My article in last year’s winter Newsbriefing documented the success of developing a community-based art therapy work practice ‘The Art Room @’ through Leeds CCG, and subsequent local Council funding via Live Well Leeds (LWL), delivering free art therapy groups and 1-1 sessions for adults aged 18 plus living in the Leeds area (BAAT Winter Newsbriefing 2019).

I find myself writing again, this time in response to developments in my work-based practice as a result of the current Covid-19 pandemic. This article briefly describes:

• The context in which my work and my organisation (LS14 Trust) are currently operating
• The personal and professional impact of Covid-19 on me as an art therapist
• Setting up new systems and new ways of working
• Collaboration and networking
• Trials and challenges
• The way forward

We closed our doors to the public on the 18th of March 2020, a week before lockdown.

We are now a Covid-19 response hub in our council ward, one of 33 across the city. Leeds City council’s central help line triages calls from citizens finding themselves in need. The focus comprises addressing physical, medical and, latterly, social and emotional needs. My colleagues were running, literally right from the start, setting up new systems, recruiting and processing council and local volunteers ready to respond to those needs.

Those calls are processed and appropriately placed with the relevant response hub in their council ward. People receive either emergency food parcels, support with utilities, shopping, and, a request for a call and chat for those feeling isolated and lonely who are being shielded.

I, on the other hand, was just finishing a scope of work with clients I had been seeing since January. I was about to have an Easter break and on return start with a new cohort of clients working either 1-1 or in groups. Needless to say, the Easter break did not happen.

The endings for my clients were a priority, some were ok with this process of over the phone consultation and review. Some clients who felt they could access online therapy, and I felt there was a sufficient therapeutic alliance to transition to art therapy via Zoom, were offered the opportunity of extending their sessions. These were clients who I felt were less vulnerable and had good enough coping mechanisms and family networks to support this transition. Never having engaged in this kind of work before I needed to be sure in the first instance that I could cope with and manage Zoom myself. My new clients, on the other hand would have to wait, making holding calls and suspending therapy until lockdown ended wasn’t easy, but people said they understood.

Seeing my Trust colleagues working busily away left me feeling impotent, isolated and lost. Our funders had agreed to support us for initially three months at the start of lockdown. It was my job to work out how I could transfer from the physical to the virtual world, maintain protocols, boundaries and integrity, whilst at the same time getting ‘up to speed’ in a short space of time. I had to think of something that was practical, purposeful, and continued to support people with their mental health. But how could I do this? I empathised with the rabbit who stares into the lights of oncoming traffic - I felt stunned.

It’s fair to say that I am technically challenged. Platforms, social or otherwise, were shoes I wore in the 70’s, and, until this point in my life, Zoom was a chart hit by Fat Larry’s Band in 1982! Not this multimillion-pound multimedia communication system that traverses its way across the global cyber waves into one’s phone and onto one’s laptop like some sort of Paul Daniels magic trick …

After a week of resembling an open-mouthed fish on dry land, I was left with no other option than to take hold of the situation and act accordingly. It wasn’t easy, I was also coming to terms with this pandemic on a personal level too, as well as finding a space at home to set up my service, which was a trying experience.

My good friend and colleague had set up a Zoom ‘virtual cuppa’, weekday mornings for BAAT Region 11 art therapists. She invited me to attend. My relationship with my laptop resembled that of client and therapist. My laptop held the space as I frantically bashed its keyboard, talked and shouted at it, like it should understand my stress at not being ‘up to speed’ like all the other Digital Darlings that I assumed are out there. The laptop said nothing, it held the space as I transferred my angst into it, my anguish had raised to level 5 at an exponential rate, feeling overwhelmingly inadequate. Eventually ‘Computer said yes’. I logged on and signed in.

These past weeks have been a steep learning curve for me. Virtual Cuppa has been a personal and professional lifeline, a fulcrum point between maintaining a professional presence and disintegrating into oblivion; sharing ideas, discussing theoretical concepts and applications to our practice. Being present for each other, bearing witness to our human and professional trials, errors and successes, at times through adversity.

The generosity of spirit and professionalism shown in sharing resources and ideas. My friend had already been online for some time over the last year and her art therapy student had developed a guidance pack for online group work. I was given permission to use and adapt it to LS14 Trust needs and purposes.

Alongside this, Region 11 updates of CPD opportunities and updated guidelines and support from BAAT, have all assisted me to set up not only four short virtual creative groups a week, but 1-1 art therapy sessions with existing and new clients, peer supervision for LWL staff and delivery partners and setting up a new ‘ChatnCheckin’ Service as additional support for our Covid-19 Hub.

With the online virtual services up and running, and my 1-1 art therapy sessions taking place either by zoom or over the phone, after my initial technical phobias rescinded, I felt back in control and my confidence was returning.

I am thankful for my boundaried art therapy training, which has enabled me to resist the temptation of giving in to the pressure of this urgent and emergent crisis by setting up an ‘on demand’ service. I spent time sourcing a best practice, robust service model befriending scheme on which to develop and hang my procedures and protocols of this seemingly light touch service (Shetland Isle Voluntary Action befriending service 2020). The student came to my aid again and produced a suite of volunteer training materials for this new service for volunteers, who are sourced by recommendation and with an appropriate skills set.

New befriending schemes are being funded and set up at an unprecedented rate. My opinion and observation is this light touch much needed point of contact service is being lampooned into the heart of someone’s private living space at a time when they possibly feel at their most vulnerable, or than they had previously experienced or have ever experienced being, triggered and retraumatised.

