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Background: Emerging evidence indicates that poor mental health and loneliness increased in the UK population during the COVID-19 pandemic. At the same time media reports suggested increased public engagement with arts and culture during the lockdown period. Aim: To explore the levels of and impact of arts engagement amongst staff and students from one UK university during the first pandemic lockdown. Methods: 112 staff/students completed an online survey which asked about their arts engagement and invited them to write a haiku about their lockdown experiences. Findings: Participants engaged in a wide range of arts, cultural and creative activities; some engaged more frequently and/or in new activities. Participants reported having more time and opportunity to undertake such activities, and these activities improved their mental wellbeing and facilitated social connections. Forty-seven participants wrote a haiku, and it was evident that the haikus provided a different perspective on lockdown experiences, enabling the expression of emotions including fear, loneliness, and a lack of freedom, as well as hope and optimism. Conclusion: Haiku poetry added nuance and complexity to the themes on engagement and impact of arts, cultural and creative activities, which supported mental wellbeing and social connections through the first UK lockdown.

Reducing physical intervention in mental health inpatient care is a global priority. It is extremely distressing both to patients and staff. PROMISE (PROactive Management of Integrated Services and Environments) was developed within Cambridgeshire and Peterborough NHS Foundation Trust\ud (CPFT) to bring about culture change to decrease coercion in care. This study evaluates the changes in physical intervention numbers and patient experience metrics, and proposes an easy to adopt and adapt governance framework for complex interventions.\ud PROMISE was based on three core values of: providing a caring response to all distress; courage to challenge the status quo; and coproduction of novel solutions. It sought to transform daily frontline interactions related to\ud risk based restrictive practice which often lead to physical interventions.\ud PROGRESS (PROactive Governance of Recovery Settings and Services), a five step governance framework (Report, Reflect, Review, Rethink and Refresh), was developed in an iterative and organic fashion to oversee the\ud improvement journey and effectively translate information into knowledge, learning and actions.\ud Overall physical interventions reduced from 328, through 241 to 210 across consecutive years (2014, 2015-16 and 2016-17 respectively). Indeed, the 2016-17 total would have been further reduced to 126 were it not for the perceived substantial care needs of one patient. Prone restraints reduced from 82 to 32 (2015-16 and 2016-17 respectively). During 2016-17, each ward had a continuous three-month period of no restraints and four-month without prone restrains. Patient experience surveys (n=4,591) for 2014-2017 rated overall satisfaction with care at 87% CPFT reported fewer physical interventions and maintained high patient experience scores when using a five-pronged governance approach. It has a summative function to define where a team or an organisation is, relative to goals and is formative in setting up the next steps relating to action,learning and future planning.

Restraint in mental healthcare has negative consequences, and guidelines/policies calling for its reduction have emerged internationally. However, there is a tension between reducing restraint and maintaining safety. In order to reduce restraint it is important to gain an understanding of the experience for all involved. The aim of the study was to improve understanding of the experience of restraint for patients and staff with direct experience and witnesses. Interviews were conducted with 13 patients and 22 staff members from one UK NHS Trust. The overarching theme ‘is restraint a necessary evil?’ contained subthemes fitting into two ideas represented in the quote ‘it never is very nice but… it’s a necessary evil’. It ‘never is very nice’ was demonstrated by the predominantly negative emotional and relational outcomes reported (distress, fear, dehumanising, negative impact on staff/patient relationships, decreased job satisfaction). However, a common theme from both staff and patients was that whilst restraint is ‘never very nice’ it is a ‘necessary evil’ when used as a last resort due to safety concerns. Mental healthcare providers are under political pressure from national governments to reduce restraint which is important in terms of reducing its negative outcomes for patients and staff; however, more research is needed into alternatives to restraint whilst addressing the safety concerns of all parties. We need to ensure that by reducing or eliminating restraint, mental health wards neither become, nor feel, unsafe to patients or staff.

