An Annual Creative Writing Competition in Mental Humanities for Students in Canada

A Descriptive Report and Thematic Analysis

Abraham Rudnick and Lara Hazelton

Abstract: The Department of Psychiatry at Dalhousie University has conducted an annual creative writing competition for undergraduate and postgraduate students among Canadian medical schools since 2010. This report briefly describes the process and thematically analyzes some output of this competition during its first decade. Both undergraduate and postgraduate students from most medical schools in Canada have applied and won recognitions for poetry, short fiction, and graphic prose works. The winning pieces commonly incorporated themes of sadness, loneliness, and death. Expansion of such an endeavor to other disciplines and countries may be beneficial.

Introduction

Health humanities, which is interdisciplinary scholarship and creativity in the humanities and arts as it relates to health, has grown in recent decades, expanding to involve non-medical disciplines as well as lived experiences of people with health challenges and their families. [1] At many universities, learners are involved in health humanities initiatives, such as The Health Humanities Journal. [2] Another example is the Dalhousie Department of Psychiatry Annual Student Writing Contest (ASWC), [3] which is part of this department’s Medical Humanities program that is separate from but complementary to the HEAL program, Dalhousie Medical School’s Medical Humanities program (one of the first in North America). [4] This creative writing competition focuses on mental health and related topics, due to the host department’s scope and faculty expertise. [5] The establishment of the competition was described previously by Lara Hazelton and Nicholas Delva. [6] In this report, we provide a brief overview and a thematic analysis competition and its winning entries during the first decade of its existence. The data analyzed in this report is in the public domain with continued approval of all concerned and involved.

Brief Overview

The writing competition was introduced in the year 2010 and has continued annually. All undergraduate and postgraduate (residency and fellowship) students at the seventeen medical schools in Canada are invited to submit entries a few months before the deadline, which occurs each spring. The creative work submitted typically consists of poetry, short fiction, graphic prose, and essays. Additionally, confidentiality is required for anyone mentioned in the work, excluding the author. Adjudication has involved semi-structured reviews by faculty psychiatrists who were advised by a creative writing expert. Winning submissions are posted on the host department’s website, and their authors receive formal recognition and $100 CAD. [3]

In each of the first two years of the competition, only one submission won first place; since then, one or two undergraduate submissions and one or two postgraduate submissions have won first place each year. In addition, two to three honorable mention submissions were awarded in the first six years. Approximately half of the winning entries in the writing competition were poetry while half appear to be short fiction, although some may in fact be reflective personal essays. A handful of graphic prose works have also won first place. The distribution of poetry and prose was similar across the years and across winning entries.

Thematic Analysis

A thematic analysis of the winning entries identified three themes that predominate: sadness, isolation, and mortality. These frequently cooccurred in the same work. The theme of sadness and its variants (e.g., depression, desperation, and grief), were the most common among winning entries. The second and third most popular themes found were solitude (e.g., loneliness, social isolation, and withdrawal) and mortality (e.g., suicide, dying, and witnessing death), respectively. The following themes with negative valence were found at a lower rate than the aforementioned: losing control, feeling insane, ignoring suffering, and experiencing guilt. Further, there were themes with positive associations (i.e., expressing compassion and appreciating beauty in a painting or colors of nature), but they had low prevalence. Among the evaluated pieces, many authors acknowledged the perspectives of both students and patients, thereby providing an overarching theme of students mirroring patients’ and their families’ experiences.

Discussion

These findings suggest that medical (undergraduate and postgraduate) students who creatively write effectively about mental health and related matters may be preoccupied with negative experiences and their impact. On the other hand, it could be that these winning submissions were judged as more effective by the faculty adjudicators than submissions involving humor or focusing on more upbeat topics. It is encouraging that the authors were able to empathize with patients and their families. These findings pose educational implications, such as focusing attention towards supporting learners as they process negative or otherwise distressing clinical experiences. Important limitations of this report are that it addresses only Canadian medical (undergraduate and postgraduate) students and that its thematic analysis addresses only winning entries of the competition. Opening up the competition to other disciplines and learners from other countries may be beneficial. There are also opportunities to involve patients in adjudication. In addition, starting in the year 2020, experts in creative writing will adjudicate submissions alongside psychiatrists.

Conclusion

The past decade has shown that it is possible to have a sustainable creative writing competition that offers medical learners a chance to explore themes with depth and complexity. We anticipate future collaborations with other institutions interested in sponsoring related creative writing competitions, as we believe it is a worthwhile endeavor for all involved, enriching psychiatry practice, education, and research with emerging contributions of health humanities.

References

1. Karin Eli and Rosie Kay. Choreographing lived experience: dance, feelings and the storytelling body. Medical Humanities 41, no. 1 (2015): 63–68, http:// dx.doi.org/10.1136/medhum-2014-010602.

2. The Health Humanities Journal of UNC-CH, http://hhj.web.unc.edu/.

3. “Annual Student Writing Competition,” accessed February 2020, https:// medicine.dal.ca/departments/department-sites/psychiatry/education/ medical-humanities/writing-competition.html.

4. Thomas J Murray. Development of a medical humanities program at Dalhousie University Faculty of Medicine, Nova Scotia, Canada, 1992–2003. Academic Medicine 78, no. 10 (2003): 1020–1030.

5. Abraham Rudnick, ed. Recovery from Mental Illness: Philosophical and Related Perspectives (Oxford: Oxford University Press, 2012).

6. Lara Hazelton and Nicholas Delva. Exploring the Intersection of Mental Health and Humanities: The Dalhousie Psychiatry Student Writing Competition. Academic Psychiatry 40, no. 2 (2016): 337–338.

-Abraham Rudnick, MD, PhD, is a professor and the current Medical Humanities Coordinator in the Department of Psychiatry at Dalhousie University, Canada.- -Lara Hazelton, MD, is an associate professor and the founding Medical Humanities Coordinator in the Department of Psychiatry at Dalhousie University, Canada.-