Published: 19 May 2020

The power of pictures for mental health

A picture paints a thousand words, and Professor Agnes Higgins knows. She led a HRB Knowledge Exchange and Dissemination Scheme (KEDS) project to create a photo exhibition by people with a diagnosis of psychosis, and create opportunities for connection, conversation and crushing the stigma of mental illness. She spoke to Dr Claire O’Connell.

At a time when most of us are not leaving our houses much, Professor Agnes Higgins is using pictures to bring joy and connection to those she loves. She sends postcards to relatives who live alone and who are ‘cocooning’, and it’s a way of bringing some positivity to both sender and receiver.

'My husband and I found lots of postcards that we had brought home from our travels, and I’m using them to write to people now with little stories about where the postcard came from', says Agnes. 'My mother is 91, living in the west of Ireland, and she loves getting these stories in the post'.

Lived experience

It’s not the first time Agnes has seen how pictures and stories can build a connection. She was recently involved in a HRB KEDS (Knowledge Exchange and Dissemination Scheme) project that supported people with a diagnosis of psychosis taking and displaying photos. The resulting exhibition and photobook called ‘The Road we travel…’ have helped to empower people with a diagnosis of mental health problems and opened up new conversations and understanding about their experiences.

It arose from EOLAS, an intervention to help people with psychosis and their families to learn more about the condition and how to access care and support. 'We had evidence that mental health service users and their families didn’t know how to navigate the services, how a diagnosis is made and what it means', explains Agnes.

'So we started an 8-week programme where services users or their families attend sessions and learn about the service, the diagnosis, recovery and coping skills not only from a clinician but also from a peer facilitator who is a service user themselves, or a family member of someone with a diagnosis of psychosis. The peer facilitator has lived experience of what many in the room are going though'.

EOLAS piloted in 2012 in the mental health services in Celbridge Kildare, and it has since evolved to a full programme around the country.

'We listen to what the service users and their families say they would like from the programme and we update it to reflect that', explains Agnes. 'We also see the hope and the power of people meetings with others who have similar experiences, the power of  peer support. We are hearing that some participants go on to set up their own groups or initiatives afterwards, so maintaining that peer connection'.

Snapshots of life

To bring the power of the EOLAS programme to others, the steering committee decided on a photographic exhibition and enlisted the company PhotoVoice and curator Christine Monahan to work with some of the peer facilitators - to build their photography, skills and tell their story through pictures.“

'The participants took pictures that represented some aspect of their experience with the EOLAS project, their experience of mental health and created a narrative text to accompany the pictures', explains Agnes. 'They also came together help us design the exhibition and the photobook. This was very much about the services users and family members having their voices heard, rather than the academics'.

Exhibitions ran at Trinity College Dublin, at Dundalk Institute of Technology and in Newbridge. 'There was a great sense of camaraderie and achievement among the participants, and they and indeed all of the team involved in the project felt huge pride in having their families and other people come to see the photographs. We have seen members of the public connect with the photos too and it gives them another and maybe more realistic perception of mental distress' , says Agnes. 'We were due to have one in Letterkenny, and then COVID-19 took over, but we still have the photobook online'.

Mental health

Her involvement with the project has helped to keep Agnes emotionally connected with people’s lived experience of psychosis. Indeed, mental health has been a seam of interest throughout her career, starting when she was just 17.

'That’s when I started nursing in mental health, and I kept that passion for the rights of people who experience mental health problems and their family members throughout my time working in mental health and general nursing as well as my time  working in hospice and palliative care. It’s so important for us in nursing to maintain that emotional connection with the lived experience of people in order to support their emotional wellbeing and mental health', says Agnes, who is now a professor in mental health nursing within the School of Nursing and Midwifery at Trinity College Dublin.

'I currently chair the board of Mental Health Reform, which is the national coalition of organisations campaigning to transform mental health and well-being supports in Ireland, and that also keeps me very connected to realities on the ground'.

Lockdown advice

It’s important to protect emotional wellbeing and mental health during the ‘lockdown’ of COVID-19 restrictions, and Agnes has some sage advice.

'It’s hard to believe all this is going on, sometimes I forget about it and then suddenly remember the whole world has been stopped by a virus', she says. 'It’s a time of insecurity and uncertainty and it’s important to try and keep human connections, whether it’s writing a postcard or making a Skype call. You also need to forgive yourself for not doing all the other things you had planned to get done. Day to day, we just need to be good enough and be happy with being good enough'.

Agnes is also grateful she and her husband are healthy and able to work from home, and they take daily walks together.

'We live near an estuary and when we go on walks we can see birds nesting and plants growing and blooming', she says. 'A field near us was ploughed just at the beginning of the COVID crisis, and we are watching it getting greener each day'.

Agnes is rediscovering the joys of reading for leisure too. 'In my job you could read all day but it would be all work-related', she says. 'So I’ve been setting aside books that have nothing to do with work and enjoying reading them in the evenings'.

Then, of course, there are postcards to be written. 'I was born in Galway, and as well as my mother I still have relatives living in the west', says Agnes. My aunt lives there on her own, and she says she loves the sound of the letterbox now, as she knows there will be a card for her from me'.

You can see the full photobook “The Road We Travel…” here (26MB) [https://nursing-midwifery.tcd.ie/outreach/assets/pdf/EOLAS-PPP-epub.pdf]