Partnerships for Recovery Musician in Residence

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Partnerships for Recovery Musicians in Residence Liverpool Philharmonic and Mersey Care NHS Foundation Trust

2008-2017

Contents Foreword

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Musician in Residence programme

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Settings 6 About the Sessions

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Outcomes for Service Users

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Outcomes for Families and Carers

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Outcomes for Professionals

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The Future

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Hill Dickinson has been pleased to support the commissioning of the review of the work of the important partnership between Liverpool Philharmonic and Mersey Care. Mental health and well-being is one of the most important issues in our society today. Creative programmes such as the Musician in Residence programme are proving to have positive impacts in supporting some of the most vulnerable people in our communities, and their families and carers, who are living with and managing mental health conditions.

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David Wareing, Chairman

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Foreword We are delighted to introduce this review which outlines the impact of an innovative and far reaching partnership between Liverpool Philharmonic and Mersey Care NHS Foundation Trust which is now entering its tenth year.

The partnership, which delivers a Musician in Residence programme, supports some of the most vulnerable people in Liverpool and improves the recovery, health and wellbeing of participants through music, benefiting 10,000 service users and their families and carers since 2008.

The work increases people’s confidence and self-actualisation, reduces their isolation and exclusion, develops new skills and creates new opportunities for independent living.

The programme has had a profound impact on service user – carer relationships and has embedded alternative, non-clinical, approaches to recovery within Mersey Care’s clinical and community settings.

The findings in this report are based on a programme review carried out by Dr Susanne Burns in 2016–2017. Her review included interviews and case studies with key personnel involved with the programme over the nine years, including Mersey Care’s clinical staff and service users and Liverpool Philharmonic musicians.

We would like to acknowledge the generous support from Liverpool Philharmonic’s Premier Sponsor, Hill Dickinson LLP, which has enabled us to commission and publish this review of our Musician in Residence programme.

Michael Eakin

Joe Rafferty

Chief Executive Royal Liverpool Philharmonic

Chief Executive Mersey Care NHS Foundation Trust

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Lead Musicians at Mersey Care’s Clock View Hospital

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The Musician in Residence programme supports some of the most vulnerable people in society and the recovery, health and wellbeing of its participants through music.

We bring live music performance, practical music making, and composition to adults of all ages with mental health needs and learning disabilities across a range of NHS settings to increase people’s confidence, reduce their isolation and exclusion, and create new opportunities for independent living.

Mersey Care NHS Foundation Trust works with people with mental health needs, addiction, brain injury, and learning disabilities towards recovery and improved wellbeing.

Liverpool Philharmonic enhances and transforms lives through music

Together we are demonstrating that engagement with creative arts and culture improves the wellbeing of people with mental health needs and makes a difference to their lives.

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Settings Since 2008, the Musician in Residence programme has worked across 24 NHS, community and Liverpool Philharmonic sites throughout the Liverpool City Region.

Adult mental health units Ashworh Hospital

Dementia wards

Drug and alcohol rehabilitation

Communitybased programmes Liverpool Philharmonic musicians visit local and secure services and community settings

The Life Rooms

Brain injury unit

Psychiatric intensive care unit

Elderly care

Learning disabilities units

Secure units

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Since 2008, 50 Liverpool Philharmonic musicians have provided over 3,500 sessions to more than 10,000 service users throughout Liverpool City Region.

Key ingredients of successful partnership working within the Musician in Residence programme are:

Accessible and inclusive • Bespoke provision for those in temporary seclusion or too ill to take part in group sessions • Community-based and inpatient music sessions • Flexible and accessible progression routes for service users • Opportunities for individuals to continue to access the community programme on discharge • Supported access to Liverpool Philharmonic’s concerts and events

Responsive to Service Users’ interests and needs • Sites and sessions vary greatly and generate challenges requiring the adoption of different techniques and approaches • Content differs as appropriate with musicians using instruments, voice, improvisation and a varied musical repertoire • Musicians respond to, and often use, music to change the mood of the group including specific requests for music • Some sessions are relaxing, while others feature interactive engagement depending on participants’ cognitive function • Particular challenges are involved in work in NHS Secure Services and High Dependency Units

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Collaborative working with co-designed content, aims and outcomes • Musicians • Occupational Therapists • Activity workers • Clinical staff • Management teams from Liverpool Philharmonic and Mersey Care

Diversity, breadth, reach, longevity • High quality delivery from a highly experienced team of musicians • Varied approaches and bespoke provision • Staff buy-in and passion in both organisations • Building an ethos of trust, honesty and support • Continuity and commitment to long term partnerships to ensure consistency

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About the Music-making Sessions Session activities include: • H igh quality music making, and informal opportunities for musical learning • M usical history, composition and improvisation • Chamber group performance • Group discussion and reflection • Group composition and song writing • R ecovery College music courses including singing and music appreciation • E mployability opportunities and skills development such as interview skills Continuity of provision is of crucial importance if long term recovery is to be supported.

The community programme provides a bridge to independent activities such as visits to rehearsals and concerts by the Royal Liverpool Philharmonic Orchestra and participation in music making activities at Liverpool Philharmonic Hall. The community programme has expanded extensively with the opening of Mersey Care’s Life Rooms facilities.

About The Life Rooms Mersey Care NHS Foundation Trust breathed new life into the former Walton Library in Liverpool by transforming it into a new centre for learning, recovery, health and wellbeing. Mersey Care extensively refurbished the interior and preserved the historic exterior of the building. In addition to retaining some popular library services, Mersey Care funded a restoration of the building into a base for a range of life opportunities for service users and carers and services to the wider community in a way that challenges stigma and promotes positive mental health and wellbeing.

