog post that the ‘arts shape the mind for creative inquiry, build intellectual muscle for asking what-if and if-then questions, and develop outside-the-box thinking. Simply put, education in the arts builds creativity’,” Jim said.
“Almost without fail students and professionals with a level of arts training or engagement do better than those without.”
With social media such a large part of the lives of young people in particular, Jim said it occupied a “tricky space in today’s cultural landscape”, with impacts far beyond youth demographics.
“Art is social and now the internet is too,” he said. “Rather than being homogenous, each platform has attributes that can be harnessed.
“Some platforms act as vital tools for connecting artists directly with their audiences and markets, while others make it incredibly difficult for creators to maintain their rights and ability to earn a living.
“And there are serious questions emerging about the attention economy, privileging the sensational over the nuanced, privacy and data footprints.
“Given the ubiquity of social media, I’m also surprised more artists aren’t engaging with social media as a platform for artmaking rather than using it just as a distribution channel.”
Jim himself has a history of more than 20 years in the arts field and said he had been interested in any form of cultural activity he came across from a very early age – music, theatre, dance, visual arts and writing.
“I’ve since been involved in significant projects spanning all these fields and more,” he said.
“The projects that have meant the most to me are those that have introduced new and unexpected experiences to people that might otherwise not have been afforded similar opportunities.
“Often this isn’t actually about the art itself but how it’s delivered, who’s being invited, how the experience is being shared with others.”
He said he likes to push himself into new territory, do things that are less ordinary, and encourage others to do the same.

  • Jim Rimmer is giving a plenary presentation Creative to the Core at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW.   #artshealth17 

                   Alison Houston, writedirection gc

Arts crosses divides to tap into our essence

Cover image: Michelle with Good Times program participant
In Conversation with … Michelle Weiner
Creative Ageing Consultant
One of the many powers of the arts is its ability to cross age, health, socio-economic and ethnic divides and “tap into your very essence”.
The arts is “a central point to make connections and draw out what makes us the same, but at the same time, what makes us uniquely different”.
Anyone can learn from a work of art and anyone can create, according to Michelle Weiner, an artist and creative ageing consultant, who spent six years directing community programs at Dulwich Picture Gallery in London.
She will present ‘Barriers, Budgets and Baked Goods: Adventures in Creative Ageing with England’s Oldest Art Gallery’ at the International Arts and Health Conference.

Having been involved for years in the gallery’s Good Times: Art for Older People as well as its more recent Mini Masterpieces program for children 6-24 months, Michelle said she could say “hand-on-heart I truly know the transformative effect of the arts from birth up”.
She believes anyone can learn from a work of art and anyone can create.
“I’ve seen babies as little as eight months old explore paint and paint brushes for the first time, and very rarely do you see them all do the same thing. As early as this, you can see expression of sensitivity to texture, colour, likes and dislikes.
“On the other end of the spectrum, are older adults – just because they haven’t participated in any art since school doesn’t mean that they’ve somehow ‘missed the boat’.
“We can be very prejudiced about learning … I have seen people living with dementia retain new information and someone who had never engaged in printmaking before be inspired to make a printing-press out of kitchen utensils to make Christmas cards.”
She said at some of the artmaking workshops for people with dementia and their carers, it would be a challenge to the outsider to recognise who had a diagnosis just by looking at their work.

Because the arts work as a ‘leveller’, she said she looked at museums as great ‘melting pots’ where ideas could be exchanged and collections scrutinised.
“Does it matter that you’ve not read Art History at university or that you don’t speak the same language as the painter whose work you are inspired by? No,” she said.
“The collections themselves are not to blame for the divide that has happened with gallery attendance, it’s the people who look after them.”
She does not believe in museums and galleries being “quiet, sacred places only for the cultural elite” and said museum professionals are increasingly throwing off a lot of the intellectual snobbery of the past and looking to their audiences to co-create with them.
“Capturing a new audience means being committed long-term. Flash-in-the-pan, one-off, projects won’t get repeat visitors. People have to know what is inside is for them and that they can be part of that story,” she said.

