The NHS offers little help specifically for bereaved people as their care is not a government priority. In addition, our society lacks any long term support structure for the bereaved, who often feel abandoned to cope on their own after the first wave of sympathy is over.
At the Bedminster Family Practice in Bristol we decided to try out a scheme for our older patients who had been bereaved. We set up two mixed poetry and art courses called 'From Shadow Into Light', each running over a 10-week period.
We offered the courses to any of the practice’s patients who felt they wanted help to cope with a bereavement, and our local branch of Cruse Bereavement Care, the national organisation that aims to help bereaved people, also publicised the sessions.
Why did we set up this scheme?
Taboos around death and bereavement often result in the bereaved becoming neglected and marginalised, especially in the elderly population. Few organisations offer services to help the bereaved.
We discovered that there was a waiting time of several months for bereavement counselling in Bristol from Cruse Bereavement Care. This suggested that people in Bristol were seeking help to cope with bereavement but that current services could not respond quickly to their need.
GPs in our practice identified that many patients, particularly the elderly, experience social isolation and/or mental health problems following a bereavement and are therefore a very vulnerable group.
Evidence from research in the arts and health field and evaluation from previous arts groups run for patients at Bedminster Family Practice have shown that people find creative activities helpful in dealing with mental health issues such as depression and anxiety.
Also, such arts activities can improve quality of life and increase social inclusion, and the skills learned and mutual support and friendships developed in such groups can endure after the arts projects have ended.
Poetry and art
The two 10-week courses took place between November 2011 and April 2012, with about 10 people taking part in each course.
We obtained £6,000 of funding from two sources – the Rayne Foundation, a national organisation that aims to understand the needs of UK society and find ways to meet those needs, and the Quartet Community Foundation, a charity.
The funding covered all costs of planning and running the two courses and most of the costs associated with carrying out evaluation of the project. Bedminster Family Practice gave support in kind, providing a large meeting room free of charge for each session, as well as printing flyers and posters and providing admin support for the project.
A writer for therapeutic purposes, and an artist were session leaders for the courses and a volunteer counsellor trained by Cruse attended every session.
Participants were recruited via Cruse, Bedminster Family Practice referrals from GPs and through adverts in the local and wider Bristol community. Sessions were held in a large, bright meeting room at Bedminster Family Practice.
During the sessions participants created poetry and art both cooperatively and individually. They used techniques such as collage, drawing and origami, and for poetry used forms such as pantoum (in which some lines in a poem are repeated) and haiku.
We carried out both qualitative and quantitative evaluation of the first two 10-week courses. Participants completed the Warwick-Edinburgh Mental Well-Being Scale and the Texas Revised Inventory of Grief before and at the end of the course and again three months later.
The evaluation showed significant improvement in mental wellbeing scores at the end of the course for nearly 70 per cent of participants. This improvement was maintained in the majority of patients three months later.
Comments on the evaluation forms completed by participants included:
- The gathering together of people all struggling with bereavement does not sound as though it could necessarily be a positive experience, but it was.’
- ‘It’s been great…Doing artistic expression, using techniques to help us with writing and art work, having one-to-one support available, bonding with a group of varied and loving people; being heard, listening.’
- ‘It has provided ways through art and writing of expressing pain, grief and other emotions. Being in a group with others in the same situation makes it okay to do this.’
The initiative has helped us deliver a new cooperative venture between NHS primary care and a charitable organisation that could be rolled out to other GP practices locally and nationally in the future.
We have demonstrated to bereaved people how art and poetry can be powerful tools in helping them cope with their loss.
Direct feedback from participants in this project suggests that we have helped to improve the quality of life of people who have been bereaved and have experienced social isolation and/or mental health problems as a result.
As much as we would like too, we have not been able to host further courses. The only thing holding us back is lack of funding
- Dr Rice is a GP at the Bedminster Family Practice in Bristol