The project aims to be a means of providing a therapeutic activity on the ward as well as combining patient and staff wishes to decorate and brighten the ward environment.

The objectives were to use the Mural Project as a motivational factor in involving the patients in the Occupational Therapy process. The Occupational Therapist could also use the activity to assess the cognitive functioning; sensory, interpersonal and community abilities of the patients.

The project was also a means of improving the ward environment and brightening the mood of those patients who use the room. It could also contribute to provide a relaxing environment.

There is a flow chart describing the process included in appendix.

The process was repeated individually for each wall as there is a high turnover of patients and by completing each wall as an individual project it allowed those patients engaging in the project to see a finished result. It was also easier to monitor the sessions and assist with painting if needed; however, this did restrict the number of people able to paint at one time due to the space available on the wall. The project would run up to 3 times a week for 30 minutes to 60 minutes, depending on the client’s ability to concentrate in order to facilitate the project to completion.

It is important to note that the decision process of the choice of picture was a vital part of the project. Although the clients were unable to leave the ward due to section status, they were able to choose specific types of scenes. Pictures for the local or familiar areas led to people discussing memories, holidays, and experiences. These discussions alone could fill the entire therapy session. It also provided an opportunity for those patients, who did not have the confidence or ability to paint, to engage in the process.

A number of people participated in the project over time. Those who were unable to paint or engage in conversation; e.g., patients suffering from Huntingdon’s disease, were allowed to sit in the room and observe. Chairs were left in the room for patients to sit and watch. The equipment was well monitored. An informal atmosphere was maintained to encourage participation without any anticipated pressure to perform.

Difficulties Encountered

Choice of Picture
Some patients wanted to draw death scenes or drug representations. It can be difficulty to refuse these options when the patient has no insight into their situation. An explanation that it was a shared area and others may not enjoy such violent images generally was sufficient.

Lack of Tolerance for Others
There were many pictures chosen during the discussions and finding an ultimate choice could be difficult if certain patients were very fixed about their choice. Having the 4 walls allowed from some negotiation around this.

Painting Skills
As some of the patients participating were very unwell, there were occasions where they struggled to mix the patients to complete the scene. Part of the exercise was to increase patients’ self-esteem so it required certain painting techniques and handling skills, which allowed the Occupational Therapist to assist in the patients’ area of painting without it seeming that the Occupational Therapist took over.

Lack of Ventilation
Most of the equipment was low odour; however, when certain paint and varnish was used the room did not have sufficient ventilation to remove the odour. This then perpetrated the entire ward. This is an environment that will reputedly have less ventilation due to the nature of the ward being a locked environment.

Equipment
It is important to note for future projects that the acrylic paint is water based thus can be washed off the walls. The fire retardant spray when sprayed directly onto the paint will wash it off the walls. The walls were thus sprayed with a fixative spray prior to the fire retardant spray.

Both staff and patients enjoyed this project. It allowed an opportunity for the patients to have some control over their environment. All those involved had not completed a project like this and none of the participants were artists. The final result was better than the group expected and all those involved were proud of the final work.