Evaluation of Artworks Royal Aberdeen Children’s Hospital 2006 – 2009 June 2009 Delday and Douglas, rgu insert Insert rach rgu art logo logo

5.2.6 Negotiating the end product
Practice as artist and designer

The artist was trained in interior design though her practice seemed to straddle two disciplines - interior design and art. The coordinator observed this, describing her as being ‘on the cusp’ between the two.

‘… she has a fine artist approach in the way she consults, the way she talks to people and the way she really niggles what goes on in a department and then she’s got an interior design finish (final artwork/installation). She got under the skin of finding out the bits that really needed attention – “making the space loved” – (in the artist’s vernacular).’
From the outset and continuing throughout the process the artist drew from many people, all contributing in terms of directing her thinking and the resulting final product. On occasion someone would have a big effect on the direction of the work. For example one of the mums suggested having the two waiting rooms with two different themes, so that people could choose which one to go into depending on your ‘mood’ or feelings at the time. The same mum also suggested that child-friendly public spaces were rare and could often be ‘patronising’ and this helped influence the artist’s ideas for the exterior (and echoed some of the staff’s concerns about not drawing too much attention to the building through using bright primary colours). One of the autistic children influenced the making of the kaleidoscope image (installed in a meeting room) through his interest in ‘splashes’ and his favorite toys. This image became a real favorite of the staff and was installed on a meeting room wall.
The artist presented design ideas (visuals) to staff, children and family members and to Studio 77.

Staff were very eager to see and discuss the ideas and she spoke to them one-to-one making notes of their responses and incorporating them into the final ideas.¹⁹ There were many in-depth discussions. For example, reviewing different kinds of furniture and considerations as to how comfortable and relaxed or how formal the seating should be and where and how it would be used - the waiting areas, meeting with clinicians, and whether this was one-on-one or as a family meetings. Another example was where the staff representative didn’t want to loose the ‘words on feelings’ because they had ‘generated so much positive feeling amongst the children’ and the artist later incorporated these as individually framed pieces within the overall installation.

The final installation includes new signage on the CAFMH entrance and artwork on the exterior walls of the building; artwork along the corridors, in two waiting rooms and two meeting rooms along with new furnishings and interactive activities of the children families. (ILLUSTRATIONS)
5.2.7 Completion of the project: reflections on process and responses to final artwork
Relationship between staff and artist as key to a successful project

The Art Group and the coordinator appreciated that the productive relationship between the staff and artist had resulted in such a successful project – the building had undergone a ‘transformation’ from the improved exterior (entrance) right down to the fine detail, such as colour-coordinated lego. The staff’s ‘generosity, support and encouragement’ had been fantastic and this had resulted in the artist giving ‘the extra percentage’ to the project. The staff had given her the dialogue she required as well the practical support. The Art Group were delighted with the final result, a ‘colouful, fun-filled and welcoming environment for children, families and staff.’ It was also recognised that the artist was ‘ideally suited’ to working in this context and also to her having qualities of perseverance and determination.

The most thorough consultation process and biggest project challenge to date

The artist enjoyed the whole experience because the staff had welcomed her and ‘really wanted her to be there’. They had fully supported her, were ‘open to change’ and ‘eager to be involved at each stage of development’ and ‘extremely positive’. Because the project lasted for over a year she was able to ‘bond with different members of staff’ and their attitude and involvement made her ‘stretch the possibilities and budget’ to the full so that she ‘could give them something that would truly make a difference to how the space felt’.