And that, to a large extent, is the secret to Dulwich Picture Gallery’s success. Despite being a national gallery, being in a village, it is very community-focused, and the locals are not just extremely involved, but devoted to the gallery.
“Being England’s first purpose-built public art gallery means that it was created for everyday people and this underpins the work of the Education team especially,” Michelle said.
The gallery has hosted award-winning programs for 30 years, with its smaller size and private operation allowing it to ‘push the boundaries’ rather than getting tied up in the red tape of larger government-run facilities.
“I think museums are coming around to the idea that counting visitors doesn’t tell us much about the quality or impact of the experience and that sustaining a museum is as much about being relevant now to the lives of the visitors (and beyond) as it is about accounting for the past,” Michelle said.
The impact of the Mini-Masterpieces program, she said, was holistic, incorporating social, sensory and creative elements, and was as much for the child as the adult with whom they attended the sessions, which begin in the gallery and end with art-making.
“This is an age where a child is rapidly developing through sensory and physical exploration so the program is designed to support this through accessible, manageable and safe materials which will aid their explorations,” Michelle said.
“The child and adult have the opportunity … to enter into a full partnership where they can explore and learn together.”
In a similar vein, the Good Times: Art for Older People program encourages equal participation from carers and participants with a particular diagnosis such as dementia.
“I’m always surprised by how quickly older participants engage in these sessions,” Michelle said.
“There is hesitancy, of course, but generally, with good tuition, participants can achieve a good end result. This is what builds confidence – an achievable task that looks complex.
“I love it when a person living with dementia can’t believe that they have created the painting you hold out in front of them.
“I think it’s this validation that can’t be underestimated. Having your output, your creation venerated is huge if you feel invisible, or not worth the time.”
Another important element of the program is social interaction, with figures of social isolation in the UK including that only one in five older people has regular contact with their family, at least 800,000 people have dementia and five million older people name the television as their primary companion.
“Older people can go weeks without any meaningful interaction with other people,” Michelle said.
“What these experiences give people is the chance to express themselves, to be heard and be appreciated. I remember a lady saying to me, ‘how nice of you to spend the time with me, no one usually bothers’.
“I would argue that this is why, while there are physical and cognitive benefits for taking part in arts activities even in your own home, the emotional and mental benefits are profound if one can experience this as a group.”
Program outcomes include opportunities for self-expression, autonomy, social interaction, increased confidence, resilience, improved communication, self-esteem and morale.
And it doesn’t all come down to painting, with participants sometimes challenged to sing, use a new material or write poetry.
“Sometimes people have profound difficulties with mobility and fine-motor skills or severe visual impairments. The reason why this job is so challenging for us as facilitators and artists is that we need to use our creativity to adapt the session to make the task appropriate to accommodate all these disabilities,” Michelle said.
“There are no rights or wrongs, dos or don’ts, or goods and bad. Without absolute answers, everyone can be involved.”

  • Michelle Weiner is giving a plenary presentation on ‘Barriers, Budgets and Baked Goods: Adventures in Creative Ageing with England’s Oldest Art Gallery at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW. #artshealth17  Alison Houston WriteDirection gc


Animation the way to people’s minds and hearts

In Conversation with … Emma Lazenby
Director ForMed Films – a not-for-profit Community Interest Company
Animated films allow people to tell authentic and personal stories about difficult subjects, using their own voice but retaining anonymity.
Because they are visual, they are also an accessible way for people of all ages (especially those with low literacy levels or of different ethnicities) to access important information in an immediate way.
That’s what makes them so powerful for conveying messages regarding important medical information, according to Emma Lazenby, who created ForMed Films in January 2015 for that very purpose.
Themes to date have included anaesthesia, mental health, birth and midwifery, exercise, teeth, radiotherapy, and cervical screening.
Emma is presenting a one-hour workshop directed at clinicians, community health and health promotion practitioners interested in using animation to help better inform patients at the International Arts and Health Conference.
Having worked in the animation industry for 19 years, including for the BBC, Disney, Aardman and Channel 4, Emma says she genuinely believes animation is the best format by which to talk to people about medical and health issues, which can sometimes be overwhelming in their technicalities.
ForMed Films states its vision is “to create films that touch lives and help people make better health choices and engage in treatment,” and Emma said they do this by becoming totally immersed in their subject.
“For example, for ‘A Little Deep Sleep’, our film about anaesthetics, we shadowed anaesthetists and patients for a number of days in Bristol Children’s Hospital,” Emma said.
“It feels like such a privilege to be able to wear scrubs and attend surgery; to observe, draw, record sounds etc, and to be around families at this vulnerable time and share the experience with them.
“The films need to honour the people, professionals and the real-life experience that people go through and will go through in each situation, so we make the films the best they can be.”
The secret to successfully getting the message across in animation, Emma said, was working collaboratively with professionals, being curious and fascinated, and having a joint clear aim of what the film’s message needed to be.
Again, she emphasised that speaking to “real people with experience and letting the power of their story and their voice talk to the viewer” was vital.
“It is like a big puzzle that needs exploring from all angles and there is no simple answer – every project is different,” she said.
“The aim is to speak to the audience in a non-patronising way, to give the story and information they need to hear. It is working out what will impact the audience the most.”
In the case of ‘My Mum Has a Dodgy Brain’, which deals with mothers experiencing mental health problems including depression, anorexia and bipolar disorder, the ForMed team interviewed three children for about 40 minutes about their experiences before editing them down to a six-minute animation, using the children’s own voices.

The film, which has been shown at festivals and conferences, and is being used by the UK’s National Health Service, aims to increase public awareness, as well as helping children in a similar situation and highlighting to professionals working with parents with mental health issues what their children experience, so they can receive the help they need as well.
 “The voices and the stories make the film,” Emma said. “It feels important for children to speak to children. I think they are often talked over, or down to or patronised.
“Having real children explaining honestly is the best way to get a message across to children.  It gives children, parents and professionals empathy to hear a child talk so openly and clearly.”
Where possible, she said, ForMed always used the voice of those involved, but sometimes films needed a narrative to compress all the information into a compact space of time, such as in ‘Movement is Life’, narrated by a doctor with the message that cell inflammation as a result of inactivity over time causes most major diseases.

