Strategic Plan 2018 2022 Our Vision Access to

Strategic Plan 2018 -2022

Our Vision Access to appropriate mental health care provision for all in Zambia Our Mission To improve outcomes for mental health patients in Zambia through the use of 'Therapeutic Art' 2

Long-term aim Zambia Therapeutic Art (ZTA) is a volunteerled Scottish charity which aims to improve care for Mental Health service users by designing, developing and delivering practice based training in therapeutic use of ‘art’ to health and social care staff; working to ensure its ongoing sustainability; monitoring and evaluating the continuing practice; and conducting research on this topic. With Zambia acting as our pilot, we aim to produce a sustainable model of training and service delivery which can be directed, owned, & managed by locals, and that can be continued successfully with minimal external support. 3

Context: Mental health care in Zambia Mental health services in Zambia are recognised as significantly under resourced. There is little specialist provision at community level with services tending to be centralised to hospital facilities in Lusaka. The lack of resources impacts on staffing levels and treatment options; which are almost entirely pharmacological. Legislation is seriously outdated: A new Mental Health Bill is in process. Issues around the rights of mental health patients and stigma are well documented. The Ministry of Health (Mo. H) and key training institutions recognise these gaps and difficulties so welcome evidence based psychosocial initiatives such as The Zambia Therapeutic Art (ZTA) Course which can work in alignment with national and international guidelines and policies. Therapeutic Art Course & Zambian context Therapeutic Art training rapidly up-skills the trainees, building on their existing knowledge and skills; and through its practice based approach enables trainees to independently use Therapeutic Art skills as a new skill in their ‘toolbox’ following the course. The short nature of the course (current format - 24 hours over 6 weeks) minimises the impacts of withdrawing hospital staff from their work – in respect of the challenges to staffing levels in mental health care. The course is designed to be accessible for mental health professionals at all levels – ward assistants, mental health nurses, physiotherapists, counsellors, psychologists, doctors, clinical officers, clinical neuropsychology trainees, MSc mental health nurses, and MMed psychiatrists: This increases the opportunity for patients to access Therapeutic Art and provides a commonality of understanding of the approach across all staff levels. Trainees are trained in their normal work/study time and workplace – avoiding expensive training overheads and enabling opportunities to use skills learned in their everyday work with patients, during the 6 week training period Enthusiasm for The ZTA Course, based on its demonstrated potential for enhancing patient care has led to a request by key stakeholders in Zambian Mental Health that it be included in all pre-service curricula of Mental Health Professionals. 4

Since 2011 ● ● Lesley Hill and Joanna Pearce, UK Art Therapists have developed and delivered training for Mental Health professionals and trainees in the Therapeutic use of Art in Zambia. A total of 562 mental health professionals and trainees have received training inputs. The ZTA Course – which was designed and shaped from learning year on year ‘what works’ has been completed by 150 of these trainees. Since 2014 the full practice-based training has been delivered in various settings to 81 students in pre-service training, 37 Masters and other higher students and 78 professionals in Mental health teams in Lusaka, Livingstone and Ndola. 7 Zambian Trainers have completed the 2 stage certification process to become trainers themselves 5

Feedback from mental health professionals trained by ZTA I used to overlook and never paid attention to my patients but now I see that they also need the attention and caring relationship I can use art exercises to learn about what the patient is feeling without their having to say much It will help me to be more patient with my clients I believe patients have benefited so much from the art sessions in that it provides a platform where they are given the choice to express themselves, something which they may not be able to do on the ward It can change my way of thinking about patients as I feel more nonjudgmental now Art helps us access memories and recovery of feelings and emotions 6

Our Principles & Approach ● ● ● ● Defending the rights of people facing mental health problems - often the most isolated and disadvantaged in the world Promoting the vital role that art can play in restoring and maintaining wellbeing, for all individuals, at all stages of life Following the principles of recovery and rehabilitation, as laid out by WHO guidelines Contributing actively to Sustainable Development Goals 3 and 10 Ensuring that all people who come into contact with any aspect of our work are treated with dignity and respect, and that their rights, health, safety and wellbeing are of utmost importance at all times Practicing equality of opportunities and embracing diversity in all aspects of our work Working closely with civil society and governmental partners to ensure the mid to long-term local ownership & sustainability of programmes Acting transparently, sharing financial and evaluation reports publicly Learning from our mistakes Embedding new skills into current systems through a ‘cascade model’ of training Introducing knowledge using skills-based training, through practice Using highly qualified, experienced & certified volunteers to ensure both quality and safeguarding Keeping costs low to achieve maximum impact 7

Priority 1: ESTABLISHING OUR MODEL Establishing an effective cascade model of therapeutic art training, which enables the long-term, sustainable introduction of a psycho-social therapy for people with mental health problems How we will do this ● ● ● ● Complete all current programme of training of trainers, providing good quality training that leads to better equipped staff and more effective therapeutic services Engage national and local stakeholders at all levels of model development Support Zambian governmental and civil society organisations to work together as a coordination body Take feasibility study learnings forward into full-scale pilot 2019 -2022 Explore training delivery options within community settings Support Zambian trainers to explore how they can take their new skills further, and deliver trainings more widely Maintain an effective monitoring, evaluation and learning cycle to ensure constant learning & improvement 8

PRIORITY 2. EMBEDDING SUSTAINABILITY Ensuring therapeutic art in Zambia can be sustained with minimal external support, and initiating its introduction elsewhere How we will do this ● ● ● Support Zambian governmental and civil society organisations to work together as a coordination body, taking ownership of embedding therapeutic art into national systems in 5 -10 yrs (including curricula in training institutions) Identify opportunities and barriers to governmental adoption of the programme, and alternative options if necessary Evolve ZTA’s role from one of implementers to one of advisors in Zambia Engage local stakeholders at all levels of model development Introduce the (adaptable) model to a second country e. g. Malawi Examine potential for freelancing for trainers, 9

PRIORITY 3. CHANGING ATTITUDES Working to improve attitudes towards mental health and its essential services on a local, national and global level How we will do this ● ● ● Break down barriers by introducing art as a tool for communication Contribute to wider debates on mental health provision, therapeutic art, and international development, within both academic and professional spheres Remain up-to-date on mental health policy and programmes on a global and country-specific level 10

PRIORITY 4. STRENGTHENING OUR ORGANISATION Becoming more efficient and effective in the ways that we work How we will do this ● ● ● Strengthen governance procedures to ensure we become a more robust organisation Raise our public profile, through improving our public image and presence Prioritise fundraising activities in the short-term, to answer urgent need and to diversify our funding sources Develop better planning systems to ensure we make the best use of our resources (financial, human…) Improve internal communications systems Strengthen our board by recruiting to fill skills gaps 11