Embedding the arts in healthcare

In 2017, my research with Arts for Health spread beyond the UK when a Churchill Travelling Fellowship enabled me to visit Finland, Belgium and the US to explore best practice for the arts and culture in healthcare. My report Art Thou Well? Creative Devolution of Mental Health in Greater Manchester, which involves 40 organisations and more than 300 people, assembles the myriad roles the arts could, and do, play in the service of mental health, and presents some of the most innovative, effective and ethical models of practice I encountered.

Arts-based interventions can help foster those vital ingredients of recovery that we cannot target with medication or talking therapies alone

My fellowship asked how Greater Manchester’s mental health strategy could benefit from considering the role of the arts and culture, drawing on examples such as the repurposing of an old Helsinki mental health asylum into a beautiful and accessible wellness centre, and the LAND (League Artists Natural Design) studio in New York, where young adults with learning disabilities are taught life skills through art.

Finnish inspiration

Greater Manchester is making the arts and culture integral to its health strategy. This bold move takes inspiration from Finland, and is based on evidence from this and other Nordic countries. For more than 40 years, Finland has had 40 arts promotion managers in government, tasked with ensuring that all citizens have access to the arts and culture.

Faced with challenges including some of the highest suicide rates in the world, the Finnish government is leading a series of major cross-sector projects as part of its Art and Culture for Wellbeing programme (2011–19). Policy decisions like this indicate a clear understanding that culture and creativity can be effective tools for strengthening social inclusion at the individual, communal and societal level.

So far, the implementation of these key projects has encouraged a groundswell of support to develop – with backers ranging from artists to frontline clinical staff – and the rapid uptake of arts and health initiatives. This underlines the importance of securing backing at the highest level. The Finns have also identified a need to prepare and train artists to work in healthcare settings – and clinical staff to work in arts-based ways.

In Finland, play and creativity are understood to be fundamental ingredients of problem-solving and wellbeing, and therefore critical to resolving health inequalities and dilemmas. The versatility of the arts is acknowledged, and there are numerous examples of how their use helps people to engage with health and social services, connect generations (Baby Dance Hour), communicate messages about mental health to new audiences (Mieli: The Finnish Association of Mental Health), and support recovery through skills development and social participation.

Creative health in the UK

Finland’s model values imagination, participation and rehearsal in the quest towards understanding and addressing mental health difficulties. But innovative, solution-focused practices that address social and environmental concerns pose a challenge to the outmoded systems embedded in the UK.

Increasingly though, social prescribing is enabling arts and health work to flourish in Britain too. The 2017 report Creative Health: The Arts for Health and Wellbeing amasses the ample evidence base for arts-based interventions, while highlighting the appetite among service providers and users for wider treatment options. In June this year, the Culture, Health and Wellbeing Alliance formed a national body involving over 40 leading organisations.

Greater Manchester is positioning itself at the leading edge of this work, thanks to devolution. The recently established Manchester Institute for Arts, Health and Social Change and the Live Well: Make Art network both exist to formalise and catalyse innovation. For researchers, there is the Arts Health Early Career Researchers Network, which links people in the field to promote learning and collaboration.

In my experience as a child and adolescent mental health services (CAMHS) clinician, arts-based interventions can help foster those vital ingredients of recovery that we cannot target with medication or talking therapies alone, while at the same time empowering community members to support each other.

My CAMHS team have begun collaborations with arts partners to help shape and deliver mental health messages and interventions to the community. In August, families had the opportunity to participate in the much-loved Vintage by the Sea festival. Next year, The Dukes Theatre in Lancaster will support Year 7 and 8s to deliver mental health-themed monologues to younger children.

Growing interest

Since my report was made available, I’ve been invited to contribute to numerous forums including the Devolution Reference Group and clinical commissioning groups. That my contribution is welcome in these circles indicates the sea change that Jon Rouse, Chief Executive of the Greater Manchester Health and Social Care Partnership, is helping to bring about. In September, all ten lead commissioners for children and young people’s services for the area will gather to consider some of the findings of my report and how they might be usefully implemented.

These developments should also be of interest to the Care Quality Commission – because crucially, the arts do not carry risks in terms of side-effects, contraindications or toxicity, and thus protect patient safety and choice. Moreover, participatory arts support major components of recovery such as agency, self-esteem, and – critically – hope.

Manchester has a long history of quality arts-led health services, and this is now becoming mainstream, with cross-sector training and events becoming more commonplace among healthcare providers and arts partners. Organisations such as Cartwheel Arts, Start in Salford, and 42nd Street are all now in a position to demonstrate, with proper support and research programmes, knowledge that has been in action all along – that the arts, culture, music and storytelling are not alternative but an essential part of healthy and connected communities.

Katherine Taylor is Senior Clinical Psychologist in child and adolescent mental health services at the Lancashire Care NHS Trust.
www.lancashirecare.nhs.uk

Join the Arts Health Early Career Researcher network here. Join the Live Well Make Art mailing list by emailing [email protected]. You can also follow the work of the North West Arts and Health Network through Clive Parkinson's blog.