The Arts: Reaching Hearts and Minds to Counter Discrimination Associated with Mental Illnesses
One of the causes of social exclusion and discrimination associated with mental health problems is a misperception that people who have mental illnesses lack the same interests and abilities as everyone else. Art, including the visual and performing arts, can be a powerful force in correcting this misperception. While not every person who has a mental illness has the artistic talent of Michelangelo and Vincent van Gogh (each believed to have had a mental illness), helping people recognize and develop their artistic talent can have numerous benefits. Engaging people in arts programs not only reduces negative self perceptions but also educates the public that people with mental illnesses are just like anyone else, with a range of talents, skills, and enthusiasms.
The purpose of this booklet is to provide inspiration and guidance in using the visual and performing arts to increase social inclusion and promote acceptance. The booklet begins with synopses of some of the many programs that offer consumers of mental health services opportunities to perform or to display their artwork to the public. The next section offers some insight into ways that these and other arts programs work to reduce discrimination building confidence among participants and educating the public about mental illnesses and the talents of people with mental illnesses. The booklet concludes with some hints about starting arts programs that will promote acceptance, dignity, and social inclusion.
Arts Programs Developed to Promote Acceptance and Reduce Discrimination
Across the nation and around the world, countless programs expose mental health consumers to the arts, and in turn may offer venues for consumers to display their skills in the performing arts or show consumers' artwork to the general public. While it is impossible to list every arts program designed for mental health consumers, the following examples provide an idea of some of the types of arts programs that are actively educating communities and working to promote acceptance of people with mental health problems. Most programs operate at the local level, but a few have sought a statewide, national or even international audience.
Brushes with Life, Chapel Hill, North Carolina
The Neurosciences Hospital at the University of North Carolina (UNC) features a rotating exhibit of artwork created by consumers, including current and former hospital patients and participants in a local psychosocial rehabilitation program. Additionally, the program started a traveling exhibit, showing artwork in public places, such as museums and airports. For more information, visit www.brusheswithlife.org or call (919) 966-0011.
On Stage!, Spokane, Washington
The Washington Institute for Mental Illness Research and Training sponsors On Stage!, a theater group in which consumers, providers, and volunteers work side by side as cast and crew. A goal of the program is to help people develop the confidence needed for returning to work or school. For more information, visit www.spokane.wsu.edu/research&service/WIMIRT/WIMIRT_theatre.html or call (509) 358-7676.
Movie Monday, Victoria, British Columbia, Canada
Started by a former patient at a local psychiatric hospital, the program takes advantage of the presence of a small theater in the hospital to show movies each Monday. Artwork created by consumers is also on display. Although many current and former patients attend the movies, which vary in theme, the showings are open to the public and provide an opportunity for social interaction and for discussion about mental health issues. For more information, call (250) 595-3542.
9Muses Art Center, Lauderhill, Florida
The Mental Health Association of Broward County sponsors a consumer-run art studio, together with a studio and frame shop that generates income for the artists and support the program. As a consumer-run drop-in center, the program offers participants both art education and peer support. For more information, visit www.mhabroward.org/gpage1.html or call (954) 746-2055.
Scripps Behavioral Health Creative Arts Program, San Diego, California
The Scripps Mercy Behavioral Health Center brightens up its hallways and group therapy rooms with artwork created by both professional artists and mental health consumers. Consumers are assisted in creating their own artwork by the professional artists whose art is displayed. For more information, call (619) 260-7111.
Voices Mental Health Consumer Theatre Company, Pittsfield, Massachusetts
The Voices Mental Health Consumer Theatre Company's performances include a number of short skits based on troupe members' personal experiences with mental illnesses and treatments, followed by audience discussions. The troupe performs for university students and mental health service providers and at consumer events. For more information, call (413) 442-1928.
The Art of Recovery, South Carolina (Statewide)
Originating as an art gallery at the State Department of Mental Health's main administration building, the Art of Recovery features regular competitions open to all people receiving services through the department. Winners of the competition, judged by local artists, are initiated into the "Order of the Brush"; some of the program's outstanding artwork is displayed in galleries and shows. For more information, visit www.state.sc.us/dmh/artrec.htm or call (803) 898-8582.
Madness and Arts World Festival (International)
The Workman Theatre Project (WTP) in Toronto features a number of arts programs, including Being Scene, an annual juried art show for clients of the Centre for Addiction and Mental Health, and Rendezvous with Madness, an annual festival of films dealing with mental health issues. In 2003, WTP hosted the first Madness and Arts World Festival, bringing together artists from Canada, the United States, Europe, Japan and Australia, and featuring dance, theatre, films and visual art. The festival also included symposia about mental health issues, including a presentation by a noted stigma researcher. For information about WTP's art initiatives, visit www.workmantheatre.com or call (416) 583-4339.
