Posts Tagged ‘Music’

Mental Health and Wellbeing Services for Performing Artists: Guidance for the Performing Arts Sector

Tuesday, July 30th, 2019

Consultation Paper

BAPAM is pleased to have brought together a working group of clinicians and performing arts organisations interested in addressing challenges to the mental health and wellbeing of those who work in the sector. The group has produced guidance to support the development and delivery of services specifically for performing arts professionals and students. The guidance is designed to be used by:

• organisations commissioning or wishing to commission mental health services for performing artists

• organisations and practitioners providing mental health and wellbeing services for performing artists

• education providers offering mental health and wellbeing support to students

• individuals and agencies wishing to support best practice for performing artists

• performers and other performing arts professionals wishing to understand the standard of practice they can expect from services.

This guidance has been developed by BAPAM’s Psychosocial Working Group. We aim to make a real difference to the quality of services available. The purpose of the group is to provide a forum in which approaches to prevention, care and support can be discussed, and clinical leadership can be provided for developing and maintaining an evidence-based service designed to support performing arts professionals and students with vocation-related mental health issues. The group has drawn on the clinical evidence base, including National Institute for Clinical Excellence (NICE) guidelines, which contain reviews of published evidence for healthcare interventions from clinical and cost-effectiveness perspectives, to produce this guidance for the performing arts sector. There are seven key areas of focus:

1. Preventing Mental Health Problems
2. Early Clinical Assessment
3. Brief Intervention
4. Peer Support
5. Ensure Links with the NHS
6. Multi-disciplinary Team Approach
7. Managing a Crisis

We are publishing this paper for consultation and welcome all comments which will be considered prior to the final launch.

Read or download the paper here:

Mental Health and Wellbeing Services for Performing Artists: Guidance for the Performing Arts Sector – A Consultation Paper

Comments can be posted via the online survey here: https://www.surveymonkey.co.uk/r/NKRFVGD

The consultation is open until 15 September 2019.

BAPAM Psychosocial Working Group

Tuesday, May 7th, 2019

BAPAM has convened a Psychosocial Working Group to bring together clinicians including doctors, clinical psychologists, psychotherapists and counsellors, charities working with performing arts professionals to support mental health, and academics conducting key research.

The group provides a forum in which approaches to care and support can be discussed, and clinical leadership can be provided for developing and instantiating a service designed to support performing arts workers with issues related to vocation-related physical and mental health issues. We are using the NHS-approved evidence base produced by the National Institute for Clinical Excellence (NICE), who review the published evidence for healthcare interventions from a clinical and a cost-effectiveness perspective, to map the services available to performing artists against the clinical evidence for best practice and identify gaps in those services.

The prevalence of mental health problems is considerably higher in the performing arts community than in the general population, and suicide rates are well above the national average. There is an acute awareness of the problems within the performing arts industry and many artists have been sharing their mental health experience in the context of their work.

The group has mapped many of the initiatives developed to support performers including Help Musicians UK’s Music Minds Matter helpline, Theatre Helpline, Music Support, which has a particular focus on addictions, Equity supported Wellbeing Drop-in sessions at the Actors Centre,  Music & You, Music for Mental Wealth and BAPAM’s own free service, which provides clinical assessments for performers across the UK. In addition, there is a growing number of practitioners who have trained to work in this area, building on insights gained from previous careers in the arts industries, for example, the Music Industry Therapist Collective.

We are grateful to have had so many valuable insights from practitioners and agencies involved in this important work and together we’ve begun identifying what is available, what is missing and how we should work together to support a comprehensive approach to mental health services for performers.

Mental illness is not a straightforward condition. Some people will experience just one episode of mental ill-health in their lives. Of those who receive a brief intervention, half will recover and never have another one. Others, however, experience recurrent episodes and will continue to do so through their lives even though they may be well for significant periods of time. It is essential that performing arts professionals experiencing challenges to their mental health receive accurate diagnoses as quickly as possible to ensure they access the right care. Where brief interventions are indicated, these should be delivered by practitioners who have a track record of working with performing arts clients. Healthcare practitioners, however they are employed, need to be able to access professional support from mental health specialists to ensure they are making the right diagnoses and to refer on if necessary.