The experience had been hugely rewarding for her and the project was one of the most challenging in her career. The creative consultation was ‘the most thorough she had ever been involved in’ and yet this had ‘led seamlessly into the final artwork’. It was the first time in any commission of this scale that she had used so much of the participants’ imagery with this becoming ‘the backbone of the work’. There was also a ‘flow’ in the way ideas developed. She describes an example:
‘Simple things, like a participant saying that it would be great if she were able to create a private space for her and her child if another family came into the waiting room, led me to the idea of using the walls as creative spaces, having a chalkboard, Lego board, and magnetic board, so that people could have their backs towards others in the space, therefore creating their own space without it seeming rude. This in turn meant that there would be no mess left on the floor, which meant less tidying up. This in turn triggered the idea of the Lego in the drawers being colour-coordinated with the space, so that when it was displayed in the display squares, or left on the wall, it fitted in visually with everything else.’
The commission took more time and resources than she had originally imagined and became pressured at the installation stage with ‘so many facets happening at once’ (10-15 sub-contractors and suppliers and a ‘catalogue of problems with delivery and materials). However she felt that what had been achieved was well worth the ‘extra effort’ she had put in, and was proud of the work and felt that the result had given the place its own identity, had made it more child-friendly ‘without being patronising’ and visually it was ‘bold without being overbearing’.²⁰ She had wanted to change how people felt in the space and how they interacted within it and she had the opportunity to observe this and was extremely pleased to see people use their imaginations, and come up with their own ways of interacting in the space. For example, when a restless child wanted to leave and his mum started playing a game of finding lego heads hidden in the images on the walls. Another example was where a whole family was in a waiting room, the dad was with the child and the mum with a second child, each working with different activities in a relaxed, at ease and conversational way.
The artist was also pleased the staff felt proud of what had been achieved. She believed that, because they had been so involved in the process, ‘they had added interest in it staying looked after’ and felt confident that they would take care of things and contact her in the event of anything needing to be fixed or replaced in the future.²¹
Benefits and value of the project for the service users and staff

Responses (i.e. interviews) from staff about the process and the completed installation were conducted approximately 2 weeks after the installation was completed.²² All the responses were extremely positive in terms of the way the artist worked with themselves and the service users, as well as in relation to the ‘complete transformation’ of their working environment. The benefits are summarised as points made by the staff interviewed i.e. the staff representative (consultant psychiatrist), two other consultant psychiatrists, clinical psychiatrist, medical secretary and mental health clinician.

Process

• The art project helped push forward the planned refurbishment that had been promised for a long time. This in turn boosted staff moral in that ‘change was possible’ and forced them to ‘step out of their comfort zone’ and ‘take ownership’ of the project to make change a reality.

• The workshop activities and visible presence of the project happening created a ‘buzz’ and a feeling anticipation of change.

• The consultations with staff, through workshops and discussion, helped them see how to improve their working environment (i.e. things that as clinicians they had not considered)

• Participation in the workshops had helped children with their sense of self-esteem and confidence.

• Workshop activities could act as motivation for children to come to Rosehill (get out of the house) and be opportunities to ‘practice management strategies’

• A number of children taking part in the workshops were better able to cope with the issues they were dealing with at the time. For example 1) a child with severe anxiety problems had taken part in the workshops and this had helped him gain confidence and cope with returning to school. It was possible that without the benefits from taking part he would have been prescribed medication to help him with his anxiety. 2) specific activities gave parent and child a relevant and shared experience useful to the work they were doing i.e. adding to the clinicians’ strategies for managing self-expression²³

• The workshops encouraged meaningful dialogue between children and the family members (e.g. was thought provoking).²⁴

• The workshop activities were excellent for children with autism where (typically) looseness of the joints make drawing/writing difficult

Product

•The entrance for CAFMH is more clearly identifiable and ‘more welcoming’; however, it is not garish or too bright.

•The layout of the department (on two floors and shared with other NHS Grampian offices) is visually coordinated making it easier to navigate.

• There is a pleasing and useful balance throughout the building with distinct areas that are visually stimulating, others that are visually more calming, and areas that remain very clinical (i.e. no artwork).

• The look and atmosphere of the whole environment has helped to reduce the stigma attached to mental health from the children’s perspective (e.g. an example of a child taking photos of Rosehill to show at their school) and from the parents’ perspective as observed in the increased conversational and relaxed atmosphere in the waiting rooms and family or group meeting rooms.

• There are more, and appropriate interactive activities for the children which have helped to keep them occupied. For example children are now playing in the waiting rooms and this has helped reduce stress levels and creates opportunities for children and parents to interact together.

• An effect has been to ‘almost hide things’ (e.g. drawers in the storage solutions) which encourages children ‘to explore’. This also reflects an ethos of the department as ‘a learning environment’.

• The reorganisation of space and the use of new furniture in the waiting rooms allows for more privacy when people share the room and thereby reduce some of the awkwardness for families whilst waiting.

• The waiting rooms have encouraged more conversation and is a more relaxed environment which (hopefully) is reducing the ‘stigma attached to mental health’.