Emma said the information gathered, which was aimed at teachers and increasing their awareness of the vital need for students to exercise daily, was eye-opening to her as the filmmaker.
“It changed my life. Though I was already very active, it has made me very aware,” she said.
“This was carefully scripted, edited down from a lecture given by Dr William Bird, who re-narrated the film to our script. 
“The film had to be 3 minutes long and there was a lot of information to get in, which meant simplifying and simplifying – which is always a good thing.”
And it’s not just the voices that are real. Emma said the real-life backgrounds of hospital and staff, gave people familiarity when they entered the hospital environment. 
While she thoroughly enjoyed her time in the commercial arena and learned a lot, covering every area from animation to design, art directing, directing, concept art and sound design, Emma said she found making medical films fascinating.
“I care so much more deeply about the end product – that it is the right film and that it honours the people involved. It is so much more satisfying to be doing good,” she said.
The difficulty can be attracting funding, which led Emma to attempt Crowd Funding for a project called ‘Perinatal Positivity’, a film about maternal mental health for parents-to-be, to promote wellness and early identification. 

“The films are professionally made, commercial products,” Emma said. “They take a long time to make and involve a skilled team … Finding the money in the health system can be very difficult, where commercially these budgets would be reasonable.
“Though it wasn’t successful, we made amazing connections (through Crowd Funding) and are in the early stages of production for the project we were pushing … We are still looking for a few partners…”
And for the future? Emma said ForMed Films was started to make medical and educational films, including issues related to mental health and wellbeing.
“There are so many other aspects that do come into it.  There are so many films to make, and no limit really,” she said.
Emma is excited to be the artist in residence at the International Arts and Health Conference, something she has not done before.
“I do always draw at conferences and make notes but they are usually just for me. Watch out for my tweeting throughout the conference @ForMed_Films.”
Watch ForMed’s films at

  • Emma Lazenby is presenting the Animation for Medical Education Workshop at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW. #artshealth 17.
  • Alison Houston, writedirection gc

Arts on prescription: the logical step for health and wellbeing

In Conversation with … Chris and Ros Poulos
Physicians, academics and proponents of Arts on Prescription

WITH the groundswell of empirical evidence regarding the arts’ positive impact on both physical and mental wellbeing, particularly in older age, why shouldn’t it be as readily available to the public as any medication?

Sydney’s Chris and Roslyn Poulos are championing the concept of Arts on Prescription in Australia.
Chris is head of Research and Aged Care Clinical Services for HammondCare, one of Australia’s leading providers of aged care, dementia, palliative care and rehabilitation services.

He is also conjoint professor in the Faculty of Medicine at the University of New South Wales (UNSW) and a consultant physician in rehabilitation medicine.

Ros is a public health physician and associate professor at UNSW, teaching and researching in the field of ageing and health.

Their participatory Arts on Prescription program is based on a model developed in the UK whereby health professionals, including GPs, write prescriptions for their patients to participate in the arts.

“It is always done in association with traditional health care, but it recognises that there is more to achieving health and wellness …,” Chris said.

“A prescription is a good reinforcer for the person that their health care professional sees involvement in the arts as an important thing, alongside their traditional health care, in helping them achieve greater wellbeing.”

Chris and Ros’s program specifically targeted people over 65 experiencing a range of health and wellbeing challenges, rather than a single issue. These included frailty, declining physical function, anxiety, depression, mild cognitive impairment, bereavement, social isolation and/or carer burden.

Groups of six to eight people worked for two hours per week for 10 weeks in the arts area of their choice, with a professional and specially trained artist, using professional-standard materials.

Classes covered visual arts (oil and watercolour, drawing and printmaking), dance and creative movement, music and photography, with many participants signing up for more than one genre.

The artistic area was not chosen ‘for’ the participant because engagement was the primary goal and Chris said it was felt that many forms of arts activity would achieve other health and wellness targets such as socialisation, movement and creativity.

“The thing with any form of activity is motivation is always key,” Chris said.

Ros agreed, saying “the beautiful thing about the arts is they can be incredibly flexible and can be modified to whatever individual health problems people may be experiencing”.

Data from 139 participants in the program was analysed and followed up with interviews and focus groups to explore people’s experiences anecdotally.

Ros said there were significant improvements reported from pre- to post-program on the Warwick-Edinburgh Mental Health and Wellbeing Scale, and statistically significant increases in self-perceived creativity and frequency of creative activity.

“We found people said the program had given them a sense of purpose and direction,” she said.
“It had also given them a new talent to explore.

“Doing art in a group also gave them something in common, so there was a lovely connection with each other.”
Many participants had entered the program saying they were not artistic and would not be able to create anything, she said, meaning when they did so, there was a real sense of achievement and personal growth.

“People had a sense of seeing beyond their expectations of themselves, which was a real feeling of empowerment, that they could ‘think bigger’ – if I can achieve this, maybe I can do other things,” Ros said.

While some measures of frailty were taken, it was not a focus because the program was a funded service rather than a research project, however, Ros said that anecdotally, people did report greater physical activity and this was something which could be explored in the future.

“When we talk about wellbeing, we are talking about feeling happy, but also about more long-lasting attributes such as sense of purpose, achievement and being important to other people,” Ros said.