Discussions to date have identified many areas for action, but the immediate areas to take forward have been identified as follows:

  1. Development of guidance for the performing arts industry covering points of best practice for performers, care providers and all organisations commissioning care for performers
  2. Rapid access to clinical assessment to determine the best care pathway
  3. Provision of brief interventions tailored to the needs of performing artists,  focusing on performance anxiety
  4. Access to mental health specialists (e.g. psychiatrists and clinical psychologists) for advice on the management of patients’ complex needs, for practitioners working outside the NHS
  5. An annual CPD event for psychosocial practitioners working in, and developing their career in performing arts health care
  6. A collective effort to support fundraising which aims to meet identified gaps for all practitioners

Event Report: Occupational Health in the Performing Arts Industry – The Original Gig Economy

Tuesday, May 7th, 2019

Health in the performing arts industry – whose responsibility?

Every year BAPAM helps with hundreds of inquiries about health problems related to working in the performing arts. These include musculoskeletal problems caused by strain and intensive use of parts of the body, vocal health issues which need specialist diagnosis and treatment, psychosocial problems including performance anxiety, stress related to the uncertain nature of the work (82% of the workforce are freelance) and more complex and enduring mental health conditions as well as hearing health problems. Performers, in common with other freelancers, tend to ignore health problems and seek help at a very late stage.  The research shows that, at any one time, 75% of performers will have a health problem.

We were delighted when the Royal Society of Medicine chose to partner with BAPAM on a professional development event held on March 27, 2019 to consider occupational health in the performing arts sector and its relationship to the wider ‘gig economy’. We were lucky to have a stellar line up of speakers from the arts, academic and clinical worlds to provide a range of perspectives on this question.

Kicking off the conference, Jane Dyball, former CEO of the Music Publishers Association outlined the complexity of the industry and the relationship of an artist to industry bodies at different times of their career. In the early stages, the artist may be very dependent on promoters, venues, managers, but that relationship changes when they are successful so that those bodies are dependent on the artist for their own success.

Dr. Colin Thomas, Chief Medical Officer of the BBC, added to the picture as he described the plethora of jobs undertaken by freelancers in broadcasting and the difficult balance between their tax status as self-employed workers and the duty of care issues that organisations owe to both employees and freelancers.

Zeb Soanes, BBC Radio 4 broadcaster and BAPAM Patron, described the moment when he suffered paralysis of one of his vocal cords and his journey back to full health and employment. He spoke with courage of the isolation and anxiety of losing your identity and the difficulties of accessing the right care in this very specialist area.

Professor Aaron Williamon of the Royal College of Music’s Centre for Performance Science, described results from recent research which demonstrated the lack of general fitness, particularly amongst student musicians.

In the afternoon we heard examples of good practice from Peter Garden of the Royal Liverpool Philharmonic and Professor Emma Redding, Head of Dance Science at Trinity Laban. Peter outlined Liverpool Philharmonic’s approach to developing and supporting performance excellence through providing health and wellbeing services to orchestra musicians. He and the Board have seen the impact of this investment on enhanced performance, improved employee satisfaction and engagement, and positive signs of reduced reliance on freelancers to cover sickness absence due to playing-related musculoskeletal injuries. Professor Redding outlined the advances in healthy practice in dance education and how a specialist health insurance scheme is helping to provide access to occupational health services.

Dr Rob Hampton, RCGP representative at Public Health England and a practising GP, described his own caseload and the difficulties for freelancers in accessing support with work-related health problems, the impact on the NHS and the evidence that working itself improves health. Dr John Etherington, NHS lead for rehabilitation, drew on research on performance enhancement in the military and in sport to demonstrate that effective training for the physical and vocation-related psychological demands as well as good rehabilitation after an injury can significantly improve health.

In this conference, the problems were clearly laid out and examples of solutions are available, but whose responsibility is it to drive the improvements? With over £5bn in UK annual revenue coming from the performing arts, it doesn’t seem sensible NOT to look after the health of the workforce, and leaving this role to charities on their own is not a sustainable solution.

Here are some thoughts from the BAPAM team on how the current position might be improved. First of all, to answer the question, who is responsible for improving performing arts health?