• The waiting rooms give ‘a clear message of who is important’, i.e. parents get the impression that the emphasis is on the child and not on them.²⁵

• The ‘child-friendliness’ of the installation has led to a significant improvement in compliance (i.e. children willing/wanting to come back to Rosehill House).

• The kind of imagery on the walls (Lego, dinosaurs flowers etc) is felt to be appropriate for boys and girls and, for all ages. They are considered ‘universals’ which adults can also relate to. The absence of faces and people in the imagery is beneficial for children with autism (who find it difficult to relate to faces and emotions).

• The artwork on the walls has created the opportunity to use it playfully (e.g. families inventing games of finding images).

• For the clinicians the imagery on the walls helps with distraction and reduces stress levels especially when taking children with learning disabilities through the long corridors to the testing rooms. This often made the children extremely anxious with stress levels ‘going sky high’.²⁶

• Children felt ownership of the installation by recognising their own images in the ‘trails’ of imagery on the walls.

• Staff felt ownership of the installation where parts of the imagery/installation ‘belong’ to a member of staff (e.g. a specific image on the clinician’s door, a framed word made by themselves, a suggestion taken on board).

• Staff are actively using the environment in different ways:

They can choose between the two meeting rooms each having its distinct mood or atmosphere - one with warm, vibrant (‘energising’) colours, and one with cool calmer colours. The cool blue room was felt to be especially good for children with learning disabilities. Sometimes staff choose to use a meeting room instead of their own rooms because these are so much better.

The new furniture and layout in the two meeting rooms has created a better environment for families working with clinicians. They have two co-existing areas - one where children can be occupied and one for adult conversation.
Children are using the bean-bags which helps creates a better (‘cozy’) conversational dynamic between the patient and clinician. An example was a girl who could ‘lie back and relax and she could talk about some very difficult stuff’.

The storage solutions have made the day-to-day work easier for the staff (better organised, less clutter, being able to take a drawer full of toys to their own rooms).

• The way the children use the interactive activities (magnetic boards, Lego, chalk boards) is interesting and useful from a clinical (i.e. therapeutic) perspective. For example, observing children’s behaviour such as obsessive tidying, observing how they express themselves making words using magnetic letters where they don’t have to write which is helpful, as well as expressing things they may not want to talk about.

• Staff are looking forward to how children (and families) will continue to find news ways of using the activities and ‘inventing games’.

• Staff moral has been hugely boosted and they feel very proud of their environment. It has given them the motivation to ‘carry on and get other bits of the building developed’. They feel that Rosehill now has ‘its own identity’, is much more child-friendly and reflects the aims and the strong team spirit they have as a group.
5.2.8 Learning from the experience
The Art Group recognised that the good relationship between the artist and the staff had led to a fantastic result that went beyond everyone’s expectations – their own, the staff’s and the artist’s.
Developing an appreciation and confidence to voice an opinion (youth group)

Some of the external youth group members (Studio 77) learnt new artistic techniques and had the experience of a large complex project. However, overall, they preferred the community art-style project with the artist living locally enabling much more regular contact, and with their work more clearly (i.e. visually) being part of the finished product. This was also the view of the youth group leader. Importantly, she explained that, by being involved in two RACH projects, with two different styles of working, had given the young people the experience and confidence to have and express opinions. They were learning how to express themselves:

‘Being able to appreciate why you don’t like something (in art – and life!!), and be confident enough to speak up, is a valid skill.’
From her own perspective she felt that she had a personal stake in the RACH project. Having been a parent with a child in intensive care ‘it was the most amazing feeling to be able to give something back to the hospital through Studio 77’s involvement.’
The RACH event (28^th March 2009)

The Art Group decided to host an event to mark the completion of the programme and launch a publication ‘celebrating’ the completed artworks.²⁷ Key people were invited for a half day where groups could be taken by themselves (with staff assistance) on 3 different tours to see the artworks in the different departments. The external youth groups and project partners were invited and this would be (for all of them) the first time that they would see the final work.²⁸ Studio 77 were asked to make a presentation of their involvement in the project. (This idea by the coordinator was partly in response to the fact that they did not seem to understand their part in the process). Two of the group were able to attend and were asked about the project having now seen the completed work. Both responded enthusiastically saying that they ‘were proud to have been involved’, it was ‘fantastic to be involved from start to finish’, ‘loved it when we walked in and it was just there. It was just like her computer pictures and to actually see it in the flesh was amazing.’

