Breaking new ground: how do the arts affect mental health?

Dr Robyn Dowlen, Postdoctoral Research Associate at the Centre for Cultural Value, is working on a series of research digests covering key aspects of culture, health and wellbeing. In conversation with the Centre’s Co-Director Anne Torreggiani, she outlines her research and shares some valuable insights already discovered on arts and culture’s impact on young people’s mental health and wellbeing.

Tell us more about the scope of your research?

One of the Centre’s core objectives is to develop an independent, robust research and evidence base which outlines the impacts of arts, cultural, heritage and screen-based experiences on people’s lives and on society. We also want to communicate and disseminate key findings to the cultural sector through our research digests, which clearly summarise the research that makes up the evidence base.

The first area that we are focussing on is culture, health and wellbeing and I have been conducting rapid reviews of literature relating to topics that fall under this umbrella. This includes digests on ‘culture on referral’ programmes, cultural practitioners’ experiences of working in healthcare contexts, and the use of culture in the training and development of healthcare students.

Our most recent review looks at the value of cultural experiences for the mental health and wellbeing of young people. This is a very broad area that encapsulates many different types of cultural experience, but we are specifically focussing on research which has primary outcomes relating to mental health, wellbeing or resilience.

Is more generalised research on arts and health a problem?

What is difficult in this field is to be able to showcase the specific value of arts, culture, heritage and screen when many of the ways in which people have access is through group-based experiences. This can make it difficult to determine whether positive (or negative) outcomes and impacts are related to cultural experiences themselves, or to the related opportunities to meet with others who have challenges relating to their mental health or wellbeing.

This is a key finding that has emerged from our review of culture on referral programmes: would we see the same positive benefits for wellbeing if the cultural experience itself was taken out of the equation? A lot of research examines short-term impacts of individual projects but without longitudinal research, which compares cultural experiences to control settings, we cannot yet make too many judgements about causation.

Another limitation is that there is often really poor description, as well as a lack of critical analysis, of the cultural experiences themselves, with the focus being firmly placed on outcomes over process. I think we need to learn more about what happens ‘in the moment’ when people take part in cultural experiences. This might complement what we know about health and wellbeing outcomes and impacts through measurements before and after these experiences, and would enable a more holistic understanding of the cultural experience and how it may contribute to health and wellbeing needs.

The Centre is keen to stress the value of research as a process for learning rather than an output for advocacy. Is this a particular challenge in arts and health?

I think one of the main challenges is that culture, health and wellbeing must span two worlds when communicating and conveying value. The cultural sector is trying to understand outcomes and impacts themselves for their own learning and development, but is also having to learn and adapt to processes and language used to build evidence-based healthcare practices. There are many cultural organisations who are very skilled in bridging these two worlds, and healthcare professionals who are advocates for cultural experiences within healthcare, but it is essential that culture and health representatives come together in for critically reflective discussion and action.

You are currently reviewing research relating to the value of culture for the health and wellbeing needs of young people. Why has the Centre chosen this focus?

Many mental health challenges have their first onset within adolescence, with it estimated that one in ten children and young people in the UK are living with a mental health diagnosis. With the Covid-19 crisis there is the potential for young people to experience more loneliness and isolation, as well as feelings of uncertainty and instability. We therefore wanted to evaluate the evidence base relating to cultural experiences for young people and how it impacts on their mental health, wellbeing and resilience.

We also know it is an area that many cultural organisations work in and was a key area of discussion at our consultation events. Attendees at our consultation events stressed that it was important that our definition of culture was really wide for our reviews, stressing that forms of experience like breakdancing and engagement with digital culture were not always recognised as having value for young people’s mental health. So, we are keeping our search criteria very broad to enable us to explore the myriad of ways in which cultural experiences may contribute to mental health and wellbeing.

What kind of evidence have you come across so far?

There is a really broad range of cultural experiences reported within the literature, ranging from song writing to visual arts participation, but music is by far the most commonly reported. The majority of research focuses on teenage populations, with fewer studies focusing on children aged 0-11 or young adults aged 18+. A handful of studies look at specific contexts that young people may encounter, such as homelessness, being a refugee or being in a youth justice setting.

Most of the studies don’t focus on young people who have a specific mental health diagnosis, but are aimed more generally at improving wellbeing outcomes for young people who are economically or socially disadvantaged, or who are disengaged from education.

Do you think there’s a strong enough evidence base to show that culture is an ‘untapped resource’ for young people?

Most of the research we have identified shows positive impacts relating to the mental health and wellbeing of young people, but there are gaps. We have observed the importance of cultural experiences in enabling young people to develop their confidence and to have improved self-esteem; however, a lot of research focusses on standalone projects and does not give a clear indication of sustained benefits of these experiences in the medium- and longer-term. There are many layers of complexity and nuance that need to be researched further to create a stronger evidence base that is founded on rigorous research and evaluation. 
How can people get involved with your research?

As part of our festival of ideas, 2– 13 November, we are running a research workshop which will help us narrow the focus of this review to be as useful as possible in addressing specific questions from the cultural sector. This will enable the research digest we produce to be as specific as possible and highlight what we know for certain, where there is emerging evidence, and where further research is needed. People can also let us know if there are any research studies or evaluation reports that may have slipped through the net in our searches! We will be running similar workshops in the future for other areas of research too.

Dr Robyn Dowlen is a Postdoctoral Research Associate at the Centre for Cultural Value and Anne Torreggiani is Co-Director of the Centre for Cultural Value and Chief Executive of The Audience Agency.

Find out more details and register for the young people’s mental health research event.

This article, sponsored and contributed by The Audience Agency, is part of a series sharing insights into the audiences for arts and culture.

The Centre for Cultural Value, based at the University of Leeds, is building a shared understanding of the differences that arts, culture, heritage and screen make to people's lives and to society. Following in-depth consultation with stakeholders across the cultural sector about how and where the Centre should focus its energies, its core activities and plans will be showcased in the forthcoming Festival of Ideas, a programme of online events taking place between 2-13 November.