  1. Employers and Education Providers. These bodies do have a duty of care to employees and students. Liverpool Philharmonic has demonstrated the economic and artistic case for employers investing in healthcare. Many employers can and do support occupational health for performers. A consistent approach here would improve the health of 18% of the workforce. There are 50,000 students in performing arts education and Professor Williamon’s research, the practice in Dance Education and the work of the Healthy Conservatoires Network demonstrate what can and should be done to develop healthy behaviours in students and ready them for the realities of working life.
  2. The Freelance Performer. The performer is responsible for their own health (however, see point 3 below), including seeking help at an early stage and following the health behaviours which are evidenced to reduce the likelihood of health problems. Freelance performers who have learned these behaviours in education should be equipped for the working environment, but many performers have not had access to performance education. The provision of educational sessions and written and online materials together with peer support networks is crucial for this group. The Musicians’ Union, ISM, Equity, Help Musicians, Music Support as well as BAPAM and many other individual coaches and writers are currently offering support in this area.
  3. The Performance Environment. Research evidence tells us that good self-care is best achieved within organisational structures that support individual wellbeing. While other organisations in the industry may not have a direct responsibility for performers, they do have a responsibility for ensuring that the environment enables the performer to carry out their personal health responsibility. In addition to statutory health and safety duties, a culture and environment that encourages and supports healthy practice will help performers. As a very basic example, hydration is vital for performers – if there is no water available in a venue, it becomes difficult for the performer to practise this behaviour. What if the acoustics are so bad in a venue that the only way performers can hear themselves is turning the amps up excessively? What if there is a culture in your organisation that discriminates against certain groups or individuals, contributing to negative social relationships and mental health problems? What if the people you depend on don’t know where to go for help when they need it?

If this is a structure we can organise around, then what would a Health Manifesto for the Performing Arts look like?

  1. Everyone in the performing arts world needs to understand what healthy practice means, from the educator to the employer, individual performance professionals and any organisation or individual working in the business (managers, promoters, agents, labels etc).
  2. Everyone needs to know where and how to get clinical help when they need it.
  3. All funding options should be explored to develop a system-wide approach to providing for the health needs of performers, combining charitable funding sources with other sources of support including industry-specific insurance schemes, access to work funding etc.

We welcome responses by email at info@bapam.org.uk

Hand Surgeon and Professor of Piano joint BAPAM clinic

Wednesday, May 1st, 2019

There are intrinsic relationships between health and performance excellence, and educational and clinical expertise in the performing arts. In overcoming medical problems, specialist diagnostic and medical expertise can be complemented by performance technique and lifestyle and health-related guidance. In a new joint clinic at BAPAM, Mr Mark Phillips, Hand Surgeon, and Penelope Roskell, Professor of Piano at Trinity Laban, are exploring this opportunity for clinicians and educators to provide each other with unique insight and feedback. We asked them to tell us more about this innovative approach.

Could you explain the idea behind the joint clinic and why you decided to do it?

Mark Phillips: In my experience when treating musicians I found quite an overlap between the physician’s knowledge and the specialist physiotherapist/hand therapist’s knowledge, who’s an expert in musicians. But I soon realised there was a huge gap for the third element which is filled by the expert tutor on that instrument. I happen to be a trumpet player so as a musician I have some insight into the patient but that’s not enough when it comes to some of the issues they face. I can relate to some of the psychological performance issues, but the expectation patients have is of someone that can really understand how the technical demands of the instrument interface with the physiological problems they’re having and anatomical problems they may have and the outcome of the clinical assessment.

Penelope Roskell: The knowledge we have between us is enormous. My students have included musicians with injuries for 40 years, and so we fill in the gaps. Seeing musicians together in a joint clinic is very important because you can then see the whole picture and then decide on the best way forward. Sometimes it may be steroid injection and sometimes it may be surgery. But sometimes it may be that a tweak or a change of technique will solve that problem and reduce the need for further intervention. So, seeing them together we can get to the root cause, which we can’t always do if seeing them independently.

How do you decide if a patient would benefit from this dual approach? What can a patient expect at a typical joint session? How do you each approach the patient?

How do you prepare for a joint clinic session?

Mark Philips: Normally I will contact Penelope to say I’ve got a patient or she may say she has a student. We will both select patients for this clinic.