Asked if they had learnt anything from the experience both said that they had - ‘about the process from the start to the finish in a project of this size and complexity’ and ‘that you don’t have to just go with some pretty pictures on the walls you can use the walls as a canvas.’ Using material from the workshops one of the girls learned presentation skills by making a ‘comic strip’ to tell the story. (ILLUSTRATION)
Also at this event feedback (from children and adults) was gathered from the visitors as ‘postcard comments’ (37). This gave broad set of responses to all the new artworks throughout the hospital. Every response was positive. (See Appendix)
(ILLUSTRATION OF SCANNED IN RESPONSES)
Selecting an artist – reflections on a successful process

Initially the staff representative had been anxious about selecting the right artist and spoke about the ‘vital importance’ of the (RACH) selection process. Clearly this involved selecting an artist that could work with the children and themselves. Reflecting on (the success of) the project she thought it crucial that when the artists ‘say they believe in consultation that they genuinely mean consultation.’ She explained that, for Rosehill staff, ‘artist was a new concept’ having never worked with one before and that by being ‘a bit naïve’ and ‘not having preconceptions’ was quite helpful in that they could ‘take directions’ from the artist. Equally, knowing that the artist did not know their children or families ‘highlighted’ the kind of information they needed to communicate to the artist, and that she needed to ‘be amongst’ them to learn from them. So, in order for the project to succeed, ‘a huge amount of openness was required from both sides’. It needed staff to take ownership - ‘to take it into their hearts’. It was also about keeping ‘very open lines of communication’ and ‘being available’. In short, it does take a ‘huge commitment from both sides’ (a practical and ‘emotional commitment’) to make it succeed, but is a ‘very worthwhile’ thing to do and she would recommend it to any department.

On reflection she thought that what had been achieved in the project was reflected in the artist’s ethos of ‘making the space feel loved and cared for’ and this was completely appropriate with the aim of the service ‘to make people feel better within themselves and accept themselves’ so there was ‘a common understanding of what might work’. She explained that (in future) she would ‘not find it rewarding to work with an artist where the art is about the artist and not about the interaction’ between artist working with others. Interestingly she commented that the aesthetic of ‘dinosaurs and flowers side-by-side’ really worked well, and had someone described this at the outset of the project she would never have believed that it could possibly work. She felt that what the project had done, and the artist’s way of working was to re-affirm something that they had ‘forgotten a bit’, – that ‘children like to have fun’.
Time management and scheduling

The staff representative felt that the time management of the artist could have been handled a little bit better by the coordinator. The delay in the planned time for installation meant there was added pressure on the artist (and herself) to complete the project in time (i.e. 28^th March). She felt that scheduling was very important because the artist was also ‘being a little experimental’ in what she was attempting and this needed ‘time to allow for potential designs to fail’ and also if there was a need to re-order things (e.g. furniture). It was also ‘a learning process for the artist’ and she was impressed by the artist’s ‘refusal to compromise’ over aspects of the installation. She thought that more of the background work by the Estates Department (e.g. painting, replacement of windows, removal of wallpaper) could have been coordinated better, i.e. completed before the installation was underway.

Future work by artists

Parents had asked the staff representative if the artist’s workshops could continue, particularly during the summer holidays. (These workshops would not necessarily become part of the installation). Parents valued having something worthwhile they could do with their children and that did not cost a great deal of money. At the very least workshops could help motivate a child to get out and take part in something and for some children making anything at all was a huge achievement. Another clinician (a view voiced by other staff as well) commented on the ability of an artist to see aspects of their working environment that could be improved that they as clinicians couldn’t, and she wondered whether an artist might do further research on toys suitable for different age groups.

Interestingly all the staff, on being asked about a (hypothetical) future project, were very keen and almost everyone described this as a continuation of the existing work – particularly taking the installation into their own rooms where they often meet with service users.
Limitations impacting positively on the aesthetic

The restrictions the artist faced in the Lowit unit of not being able to ask children about their feelings led to her developing the colour spectrum idea by incorporating the children’s photographs (‘photographic colour spectrums’) as final artwork. This was something she had not done before and this idea became essential to the final aesthetic and ‘the linchpin of the project’ in Rosehill House.

