The MiR programme involves a team of 8 Liverpool Philharmonic lead musicians and a further 30 Royal Liverpool Philharmonic musicians delivering sessions that bring live music performance, practical music making and composition to adults of all ages (18-80) suffering from mental illness in Mersey Care NHS Foundation Trust.
What We Did
The MiR programme involves a team of 8 Liverpool Philharmonic lead musicians and a further 30 Royal Liverpool Philharmonic musicians delivering sessions that bring live music performance, practical music making and composition to adults of all ages (18-80) suffering from mental illness.
In 2015/16 the team delivered sessions to 2282 services users within in-patient and community settings, across a wide geographical area of Liverpool city region to the benefit of over 10,000 service users since 2008.
The benefits & outcomes from individual involvement with the in-patient programme include: supporting recovery, improving health and wellbeing of service users, reducing isolation, increasing confidence, communication and participation of service users through high quality musical and skills development. Music sessions provide opportunities for social care and group participation; including service users’ friends, family and carers – vital in an environment that can be extremely stressful for families to visit
MiR offers opportunities to access to positive experiences, outside of health care environment- for service users and staff. Liverpool Philharmonic works closely with Mersey Care trust-wide, through individual settings to devise programmes that respond to the changing needs of service users and settings, reviewing the content and impact of the activities at regular intervals with Mersey Care
Liverpool Philharmonic musicians, individually and collectively in ensembles, work on the wards and in education spaces across all Mersey Care inpatient services, and within the community programme with Mersey Care’s Community Mental Health Team. The sessions are co-facilitated with Mersey Care staff, who participate in the sessions and document engagement and impact on service users as part of each individual’s care and recovery plan.
Advocacy from Mersey Care staff who deliver its community programme offers progression routes for patients within the community as part of their recovery. 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
Feedback from Scott Clinic; “These sessions epitomise supporting service –user engagement. Coupled with joint –participation from staff and impeccably led by the Lead Musician, the sessions are consistently pitched ( no pun intended!) at the appropriate levels to promote a positive response . The uplift in mood and demeanour by those present is tangible and greatly appreciated by all concerned.”
Feedback from a community patient (formerly Windsor House patient): “Attending the MiR sessions while an inpatient led me to going on a visit with the group to watch rehearsals at the Philharmonic Hall. I went away inspired and took up playing the flute again which I had not played since a child.”
Wider Active Support
The Musician in Residence (MiR) programme is a partnership between Mersey Care NHS Foundation Trust and Liverpool Philharmonic and has been running since 2008. From small beginnings it is now delivered in 18 sites across the Trust, working across local and secure services, with a growing community-based programme.
Mersey Care commissions the Philharmonic to provide the session but the relationship is much more than the client-provider roles and has grown to become a close working relationship that tackles the stigma of mental health in a variety of ways, e.g. The Phil not only provides patient-centred sessions but also supports the trust in other ways, such as providing tickets for taster classical music concerts for service users, the opportunity to attend and watch full orchestra rehearsals, events with the Philharmonic, and an integrated approach to patient care that moves from inpatient settings into a fully supported community programme based at the Philharmonic’s newest building.
This partnership programme has had a profound positive impact on both Service Users and staff. The following are real-life quotes by way of feedback.
Testimonial from staff member at Ashworth Hospital: “I just wanted to highlight the Lead Musician’s amazing commitment to both music and working with vulnerable adults. Her passion and dedication have inspired our patient group to share experiences, learn new skills and establish respectful friendships. Over the years she has been guided by the patients to develop the project and as a result the patients have achieved amazing accomplishments including 2x CDs, evening groups and they were also recognised at the National Service User Awards 2015.”
“Today we witnessed one individual, who prior to the group offered little in the way of social interaction, deliver a heartfelt speech about his journey and the value that this group has offered. He reported that the group has had a positive impact upon his self-esteem, which is evident to those within the group. All the group participants supported the individual and all offered their views on how the Lead Musician and the MiR Project have inspired a sense of hope to their lives.”
Even when working on the High Dependency Unit sessions the Lead Musician has conveyed her respect for patients and staff alike. This has enabled the development of therapeutic relationships and as a result has broken down numerous barriers. Each of our professional MiR visitors has treated our patients and the environment with the utmost respect and has allowed some amazing experiences to develop.
