WHAT DO THE ARTS BRING TO MENTAL HEALTH PRACTICE?

The study and treatment of mental health is fraught with difficulty. It is a major healthcare issue with one in four people experiencing mental illness in their lifetime. Other estimates suggest that as many as half the (United States) population will experience mental disorder.⁶ There are often no overt physical signs to examine as there are in other branches of medicine, and the concept of mental illness itself continues to be contested.⁶ This has contributed to a move towards a biological understanding of mental ill health and a preponderance of research studies which utilise imaging techniques to demonstrate what is occurring in the brain. Yet, what does this tell us about the reality of living with depression, anxiety or schizophrenia? When a person is seen in the clinic, hospital or at home, a healthcare professional can observe an individual but is reliant on verbal reports or a narrative account to make sense of their experience of mental distress or illness. This emphasises the importance of perception, subjectivity and interpretation in mental healthcare.

The humanities integrate spiritual, physical, emotional and psychological elements, all of which must be considered in holistic, patient-centred healthcare practice.⁷ The combination of arts with medicine evokes the German idea of Wissenshchaft, a science that includes both science and humanities⁸ and is compatible with the recognition that psychiatry is both a science and an art.⁷

Art with its revelatory power has the ability to 'reach and express the depths of human experience' (p. 802), of critical importance in understanding mental health.⁹ Humanities assist with the acquisition of a shared understanding by focusing on patient and doctor perspectives. This is essential for the accurate interpretation of a medical history, particularly in psychiatry where many symptoms are socially constructed.⁸ Subjective experience is crucial in understanding mental disorders such as schizophrenia¹⁰ and this is where the humanities can contribute in its many depictions of the human condition.¹¹ For example, from a psychoanalytical perspective, art can be used as a route into unconscious processes,¹² and by engaging with music, psychiatrists can move beyond observation and categorisation to understanding the inner world of patients.¹³

Humanities teaching emphasises reflection and active participation which may be viewed as an anecdote to the reductionist and technical learning which predominates in mental health education.⁵ This is true of psychiatry where there has been a shift in focus from the mind to the brain¹⁴ and where biological models for understanding mental pathologies currently dominate. At a macro level, involvement in the arts can facilitate community engagement and hence 'learning beyond the classroom'⁴ Such community involvement has many benefits including engendering a sense of belonging and cultivating 'cultural citizenship'.¹⁵