Researchers at the University of Gloucestershire have recently evaluated data from nearly 1,300 primary care patients in South West England, finding a course of arts-on-prescription to provide a significant improvement in overall wellbeing, including in those with very complex care needs.
The group’s findings have been published recently in European Journal of Public Health.
“Social prescribing”, or the provision of non-medical interventions in primary care settings, has been on the rise in recent years. It is based on the knowledge that health is determined by a wide variety of factors, and these wider factors (social, emotional, and economic) cannot be remedied by medicine alone. They are a response to the biggest public health challenges we face today; mental health, loneliness, ageing, and long-term health conditions. Patients can be referred to participate in these schemes for very general reasons, like increasing overall wellbeing, self-esteem, or confidence; or for more specific reasons, like providing support during bereavement, or reducing anxiety or depression.
Unlike art therapy, arts-on-prescription schemes provide art courses where patients can choose to learn how to draw, paint, create mosaics, or playwright. The courses are led by local artists, and are community-based rather than being based on specific medical needs. The groups that are referred are usually quite small, with between three and ten individuals, and may be based in local surgeries or community facilities. Those who take part are then provided with materials, and a dedicated space to carry out their activities. What makes these interventions unique is that they provide the participants with anonymity from what has brought them there, eliminating a shared “elephant in the room” that is their diagnosis, or specific medical need.
Well received by patients, health professionals, and arts providers alike, the benefits of art for health schemes have long been recognised as valuable. Despite this, they have still been struggling to gain traction in mainstream primary care, even with recognition from a recent inquiry report by the All Party Parliamentary Group on Arts, Health and Wellbeing. Until recently, the evidence base for these interventions has been from studies using small groups of patients, making it difficult to draw solid conclusions from something that will ultimately involve investment from the public purse.
The researchers have evaluated evidence from patients referred for arts activities through Artlift, a charity based in South West England that provides courses with local artists across the region. Through using the largest database available of patients referred through such schemes they have found that patients experience quantifiable improvements in overall wellbeing from participating in these arts courses.
Diane Crone, Professor in the School of Health and Social Care at the University, said: “We’ve worked with Artlift for a long time now, and have known through some previous research how the patients feel about it. One comment that’s really stuck with me from speaking with patients was that ‘Artlift lifts your heart’. For me, this captures the personal significance of it brilliantly”.
“It’s great to be able to finally provide substantial, and significant evidence from data collected over 7 years for these interventions,” she added.
Even in recent years, where tightening budgets, and challenges to health commissioning have been on the increase, the evidence supports the benefits of these interventions to those who need it the most. Since beginning to provide arts-on-prescription in the region, Artlift has had to change the services it has offered, from an initial 10-week course with the possibility of multiple re-referrals, to an eight-week course with only one additional re-referral available.
Despite this, the evidence shows that the benefits in improved wellbeing experienced by the patients being referred are not only still significant, but they actually seem to be greater in these shorter courses.
Paul Flynn, executive director of Artlift, comments: “Artlift has been providing arts for wellbeing benefits for nine years, so the results of this research are welcome, but not surprising. We are told almost on a daily basis that the interventions have significantly improved the lives of participants who have felt better able to cope with serious life issues. We hear of people developing friendships, returning to work and even being able to repair marriages and other relationships, such is the impact that Artlift can have.”
The work carried out by Professor Diane Crone and her team at the University of Gloucestershire also shows that this intervention is effective in increasing wellbeing in what is perhaps the most complicated, but increasingly important group in primary care; those with multiple health conditions. The team have been able to identify just over 200 people within the dataset that have multiple medical conditions across different categories like cancers, diabetes, pain conditions, mental health problems, and cardiovascular diseases.
Professor Crone says: “These complex multiple care needs are becoming more and more common in primary care in the UK, and beyond; so understanding how they can be supported will be vital in helping to navigate the key public health issues we see today.”
Whilst these findings are important for primary care providers, the researchers note that the most important message here is for health commissioners.
“These non-medical interventions can potentially offer solutions to some of the most challenging issues arising in public health. While wellbeing is often viewed as something intangible, it is a critical issue that is central to supporting physical health,” Professor Crone says.
Artlift executive director Paul also confirms the importance of using this important evidence to support improvements in policy: “We welcome the findings of this report and thank the University of Gloucestershire for their rigorous efforts in its production. We hope it will convince those responsible for health budgets to seriously consider arts interventions to benefit their communities – there is enough evidence now that arts are not a ‘nice to have’ but a genuinely beneficial intervention – and cost effective for the NHS.”
By providing community-based arts activities, like those supported by Artlift, patients are given the tools and space to express themselves, a new skill that can be sustained well beyond the scheme itself; and they are introduced to others in their community, increasing connectedness in a society where loneliness is becoming the norm.
