Feature

The art of well-being

Can the creative arts prevent or cure mental illness? Despite increasing interest there is still very little evidence available, say Jamie Cowling and Emily Keaney

In Yann Martel’s exhortation to support artists, and thereby all our imaginations, he makes explicit the link between the creative arts and our minds. Anecdotal evidence has long linked the arts to individual and social well-being. Is there the evidence to back this up?

According to the Office for National Statistics, one in six adults in the UK has a mental health problem of some severity. A key aim for the NHS is to promote positive mental health and reduce the stigma and discrimination currently associated with mental health problems. Department for Work and Pensions statistics show that mental illness is the fastest growing cause of claims for incapacity benefit (IB), and those with mental health problems are the least likely of all IB claimants to move back into work (www.dwp.gov.uk/asd/ib_sda.html).

Undoubtedly, improving the mental health of the population should be near the top of the Department of Health’s priorities, but should it be for the Department for Culture, Media and Sport too? Much is claimed for the arts’ potential contribution to the field of mental health. Advocates claim that it can be of enormous value across the whole spectrum of treatment and care, and believe that the role the arts could play in improving mental health outcomes is threefold.

First, the arts can be and are used as a therapeutic strategy. Second, the arts could play a key role in breaking down barriers to understanding mental health problems and could help clients re-integrate into the wider community. Finally, it is possible that engagement with the arts could play a role in preventive care, encouraging a sense of well-being.

The current challenge is to provide robust evidence that demonstrates the arts’ contribution to improving mental health outcomes to the wider medical community, the DoH and, ultimately, the Treasury.

The ‘arts in mental health’ sector divides into two broad categories: the formal therapeutic sector and the informal arts in health sector. Arts therapists are established professionals in the UK, registered by the Health Professionals Council. The NHS currently employs 747 arts therapists, up from 638 in 1997, and more arts therapists work in the private or not-for-profit sector. Artists have been quietly working to improve mental health outcomes for some time. Recently, both the Whitechapel and Serpentine Galleries have collaborated with Look Ahead Housing Care to engage Look Ahead’s residents with their environment through designing and improving hostels. There has also been increasing interest among artists in establishing better links with the formal health care sector.

However, little policy discussion has been devoted to how this thinking can be ‘joined up’ to enable the arts to help reintegrate people with mental health problems into the wider community. A paucity of robust evidence undermines the likelihood of a joined-up approach being embraced by the medical profession. Community arts evaluation is often patchy and anecdotal and fails to speak to the concerns and needs of the formal health sector. There is a clear need for dialogue to understand how links between arts therapists and other mental health practitioners can be developed.

Measuring something like the impact of community arts programmes is difficult, but it can be done. Roger Ulrich’s retrospective study View from a Window, and the Beauchemin and Hays study, Dying in the Dark: Sunshine, gender and outcomes in myocardial infarction, although not directly related to the arts, show that it is possible to demonstrate significant quantifiable effects on clinical outcomes from what would normally be considered ‘fluffy’interventions.

To date, work and, to a lesser extent, research has focused on the arts as a cure for mental health problems rather than a preventive balm. We know that well-being is dependent on a number of social and environmental factors. The challenge for health professionals and artists is to learn from each other and develop an understanding of the arts impact on all our souls.