How do arts programs promote social inclusion and reduce discrimination?
Most people who are drawn to the arts feel the call because creating artwork or performing can be fun, challenging, and stimulating. The arts also provide a way of expressing feelings. In addition, when people with mental illnesses are given opportunities to create art, such opportunities can reduce the internal negative self perception felt by many mental health consumers, which may result in their feeling underappreciated or incapable of achievement.
In seeing the artwork, other people working in or affected by the mental health system—such as administrators, providers, and family members—are reminded to view consumers in light of their abilities rather than their disabilities. Bringing the artwork or performances to wider audiences gives the general public the opportunity to see mental health issues from the consumer perspective and learn about illnesses and treatments, often counteracting stereotypes perpetuated by the media and entertainment industries and reducing the discrimination and negative attitudes associated with mental illnesses.
Art provides creative outlets that can help to erase negative self perception.
Many people with mental illnesses believe that because of their diagnoses they will be unable to achieve their goals. Because arts programs encourage people to develop and express their talents in a supportive environment, they help to overcome negative feelings by showing participants that they are capable of creating something interesting and having fun in the process. Many artists have credited arts programs with helping them to overcome some of the fears and doubts they have about themselves. For example, the 9Muses Art Center's Web site contains testimonials from artists: Randy Starr credits the center with helping her "recover her self-esteem" and Regina Skane says the center helps to "validate her artistic existence." Some of the artists at 9Muses have revived earlier interests in art that disappeared upon their diagnosis. The testimonial of Marjorie Bryl, who earlier in her life had won art awards and a college scholarship, stated that 9Muses "has given her back her confidence as an artist and helped her regain her identity."
Philip Brubaker, whose photographs have been displayed at "Brushes with Life" exhibits at the University of North Carolina Hospitals and the North Carolina Museum of Art, said that although he was already pursuing a career in the arts, his participation in the program helped boost his confidence as an artist. "My path in film school was to become a director, and my hobby was taking pictures. At the time I was getting closer to my first episode (of bipolar disorder), I started taking more pictures. But it was not until my work was shown here that I considered my photos to be art. If you had told me 3 years ago that my photos would have been picked up in Associated Press stories and by CNN.com, I wouldn't have believed it," he said.
The "Brushes with Life" program conducted surveys of participants and the staff of the psychiatry department at the University of North Carolina. The results indicate that boosts in self-esteem are common among participants. Nancy Clayton, M.D., co-director of "Brushes with Life," noted that the results also showed that "people have become more comfortable discussing their illnesses with friends, family, and the public."
Art provides opportunities for greater financial independence, which helps to erase negative self perceptions.
For artists who have been able to sell their artwork, the financial rewards have been accompanied by a boost in self-confidence. Many mental health consumers have expressed the belief that continued reliance on income supports such as Supplemental Security Income (SSI) can contribute to negative self perceptions, and that too few opportunities exist for achieving financial independence. Art programs are working to change the situation by offering artists the opportunity to earn income through their artwork. For South Carolina's Art of Recovery project, a main goal is to move the artwork into the community so that artists can get exposure and have more opportunities to sell their art. At least one of the artists has "moved on and had a gallery pick up his work, and he is now selling his art through the gallery," remarked Sue Perry, coordinator of the state Department of Mental Health Office of Volunteer Services. Other artists have sold pieces through shows at the public library's art gallery, and numerous people have told Perry that the program "has meant a lot to them" in the recovery process.
Art events encourage interactions among consumers and the public.
Research has shown that the most effective method for reducing stigma is through direct contact with people with mental illnesses (Corrigan & Penn, 1999), and art events are a great way of bringing people together. One of the goals of the Movie Monday program in Victoria, British Columbia, Canada, is "[t]o encourage interaction between community and 'consumers' " (www.islandnet.com/mm). Taking advantage of the availability of a movie theater in a local psychiatric hospital, the program offers the public a chance to see free movies, watching them with current and former patients. According to the program’s Web site, the opportunity for interaction serves as "a catalyst for breaking down stigma" by "softening the lines" between hospital patients and members of the public.
Art events encourage extensive interactions between consumers and non-consumer artists and volunteers.
