Researchers at the University of Gloucestershire and Cardiff Metropolitan University have found that engaging in a course of creative art is associated with decreases in anxiety and depression, alongside improvements in wellbeing. The research, due to appear in the forthcoming special issue in Public Health on Arts, Creativity & Health, also examined patterns of change across two cycles of referral for this social prescribing scheme.
The use of social prescribing in patient medical care has been increasing in recent years, particularly in the UK. Social prescribing is the practice of referring primary or secondary care patients into non-clinical interventions to support their psychosocial wellbeing. Activities that patients may be referred into might be physical activity, book clubs, education on prescription, or arts courses. The capacity for these arts activities to support health and wellbeing in primary care patients has been the focus of the research group for several years.
Artlift is an arts for health provider in the South West of the UK that has been providing arts courses for primary (and, latterly, secondary) care patients for over a decade. The courses of arts are usually up to eight weeks, and may be based on visual or performing arts in various forms. Primary care patients are referred into this program via their GP, a social prescriber, or other healthcare professional, and may be re-referred should there be a continued need or desire for support. Patients might be referred into the Artlift program for any or all of the following reasons: reduce stress/anxiety/depression; improve self-esteem/confidence; improve social networks; help alleviate symptoms of chronic pain or illness; distraction from behavior related health issues; improve overall wellbeing; or to support following loss or major life change.
Previous work from the group, using the largest dataset of arts on prescription in the world, has shown that these programs are supportive of wellbeing, even in those with complex medical needs. The present study drew data from this longitudinal dataset from between 2017 and 2019, using measures of anxiety, depression, and wellbeing for 245 participants – 110 of whom had identifiable multi-morbidities. Of the 245 participants, 99 were subsequently re-referred for another course of arts on prescription, providing an analysis of anxiety and depression across referral cycles for the first time in the field.
To assess the outcomes, pre- and post-measures of anxiety, depression, and wellbeing were used per referral cycle. Participants’ demographic and clinical characteristics (sex, age, socio-economic status, and referral reasons) were used to assess whether the intervention outcomes might have varied depending on the type of patient participating. There were no associations of any of the demographic or clinical characteristics of the participants with these outcomes, indicating that all participants appear to have equivocal benefit.
Alongside overall improvements in anxiety, depression, and wellbeing, the study also found that participants exhibit reductions in anxious and depressive symptomology. These outcomes were also present for those with complex medical needs, providing further support for social prescribing and arts on prescription to improve the mental health and wellbeing of those that are often difficult to support? The analyses show that whilst participating in these arts courses is associated with improvements in all the measured outcomes, there does appears to be some level of “re-bound” between referral cycles for many participants. This re-bound was not completely back to pre-intervention levels, but does hint towards the need for additional support for some patients as they engage with social prescribing, and indeed strategies for continued support post intervention.
Speaking about the findings, Dr Rachel Sumner (University of Gloucestershire) says: “We have been able to show that these arts activities are not only supportive of wellbeing, but they do seem to make real differences to mental health too. The fact that there seems to be rebound between referral cycles suggests that there might be a need to help participants adjust when they exit these programs to ensure sustainability of their impact.”.
Prof Diane Crone (Cardiff Metropolitan University) says: “This paper provides further compelling evidence of the importance of arts for health for some of our most vulnerable people in society, who manage on a day to day basis complex and enduring medical needs. Further focus does need to consider the ongoing support of these individuals however, as the re-bound finding suggests that the ‘one off’ intervention model doesn’t suit everyone. There are implications here from program managers and commissioners of arts for health programs in these findings to date.”