Case study from Windsor Clinic: “One of the most memorable sessions I have had, was with someone who had been in and out of services for 40 years. I had gone to the session with another member of the orchestra and we ended-up playing a Beatles song. This gentleman decided to join in and sing with us. He began to cry and get quite emotional, it turns out the song had been played at his mother’s funeral but his emotions had never come out. He had been planning to leave the centre that day, but after that he stayed on. He said that it had helped overcome the tension inside him. He has now been clean for three years and credits it to what happened that day
Looking Back/Challenges Faced
The European Capital of Culture 2008 was an incredible opportunity for health organisations to develop cultural partnerships which Mersey Care embraced. But it was all new and creating partnerships that had a meaningful impact was the key, ones that could also be sustained, and ones that people, our service users, wanted, was also vital.
The range of mental health, addiction and learning disability settings across Mersey Care’s services has meant that not all sessions are identical as they have been tailored for each setting, for instance establishing sessions in a high secure psychiatric hospital was a challenge in itself. However this has been one of the gold standard provisions of the service which has had a truly remarkable outcome, e.g. high secure patients have composed their own music which has been recorded by professional musicians at the Phil. Problems or issues that may arise can be dealt with by the project manager in consultation with the musicians and ward/local staff, otherwise quarterly programme meetings are held. One challenge has been to ensure that Musicians are offered individual supervision from clinicians and senior managers.to deal with challenging or emotionally difficult situations they may encounter while on the wards.
Mersey Care NHS Trust commissions Liverpool Philharmonic to provide musicianship and expertise in delivering the MiR programme in a meaningful and therapeutic manner. Mersey Care has developed close working relationships over the past 8 years with Liverpool Philharmonic staff and musicians, who deliver the MiR programme on a weekly basis.
There is now close understanding between the two partners in terms of benefits to patients accessing the MiR programme. This has led to the development of other opportunities to provide service users with new skills and different pathways of learning The project is managed by a Mersey Care Creative Health and Wellbeing coordinator, who meets regularly with the two delivery partners to evaluate and develop the MiR programme.
It has been running over the last 8 years. Initially the programme delivered at 2 Mersey Care inpatient sites. It is now delivered in 18 sites across the Trust, working across local and secure services, with a growing community-based programme.
A number of MiR musicans have come and gone during the 8 years but the programme is now so embedded within both organisations that its purpose, values and process is so enshrined within clinical care and Mersey Care staff establishments that it is maintained at its maximum potential. The mechanisms in place to ensure governence, organisation and funding have ebabled the project to grow and flourish over the past 8 years and the fact that over 10,000 service users have benefitted over those years is testament to its sustainability and effectiveness.
A service user/carer group led evaluation has taken place and found positive feedback for MiR; this is in addition to quarterly monitoring mechanisms and an annual review of the programme’s effectiveness, coverage, outcomes and sustainability by the project manager in tandem with the Philharmonic’s lead officer. Evaluation will be built on with an academic study in 2016-2017 funded by a bursary from a Mersey Care research budget to study the sessions, their outcomes and interview service users/carers. The project has regular evaluation groups meet to look at feedback, as well as record comments from patients and staff alike from particular sessions, MiR musicians are also offered supervision. The scale of the programme offers an incredible action research opportunity to investigate, evaluate and decimate the learning throughout the health and cultural sectors.
Both Mersey Care and Liverpool Philharmonic are already advocating for the MiR programme approach through reporting and sharing learning at conferences and other events
Many of Liverpool Philharmonic’s musicians delivering the MiR programme also work throughout the North West and advocate for the success and impacts of the programme. As well as working in Mersey Care settings, Liverpool Philharmonic supports a wide range of mental health advocacy opportunities including conference attendance (both music and health based), World Mental Health day events, Mersey Care Big Brew anti stigma campaign awareness through press and PR and volunteers celebration events
Is there any other information you would like to add?
There are many examples across the country of the benefits of introducing music into health & wellbeing settings. However, we believe that the enormous positive impact that the Liverpool Philharmonic Musician in Residence programme has had on Mersey Care service users and staff within our mental health settings, including acute services, learning disabilities and substance misuse, has played a significant role in the recovery of individuals. This is a partnership which has provided something much more than expertise from an individual partner, it has brought real passion and a willingness to work together for the benefits of people’s health and mental wellbeing in a way the project could only hope for when it was commissioned all those years ago.