The library plays an active part in issues of health care

Can the library contribute to public health apart from providing knowledge? Based on a wider health concept, public health services and the library in Ikast-Brande municipality are working together on creating increased quality of life and mental health for mentally vulnerable youngsters and adults.The Salutogenic basic model. Illustration: Peter Thybo

Ikast-Brande municipality is a municipality in central Jutland with 40,798 inhabitants. For several years, the municipality has been focusing on the possibilities of a linkage of culture and health – an initiative that forms part of the municipality’s visions.

Both parties work on the basic premise that the library disseminates learning, experience and cultural activity and the public health sector is in charge of treatment, mental health promotion and the prevention of illness. Nevertheless, the two municipal sections are basically engaged in the same cause – to contribute to the experiences, quality of life and wellbeing of each individual citizen.

When the core issue moves from primarily focusing on physical health to also including mental and social health, i.e. the whole human being, the library as cultural institution has a lot to offer.

By combining the library’s core service, which is interplay with citizens and mediation of knowledge and culture, with our partners’ health professional core service, the citizens are offered more possibilities of being included in meaningful social contexts and thereby the chance to form new networks. In the long term, these networks can contribute to the citizens’ physical, mental and social health.

Combining culture and health

The starting point for the collaboration is the wider health conception based on the salutogenic research and perception of health and well-being (see fact box).The salutogenic perception stresses an awareness of protective factors, rather than the more traditional risk factors, for mental health and psychological power of resistance.

With this in mind, Ikast-Brande Library and the health sector see a potential for a combination between culture and health and a chance to collaborate on increasing mentally vulnerable citizens’ general quality of life and offer them new tools for reflecting on their life situation – and in the end become better at managing their own lives.

The means to reach this goal, has i.a. been by practising the reading method Guided community reading. In 2011 two librarians at Ikast-Brande Library qualified at the Reading Association as reading guides in the method. The foundation was now laid for contact to the social-psychiatric departments with a view to reading sessions with mentally vulnerable people.

Everyone can participate

The method Guided community reading is based on the idea of literature as a possibility for communal activity. The participants in a reading group do not read the texts before a meeting of the group. At the meeting, the reading guide reads the chosen text aloud. This method encourages you to share the initial wonder and enthusiasm that might evolve when you read a text for the first time. 

The method means that everybody can participate, e.g. people with reading disabilities, blind people, mentally vulnerable people, people with limited capacity of concentration et cetera. No preparation or special qualifications are needed for participating in a reading group, everybody can join in no matter background, age, gender and education.

A typical reading hour

The reading guide brings a copy of the texts for each member of the group. The text usually consists of a short story and possibly a poem. The guide is not an instructor, but a guide who may help to mediate the text by way of opening and triggering questions. The text is read aloud in turn with breaks along the way. The breaks offer a chance of discussion about the text and to reflect on the content.

One member might have a question or somebody was reminded of something particular during the reading. The plot and theme of the text are discussed in the group, and the members are invited to share their expectations as to what will happen in the story. Then the reading is resumed.

In this way the reading varies between reading aloud and discussion. This leaves time for contemplation and personal insight and to share your thoughts and interpretations of the text. Basically, there is no correct answer – anything that the story causes the participants to think about or feel, may be the object of discussion.

For vulnerable groups

Mediation of the story creates a sense of community and personal presence, because all the participants listen to the story together. Through the conversations, the participants are able to put individual problems in a meaningful perspective and perspectivate their personal lives. According to the salutogenetic theory participation, dialogue and networks inspire the participants’ motivation to handle and work on their own life situation and provide them with tools for mastering their own lives.

When the initiative was launched five years ago, contact was established to a social-psychiatric drop-in centre. The drop-in centre The Blue Café, which is a local government offer to mentally vulnerable people and people with mental disorders, held a total of 12 reading hours. Up until today, the offer has regularly been extended to include more target groups and new areas, for example targeted offers such as:

  • citizens with stress, anxiety and depression in the local authority job centre
  • citizens with the need for temporary care and treatment at the local authority rehabilitation centre
  • young people under 25, who are unable to complete a youth education programme and have been offered Speci ally organized Teaching for the Young
  • citizens with anxiety, stress and depression at Café Laicos, a socialpsychiatric centre
  • elderly people with dementia at the residential home Brandlundparken.
Experiences from reading hours

Common to the different target groups is that each has expressed great satisfaction with the reading hours. The participants have experienced a personal space in a safe atmosphere. The reading hours have helped to increase the participants’ selfesteem and self-understanding.

Those who in other contexts had found that their opinions were of limited value, found a haven where their thoughts and opinions were welcome, and where everybody was seen and heard in an appreciatory community with reciprocal empathy for each other’s situation and life history.

The participants also got the feeling of becoming part of a community of destiny. This created a feeling of unity and may have helped the individual member of the group to form new and thought-provoking perspectives on their own situation. Many also managed to form new social networks, which in the longer term can contribute toward increased mental, physical and social health.

The art of living

In the municipality of Ikast-Brande we are much inspired by the valuable add-on benefit that reading and other cultural activities can be to mental health and social affiliations, i.a. because it provides new ways of working on welfare. At the government now has set aside a temporary pool for culture and health of nine million Danish kroner.

Culture and mental health is an area that also attracts the interest of other Scandinavian countries. The Nordic Council of Ministers’ report Vändpunkt – forslag om kultur och hälsa I nordisk samverken (2014) provides a useful insight into the many different Scandinavian activities which are being tested in “the art of living”.

The Reading Association 

The Reading Association is a voluntary non-profit association that works to introduce as many people as possible to the joy of reading. The Association was established in 2010 and modelled on the English The Reader Organisation. The Reading Association also offers a course programme for prospective reading group guides in the reading method Guided community reading. The method aims to create the space for experiences and reflections on literature. The Association’s homepage.

The Department of Health takes as their starting point the WHO’s definition of mental health as a “state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

Librarian Head of children’s services Ikast-Brande Municipality
Health Innovator Ikast-Brande Municipality
Head of Culture and Libraries Ikast-Brande Municipality
Salutogenesis
Salutogenesis (salute = health; genesis = cause of) is developed by professor of medical sociology Aaron Antonovsky (1923-1994). Salutogenesis differentiates between health (whether you are healthy or unhealthy) and mental health (a feeling of coherence in life creates mental power of resistance). The feeling of coherence is developed through various learning processes, which results in a strong sense of meaningfulness and comprehensibility in life, as well as a belief in being able to handle demands and liabilities. This differentiation means for example that one can be sick and healthy at the same time – or healthy and mentally unhealthy.