The success of the program is clear from the comments of participants, such as Dorothy:
“This program has brought me back to life again,” she said.

“It has helped me get over my grief and loneliness. Socially, it was marvellous. It has released me to be me.”
Ahmed, at 83, said “The Arts on Prescription program and artists gave me power to try new things and the drive to keep going.”
Others referred to it as “the highlight of their week” and “the best thing that’s ever happened to me”.
Ros said the participants had throughout been treated as developing artists by their mentors. They were not ‘taught’ but ‘encouraged’ and shown how to achieve what they wanted to as part of a partnership.
A Festival of the Ageing, as part of NSW Seniors Week, was the culmination of the program, with about 150 pieces displayed in a professionally curated exhibit, allowing participants to really see themselves as artists in their own right.

Those involved in musical ‘prescriptions’ also worked towards performing before an audience, including at coffee shops, a retirement village and at UNSW.

“These things really validate the participants as artists,” Ros said. “It shows that everyone is creative.”
Some of the art was also brought in to the UNSW Medical Faculty to raise awareness among that fraternity of what can be achieved through Arts on Prescription.

Both Chris and Ros believe it is important to make Arts on Prescription a viable and sustainable ongoing program and for it to be embraced by Australian GPs, with referrals in this project accepted from a range of health care practitioners, including social workers, nurses, pastoral care workers and aged care assessment teams.

  • Chris and Ros Poulos are taking part in two presentations – How to Conduct an Arts on Prescription Program for Older People with Unmet Health and Wellness Needs, and Positive Ageing through Participatory Art: the ‘Arts on Prescription’ Model – at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW. #artshealth

Alison Houston, writedirection gc

Music video’s benefits go far beyond its health message

In Conversation with … Leanne Sanders
Aboriginal Immunisation Health Worker for Murrumbidgee and Southern NSW Local Health Districts
“I’m everything I am because one person believed in me.”
That’s Leanne Sanders’ dedication to her mentor, the late Athol Boney, who helped a teen mum, with a Year 9 education and a history of domestic violence, have the confidence to complete a university degree and see that life could, and should, be better.
“He taught me everything from culture to values – to look at things differently to how I grew up thinking things were,” Leanne said.
A mark of who he was and what he stood for could be seen in the way he signed off his emails with the quote “Being Aboriginal is a reason to succeed rather than an excuse not to”.
It’s that attitude and background which Leanne, who gained a Bachelor of Health Science Indigenous Mental Health from Charles Sturt University and has 12 years experience working within Aboriginal communities, uses to make such strong connections with teenagers as Aboriginal Immunisation Health Worker for Murrumbidgee and Southern NSW Local Health Districts.

It’s a relationship which goes beyond her role, with Leanne passionate about ensuring kids and teens know they are both valued and valuable, improving Aboriginal health, halting the increasing number of Aboriginal youth suicides, and Closing the Gap.
And she believes music has a huge role to play.
The evidence can be seen in the ‘Whatchya Gunna Do?’ immunisation music video – written and rapped by Wagga Wagga teens after a program of four workshops with professional musicians and an Aboriginal Elder – to encourage others to be vaccinated.
It was recognised recently with the Murrumbidgee Aboriginal Health Award, having been used by the NSW Ministry of Health in their World Immunisation Day promotions and distributed to health and community care centres and schools throughout the Murrumbidgee and Southern NSW Local Health Districts.
But Leanne said while the recognition was wonderful, “I just do things from my heart”.

And she said the collateral benefits from the video were many – giving the teens a sense of accomplishment and improving self-esteem, building understanding between indigenous and non-indigenous participants, and providing them with a new way to express themselves and release their feelings.
“Not one of these kids had ever done music before, but they became little celebrities,” Leanne said. “They were in the newspaper, and the Elders and the community watched the video at a special launch and celebrated it with them.
“Kids from schools where it was shown in assemblies were snapchatting them and congratulating them.
“They were so proud of what they’d done. To be recognised by the whole community is wonderful, and everyone saw the shift in these kids.”
As an added bonus, the teens went back to their families and became the educators, checking who had and had not had their vaccinations.
Leanne made the conscious decision that both indigenous and non-indigenous people would be involved in the music video.
“I hate segregation and I made it very clear from the beginning that I would invite non-indigenous kids to take part in the project as well,” Leanne said.

“It’s all part of reconciliation – building positive relationships … One girl had never even spoken to an Aboriginal person before, and she came away with friendships and knowledge.
An Aboriginal Elder showed the teens how to play traditional instruments and do traditional dancing.
“A lot of the kids said it was the best day of their lives. None of them had had that cultural experience before – and the fact indigenous and non-indigenous were part of that musical journey and learning about that helps to close the gap,” Leanne said.
It’s just one way in which she believes music can help us to connect with others and express ourselves.
“Music is so therapeutic at any time – it’s like meditation – and then to have your own words within that is very powerful,” she said.
It’s a lesson she had reinforced to her recently when returning to her tiny hometown of Finley, NSW (with a population of about 2000) for a cousin’s funeral – one of a frightening number of youth suicides.

