Dr Katherine Taylor is a clinical psychologist and Arts and Mental Health Innovation Programme Manager for Greater Manchester's iTHRIVE team. She joins our 60 Voices series to share a personal story of mental health and the benefits of non-medical strategies to improve wellbeing...

On the southern coast of Helsinki, Lapinlahti Lähde Wellness Centre, once a mental asylum, is a fine example of how creative community services can support mental health care delivery.

What happens in Lapinlahti?

Lapinlahti Wellness Centre is a repurposed asylum. A multitude of services is provided and accessed by everyone, thereby implicitly mixing wellbeing for all with mental health services. I was shown around a café, a lecture hall (in use for a seminar about the role of the arts in supporting people with dementia), therapy rooms, massage rooms, baking classes, music groups, writing groups, an allotment, and exhibition space. The entire site is infused with art, creativity, and colour to avoid an institutionalised feel. The building itself is painted yellow. This format lends itself cleverly to securing some of the fundamentals to mental health recovery via the environment itself: a hugely important cue (Daykin, 2010).

Katja Liuksiala, Director, explained that Lapinlahti is similar to the well-established work of Clubhouse International. The Leaders at Clubhouse Internationals are commonly people who have themselves recovered from periods of poor mental health and trained as Peer Leaders, emphasising the relevance of skills development and confidence-building in recovering mental health.

I’ve wanted to write about how I connected with Lapinlahti for some time, and this 60 Voices series feels like a welcoming home. Aged 19 and having just moved to Manchester, I struggled to regulate my emotions and the depressive phases I had experienced throughout adolescence began to swing into periods of intense motivation and excitability, and I was told these highs of mood, or mania, meant I was bipolar.

A psychiatrist solemnly advised I lower my ambitions, offered medication as a first line of intervention, and told me that hospitalisation was “likely” at some point in my life. It wasn’t until after I successfully graduated, secured research posts and eventually gained employment with the Spectrum Centre for Mental Health Research in 2008 that I truly understood that many people with ‘bipolar disorder’ do quite well. It took a career into mental health research to ‘discover’ this. Yet population studies clearly show that only half of all people meeting criteria for ‘bipolar disorder’ seek professional help, thus skewing any research and understanding towards the half present themselves. While we do not know, we could reasonably assume that research and clinical understandings are missing the potentially and probably more positive stories of those outside of services. Moreover, among those who do seek help, half go on to have a positive outcome. This, I was not told. For me, there was a lot of value in my highs and this continued to be the case. Why then such a gloomy, and therefore harmful, prognosis?

In addition to this, medication was offered as a first response to my mood episodes. Alongside critical concerns about the validity and reliability of psychiatric diagnoses, there is increasing evidence for the efficacy of non-medical strategies to protect and improve mental health and wellbeing (Department of Health, 2014), alongside increasing concern that the benefits of psychopharmacological approaches are overstated (Moncrief, 2013; Kinderman, 2014).

‘Wounded author’s honour’

At Lapinlahti, I was led to an installation in a room which once belonged to Aleksis Kivi (1834-1872). Aleksis is Finland’s most celebrated author. He was admitted to Lapinlahti with, according to the treating physician, ‘wounded author’s honour’ which was reportedly underlying the ‘schizophrenia’ he was diagnosed with.

Aleksis Kivi

Aleksis Kivi's former room at Lapinlahti Wellness Centre, Finland

For me, this experience connected me with a disturbing truth: I have little doubt that if I had have been born in a different time, a different place, or with a different education, I could have ended up in an asylum, dead aged 36 like Aleksis, or on psychoactive drugs, as was so very nearly was the case for me. I have had to repeatedly resist quite strongly the advice to commence prescription ‘medications’, which carry significant health risks. What is even more disturbing is that realistically, a prescription would be readily given to me, now, in the UK, if I was less curious/educated/articulate.

Many people trust doctors. People who are in vulnerable states, such as when they recognise that they need some help with calming an elevated or low mood, may be even more inclined to trust and follow the advice of a doctor. I was repeatedly urged to accept a pharmacological regime to ‘treat’ my moods and doctors encouraged me to view my resistance as a symptom of mental illness.

I do not feel, nor have I ever really felt, that I was mentally ill; only that I experienced extremes of mood that I had to learn how to monitor and regulate. I was eventually, thankfully, offered talking therapies, including group psychoeducation on self-management. I continued to experience disruptive episodes during my degree, following graduation and during my first few years working in research. My employers were knowledgeable and supported my desire to not look for a medical treatment to what I saw was an emotional ride I simply had to take, until I figured out how to stabilise my mood. Solutions emerged over time and were safe – in contrast to what I perceived as dangerous options involving long-term psychiatric ‘prophylactic’ drug use. After psychoeducation, I found music (listening, then learning, and eventually participation) to be among the most powerful self-management strategies. Open water swimming has also seemed to have a significant impact on me, and this is being supported by increasing understanding of the beneficial effects of cold water immersion.

Creative activities are another critical component of mood management. This is broad and varied, and the form doesn’t matter; what matters is that such activities can help regulate mood and empower people to formulate their own bespoke recovery.

This narrative is not encouraged in conventional services, however, I feel strongly that my story would have been radically different had I have swallowed a medical narrative and the consequent prescriptions. My role as Arts and Mental Innovation Programme Manager with the GM iTHRIVE team is made possible not only by substantial evidence for the role of the culture and the arts in fostering mental health and wellbeing but by my own experience, for which I am grateful.

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Dr Kat Taylor is a clinical psychologist in Child and Adolescent Mental Health Services (CAMHS) in Lancashire, and part of Greater Manchester’s iTHRIVE Implementation team as Arts and Mental Health Innovation Programme Manager - working strategically to implement arts-led interventions within and around CAMHS. Following a Churchill Fellowship in 2017 on the role of the arts in health, Kat was eager to implement the learning and innovation in the context of devolution. This Innovation role includes sharing evidence, fostering links and innovation between the health and the arts sectors, and implementing and evaluating arts-led interventions. Find out more about Kat via her website.