Introduction-\ud \ud Zinc Arts is a dynamic, leading arts and education charity that promotes inclusion through “arts without exception”. Zinc Arts runs a wide range of creative courses (including music, sculpture, drama, spray painting, stop-frame animation, film, and visual arts) and is underpinned by the ethos that the arts can be a very positive and powerful force in individual’s lives; awakening them creatively, inspiring future choices, providing a voice for self-expression, serving as a tool for learning, stimulating change, and resulting in a product which serves as an end in itself. \ud \ud ArtZone, a three-year arts programme run by Zinc Arts, involved working with young people aged 11-25 with or at risk of mental ill health through engaging them with a wide range of arts activities. The programme enabled Zinc Arts to deliver a mixture of six-to-ten week outreach projects to an array of organisations who work with young people in both secure and non-secure mental health services. Anglia Ruskin University was commissioned to provide a service evaluation of the ArtZone project from August 2012 to July 2015.\ud \ud Methods-\ud \ud The evaluation comprised both quantitative and qualitative methods. The quantitative strand comprised 122 ArtZone participants (across years one to three) completing measures of mental illness severity and mental wellbeing pre/post course completion, and completing a measure of course satisfaction at the end of their course. The qualitative strand comprised focus groups and semi-structured interviews with 34 ArtZone participants during years one and two of the programme.\ud \ud Findings-\ud \ud ArtZone participants significantly decreased in mental illness severity and significantly increased in mental wellbeing from pre- to post-intervention. Furthermore, participants were highly satisfied with their courses, with 99.1% rating the quality of their course as good or excellent, 96.5% indicating that the course met most or almost all of their needs, 98.3% being mostly satisfied or very satisfied with the amount of help they received and 99.1% being mostly satisfied or very satisfied with the course as a whole. Of particular importance 92.9% said that the course had helped them deal with their problems better. Furthermore, the qualitative findings revealed that the project led to a number of social and emotional benefits to participants, most notably: decreased social isolation and increased social inclusion (through an increased sense of community and connection, the development of peer support networks and friendships, increased communication and understanding); and increased mental wellbeing (through the provision of an emotional outlet, distraction, motivation, relaxation, increased self-confidence, and increased self-esteem). In addition, the qualitative strand revealed that the project sparked imagination and creativity in the participants, built new skills and competencies, and prompted thinking ahead and making future plans.\ud \ud Conclusion-\ud \ud The present evaluation has found that the Zinc Arts ArtZone project has been hugely beneficial to its participants, and has achieved its aim of engaging young people with mental health problems in the arts, enabling them to use the arts to express themselves in a safe and secure setting. The findings also support Zinc Art’s ethos that the arts can be a very positive and powerful force in individual’s lives; awakening them creatively, inspiring future choices, providing a voice for self-expression, serving as a tool for learning, stimulating change, and resulting in a product which serves as an end in itself. The project has provided opportunities for over a hundred young people in both secure unit and community settings, and their engagement with and enjoyment of the project has been clearly evident. The evaluation has shown that the Zinc Arts ArtZone project has achieved important measurable outcomes, with statistically significant improvements in mental wellbeing and significant reductions in mental illness severity. Furthermore, the qualitative findings have revealed that the project has led to a number of social and emotional benefits to participants, having an impact at both an individual and community level. The evaluation results demonstrate the importance of sustaining the ArtZone programme, so that these benefits to young people with or at risk of mental ill health may continue. Further research exploring the longer-term benefits of the courses would be highly valuable.

This report presents an updated critical review of the emerging body of literature on the value of the arts in clinical and therapeutic interventions. Based on a systematic search of the literature, there were two distinct strands of work undertaken. The first strand, builds on the seminal review undertaken by Staricoff (2004), which examined and identified a number of benefits to using arts in healthcare settings. The second strand of the review, focuses on caregivers’ perceptions of the value of the arts in therapeutic and clinical interventions.

Introduction:\ud \ud Recovery from mental health difficulties involves a process of making sense of what has happened, becoming an expert in self-care, building a new sense of purpose, discovering your own resourcefulness, and using resources in order to pursue goals. Recovery Colleges aim to assist people in the journey to recovery through education, bringing together both professional and lived experience of mental health challenges in a non-stigmatising college environment. \ud \ud Following promising evaluation results elsewhere in the UK, a decision was taken to pilot a Recovery College in Mid Essex for one year, beginning in the autumn of 2013. The North Essex Research Network (NERN), a group of current or former mental health service users, was commissioned to evaluate the pilot.\ud \ud Methods:\ud \ud Recovery College students completed measures of social inclusion and mental wellbeing at the beginning of their college attendance (baseline) and again three months later (follow-up). Demographic information was collected on the baseline questionnaire and further ratings of students’ experiences of the college were collected at follow-up. The measures were supplemented with qualitative data collected via two focus groups and an individual interview.\ud \ud Results:\ud \ud Scores on both measures improved from baseline to follow-up. At follow-up the majority of participants rated their experience of the college very positively. Additional comments on the questionnaires and the views of participants in the focus groups and interview support the quantitative results. Participants identified a wide range of ways in which their wellbeing and social inclusion had improved, and also put forward suggestions for further developing the Recovery College.