Well-meaning and caring volunteers who want to phone people to reduce isolation and offer people in the community light touch support are commendable, however, we were already working in an area of highly concentrated levels of health and wellbeing inequalities. As such, in such unprecedented circumstances, it is a bit of a lottery as to who you are likely to find at the doorstep on a delivery run, or on the other end of a chatty call. Hopefully, it might be a client that talks about what they read in the newspaper or how they are coping, such as by phoning their families and staying active, and who would appreciate your call. It is likely, however, that volunteers are going to receive the raw end of someone’s mental health, and an unadulterated account of experienced traumas and subsequent coping behaviours.

My responsibility as well as to myself is to my volunteers and clients in equal measure. The personal accounts I have encountered over these short weeks have been on a graphic level. I have raised more cause for concerns in the last three weeks than I would in a normal working year.

It was inevitable that people would begin to ‘spill out’, and training and experience has enabled me to cope with: coming into contact with people living with mental health problems; being sworn at when making a courtesy call when enquiring after wellbeing; accounts of services being withdrawn without information about if or when they may resume; of ‘well meaning’ members of the community or family members who are unable to understand the complexities of people living with psychosis currently hearing voices and experiencing visual hallucinations; well-intended assumptions of ‘it will be better when/if…’ ‘look on the bright side, cheer up’ ‘having a stable relationship will make you feel happy’, or being encouraged to forget the past and look to the future. Living in areas of deprivation, high rise buildings with 100 dwellings, not being able to safely distance or walking up flights of stairs when a person lives on the top floor instead of taking the lift. The fear of the unknown compounding all of those thoughts, feelings and experiences.

One woman, Mary (pseudonym) has given her permission for me to share her experiences in this article. Mary, who usually manages her psychosis well, found that being isolated through shielding had triggered her historical traumas of physical, emotional and financial abuse, leading to a brief hospitalisation, whereupon she was allocated Community Mental Health Team support. This support comprised short phone calls at the end of the working day on two successive Fridays. She reports not feeling listened to, conversations were hurried and she felt that the support worker was ‘putting words in her mouth’ about managing and coping so as to complete her report, to the point where Mary said she wanted to sing ‘all things bright and beautiful’ down the phone at her. Mary felt the call was supposed to be about her and for her, not a ‘tick box exercise’. This in turn led to raised levels of OCD and self-harm, requiring further medical treatment. “Don’t they think that if it was that easy for me to forget my past, move on and be ‘happy’ I would have done it by now. Everyday I try not to hear voices or see terrible things, I walk, watch my diet, exercise everyday, look after myself and my home, take part in social activities. If they took the time to learn about me they would know who I am. Their ‘help’ has just made it worse, promising to phone and visit on maybe Tuesday, or it might be Thursday, and then they don’t and not even a call or text to say they can’t make it, makes me feel like I am a speck of dirt and not worth their time, it makes me feel like I deserve what I got and should be punished for it.’‘Sometimes’ she said, ‘no call is better than just a call, I’d have been better off with just the doctor ringing me and you (therapist) they’ve done nothing for me but made it worse.”

Those mistaken in thinking that ChatnCheckin is about light touch conversations which can be carried out with those who are good listeners soon began to feel the burden of the traumas that had spilled out from those who had over-shared and opened their own personal pandora’s box. It was clear they weren’t conversations about the weather or feeling ‘a bit down’ or the neighbour’s cat.

In a ‘new normal’ of uncertainty, one thing is certain to me. Although this force of nature has and will continue to be a threat to humanity for the foreseeable future, after the main responses of attending to physical and medical needs, it has been creativity and art that has begun to flourish prominently in the forefront of this ravished landscape, as the natural antidote to assist in restoration, and balance our mental wellbeing during these unprecedented times. And it is this aRt rate that we should seek to encourage and respond to.

We already have the correct PPE, the tools of our trade, access to resources, support through our professional body, BAAT Region groups and SIGS, pooling together our collective abilities to remain creative and respond to the pandemic and this digital phenomenon.

We are in day 60 of delivery, and mental health has only now been put on the agenda for a more cohesive local and regional response. I have been invited to attend the meetings, which enable me to take the voice of art therapy and those experiencing pre-existing or recent mental health to that front-line.

Referrals into already stressed services, and those NHS departments who have been redeployed, is becoming an un-navigable labyrinth. There is currently no clear directive for people as to who and where to contact.

Now is not the time to point fingers and highlight inadequacies and flaws in ‘the system’. Now is the time to come together and shape our professional future, to work further alongside the All Parliamentary Arts In Health Inquiry (2017), UK AHP Public Health Strategic Framework (2019), The NHS Implementation plan (2019), and the WHO Mental Health Action Plan (2013) to ensure that the voice of our clients, the wider population and art therapists alike are present. To promote the spectrum of collaborative work amongst our profession. To overcome the impact this disease has ravaged on our mental health across people of all ages, cultures and nations. Now is our time to respond to this current pandemic, to capitalise on new and emerging ways of working. Using our ethics and boundaries as a rudder in these unchartered waters to embrace new digital and virtual worlds. After all, in the words of Rossevelt ‘A smooth sea never made a skilled sailor’.

Acknowledgements: Sue Ellis, Envisage Arts for sharing Online Zoom Protocols; Amy Wood (Student Art Therapist) for devising ChatnCheckin Volunteer Training materials; Region 11 Em Inman and support from art therapists attending Virtual Cuppa.