Restoring faith and self-esteem: Dr Richard Corrigall on the importance of creativity in mental health care
Create’s creative:tandem programme works with patients at Snowsfields Adolescent Unit at Maudsley Hospital in south London – an open unit offering mental health care for adolescents with a serious mental illness who require hospital admission. In April we ran a visual art project and are returning in August with jewellery and music projects. All are run by our professional artists.
Dr Richard Corrigall, a consultant adolescent psychiatrist at Snowsfields, told us about the importance of creativity in mental health care:
“Mental ill-health is thinking about yourself being difficult or problematic. To recover is therefore to restore yourself, and helping someone do that can feel enormously satisfying as a doctor, particularly when working with teenagers: they’re at the beginning of their lives and are beginning to become independent, new people.
“Our patients at Snowsfields are people for whom outpatient care is not safe or sustainable. Mostly it’s crisis admissions; a big chunk tends to be self-harming of a serious nature, suicide-related. Typically patients come in with emotionally unstable personality disorder, as in difficult mood changes and complicated social pressures. Those with psychosis and psychotic-related illnesses are another big group.
“With any mental health care, the key elements are biological, psychological and social. They’re all extremely important, it’s not that there’s just one area you need to be focusing on. Variety is what I’ve always been keen on. It’s very important to have the medical stuff and the diagnosis and prescribing, but that should fit into the broader objective of helping people to restore their lives in a rich way. It’s not just saying “These symptoms have gone away” - they’ve restored their real lives.
“Imagine you’ve got a mental illness, you’ve been in hospital – you can be very self-destructive or self-critical. So we try to restore some kind of faith and self-esteem, and I think creative things can be really good at that. There’s also the importance of shared respect. If people feel that they’ve been understood, then you’ve got a better chance of sharing the ideas and the advice you may want to give. Sometimes we have to make strong recommendations about medications which some patients can be quite resistant to. But I think having that dialogue can be more positive if you’ve given a young person the opportunity to express their feelings in different ways. You’ve demonstrated that you have real respect for them as a complicated individual, rather than just being a doctor saying: “You’ve got to do this”.
“Over the years, I’ve been prone to depressive episodes myself. In 2013 it got really severe, to the point of breakdown. When I recovered and felt optimism and interest again, after going through loads of time being negative and self-critical, I went to an art talk. One artist who was talked about was a person who’d been a mental health service user herself, and when I saw some of her art I was hugely inspired. It was related to her mental health crisis and stuff she’d been through. I really related to her art; I could understand what it meant. And then that gave me the idea of suddenly playing around with art.
“Since then I’ve been more and more interested in art. It does feel a very reassuring, healthy thing. Even the difficult things I’d been through became part of what helped with the creative expression. Which is another fascinating thing: mental health can obviously be unpleasant and disturbing, but it can also be enriching. When you see other people’s work, sometimes the things they’re able to communicate can be astonishing.
“Art can be drawing contradictory things together, which you could say is what consciousness is like. The world around us is incredibly complicated. All of our thinking is a bit of an oversimplification because it has to be. Sometimes creative things get to the depth and can connect with something that seems quite profound. Having said that, people can also use it in a very trivial way. It’s not right or wrong, it doesn’t have to have profound meaning necessarily. Sometimes it can be just doodling, it can just be relaxing. It inspires social functioning, how to get on with and relate to other people, problem solving.
“One young patient here had anorexia. She was clearly very talented at art and liked doing it, but she was very critical of her drawing and wanted it to be perfect. That illustrated the perfectionism that can relate to anorexia. We talked about how perfectionism can affect people and her trying a different approach, so she tried an impulsive, slightly random style of making art. That wasn’t her typical style, but it related in a metaphorical way to some of her psychological issues. She began using her detailed skills creatively but not getting overwhelmed by it, just in a nice straightforward way, and she was really quite thrilled by it. She actually went on to get a degree in art.”