Penelope Roskell: Sometimes Mark will send me over a video of that person playing, so I’ll have a chance to look at it and pick out the obvious problems about what I think may be causing it. I’ll also have a clinic letter which will give some sort of background.

Mr Phillips: We then meet up for a coffee and chat about the patient. So then the patient comes in, and if it’s my patient I present it to Penelope and on one occasion Penelope presented the patient. And then we do the history in the normal way, present findings and run through it all. I then suggest what may be the anatomical or physiological problem and how that relates to this person’s technique. The technique may have worked well for a long time but now there’s a problem which is unique to them. Looking at the technique can help if I’m referring to Penelope. Or similarly if Penelope is referring to me is there a way that some of my interventions such as hand therapy or injections or my approach to examination would throw some light on the matter. It’s that overlap which is invaluable really.

Penelope Roskell: So for instance one of my students came to the last clinic and she had problems for the last year and had come to me for that reason. And Mark gave her quite a different diagnosis to what she had been given in the past, which then informed me. So now we are working slightly differently in the lessons that I have with her privately, having now had this intervention from Mark and he also suggested a steroid injection which we are waiting to see the results to. We can then see the whole picture about the ways forward, because there isn’t always one solution. A patient may need a steroid injection or piano playing adjustments to the technique.

Mark Phillips: It’s multi-faceted, there may be Alexander Technique, hand therapy and it may be someone looking at their posture. I learn so much by looking at Penelope tutoring at the piano in terms of elbow position, shoulder position and what impact that has in terms of the way the fingers lie on the key for example. Each presentation has its own unique cocktail of remedies really.

There are complex multi-faceted problems by the time they come here and it comes down to how we triage these patients essentially. I don’t bring every pianist to this clinic.

Penelope Roskell: It’s inevitably going to be someone with a piano related injury. If they’ve broken their wrist by falling down the stairs then they should go straight Mark. Whereas it’s different when it’s something like accumulated stress from years of playing with a technique which is a tiny bit off balance. They may be very experienced players and their technique has lasted them well, but there’s something that just tips it over.

Mark Phillips: What I see in my patients is that half of them have the same problem as everybody else and that may affect how they use their instrument. And the other half have instrument related problems and it may be a combination of the two. And say if someone broke their wrist a year ago and it may be throwing out their elbow, their shoulder or their posture and it may well be a good way down the line that it’ll come to me that a session with Penelope would be helpful. Because it may be to do with their elbow and shoulder which may be making some notes inaccessible and we can work around. They’re so unique each of these cases an each of them would have their own relative roles for the two of us sitting together and discussing the case. It would be good to extend this to guitar, violin and cello and get tutors to do a similar thing. And it’s pretty unique, I don’t think there’s anyone else out there in the world doing it.

What do you feel are the benefits of having an educator in a clinical setting?

Penelope Roskell: It is a very formal environment which is a positive thing and it focusses everything which is very important.

It is a sort of pilot, it’s the first of its kind and I think it is very valuable and let’s hope that other clinics may take the idea from this and develop that further.

What are the direct benefits for patients of having the educator and clinician in the same room in a clinical setting?

Mark Phillips: We often find that patients are often reticent about coming to these clinics. They really don’t want to look at their own techniques and I suppose they remember back to days when they were being tutored and they feel self-conscious. They have to want to come to this clinic and to be looked at. It isn’t like going for a piano lesson or being taught. We are looking to see whether there’s anything about their technique that may be in anyway connected to the clinical problem they have. So we’re not trying to look at the way they play from any other perspective than that. People play in lots of different ways. Also videos are really useful, anyone with a smartphone can record themselves. When we look at them we can slow them down, go back over a sequence, look at it carefully, look at it together and see how that relates to their clinical problem.

Penelope Roskell: There is something different about the joint clinics, because I’m there involved in the consultation I’m able to ask them questions from my own point of view so that I’m well informed as to how best to help them in the future. Because a piano teacher is not qualified to diagnose and that is absolutely number one and nor am I qualified to answer questions that students sometimes ask me, like should I have that steroid injection or that operation and it’s not for me to advise on that but in this situation between the three of us we can discuss the best way forward viewing it from all the different angles.