Building on the success of The Life Rooms Walton a second Life Rooms was opened in Southport, in May 2017. A third Life Rooms will be opened in 2018 in Bootle with a particular focus on young people’s mental health and wellbeing.

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Outcomes for Service Users can include: • E nhanced self-determination and empowerment • I ncreased confidence, wellbeing, social interaction and development of new skills • R elaxed moods, reduced anxiety, agitation and verbal and physical aggression • I ncreased ability to make decisions, reduced isolation and improved inclusion through shared experiences (compositon projects) • A safe space to express emotions, including through non-verbal communication: music enables people to engage even when they can’t use language to communicate • I mproved mood of participants, playing an important role in recovery and maintenance (singing projects) • R einforced recollections (Service Users with dementia)

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I’ve been coming here [Living Music sessions at Liverpool Philharmonic Hall] six or seven months and it’s important to me that it’s a community venue that I can access. I’ve got friendship and learned a lot. Coming here I feel I’m just meeting a friend and having company; I like to combine it with a trip to a coffee bar or to meet some friends. I’ve started coming to evening concerts too.

Service User

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This gives moments just to be you. Self determination, freedom to have an opinion and make a choice. Service users have no control, no choices in the rest of their life so this can be a lifeline.

Occupational Therapist

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Lead Musicians at Mersey Care’s Clock View Hospital

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He would enjoy improvising, filling in the gaps in songs with skill and a sense of real fun.

While he was in the music group he seemed relaxed, was courteous and behaved entirely appropriately; it gave staff and fellow patients the opportunity to see his other side and perhaps glimpse what he might have been like before his illness [dementia].

Musician

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Lead Musicians at Mersey Care’s Clock View Hospital

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• A cquisition of new skills and enhanced decision-making (Recovery College sessions) • M aintained engagement, reduced social exclusion, supporting recovery and creating opportunities for independent learning and social interaction (community based sessions)

Mersey Care’s Chairman, Beatrice Fraenkel presents Adult Learners Northwest Awards certificates to our Lead Musicians celebrating their contributions to the Musician in Residence programme

Mersey Care Service Users take part in the first Supersing with musicians of the Royal Liverpool Philharmonic Orchestra, conducted

by Ian Chesworth

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Outcomes for Families and Carers • T aking part with Service Users is a social and enjoyable shared experience – it is doing something normal.

• W hen family members and carers see this – and even take part themselves - it can be a powerful reminder of the person their loved ones once were.

• T his can inject joy and normality back into a relationship, even ones that have become traumatic.

• S essions reduce stressful times at visits, develop new shared interests and support families by providing respite

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It can be a traumatic time for them – visiting can be difficult – if they are invited to music, they can relax, hold hands and communicate in a different way. We get to know more about the loved one and they feel supported and relaxed and get time to enjoy their loved one.

Occupational Therapist

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She was very unsettled and showing physical and verbal aggression. We left the door of the room open and at first she wouldn’t come in, but gradually she eased her way in and eventually she danced. Her family saw this and saw a bit of mum that they remembered.

Occupational Therapist

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Lead Musicians at The Life Rooms, Walton

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The musicians build up a relationship with the client. They set conditions where therapy can take place, they feel safe. We hold the clinical knowledge and have their back – they follow our cue on this. We both know our roles and work together.

Occupational Therapist

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Vasily Petrenko Chief Conductor, Royal Liverpool Philharmonic Orchestra

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Outcomes for Professionals • P eer to Peer learning between musicians and clinicians • B enefits from co-production and co-delivery of services • S ocial benefits • E mbedding alternative approaches to recovery within Mersey Care’s provision • L earning about what is needed to work effectively in complex health settings – warmth, humanity and integrity • T he value of continuous learning and reflection

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Musicians need to be committed, good communicators, open and willing to include people, able to accept criticism and not take it too personally, flexible to circumstances, responsive – take it in their stride and keep the door open to people. They can’t come in with a plan but it’s like a plumber who comes to a job with the tools without knowing what the job actually is until they get there.

Occupational Therapist

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The Future Enhance partnership • Increase activity to benefit more Service Users throughout Liverpool City Region • Create employability opportunities and choices for service users • Expand community-based music provision with new NHS and Public sector partners

Knowledge and Skills • Train Liverpool Philharmonic staff to better support the mental health needs of audiences and employees • Expand provision to new sites and neighbourhoods • Create opportunties for more musicians to take part in the programme

Advocacy • Work together to raise mental health awareness through anti stigma activities • Strengthen the evidence base for arts-based mental health provision • Encourage more NHS organisations to invest in creative recovery programmes

Vasily Petrenko and all at Liverpool Philharmonic supported Mersey Care’s Big Brew Campaign which aims to raise awareness of mental health issues

© Mark McNulty

PRINCIPAL FUNDERS

Thanks to the City of Liverpool for its financial support PRINCIPAL PARTNERS

PREMIER SPONSOR

Thank you to the many individuals who have been involved in the delivery of the Musician in Residence programme over the last nine years.

Special thanks to: – The Service Users who have contributed their testimonials so openly Our highly experienced team of Lead Musicians Musicians of the Royal Liverpool Philharmonic Orchestra The many Mersey Care staff and volunteers who support the programme every week Liverpool Philharmonic company members from across the organisation who welcome Service Users to our facilities and activities Liverpool Philharmonic Mersey Care NHS Foundation Trust Report researched and written by Dr. Susanne Burns Summary Report edited by Christopher Allen Report commission supported by Hill Dickinson LLP – Commissioned photography Mark McNulty, Mersey Care NHS Foundation Trust and Joel Goodman liverpoolphil.com LiverpoolPhilharmonic @liverpoolphil