She showed the immunisation video to some of her primary school-aged cousins, and was surprised the next day when they presented her with their own song.
“They had all written me a song about their grief; how they were feeling and school bullying,” she said.
“Music is an incredible tool because it helps these young ones express themselves … They’re writing down their feelings when they write songs, but they’re not even aware that’s what they are doing.”
As a result of the video’s success, Heaps Decent, which was involved in the production and has been working with young people from marginalised and disadvantaged communities since 2007, is continuing to work with teens in the area when possible, dependent on funding, giving them a way to tell their stories their own way.
In workshops, the teens spend two hours with facilitators making a beat, writing and recording a song.
Leanne has a gift for thinking outside the box, and having held a number of the  sessions at the Riverina Community College, is moving the venue to the PCYC, allowing the teens to see first-hand, and almost by osmosis, what courses and opportunities are available simply by being there.

“These are kids that would never usually walk inside the doors of these places or access services, but they get to meet the staff and it starts to knock those walls down and starts a relationship,” Leanne said.
She also hopes to build on what she learned regarding the teenagers’ interest in their culture and wanting to know who they are, discussing with an artist uncle the possibilities of a traditional-style corroboree, with music, art and dance.
The possibilities, lessons and gains from a single music video appear almost endless.

  • Leanne Sanders is giving a presentation on the ‘Whatchya Gunna Do?’ music video at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW. #artshealth 17
  • See the video at Whatchya Gunna Do? YouTube Alison Houston, writedirection gc


Community arts helps us each ‘write our world’

In Conversation with … François Matarasso
Artist, producer, researcher, writer and trainer

Community arts’ empowerment comes from encouraging people to use art to explore who they are and their relationship with the world in ways that can be shared with others.

“It allows us to write the world,” said François Matarasso, who will present twice at the 9th International Arts and Health Conference from 30 October – 1 November, including giving the Mike White Memorial Lecture.

“Art allows us to make sense of our experience and connect with others who share the sense we make,” he said.

“Without that capacity, we are only subject to other people’s sense-making. We are written by others. We lose agency.”

François has worked in community arts since 1981 as an artist, producer, researcher, writer and trainer, with experience across 40 countries, and has published influential work on the social outcomes of participation in the arts, and on the history, theory and practice of community art.

François was a close friend of Mike White, a pioneer in community arts and health who was behind establishment of the Centre for Medical Humanities at Durham University, and wrote the seminal book on the topic – Arts Development in Community Health: A Social Tonic. He died of cancer in June 2015.

“So often the difference we make is in what we do, not what we say,” François said.

“Mike’s work, as a producer, community arts worker, local authority officer, researcher, teacher and speaker touched thousands of people very deeply but always, I think, because he breathed his values.

“He was a gentle man, unduly modest, but brimful of enthusiasm and joy at the good things others achieved. I think, above all, he gave many people the confidence to fulfil their potential. That’s a great legacy.”
François’ memorial lecture is A Restless Art: Community Art and Empowerment, discussing community and participatory arts in Britain from a rights-based perspective.

He explained that community art had emerged in the 1960s as part of that decade’s “cultural revolution”, and ended as a movement in the late 1980s, since which time it has broadened and diversified under the name participatory arts.

“For me community art is a rights-based approach to co-operative artistic creation between professional and non-professional artists who set their goals and terms of success together …  it is equally open to all ages, abilities, cultures, faiths etc,” François said.

Many would perhaps not know that participation in the arts is actually a right set out in the Universal Declaration of Human Rights (article 27), which states: “Everyone has the right to participate in the cultural life of the community and to enjoy the arts”.

François said there had been any number of stand-out successes over his years in community arts. In fact he says he has seen “very few genuinely bad community art projects, perhaps because even if they didn’t have the skills or knowledge, the people involved had a commitment that allowed them to create something at least worthwhile”.

However, he pointed to one project in 1990 that remained particularly close to his heart – an 18-month residency by writer Rosie Cullen and photographer Ross Boyd which helped residents of a psychiatric hospital, which many had called home for years, deal with its closure and their move to small community-based facilities and homes.

François was working at the time with East Midlands Shape, a community art organisation involved with disabled people and people living in hospitals, care homes and prisons.

“It seemed important to do something on this policy that affected the lives of so many of the people we worked with,” François said.

“The result was a project called ‘Looking Back, Looking Forward’, in which residents of one hospital scheduled for closure could use art (photography, poems and stories) to reflect on their changing lives.”
The texts and images were collected into two books, one about life in the hospital and one about life outside, and a photographic exhibition toured the UK, including the Department of Health’s London headquarters.

“It was a symbolic way of ensuring that the voices of the people affected by the ‘Care in the Community’ (Thatcher Government policy which had forced the closures) would be heard where the decisions that transformed their lives were made,” François said.

“For me, it had everything that a good community arts project should be, in the sense of producing some great art that gave people who are undergoing life-changing events, not of their choosing, the power to express their feelings about the experience to each other but also to the wider public and even in the policy context.

“Nearly 30 years later, the words and images of that community art project still move me. Some have an aesthetic quality equal to that achieved by professional writers and photographers. Even the least accomplished – and there aren’t many – have truth and authenticity.”

And that, according to François, is the beauty of the arts and its potential for all, given access to its multi-faceted powers of expression, healing, wellbeing and empowerment.