Any challenges you are finding with the joint approach?

Mark Phillips: It’s 30 minutes long, which is short. We are just getting into our flow by half an hour.

We haven’t had a chance to find out what patients think, especially how they feel about the added value of seeing us both together.

The four patients we have seen in this format have individually expressed to us they thought it was a good session and it stimulated a lot of discussion and ideas. It would be great in the future to include a hand therapist and do a proper multi-disciplinary clinic. Hand surgeons always work very closely with hand therapists. Because there are so many different joints in the hand and different diagnoses. In the hand you’ve got unique problems to one finger or there will be a combination of problems. So your hand therapy is always bespoke, it’s all tailor made to that patient so you have to discuss each patient individually and with musicians it’s even more so.

Certainly with the three most commonest instruments this is going to be a major area of growth in the next ten years and it’s very exciting.

During the half an hour the patients sense the trust we have with each other (Penelope: we work very well as a team, we both have a lot of respect for each other’s knowledge. So I think they go away feeling they’re whole picture has been seen and assessed and we are seeing them as an individual with a problem that can be resolved.)

All patients have been bought over by the end of the 30 minute sessions. You can see the reticence and slight nervousness at the start of the half an hour turning into trust and outpouring of confidence and sharing of the problem and by half an hour we are in to the nitty gritty aren’t we. The output of that is usually I will see them again or Penelope will see them again.

What they can do is continue seeing Penelope for a while and see me in the clinic two months later and see how things have been going on in the meantime. And because we know each other well we can send secure emails back and forth and stay in touch.

Occupational Health in the Performing Arts Industry: The Original Gig Economy

Tuesday, February 5th, 2019

 

Wednesday 27th March 
Royal Society of Medicine
London

 

Registration for this event is now open.

Training arts professionals in healthy practice skills is vital, but we believe that healthy individuals also require systematic support from the industry that is built on their work. 

The majority of workers in the performing arts are freelancers and all are likely to, at some point in their career, experience an injury or have other health problems as a result of their work. The particular needs of those in this industry translate to other areas of the national workforce where, with the expansion of the ‘gig-economy’, traditional occupational health provision increasingly may not reach. 

The Occupational Medicine Section of the Royal Society of Medicine and the British Association for Performing Arts Medicine have therefore come together to run a one day educational meeting that will be of interest to a wide range of people with an interest in health and work.

Talks and panels feature leading arts industry and occupational health experts, academics and clinicians, and include consideration of the economic case for investing in health, health promotion, injury prevention and rehabilitation for self-employed workers, key and emerging occupational health issues in the arts sector.

Contributors include:

Professor Aaron Williamon, Royal College of Music, Centre for Performance Science

Zeb Soanes, BBC Radio 4 presenter

Jane Dyball, CEO of Music Publishers Association Group, winner of Music Week Women in Music Award for Outstanding Contribution

Professor Emma Redding, Head of Dance Science, Trinity Laban Conservatoire of Music and Dance

Colin Thomas, Chief Medical Officer, BBC

Colonel John Etherington, Director of Defence Rehabilitation and Consultant in Rheumatology and Rehabilitation, Defence Medical Rehabilitation Centre

More information and registration

New BAPAM Clinics

Tuesday, February 5th, 2019

We now hold free Performing Arts Medicine clinics in London, Glasgow, Birmingham, Cardiff and Leeds. 

If you make a proportion of your living from, or study in the performing arts, and have a health problem related to your work, we can help you.

Our clinicians are experienced at dealing with the problems performing arts workers frequently face, and can help with an accurate diagnosis and advice including identifying efficient care pathways, both in the NHS and from other specialist individuals and services. The BAPAM team can also advise about the availability of financial support for people experiencing health problems affecting their ability to work or study.

To make an appointment, give us a call on 020 7404 8444.

Free Health and Wellbeing Webinar Series with ISM

Tuesday, February 5th, 2019

Tuesday 5th February to Tuesday 26th February

We have teamed up with the Incorporated Society of Musicians to present a series of free webinars looking at musicians’ health. Our performance health experts will lead the sessions, exploring solutions to problems frequently encountered in music careers. For more information on each session and how to book a free place click here.