In addition to providing opportunities for interacting with the general public during performances and exhibits, art opens the door for more extensive and personal contact between consumers and non-consumer artists participating in the program. Several visual arts programs either allow members of the public to use their studios, bring in professional artists to work with the consumer participants, or teach art lessons. As the 9Muses Art Center became more visible in the community, its staff wanted to move "a step beyond" the contact generated by displaying art, remarked Jan Anastasato, the center's director; that center opened its facilities to non-consumers, who pay an annual fee. "The artwork is not only accepted, but the community is also coming in here to sit side by side with consumers. People realize, 'consumers are just like us,' " she said.
Donna Douglass, producer and director of the On Stage! theatre troupe, noted that theatre students at a local college have helped troupe members develop their skills. The college students "benefit by learning that consumers are not to be feared, thus reducing stigma and promoting better understanding of mental illness," she said.
Performing arts provide an especially effective venue for interaction among consumers and non-consumers if productions include both consumer and non-consumer cast and crew. Douglass explained that Theatre Extraordinaire, the On Stage! musical theatre company, has taken this approach. "Performances provide an opportunity for consumers to interact with and learn from community artists and volunteers. In turn, the volunteers and artists are educated about the talents and potential of consumers by working closely with them in a normalized environment," she said.
Creating art can serve as a positive example and provide hope to other consumers.
Art programs provide an excellent opportunity for peer support. Even in programs with professional instructors, fellow consumers often provide the motivation to produce artwork. When people see their peers creating artwork, and especially when they see peers selling their artwork, it creates a positive example, motivating others to create their own pieces. Anastasato noted that peer support plays a major role at 9Muses. "We're a drop-in center, not art therapy. We do have classes and instructors, but people can get up and walk around or quit if they want to," she said. However, interactions with peers keep many of the artists at the center focused on their work.
Displaying artwork by consumers helps providers see consumers as people rather than as clinical cases.
In Massachusetts, the Voices theatre troupe often performs for providers and students of psychology and social work. Voices coordinator Sally Filkins said that a typical reaction from providers during the discussions following the troupe's performances is, "You've helped me to understand the experiences of my patients and the world they live in." When performing for provider groups, the troupe often portrays some of the darker aspects of the mental health system, such as abuse. In one of the troupe's skits—based on the personal experiences of two members—a doctor sutures the wound of a woman who has cut herself, and he refuses to use anesthesia in order to teach the woman a "lesson." The doctor in the skit, who ends up having a "battle royale" with the psychiatrist on duty, "is trying to help, but he's uninformed," Filkins said. She acknowledged that portraying abuse often makes providers uncomfortable or defensive. However, she said, the troupe hopes to remind providers that they must be ever vigilant against abuse, intentional or unintentional.
Nancy Clayton noted that the Brushes with Life exhibit at UNC has generated many positive responses from hospital staff. She said that, within the psychiatry department, numerous staff members have been impressed by the quality of their patients' artwork, and that staff from other departments have also been impressed, with many people inquiring about purchasing the artwork.
Consumers can portray the experiences of mental illness and recovery through their art.
Many mental health consumers are initially drawn to visual or performing arts as a means of expressing some of the feelings that accompany their illnesses and treatment. For example, "Voices is dedicated to presenting original plays portraying the pain, terror, confusion, isolation, loneliness, and struggle that comprise the experience of mental illness," notes the troupe's brochure. Filkins shared a comment from an audience member that illustrates the impact the performances have had: "When I was in middle school, a dear friend hung herself and I never understood why, until this play. It helped me understand that sometimes everything is not okay, despite the outside appearances."
Artwork can serve as a springboard for discussion or disseminating information about mental health issues.
In addition to portraying the personal experience of mental illnesses on canvas or on stage, art events also provide an effective forum for transmitting information about mental illnesses and mental health services. Because they are fun and interesting, art shows and performances attract people who are interested in the arts but who might not know very much about mental health issues, especially consumers' perspective on the issues. Many art programs serve as an outreach program, offering information through pamphlets, providing factual information about illnesses and treatments, and brochures from local services and consumer initiatives.
Sometimes the information shared through art events can have an immediate impact. Filkins shared another comment written by an audience member, who noted, "The Voices performance shocked me into action. Certain mental illnesses run in my family, and I started thinking about the (health) of my own family. One of the performers stressed early diagnosis, so I did some research and will be sharing it with my family."
Creating artwork allows consumers to define themselves by their abilities rather than their disabilities.