“Because it comes from within, it is possible to create something extraordinary the first time you try,” he said.

“In fact sometimes not knowing the rules gives you more freedom than someone with decades of skill, experience and knowledge.

“That doesn’t mean that skill, experience and knowledge won’t increase your chance of making something great, but great things can happen without them, differently.”

  • François Matarasso is giving the plenary Mike White Memorial Lecture, A Restless Art: Community Art and Empowerment and a second presentation on Artistry in Old Age at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from 30 October to 1 November  at the Art Gallery of NSW.
  • François Matarasso’s visit to Australia has been sponsored by the National Gallery of Australia, Canberra. François is giving a presentation at the NGA on Saturday 4 November.   #artshealth17              

                   Alison Houston, writedirection gc

Sharing humanity through reminiscence theatre

In Conversation with … David Savill
Artistic director of Age Exchange
Image: David Savill Age Exchange On the River

“Reminiscence theatre, at heart, is about shared humanity.”

That’s what drives David Savill, artistic director of Age Exchange, the leading UK charity specialising in reminiscence practice which aims to change perceptions of “how we see older people in our society and how we value them and the lives they have lived”.

David, who has worked in the field for over 20 years, said it still saddened him to hear older people say ‘I didn’t think my life was important’ or ‘I just wanted people to know about his/her life’.

“What are the arts for if not to help people express themselves and share their story so we can learn from it, appreciate it?” David asked.

The process generally takes the form of group reminiscence with the older participants, identifying memories/themes over 8-10 sessions.

Alternatively, a theme may already have been chosen, or the producers can record individual interviews, and work with the interviewee to funnel down to the specific memories they want to perform or to be performed, particularly in the case of intergenerational projects.

“Having the person share their memory of an important experience in their life with an audience is electric. It is … a very enriching, cathartic experience,” David said.

Its power can be felt even in the retelling of his work. It is hard to hold back the tears as David recalls one of his earliest experiences of devising reminiscence theatre with 93-year-old Phyllis.

After a period of remembering and improvising, Phyllis chose to perform a memory of her father, with her playing herself as an 11-year-old and David her father.

“She gave me verbatim the words she remembered him saying to her,” David said.

Her father had been a boot and shoemaker in Bournemouth and, as such, was in a reserved occupation, which meant his services were needed at home rather than in the trenches.

Phyllis remembered the day two women entered the shop and gave her father white feathers to signify he was a coward for not enlisting. He ran off that night and joined the Dorset Infantry.

It was the memory of his homecoming at Christmas 1915 – the last time she would see him – that she wanted to share.

“I was playing out in the street with my sister and it was snowing hard. Then some way off we saw a shape comin’ towards us through the snow … I hardly recognised him at first, he was so changed, so thin in his uniform.

“… He’d come home you see. He had two days embarkation leave. While he was in the trenches he’d got it in his head that somehow he had to get home to us, he had to cut down a Christmas tree and decorate it with us and then go back.”

David and Phyllis recreated the scene of cutting down a Christmas tree under a starry night, then heading home to decorate it together, accompanied by another older participant singing Silent Night.

David explained, “Phyllis ended the scene by handing her dad the scarf she had wrapped up as his present – the actual scarf she had given him 73 years ago. Dad hugged her and was gone.

“The following summer he was gassed at The Somme.”

David still remembers the stunned silence and tears of the local Dorset audience.

After the performance Phyllis introduced David to her daughter and granddaughter.

“She was holding them both by the hand and looked at them and said ‘You didn’t know did you? I never told anyone. But now you know. Now it’s your memory too’.”

Phyllis died two months later and David said he believed sharing that memory was immensely important to her – “part of her life review, I suppose, and she’d waited a life time to tell it”.

David’s initial introduction to Age Exchange was arguably serendipity at its best.

Having trained as an actor in the mid-1980s he was writing and directing work, including projects with younger people with behavioural needs and disability in the mid-1990s.

While waiting for a bus, two older ladies began chatting to him, and he recounted the play he was directing which he and his wife Jenny had written about wartime evacuation for a nearby South London youth theatre.

“To my surprise they asked if they could come and watch it and maybe even speak to the cast afterwards (of their wartime experience),” David said.

They did so, sharing their reminiscences of, in Cathleen’s case, being a child evacuee, and in Eileen’s building the wings for Wellington bombers and caring for her badly wounded husband.

“That’s when I realised my play was poor compared to their real stories which were better than any theatre I’d been in or created,” David said.

It turned out that both ladies were volunteers at Age Exchange, introduced David to the founder and director Pam Schweitzer, who had introduced the concept of reminiscence theatre, and who immediately gave him a job.

David said Eileen, now nearing 100, is still a volunteer with Age Exchange and was this year recognised with The British Empire Medal for her long life of work and volunteering.

It’s just one of any number of heart-warming stories David can recount of his work in reminiscence theatre, which has covered subjects including World War 1, the Holocaust, Dr Bernardo’s children’s homes, first loves and the peace movement.

In many cases, when the subject is directed by those reminiscing, as in Phyllis’s case, there is no script, an initiative of David’s, removing the pressure of remembering words for frail and older participants.