Looking after yourself on tour: Tuesday 5th February
Health in the gig economy: Wednesday 13th February
Resilience and bullying in the workplace: Tuesday 19th February
Preventing playing related injury: Tuesday 26th February

 

BAPAM Performance Environment Day

Tuesday, November 6th, 2018

What would an ideal performance environment look like? Is such a thing even possible when we work in such widely different spaces? How do our environments affect our health, our creativity, our social relationships? What can healthcare professionals, technicians, artists, support organisations and communities do to both support performing arts wellbeing and facilitate excellence in artistic practice?

Our Performance Environment Day explores these topics, from a healthcare perspective and including the experiences of other professionals including artists, technicians, educators and people working in arts support roles, some with additional needs due to illness, injury, difference or disability

You can now read the full programme.

The event takes place at Resource for London on November 17, 9.30 – 17.00.

Tickets are available here.

 


Presentations and Discussion

The Performance Environment: Challenges in the Performing Arts Industry
Sophie Lane, Specialist Performing Arts and Sport Physiotherapist

Saving Your Ears for the Music!
Gladys Akinseye and Jordon Thompson, Clinical Audiologists and Hearing Therapists

Preparing for Challenging Performance Careers
Arran Peck, Athletic Development and Conditioning Coach, National Centre for Circus Arts

Cognitive Function of Adult Amateur Pianists
Dr Marie McKavanagh, GP, MSc Performing Arts Medicine Shipley Rudge Award Winner

Anxiety and Psychological Support for Theatre Productions and Artists
Dr Anna Colton, Chartered Clinical Psychologist

Panel Discussion/Q&A

Do our performance environments facilitate or obstruct artistic practice? How can the ways in which we design, manage, use and share space be a positive factor in healthy practice? Collective support in creative communities, accessibility and participation.

Kris Halpin, Musician/Producer
Robin Townley, CEO Association of British Theatre Technicians
Lisa Tregale, Head of BSO Participate, Bournemouth Symphony Orchestra
Siân Willett, Co-creator of Wellbeing for the Arts

Dan Hayhurst, BAPAM Information Coordinator (Chair)

Vocal Health Workshop in Glasgow

Friday, September 7th, 2018

Top vocal and performance coach Lucy Heyman will be conducting an afternoon workshop for vocalists in Glasgow.

The BAPAM training session organised by the Musicians Union will take place at the Scottish Trades Union Centre in Glasgow on 13th September. It will cover essential skills for enhancing vocal performance with the aim of giving tools and skills needed to succeed and thrive in music careers.

As a manager Lucy Heyman has worked with a range of artists including some of the UK’s biggest names, so has a real understanding of the trials and tribulations a performer goes through.

The topics she will cover include vocal techniques and warm-ups, preparation for performance and psychological skills for optimal performance.

BAPAM’s healthy performance training sessions are designed to avoid health problems which are often encountered in the course of an arts career and are led by the experts in the field. To enquire about booking a BAPAM training session email info@bapam.org.uk

We also run free medical assessing clinics for performing artists in Glasgow every month. (Next one is 5th October) To register as a patient and book an appointment call our helpline on 0207 404 8444/5888

Bournemouth Symphony Orchestra are recruiting an Orchestra Doctor

Monday, July 9th, 2018

The Bournemouth Symphony Orchestra is looking for a local GP to become one of the Orchestra’s Doctors. The GP will ideally be interested in music. This is an interesting voluntary role which will consist of giving a few hours each month in return for concert tickets where possible.

The successful Doctor will become a member of AMABO (Association of Medical Advisors to British Orchestras) and BAPAM (British Association of Performing Arts Medicine) which will involve one or two training days per year.

As one of the Orchestra’s Doctors you will be expected to come into rehearsals every couple of months or more frequently if desired, to meet with orchestra members who wish to discuss any health problems especial those which are performance-related. An interest in Rheumatology and MSK type disorders would be an advantage.

For further information please contact Natalie Wright at the BSO directly:

T: 01202 644704
E: nwright@bsorchestra.co.uk

You can also apply with CV and covering letter to the BSO.

Closing date for application is Monday 23rd July 2018 with interviews being held in Poole towards the end of the summer. Start date will be beginning of October.

The BSO is an equal opportunities employer.