According to Donna Douglass, people who see the On Stage! troupe perform leave with an entirely new impression of the abilities of people with mental illnesses. "The audience witnesses firsthand the results that can be achieved by consumers if they are given the opportunity to develop their potential. Stigmas and myths are dispelled by the professionalism and talents demonstrated by the performers and the unbelievable energy and enthusiasm communicated to the audience," she said.
Filkins said that the Voices troupe's performances help to debunk another misconception: that the people employed by peer-support services and other consumer-run initiatives (i.e., people who are themselves consumers of mental health services) do not "really " have mental illnesses. "People have said, ’If you were really mentally ill, then you couldn't do this.'" To help prevent this type of misunderstanding, she now makes a point of announcing before the troupe's performances that all its members have experienced serious mental illnesses and periods of hospitalization.
Art programs also provide a venue for discussing an entirely different stereotype: that people with mental illnesses are all unusually creative. This stereotype is probably fueled by widespread accounts of artists, musicians, and writers who have had mental illnesses, including Vincent van Gogh, Ludwig von Beethoven and Virginia Woolf. Showing artwork by people with mental illnesses demonstrates that they have a wide range of interests and talents, just like everyone else.
Methods for Using the Arts to Promote Acceptance and Reduce Discrimination
Some of the programs described in this booklet have become very successful in generating exposure for their artists and for mental health issues. However, most art initiatives, including some of those described here, start out as small, community-based efforts and grow through hard work and dedication. Some general ideas for starting an arts initiative are:
- Look for a sponsoring agency that is willing to support an arts initiative. Many of the projects described in this booklet have received space from provider agencies or faith or community groups, as well as other assistance, including help purchasing needed supplies.
- Recruit volunteers who are willing to share their artistic talents. Although some of the art described in this booklet is true "outsider art," created by people with no formal training, most artists benefit from lessons or less formal interactions with trained artists. ("Outsider Art" is a term coined by art critic Roger Cardinal in 1972 as an English synonym for Art Brut, which literally translates as "Raw Art" or "Rough Art," a label created by French artist Jean Dubuffet to describe art created outside the boundaries of official culture. Dubuffet focused particularly on the art of people with mental illnesses.)
- Develop contacts within the local media. Many local publications and television stations have covered arts initiatives for mental health consumers, because they make interesting news and raise awareness of mental health issues. Even national media outlets such as the Associated Press and CNN have covered artwork created by mental health consumers.
For more specific information about starting arts initiatives, the publication Reaching Across with The Arts: A Self-Help Manual for Mental Health Consumers offers much helpful information. Included are detailed suggestions for starting specific types of initiatives, including art centers, theatre groups, art shows, talent shows, writing groups, publications and service businesses such as graphic design, printing, and framing.
The following suggestions are meant to give arts initiatives ideas for effectively increasing social inclusion and addressing discrimination through the arts.
Display consumer artwork in mental health treatment facilities or administration buildings.
Displaying artwork in mental health facilities provides a means of reducing negative attitudes and discrimination within the mental health system by providing a positive example of consumers' abilities to administrators, providers, family members and other consumers. In South Carolina, the Art of Recovery Project started as an art gallery within the State's Department of Mental Health's administration building, and, in North Carolina, Brushes with Life started as an art gallery in a psychiatric hospital. The displays sent the message to consumers that their talents were appreciated, helping them and their family members feel welcome. Displaying artwork can also remind providers and administrators of consumers' abilities: 9Muses Art Center has several pieces of its members' artwork hanging in a conference room used for many high-level meetings of administrators and providers.
Provide opportunities for consumers to display their artwork in studios, shops, or art shows.
Although displaying artwork in mental health facilities fulfills an important role, many art programs also make efforts to reach the general public, in order to combat widespread misconceptions about mental illnesses. Visual art programs such as Brushes with Life, 9Muses and Art of Recovery have all displayed artwork in places open to the public, including art shows and studios, libraries, museums and festivals. Often businesses such as coffee shops, restaurants and bookstores allow artists to hang their work in rotating displays that last a month or two, providing an excellent chance for exposure.
Organizers of arts programs stress the need to develop contacts within the local art community, studios, libraries, faith communities, civic organizations and businesses, and to keep in touch with those contacts. If the program has not displayed its artwork in a particular venue in a while, a phone call could lead to opportunities for exposure.
Provide opportunities for consumers to sell their artwork in studios, shops or art shows.
In addition to generating awareness of mental health issues, displaying visual art publicly also provides an opportunity for artists to gain confidence by selling their artwork. Since the Art of Recovery began displaying its artwork in a public library gallery, sales have jumped, propelling at least one artist into a career as a professional artist. The 9Muses Art Center sells framed and unframed artwork of the artists, who keep a significant percentage of the proceeds.
