This post was co-authored with Professor of Psychiatry Philip Asherson. A shorter, abridged version was published on The Conversation as ‘How ‘lofty’ art can help the medical world reimagine mental health’, on 31 October 2018, which was the last day of ADHD Awareness Month. The article was read more than 2000 times within 2 days of publication. Caption for featured image above: Andrea Bilbow OBE (ADHD Information Services ADDISS Executive Founder, ADHD Europe President) performing at Brisk/Risks, #MagicCarpet’s Open Mic event. 4 December, Bush House Arcade, part of King’s Together group exhibition. Standing next to her is Jacqui Beckford, who interpreted her words into British Sign Langauge. A short film version of the event will premiere in March 2019 at the Reading University, where Kai and Philip give a talk, hosted by Professor of Social Pharmacy Kath Ryan. 

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Thinking outside the Pillbox

We are amidst a global mental health crisis, states an 2018 review by the Lancet medical journal, and our ‘collective failure’ to respond to this results in ‘monumental loss of human capabilities and avoidable suffering’. 20 antipsychotics and 30 antidepressants developed over the past four decades have not improved morbidity or mortality of mental disorders. In England, mental illness costs £105.2 billion annually. People consider the stigma around mental health worse than the illness itself.

To bring about policy and culture change, we must think outside the pillbox. The excellent All-Party Parliamentary Group on Arts, Health and Wellbeing inquiry report puts forward a robust argument for how the arts can ‘stimulate imagination and reflection’ and ‘change perspectives’, through for instance case studies of how art therapy can improve conditions like dementia. Focusing on the efforts of the non-profit arts sector, and concerned with the quality of the artistic activity ‘rather than that of the output’, the report rejects art that is ‘lofty activity which requires some sort of superior cultural intelligence to access’.

But why should art of the ‘lofty’ variety be excluded from this conversation? Surely different types of art and different efforts should also chip in to help rectify our collective failure. As well as the quality of the artistic activity, the quality of the artistic output could also be a salient part of transforming how we see mental health, so that it is not shameful and not negative. Art stimulates and changes perspectives because it engages and develops cultural intelligence.

Illness as methodology

As the Research Councils argue, a ‘major societal challenge’ like mental health demands ‘novel’ cross-disciplinary efforts. Our own novel approach is to bring visual art practice in dialogue with Attention Deficit Hyperactivity Disorder (ADHD). ADHD presents a powerful case study and methodology both because it is classified as a mental disorder, and because the problems surrounding mental health are amplified in ADHD. Affecting 3-4% of adults worldwide, ADHD is characterised by inattention, distractibility, disorganisation, over activity, restlessness, impulsiveness and mood dysregulation — put another way, people with ADHD have high-level energy, extraordinary creativity, out-of-the-box thinking and spontaneity.  There are thus instances of successful individuals with ADHD such as Olympian gymnast Simone Biles and comedian Rory Bremner. ADHD is invisible not just because it is a non-physical condition, but is hidden from public discourse and imagination. If at all mentioned, we speak ill of it or mock its existence, linking it with male criminals or bad parenting. With two ‘d’s in its name – ‘deficit’ and a ‘disorder’ – ADHD can only be mired in stigma. No wonder ADHD – and psychiatry – seem ostracised even within the medical sector. ADHD’s bad press is something that efforts like ADHD Awareness Month, which falls in October, aims to counter. The arts in conversation with ADHD is compelling also because related conditions like dyslexia contribute to an over-representation (30%) within the arts, yet many in the sector seem to distrust the medical models of health. ADHD thus presents a fertile starting point to consider how we (mis-)understand mental health.

Kai and Philip in Conversation at the Unlimited Festival, Southbank Centre 2018.
Photograph by Studio Maba for #MagicCarpet.


Productive Antagonisms

Our own conversation began when Kai, an artist, wanted to learn about ADHD, including her own. She approached Philip, a global authority on ADHD. Art is Kai’s process of interrogation, disruption and dialogue. Our public conversation is entitled #MagicCarpet. As the first artist-in-residence at the Social, Genetic and Developmental Psychiatry Centre at King’s College London, Kai attends seminars and takes part in research protocols. A key output is a tapestry art installation, which people can sit on to chat and make drawings about their mind. #MagicCarpet thus invents a creative space for people to discuss (their) mental health.

29 exhibitions, presentations and workshops on, it has been a revelation. Sat shoeless on the #MagicCarpet, clinicians confess their own ADHD and mental health issues, which motivated their interest in the field. The work is contributing to both local and national training with health care professionals and researchers. We created a diagram for an article in Neuroscience & Biobehavioral Reviews journal positing a new framework to understand ADHD. At the recent 5th European Network for Hyperkinetic Disorders Conference (EUNETHYDIS), we invited the 500 researchers and psychiatrists to consider #ADHDart created by #ADHDwomen. We have also designed a proposal for an unusual PhD programme investigating the public perception of ADHD through creative practice. Perhaps #MagicCarpet’s greatest contribution lies in its gathering people from different sectors – and thus with distinct bodies of knowledges and practices –to generate new insights. Researchers, arts and health professionals, service users applaud its ‘productive antagonisms’. #MagicCarpet encourages ‘everyone to step outside of their comfort zone’ and creates a ‘family’ for people with ADHD – because the tapestry is ‘beautiful’ and ‘screams’ for your attention. On a photo montage from the project that was awarded the National Centre for Coordination of Public Engagement 2018 Images Competition for ‘Culture Change’, the judges say that ‘[The work captures] the spirit of culture change: an animated group challenging established ways of framing disability, challenging the old with the new, taking risks. [It captures] vividly what it feels like to be caught up in the thrill of creating new knowledge which challenges and changes the world’. Working across sectors and disciplines and artfully mixing things up, perhaps in what could be called an ‘ll-disciplined’ approach, can disrupt the status quo.

#MagicCarpet at the Art Workers’ Guild, 2018. Shot by Marco Berardi for #MagicCarpet.

Towards cultural change

Art is no magic bullet. Yet, with its propensity for play and ambiguity, it can open up new spaces for us to ask new questions. Our work joins in other examples of co-creation and sharing of knowledge through well-made art, like The Heart of the Matter, a creative exploration of the heart, and Hubbub , which explores rest, noise and tumult led by Professor in Social Science in Medical Humanities Felicity Callard. Let’s work towards culture change. Let’s re-imagine mental health through visual art practice in conversation with ADHD.

Professor Philip Asherson MB, BS, MRCPsych, PhD is Professor of Psychiatry at the MRC Social, Genetic and Developmental Psychiatry (SGDP) centre at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London in the United Kingdom. Since 1996 when he moved to the IoPPN he has worked closely with Professor Jonna Kuntsi to develop a program of research on clinical, quantitative and molecular genetics of ADHD. In his own work, he has a particular focus on adults with ADHD. Current research projects include investigations of the neural basis of mind wandering in ADHD, clinical trials of prisoners with ADHD, and the impact of ADHD on learning in University students. He is the author and co-author of more than 300 articles and book chapters on ADHD and other neurodevelopmental disorders and traits. 


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