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Restarting Covid-safe frontline delivery

“Enjoying it so much they didn’t want to stop“
Good Vibrations’ experience of returning to front-line delivery post Covid

Six months ago, to protect participants and team members from the pandemic, Good Vibrations made the heart-breaking decision to stop front line delivery.

Two months ago, however, with virus rates decreasing, and after having worked with partner organisations to assess and put in place careful plans to manage the risks, we restarted three projects in a socially-distanced way. We are now delivering weekly music-making sessions at Wormwood Scrubs Prison and Bethlem Royal Hospital in London, and the Middle Street Resource Centre in Nottingham, and are confident that these sessions are bringing considerable benefits to people’s mental health.

HMP Wormwood Scrubs

Since the beginning of July, we have been running weekly, small group gamelan sessions in HMP Wormwood Scrubs’ Inpatient Unit. This unit houses about 20 people with mental health issues. This area has been deemed a ‘bubble’ as the patients on the wing remain on the wing, and do not have interaction with prisoners from the rest of the prison. Furthermore, there are protocols in place to ensure the physical health safety of all group participants. Each week our facilitator, John, works with two to five participants.

Lockdown measures in UK prisons from March have had, unsurprisingly, a negative effect on people’s mental well-being, with extra hours locked away in cell and all activities – e.g. education and arts projects – being cancelled. As far as we’re aware, Good Vibrations’ weekly sessions on the Inpatient Unit were one of the first activities to restart at this prison.

As usual on a Good Vibrations project or course, participants don’t need any musical experience to join in. Some will be musicians, but it’s not a requirement for playing the gamelan. When the group starts to play, it can be ‘all over the place’ musically for a while, with no beat or anything to latch onto, but gradually more musical sense emerges and interesting improvisations develop.

In some of the sessions, there is a real delicacy to the music-making. Sometimes the space feels safe but the music is fairly non-exploratory. At other times things are livelier, with dancing and individuals improvising solos that take the whole group off in a completely new direction. In between pieces, the group chat and open up a bit about their lives. The experience seems to help patients relax and smile more, which John says makes it feel very worthwhile.

“Overall, musically, it was a continuous stream of consciousness; some remarkable improvs, each one unrelated to what had gone before. They very definitely were enjoying it so much they didn’t want to stop.” (Good Vibrations Facilitator, John)

Sometimes nurses, officers, and cleaners join in. The mental health team, are especially sensitive to what is going on, and adept at giving space and supporting the process on a musical level. Good Vibrations has now become part of the routine on this ward, with staff there understanding the benefits of patients participating, referring them to sessions, and supporting them to attend.

The venue is ideal as music gently seeps out into the whole unit, giving it a lovely atmosphere. Sometimes John also plays and sings alone outside the rooms of older patients who don’t get out much, and they have told him how much they enjoy it.

As an organisation, we are delighted to have been allowed back into the prison after lockdown to help this group. Our initial impressions are that they seem to be benefiting from the experience in so many ways: from becoming better at listening and working with others; to being more flexible; to persevering with overcoming challenges; to growing in confidence in how they communicate with their peers.

Middle Street Resource Centre                                                         

We have also started running weekly gamelan sessions again at a community centre in Nottingham as part of our Resonate programme. These sessions are open to all, but targeted particularly at people experiencing mental illness. The sessions take place every Monday at Middle Street Resource Centre in Beeston, who we have partnered with for many years.

Our facilitator, Nikki, works with a regular group of up to five participants at any one time. Many of these are people we have supported in the past and most have fed-back that lock-down negatively impacted on their well-being.

Nikki maintained one-to-one contact with most of the core members of this group throughout lockdown through friendly calls and emails, and sharing information and links of interest. This seems to have been much appreciated. Conversations focused more on individuals’ wellbeing, feelings, and challenges they were facing. This built trust, helping Nikki be able to consult with them about when and how to bring back face to face sessions in a way they would feel confident about and safe to attend.