The artist learnt that the ‘care and passion’ of the staff to change the space had had ‘a profound effect’ on her and her ‘desire’ (and effort) to fulfill the requirements of the brief. The project experience had fuelled her passion and belief in the value of art in public spaces (in its wider sense) to make real and lasting difference – particularly in hospitals because of the therapeutic benefits it can produce.
She felt that (in the future) the coordination of a programme of this scale (9 commissions) would require a full-time arts coordinator or two part-time people.

5.2.9 Summary of findings
(Focus: 2.1)

1. The impact of the artist on the environment

2. The effectiveness of the creative consultation

3. The appropriateness of the artwork to the users, reflecting the diversity of age

groups attending.)
Process and product

The staff representative had four main concerns at the outset - the importance of selecting an appropriate artist, the final artwork should not be too over-stimulating for the children, the project not disrupting clinical routines and completing the project on time. The rigorous commissioning process ensured a suitable artist was engaged who worked sensitively and skillfully with children and families. She fitted in and worked unobtrusively becoming ‘part of the team’. The final installation was a major transformation of the building, making parts of the building stimulating and other areas calmer and others left as purely clinical. Only the concern of completing the project on time became a reality and led to rush at the end (completion was delayed by 3-4 months).

The success of the project was in part due to the staff’s motivation – the need and desire to improve the building. It was also their support for the artist in ‘hosting’ the project that ensured a close productive relationship. They were ‘open’ to each other’s ideas and suggestions and shared a ‘common understanding’ in terms of what the art project might achieve. It was a genuine collaboration in terms

of both acknowledging each other’s expertise and taking guidance from the other. Because of this both ‘gave 110% effort’ to make the project succeed.

The project was felt to be extremely successful in terms of involvement and enjoyment by children, families and the staff. With the artist working one-to-one everybody felt part of the project and fully consulted, with different people benefiting in different ways. Similarly individuals felt ownership in different ways – from a child recognising an image they had made, to a staff member making a clinical suggestion on how something might or might not work. The external youth group learned from the experience and were very impressed with the finished work, though this type of project was not their favourite by comparison.²⁹
The impact of the project (process and product) was considerable in terms adding value to the service. The therapeutic benefits of taking part in the workshop was felt by parents taking part in the process with their children. Staff saw the workshops as significantly contributing to their clinical aims and methods (e.g. increased confidence and self-esteem and returning to school, strategies for managing self-expression, reduction of stress). The artist made the process ‘accessible’ and ‘understandable’ and some parents asked staff if art workshops could be available in the future, particularly during the school holidays.

The impact of the installation (artwork on the walls, new furniture and interactive activities) was felt to be a complete transformation of the whole clinical environment. It was like ‘night and day’. Children, families and staff were all using the building in different ways and staff felt proud of their environment. The building was felt to now have its own identity giving an appropriate message of being welcoming and child-friendly (i.e. ‘non-threatening’ and not so institutional looking). The installation had, to some extent, helped reduce the stigma attached to mental health and clinicians observed an improvement in compliance (people returning) as well the therapeutic benefits of staff being able to use the installation in their day-to-day work. The project went beyond the staff’s initial hopes and expectations.

The project was the biggest challenge for the artist to date (the most thorough consultation and complex at the installation stage) and she was very proud of the results. The consultation directly influenced the final aesthetic and contained more participants’ work than in any other project she had done and the staff’s enthusiasm and support meant she responded giving that extra effort to stretch her efforts and maximize the budget. It is significant that the extent of the work installed was possible because the project budget, originally for two locations, was used for just this site.
The ambition of the brief and an unexpected outcome

The original brief was for work in two sites (Rosehill House and Lowit Unit) and this did not work out (see 2b). One of the aims in the brief was to ‘join the two sites visually’, and in an unexpected way it did. The limitations experienced by the artist in the Lowit Unit i.e. not being able to ask the children about their feelings (e.g. workshops making words on feelings) led the artist to change her process and use more photography which was made into colour spectrums. This was not only a change to her usual process and visual style, this became the ‘linchpin’ or ‘backbone’ of the aesthetic and overall look of the installation in Rosehill. Incorporating the photographs taken by the children as content was important in terms of the children recognising their part in the process (recognising their photo in the installation) and, a key to the way the artwork was used e.g. inventing games with the imagery, such as ‘go and find’, and the way the images and new interactive activities, such as Lego, linked.