The Art of Healing – Annual Report 2024

When you walk into the art room at Women’s College Hospital (WCH), you’ll see the prompt of the day written across the whiteboard. Today’s prompt is ‘Light in Darkness.’ It’s not uncommon to have preconceived notions about what therapy is and what it looks like in practice. But many may not imagine an art room with paints, fabrics and clay.

Art therapy is an effective technique for approaching complex feelings or trauma because it provides a nonverbal method of exploring experiences, thoughts, and feelings that patients may struggle to put into words. Whether it’s visual arts like painting and sculptures or written art like songs, narrative stories or poetry, patients are encouraged to connect with their emotions using creative mediums.

Through the mental health department and the sexual assault/domestic violence care centre (SA/DVCC) at WCH, art therapy is built into their approach to facilitating recovery.

“In the Trauma Therapy program, training for our learners in psychiatry, psychotherapy and social work includes exposure to the modality of art therapy,” says Dr. Nancy McCallum, a psychiatrist at WCH. “It’s another way to get to know their patients.”

The Women Recovering from Abuse Program (WRAP) is designed to support women and gender-diverse people who are looking to heal and recover from the impact of childhood interpersonal trauma. As the longest-standing trauma therapy program at WCH, this multimodal intensive day program revolves around group therapy, with art being one of its core pillars.

Approaching therapy from an artistic lens can be the gateway many patients need to overcome barriers and inhibitions in their healing process. Cultural or personal beliefs and language barriers are common deterrents from traditional talk therapy, but using art as a tool for self-expression can allow patients to overcome these deterrents.

“Not every patient comes in ready to talk about their feelings or the trauma they’ve experienced,” shares Dr. McCallum. “But art can provide them a safe space to help them do that.”

Art therapists' primary intervention is to inspire curiosity. They encourage patients to reflect on the experience of creating their artwork, interpret its meaning, and consider their emotional responses. In art therapy, it’s not about the end product—it’s about embracing the journey and the feelings it brings forth.

Left to right: Abby Hershler, psychiatrist, and Julie Blair, social worker and mental health therapist

“Art grants us access to playfulness and reminds us not to take ourselves too seriously,” says Emma Moore, social worker at the SA/DVCC. “There isn’t pressure on getting something perfect or to produce a polished, final product.”

Creating a piece of art that mirrors vulnerable emotions and sharing it with others can be empowering and cathartic. It can even help the creator connect more deeply with the art and the emotions.

There is an affirmation that comes with sharing art, creating a sense of being seen and understanding that your feelings haven’t been made up or imagined. As damaging as it can be for someone not to feel believed in their struggles with mental health, it can be just as healing to know you are seen and heard.

“There is value in keeping artwork as a way to reflect on therapy. It’s a visual record of healing – something tangible that captures the learning or changes they’ve made in therapy,” says Emma.

Providing women with a stage to connect and heal from trauma and oppression while also giving them the opportunity to explore the parts of themselves that experience joy, celebration, growth and hope underscores the fundamental role of art therapy in the mental health services delivered at WCH.

Programs like WRAP and SA/DVCC are foundational in upholding WCH as a welcoming, safe space and a champion for women within the ever-evolving healthcare and mental health landscape.

Delivering mental healthcare within supportive housing: A hospital-community collaboration

The YWCA Elm Centre is a not-for-profit housing complex with 300 mixed housing units for women and gender-diverse people and their children. In partnership with Women’s College Hospital (WCH) and Jean Tweed Centre, a community-based substance use and mental health agency, they added collaborative psychiatric care to the existing WCH-YWCA primary care collaboration to address mental healthcare needs within the supportive housing setting.

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Team members Dr. Lucy Barker, scientist and psychiatrist from WCH who led the evaluation, WCH’s Dr. Sheila Wijayasinghe, family physician who leads the primary care collaboration, as well as YWCA’s Danielle Nakouz, share their perspectives on the importance of this partnership in addressing unmet mental health needs in permanent supportive housing settings.

What are potential challenges that may happen if mental health support isn’t provided in permanent housing support settings?

Danielle Nakouz (YWCA): All too often, hospital settings feel inaccessible to those who are most vulnerable and have high acuity needs. The concern is that without pilots or programs such as this, tenants who are experiencing mental health complexity will continue to deteriorate to the point of impacting their tenancies.

What are the benefits of integrating mental health support services within supportive housing settings?

Dr. Barker (WCH): There’s a huge need for mental health support within supportive housing settings. It’s important that people have a wide range of options to meet their needs. We wanted to ensure collaboration so that the staff working in supportive housing would have additional support and connections to resources and that the tenants would ultimately be better supported.

Danielle Nakouz (YWCA): This model was particularly important to our program as it acted as a critical eviction prevention measure for tenants whose mental health complexity manifests in their tenancies, making them very vulnerable to housing instability. If mental health interventions are successful, then there is a reduction in cost and pressure on healthcare systems.

Why was this partnership important?

Daniella Nakouz (YWCA): This partnership was unique and successful as it brought psychiatry into the community as opposed to the community needing to get to psychiatry, which can often be a barrier for those experiencing serious and persistent mental illness. The partnership supported tenants to restabilize in their own community before needing to consider more intrusive interventions, which can cause significant trauma for people experiencing mental health crises.

Having on-site psychiatry support built new skills and intervention techniques for staff, which in turn supported the resiliency and prevention of burnout amongst staff. It’s important to note that this also offered an opportunity for clinicians to learn, adapt and tailor their training and skills on how to provide care within the community. The mutual learning was really a joy to be a part of.

How has the collaboration with the YWCA influenced WCH’s understanding and approach to addressing mental health needs in supportive housing settings?

Dr. Wijayasinghe (WCH): The individuals we care for at the YWCA have often had negative experiences with the healthcare system and have sadly faced unacceptable levels of discrimination. By providing outreach care, we hope to rebuild trust to allow for reconciliation and reconnection. By providing care on-site and receiving feedback from the case management team at the YWCA, we are continuously learning and adapting to the evolving needs of the community within the building.

What are your hopes for supportive housing settings regarding mental health?

Dr. Wijayasinghe (WCH): I hope we can continue to build our program and consider expanding this model to other WCH partner sites. Beyond the care that is offered to patients, further evaluation of our capacity-building sessions for the case management team could also offer opportunities to support other agencies that do this important work.

Danielle Nakouz (YWCA): To effectively support individuals, a “housing first” approach that includes psychiatry as an integral part of the program must be adaptable and innovative. Customized care plans should be developed for each person.

By fully integrating mental health support within supportive housing, the aim is to reduce the likelihood of frequent hospitalizations or evictions. This approach would also help bridge the existing gaps between community services and healthcare.