ReVerse - How poetry can make the NHS better

by David Gilbert

May 27, 2018

Why poetry is important 

Poetry offers a quivering attention on the present, a luminous slant on intention and a myriad of refracted potential futures. It can reframe problems and provide insights into new ways of doing things.

It is inherently a slowing down tool. And places itself in opposition to our frantic habitual natures and the almost incessant stimuli surrounding us. It is also a widely misunderstood and beautiful art form.

In order to attend to the words, the sound, the rhythm and the shifted perspectives of poetry, you have to throw yourself into reverse gear. And put on the brake.

It is all too apparent to me – in my personal and professional life – that the one thing we cannot do in the NHS is to stop. And, ironically, it is the one thing we have to do. In order to reflect on practice, in order to listen, in order to communicate, in order to share. Everyone is shouting, few are conducting any form of conversation.

Now, more than ever, we need safe places to have difficult conversations. Partly because the healthcare system is in crisis. We all know that. But also because we are unwell.

People who use services are obviously unwell. And, on top of that have to face multiple system challenges to get high quality, safe, continuity of care. The frustrations of not being treated as a human being, with healing connections add insult to injury. And, as I have pointed out many times previously, the way we ‘do’ engagement, and the wasted effort expended on mechanisms that fail to have an impact and buffer people from power, further exacerbate a ‘them and us’ culture.

Staff are increasingly distressed within a turbulent, top-down, forever changing and complex environment. Staff wellbeing initiatives are usually focused on being ‘resilient’. I once saw a poster on a wall in a NHS office: ‘Overwhelm is a choice’. As if we can lay blame on individuals with little power within the system to change things.

Arts and Health - From Narrative To Verse

The All-Party Parliamentary Group on Arts, Health and Wellbeing (APPGAHW) report stated: “There is comprehensive evidence and numerous examples of practice which demonstrate the beneficial impact of the arts. However, the potential contribution has been all too little realised”.

Most arts and wellbeing programmes focus on music, dance or visual arts. The APPGAWHW report cites 3333 references to ‘art’, 326 to ‘music’, 173 to ‘dance’, 57 to ‘literature’, 25 to ‘writing’, 18 to ‘poetry’. Few case studies come from the poetry world.

‘Narrative’ and ‘story-telling’ are becoming more valued in healthcare, but poetry is seldom utilised within learning and development, quality improvement or research. Patients may be encouraged to write ‘cathartically, or seek solace in traditional forms. Individual poets may be commissioned for broadcasting messages and a few initiatives stress verse as part of a wider movement to articulate experience. The medical humanities may nod in the direction of verse from time to time.

Poetry – an oblique strategy

Fiona Sampson highlights poetry as an oblique strategy to open new windows on dark worlds. The APPGAWH states: “poetry appeals to similar parts of the brain as song, performed poetry escapes the definitional constraints of the written word to communicate through repetition, rhythm, syntax and movement experienced in the moment”. Yet the dearth of high quality interventions that harness the potential for verse to be an instrument for wellbeing verges on shocking.

Poets often dwell on ‘darkness’ and many collections deal with ill-health, cancer or dementia particularly. But there is less frequent exploration beyond the surface of mental health (e.g. meanings of different diagnoses or types of trauma). People could use poetry to articulate meaning, make sense of their worlds in different ways in order to understand, elucidate and lay claim to the words that underpin or can prevent well-being.

Staff now share many of their clients’ problems. The APPGAWH highlights “poor-quality work combines high demand and effort with low control and reward. The main causes of sickness absence are anxiety, depression and stress. Arts engagement at work and in leisure helps to overcome anxiety, depression and stress”.

Arts and humanities should be embedded in training and professional development. Dr. Alec Grant, an independent scholar, states: “Mental health workers are un-reflexively trapped in the psychic prison of rationality. Any perceived inappropriate displays of emotion from people who aren’t patients/users is disparaged. This displays wider assumptions about the need to demarcate ‘mad’ from ‘sane’ behaviour, speaks volumes about how out of step institutional cultural mental health practice is. Emotion as a resource in MH research is disparaged”.

Poetry could explore particularly the relationships between staff and service users, so as to ‘equalise spaces’, reframe experiences, promote trust, shift dynamics and reveal shared insights.

Many people will have suffered through poor educational experiences, not be able to read or write, or will not have English as a first language. Poetry can be seen as elitist or ‘difficult’. Part of the challenge for poetry in health care is to break down these barriers in different ways (using story-telling, verse or song from different cultures, spoken word, performance poetry, lyrics etc).

The time is ripe for fostering 'equalising spaces' for people to come together in safe, creative places - to discover the joy of collaborative efforts in the most liberating of art forms.

This is why I am launching ReVerse – Artful dialogue between staff and service users 

I am now running programmes that use poetry as a shared language for engagement and in order to reimagine mental health. These will create healing relationships and ‘equalising spaces’ between people who use mental healthcare and staff through reading, writing, reflecting, reframing, inspiring and improving together.

I am delighted to announce that our first programme is being run in Manchester in July. If you want to find out more, or are interested in running workshops, please get in touch: [email protected]


(c) 2018 David Gilbert

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2 comments on “ReVerse - How poetry can make the NHS better”

  1. Great blog, David. Arts in/and health is a chronically neglected area in an area where staff and users desperately need to counter the emotional bunting that tends to go with services. I will share this blog on social media.

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