“This is a complex process which essentially involves working through sensory triggers as well as artefacts, archive material and photography with older people, to identify (their choice) the reminiscence they wish to share and to make performance from,” David said.

“In our role as actor/carers we work with our older performers to improvise reminiscence together and create a structure for that improvisation that can be shared. Our role is to ensure we know the story of the scene inside out and can guide the older participant where and if needed …”

David said one of the beauties of this non-scripted, rehearsed improvisation was that as the weeks progressed and they honed the scenes, the older participants often remembered new things as they talked together and brought “more life, more humanity and more humour to their work”.

“In performance the older people often just fly, finding new wit, asides, engaging with the audience directly, and sharing their own life experience in an extremely free and immediate way,” he said.
However, despite all the research Age Exchange workers put into projects and the work they do, sometimes, David said, it does not lead to a production.

“So much of our work is just about the group being together and enriching the community they live in and share. It doesn’t all lead to theatre. This is a choice – their choice,” he said.

Often those that did perform were surprised to see that their memory was important to others – to an audience.

“This of course is a natural form of validation which is fantastic when it happens, and you can see the older performer glow when they see the audience enjoy and sometimes share in their performed memory,” David said.

  • David Savill is giving a plenary presentation on Creating Reminiscence Theatre with Older People: Structure and Starting Out at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW. Alison Houston, WriteDirection gc

The arts increase health and happiness, isolation kills

In Conversation with … Margret Meagher
Australian Centre for Arts and Health Ltd, Executive Director and Convenor of the the 9th Annual International Arts and Health Conference
Art is like chocolate for the brain
Dr Gene Cohen, Founder, Creative Ageing Movement
It’s a captivating image, and one that caught the imagination of Margret Meagher, who met Dr Cohen at an arts and health conference in Chicago in 2006. Margret would go on to establish the Australian Centre for Arts and Health and convenes the annual International Arts and Health Conference, now in its ninth year.
She’s deeply involved in the concept of Creative Ageing and how the arts can have a powerful positive impact on the mental and physical health of older people.
Dr Cohen’s landmark US study across three cities and four years found that engagement in the arts – that is actively taking part, not just listening to music or watching a movie – increases confidence and self-esteem, reduces the length of hospital stays and reliance on medication, improves heart and respiratory function and even results in less falls.
Margret believes this is due to a combination of activity, the sense of achievement and mastery involved (often unavailable to seniors), as well as the social connections made.
And socialising is vital.
“A research paper in the US made the statement that loneliness is more detrimental to health and wellbeing than smoking 15 cigarettes a day, and is more likely to usher in an early death,” Margret said.
“Older people often feel quite invisible.”
This can be overcome by participation in the community, for instance, singing as part of a choir – a growing pastime worldwide – creating something of beauty for others to appreciate.
Margret also strongly believes in the need for interconnection between generations, with old and young taking part in a knowledge transfer, for instance older people teaching the young knitting or other crafts and the young, in turn, teaching them how to use technology.
“These interconnections are really important because one of the biggest issues of getting older is ageism, which is pervasive across Western society,” she said.
“We need to recognise that older people have extensive wisdom, experience and knowledge and find a way to unlock that asset and encourage older people to recognise what they have to offer is valuable.”
This changing of perceptions is part of Margret’s work with the NSW Government Ministerial Advisory Council on Ageing, and includes altering people’s approach to the elderly so they are not doing things “for” but “with” older people.
She believes local government has a “massive role to play in the way older people live their lives”.

7th Annual Conference The Art of Good Health and Wellbeing at Art Gallery of NSW 2015

CREATIVE AGEING: Australian Centre for Arts and Health patron and former NSW Governor Dame Marie Bashir with ACAH founding director Margret Meagher.
As the custodians of libraries, community centres, art galleries, museums and more, she believes it is incumbent on local government to ensure older people have access to these activities.
That is where ageing needs to be thought of from a whole-of-government perspective, with transport links and access to the arts and services vital.
“The older population is increasing exponentially and we are coming to the point where there will be more older people in the world than young, which has massive social and financial implications, particularly with a commensurate increase in the incidence of dementia,” Margret said.
“There is no known cure for dementia, but the evidence is clear that engagement in creative activities can have a major impact on people’s quality of life.”
Hence the need to change another preconception, the idea that arts is an elitist activity.
And, Margret pointed out, involvement in the arts does not have to be expensive – joining a choir, an art or craft group, woodwork or a book club, going dancing, joining U3A or a community group involves only a minimal outlay.
“The sadness is that when people get older they tend to drop away from engagement in the arts, particularly after 75, because they are reluctant to go out at night or to go out alone,” she said.
The Creative Ageing Festival, which Margret instigated three years ago in collaboration with Port Macquarie-Hastings Council, on the NSW Mid North Coast, devised a Cultural Companions program, whereby people reluctant to go out alone can pal up with others, giving them confidence to go out, and overcoming associated problems such as transport and geographical distance.
“The case for arts in relation to health is very clear, and people in government are coming to the realisation that prevention is better than cure,” Margret said.
A prominent gerontologist, the late Dr Gene Cohen, presented the business case for the arts almost a decade ago, finding the financial savings to government amounted to millions on the basis of reduced reliance on medication alone.
“It is a basic human right that all people should have access to creative activity because creativity is an essential part of the human condition. We are all born creative,” Margret said.
However, she said, it was also up to all of us not to minimise our abilities or be constrained by age.
“There are just so many different ways in which you can be actively engaged, and it encourages us to be silly and have fun too as part of that experience.”
“If you are in a wheelchair, you can still dance – move your hands, maybe your feet and sing along.”
As for the future, Margret believes it is bright, with Baby Boomers demanding better quality facilities and services for their parents and themselves, so that access to creative activities will become an accepted part of life, not a special occasion.
“The arts doesn’t think about age, it thinks about creativity and the fun you can have in creating something. Exercising imagination is vital.”

