Art, science and the mental health we need in a pandemic

Giovanni Abrahão Salum Carlos Eduardo Filho Sara Evans-Lacko Marcelo Pio de Almeida Fleck Fernanda Lucia Capitanio Baeza About the authors

Mental health is a discipline that aims to provide the best possible care for people in need of mental health support. It is an extremely complex discipline fueled by tensions such as science vs. art, objectivity vs. subjectivity, statistics vs. stories, medication vs. psychotherapy, brain vs. mind, among others.

All these tensions are real. They are present in each clinical encounter between mental health professionals and patients: whether to rely on the results of a rating scale or an unstructured patient interview; to choose between a psychological or a pharmacological treatment; or to choose to perform a brain scan or explore art work a patient has made. Some may feel that they have to make a choice between the right or left side of those tensions, i.e., to choose between being a “soulless brain professional” or a “humanist scienceless practitioner.”

Here we argue that either form of reductionism ignores the complexity of patients’ needs. The mental health we need is plural. We need science and art; objectivity and subjectivity; statistics and stories; medication and psychotherapies; both brains and minds. Of course, the complexity (and beauty) of this discipline relies precisely on adapting and choosing the best perspective for each clinical situation. 11. McHugh PR, Slavney PR. The perspectives of psychiatry. 2nd ed. Baltimore: Johns Hopkins University Press; 1998. Pluralists called this “changing the glasses” or “shifting gears”, 22. Cabaniss DL. Shifting gears: The challenge to teach students to think psychodynamically and psychopharmacologically at the same time. Psychoanal Inq. 1998;18:639-56. i.e., adapting perspectives to the specific needs and context of each patient.

In the face of coronavirus disease 2019 (COVID-19), we believe this form of thinking is even more important. Patients with severe mental illness need us to go beyond this type of reductionism. They need us to adapt our practices collectively to apply the best evidence to their care, but also be open to new types of care which address these unprecedented circumstances. And this requires both science and art, innovation and creativity.

We recently published a paper that reports on the “statistics” of our service during the COVID-19 lockdown. 33. Salum GA, Rehmenklau JF, Csordas MC, Pereira FP, Castan JU, Ferreira AB, et al. Supporting people with severe mental health conditions during the COVID-19 pandemic: considerations for low- and middle-income countries using telehealth case management. Braz J Psychiatry. 2020 Jun 22:S1516-44462020005019203. doi: 10.1590/1516-4446-2020-1078. Epub ahead of print. PMID: 32578690. We shared a spreadsheet tool for facilitating telemonitoring and tracking patients that are at risk of food insecurity (https://figshare.com/s/826f200d872e35ea67f1). Now, it is time to also publish the “art” that captures the services we need at this time.

Artist Carlos Eduardo Filho, a student attending the 7th semester of medical school at Universidade Federal do Rio Grande do Sul, southern Brazil, spent some time at our center and captured the pluralism of our practice (his artwork is shown in Figure 1 ). In these difficult times we are living, let us all embrace and look at what people with mental conditions need! This still is one of the most important debates of our discipline for providing the best possible care for patients.

Figure 1
Pluralism of the Community Psychosocial Center captured by artist and medical student Carlos Eduardo Filho

References

  • 1
    McHugh PR, Slavney PR. The perspectives of psychiatry. 2nd ed. Baltimore: Johns Hopkins University Press; 1998.
  • 2
    Cabaniss DL. Shifting gears: The challenge to teach students to think psychodynamically and psychopharmacologically at the same time. Psychoanal Inq. 1998;18:639-56.
  • 3
    Salum GA, Rehmenklau JF, Csordas MC, Pereira FP, Castan JU, Ferreira AB, et al. Supporting people with severe mental health conditions during the COVID-19 pandemic: considerations for low- and middle-income countries using telehealth case management. Braz J Psychiatry. 2020 Jun 22:S1516-44462020005019203. doi: 10.1590/1516-4446-2020-1078. Epub ahead of print. PMID: 32578690.

Publication Dates

  • Publication in this collection
    21 Aug 2020
  • Date of issue
    Jul-Sep 2020

History

  • Received
    11 June 2020
  • Accepted
    22 June 2020
Associação de Psiquiatria do Rio Grande do Sul Av. Ipiranga, 5311/202, 90610-001 Porto Alegre RS/ Brasil, Tel./Fax: (55 51) 3024 4846 - Porto Alegre - RS - Brazil
E-mail: trends@aprs.org.br