Perform for provider agencies and professional associations.
The performing arts lend themselves especially well to training opportunities for mental health providers, such as conferences and symposia. Creating alliances with service providers can be useful because staff require periodic training. The Voices troupe in Massachusetts performs frequently for providers' professional associations and also performs for the staff of provider agencies as a form of in-service training, helping staff learn more about the personal experience of mental illness, treatment and recovery. Many mental health professionals also attend the performances of the On Stage! troupe in Washington State, and some providers participate in the theatrical productions.
Collaborate with local universities.
For the Voices troupe, local universities provide an opportunity to educate future providers about mental illness, treatment and recovery from a consumer perspective. The troupe performs frequently for undergraduate and graduate psychology and social work students. Collaboration with universities' art or theatre departments can be a mutual learning experience. Donna Douglass noted that theatre students at a local college teach twice-yearly classes in improvisation and mime to the members of the On Stage! troupe, and discover that their beliefs about people with mental illnesses are inaccurate.
Collaborate with arts groups.
Creating partnerships with the local art community can help artists hone their talents and can also lead to additional exposure. Many arts programs feature guest artists who either teach classes or share their ideas informally. Networking with local organizations supporting the arts can also help keep a program aware of any display or performance opportunities, such as local festivals. A collaboration with the South Carolina Arts Commission, which assists in judging the Art of Recovery competitions, has helped lead to a measure of prestige for winning artists.
Perform for audiences including schools, faith communities, and the general public.
Civic organizations and schools often welcome performances and can provide both a stage and a ready audience. Students are usually receptive audiences since any misconceptions they have about mental health issues tend to be less deeply ingrained than those of older people. In addition to its big annual show at the performing arts center, the On Stage! troupe gives performances for nursing homes, hospitals, service clubs, and churches. Performing for smaller groups often leads to excellent group discussions.
Enable consumers to create artwork alongside members of the general public.
Jan Anastasato believes that even with the widespread exposure generated by displays of its members' artwork, inviting members of the public to become members of 9Muses has had perhaps the greatest impact on discrimination and stigma. She noted that consumers and non-consumers have worked alongside each other and engaged in conversation, and that as a result many labels have been shed. "We no longer have to explain who we are," she said.
Rehearsals allow ample opportunity for performers to get to know one another. The On Stage! troupe assembles diverse casts to encourage interaction between consumers and non-consumers. At its largest event, the annual show at the Metropolitan Theatre for the Performing Arts in Spokane, "volunteers participate as cast members, backstage staff and lobby personnel while local performing artists participate as members of the ensemble and featured guest artists. The last major public performance had a cast of 60: 13 consumers and 47 community volunteers," said Donna Douglass.
Create opportunities for audience members to meet with consumer artists or performers.
Although the On Stage! troupe distributes mental health information at all of its performances, smaller audiences provide opportunity for in depth discussion. "The director has the opportunity to talk about the program and how it relates to the recovery movement," said Donna Douglass. "Successes of current cast members are highlighted and consumers can talk about the benefits of On Stage!, focusing on how the performing arts experience has changed their lives. The smaller venue also provides the opportunity for attendees to ask questions and talk directly with cast members."
Feature artwork that conveys the experience of mental illnesses through visual art, performance, or song.
By offering a series of short skits in its performances, the Voices troupe attempts to portray the feelings associated with various mental illnesses. The troupe also provides personal perspectives on treatments in skits such as "Meds, Glorious Meds," which addresses overmedication. Although the feature films shown by the group Movie Monday are not necessarily made by consumers, they often depict mental health issues, and such films tend to spark lively discussions afterward.
Provide educational materials about mental health issues.
Art shows or performances also provide a great "hook" for getting people interested in mental health issues, and therefore provide excellent opportunities for distributing educational materials. When the On Stage! group performs for audiences of several hundred people, said Donna Douglass, "attendees learn about mental illness and the recovery movement through program notes and handouts available in the lobby. There is also a display table with pictures, posters and research study summaries."
Create awards for outstanding artwork.
In South Carolina, the Art of Recovery program sponsors periodic competitions, which anyone receiving services from the State Department of Mental Health can enter. Local artists judge the competition, and the top three winners in each round become members of the "Order of the Brush." Sue Perry said, "The award winners see it as a prestigious recognition."
Corrigan, P.W. & Penn, D.L. (1999). Lessons from Social Psychology on Discrediting Psychiatric Stigma. American Psychologist 54, 765-776.