  • Margret Meagher is Australian Centre for Arts and Health Ltd director, adjunct senior lecturer at the University of NSW, Sydney, member of the NSW Ministerial Advisory Council on Ageing  and convenor of the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW.          

                                    Report by Alison Houston, WriteDirection gc, originally published in Seniors Newspaper Publications

Making music in older age expresses our ‘possible selves’

In Conversation with … Professor Andrea Creech
Professor in Music Education at the Université Laval, Canada
Image: Recorder group at Sage Gateshead Silver Programme
We all have a basic and lifelong need as humans to be creative and make a contribution.
And that’s where music and music-making can play a crucial role, according to Professor in Music Education Andrea Creech, of the Université Laval, Canada.
While society recognises and, to a large extent, meets the human need to be cared for and to belong, Andrea said we often forget the importance of ‘social affirmation’ – making a contribution, feeling valued and being creative.
“The arts provide a beautiful context for expression, for sharing, for cultivating that sense of meaningfulness,” she said.
This needed particular recognition, she said, for those in what is now referred to as ‘the Fourth Age’, when physical ailments often lead to dependency in residential care.
“My stepfather once explained to me that ‘the music stopped’ when he entered residential care,” Andrea said.
“Whereas music had been ubiquitous in his life, suddenly it was not there – replaced by the sounds of institutional routine.”
She said music-making – in his case singing – with his caregiver, a community musician and anyone who visited him in his long-term care facility, made life bearable in the face of multiple challenges.

Image: Silver sounds
She believes music builds resilience.
“Participating in music is cognitively engaging and is associated with lasting effects on brain plasticity as well as with non-musical brain functions such as language and attention,” Andrea said.
“Listening to music has been found to provide distraction from physical and emotional pain.
“Perhaps the most important point is that making music is both social and communicative and is strongly related to sustaining a sense of who we are.”
After enjoying an international orchestral career as a viola player, something Andrea describes as still “really a constant in my identity”, Andrea moved into the teaching and psychology behind music.

Image: East London IntergeneraNonal Music Project
Her research has focused on collaborative learning and the social, emotional, and cognitive benefits of music for older people in the community through creative ageing in and through music.
“There is a wealth of research evidence and anecdotal evidence to suggest that lifelong learning is one of the key underpinning characteristics of positive ageing,” Andrea said.
This relates to one of her favourite theories of motivation –‘possible selves’.
“Really positive ageing, I believe, is almost always accompanied by an enduring sense of having a ‘possible self’, of always having the possibility of ‘becoming’,” she said.
“I must add that although I am clearly an advocate for music, this is not to say that other kinds of activities – like baking, knitting, painting, drama, gardening, writing poetry, reading books together – cannot also be personally meaningful and hugely valuable.
“I think musical activities are so holistic (or, can be…) and that is what makes music special, but all of those kinds of activities that support our possible selves, our sense of being, belonging, becoming, are potentially valuable.”
While she said there is a growing body of research that suggests that old age can be a period of creativity, and she argues that “it is entirely possible, given the opportunity and support, to be creative at any age”, Andrea questioned whether enough opportunities were provided for older people to be creative.

Image: Elder Voices, East London
Part of the difficulty here is changing people’s attitudes to ageing, including in themselves, and reconsidering what is possible in later life.
“There is certainly a lot of work to be done here,” Andrea said.
“I think two key points are:
1) providing opportunities and support for discovering that in fact it is possible to have a ‘possible self’ and to be creative at any age, and
2) facilitating contexts where multigenerational activities can take place, where stereotypical views of ageing can be shifted.”
And she believes this intergenerational approach is important, with older and younger generations having much to learn from each other.
“I think music certainly does cross generations,” she said.
“We need look no further than some classic songs – I facilitated an intergenerational workshop recently, where we performed ‘Imagine’, using iPad guitars and keyboards. It was a magical moment, really.”
“I must emphasise though that it is not always the young people with the energy and the new ideas!”
She said it was vital that the power of music and its importance as a resource for quality of later life be realised.
“We need to take this really seriously, investing in the infrastructure that will maximise the benefits of musical engagement for older people.
“Old age is not (or should not) be a barrier to creativity.”

  • Andrea Creech is giving a plenary presentation on Musical Pathways: Creative and Resilient Ageing in and Through Music at the 9th Annual International Arts and Health Conference – The Art of Good Health and Wellbeing – from October 30 to November 1 at the Art Gallery of NSW.        Alison Houston, WriteDirection gc