Some participants also attended Good Vibrations’ online samba and gamelan Zoom sessions during lockdown.

The lockdown has been particularly challenging for the majority of this group, with noticeably negative effects from social isolation, increased anxiety, and lack of structure resulting in lost sense of purpose. This has been especially true for those that were regular users of the centre.

There was a cautiousness, uncertainty and anxiety in the initial face to face sessions, mainly around changing government guidelines and the knock on effects these had to have on Middle Street Resource Centre’s rules around PPE, access and one way systems. The anxiety has eased as the weeks have gone by and sessions have become focussed on the music.

“All went well today with the first session. It was a nice gentle way back in and felt very safe. I set up workstations with a few instruments for each person so people could stay in one place and they had a set of beaters just for their use. All the participants received the new guidelines before the session.  I provided extra bits of PPE like spare disposable masks, and have put all the notations into plastic sleeves that can be wiped down.”  (Good Vibrations Facilitator, Nikki)

The room accommodates a maximum of five participants within social distancing guidelines so we have had to find ways of ensuring that all those who want to attend can. We have required participants to book in advance, but there are often last minute cancellations because people are experiencing a poor state of mental health on the day itself.

One participant particularly lacks self-confidence and has been previously very judgemental about his own musical ability, regularly saying, “I’m not musical”. When we started back, he struggled with timing and musical memory. He has attended every week since, however, enjoying improvising, listening back to the recordings, and working one-to one with Nikki. And now his confidence, listening skills, creativity, sensitivity of playing, and timing have really improved. On Monday, Nikki noticed him smile for the first time and express a sense of his achievement.

Bethlem Royal Hospital

We have also returned to Bethlem Royal Hospital, a psychiatric hospital in South East London, to run weekly Loophole Music sessions. Our facilitators, Jerome and Kieran run these one-to-one sessions, supporting individuals to make their own music using technology, voice, and western acoustic instruments. This is a setting we have been working in for more than 10 years.

“It feels good being back at Bethlem. Lockdown there meant that patients at River House were unable to attend a lot of their usual activities like the gym, and football matches. The community hub was also not open, so restarting Loophole meant they could get creative again.” (Good Vibrations Facilitator, Jerome)

Jerome and Kieran have been working intensively with six individuals here, helping them to produce their own tracks. The sessions take place in the Occupational Therapy Department which is open to the whole hospital. Patients currently attending are from the Adolescent Psychiatric Intensive Care Unit, River House Forensic Unit and the National Autism Unit. The positive aspect of doing Covid-safe one-to-one sessions is that it allows adolescent patients to attend, who normally are restricted from mixing with other adult participants.

The project is booked up, showing the demand for creative activities in this setting. One 17 year old patient is fully engaged, learning about music production and mixing using Logic Pro and GarageBand. Two forensic patients are enjoying recording hip hop tracks, and another patient with autism, is loving using the iPads, with his occupational therapist telling us, “Simon (not his real name) is really benefitting from these sessions. It is rewarding to see him having some positive engagement and enjoying himself. This is a side we have not really seen before.”

We plan to develop this work over the autumn by: adding in extra morning sessions to meet demand; bringing on a past participant as a volunteer; and celebrating participants’ work through an online showcase.

Looking ahead

Of course, given the uncertainty around the pandemic, it’s difficult for us to know what will happen over the next weeks and months, whether we will gradually begin to do more face to face work in different settings, slowly start increasing group sizes, or whether we will have to suspend all activity again if there is another lockdown. But, whatever happens, we know now that we are able to work safely and effectively with participants, that we can be flexible and responsive to different settings, and that our team of facilitators are capable and confident of supporting vulnerable participants to feel safe enough to take a step back into creative, communal activity, which in turn will help improve their mental health and resilience in these uncertain times.

authors: Katy Haigh, Good Vibrations Executive Director, with John, Nikki, Jerome and Kieran