Perspectives in Public Health

The potential for participation in creative activity to promote recovery from mental ill health is highlighted in mental health policy and guidance, alongside a perceived dearth of robust evidence of effectiveness. Open Arts has run participatory arts courses in South Essex since 2008 and a course waiting list has developed with increasing demand for places. Given the waiting list and the need to improve the evidence base for the utility of participatory arts groups in mental health, the aim of this project was to conduct a naturalistic waiting list-controlled evaluation of the 12-week courses routinely provided and to explore participants’ experiences of their course. It was expected that people on the waiting list who were allocated places on a course would gain improvements in well-being and social inclusion, whereas those not allocated places would show no changes over the same time period.

Measures included the Warwick Edinburgh Mental Well-being Scale (WEMWBS) and the Social Inclusion Scale (SIS). People on the Open Arts waiting list who had been allocated a place on the courses formed an intervention group; those remaining on the waiting list were asked to complete the same measures over the same time period (forming a control group). Participants in the intervention group were asked to rate the service and were offered the opportunity to join a focus group.

Thirty-two people in the control group and 26 people in the intervention group could be included in the final analyses. There were no significant differences between the two groups on either measure at baseline. Intervention group total mean scores were significantly higher after the Open Arts course than at baseline on both the WEMWBS and SIS, but no significant differences across time were found for the control group. Of the intervention group 96% reported enjoying the course and most of those providing feedback reported gains in confidence (81%) and motivation (88%). Nineteen participants in the control group completed an Open Arts course later in the year and similar improvements between baseline and follow-up scores on the WEMWBS and SIS were then found in this group.

This service evaluation of Open Arts has provided some preliminary evidence that participatory arts groups are likely to have benefits for mental health service users in terms of improved well-being and social inclusion. The evaluation justifies a future randomised controlled trial and economic appraisal of participatory arts projects.

This research explored the relationship between active music making and subjective well-being, in older people’s lives. The research focused on how participation in making music might enhance older people’s social, emotional and cognitive well-being, through meeting the basic psychological needs identified in earlier research.

The research comprised three case studies, each offering a variety of musical activities to older people. In each case study a sample of older people were asked to complete questionnaires and psychological needs scales related to autonomy, competence, relatedness and self-realisation before and after a substantial period of active engagement with music.

Principal components analysis (PCA) of responses to the CASP-121 and the Basic Needs Satisfaction scale² revealed three factors: purpose (having a positive outlook on life; autonomy and control; and social affirmation (positive social relationships, competence and a sense of recognised accomplishment). Comparisons of those engaged in music making with those participating in other activities revealed statistically significant differences on all three factors with the music groups giving more positive responses.

The enhanced subjective well-being found among participants in music may have been due to the potential for music to provide a sense of purpose through progression in music and creative expression. Control and autonomy may be supported by the holistic nature of musical engagement, whereby meeting new musical challenges involves physical and cognitive engagement. Finally, social affirmation may be supported through social interaction; giving and receiving peer support; and performance, which confers status, a sense of giving something back to the community, pride and opportunities for positive reinforcement. Further research needs to identify the mechanisms through which music is able to achieve these effects.

Health-promoting strategies need to be culturally appropriate to encourage healthy behaviours and lifestyle choices in children and young people. This rapid review explores the effects of participating in creative activities on the health and well-being of children aged between 11 and 18 years.

Building on an earlier systematic review undertaken by Daykin and colleagues¹ a rapid review of the literature published between 2004 and 2011 was undertaken. The search was conducted systematically and included research on music, dance, singing, drama and visual arts, taking place in community settings or as extracurricular activities in mainstream schools. Therapies such as art, drama and music were excluded from the review.

Following rigorous application of inclusion and exclusion criteria, 20 papers were included in the review: six quantitative, eight qualitative and six mixed-method approaches. The interventions used in the studies were diverse and the research was heterogeneous, therefore overall synthesis of the results was inappropriate. The review is therefore organised into the following headings: sexual health, obesity, mental health and emotional well-being. Despite the methodological weakness and limitations of the majority of the studies there were some consistencies in their findings. It was found that participating in creative activities can have a positive effect on behavioural changes, self-confidence, self-esteem, levels of knowledge and physical activity.

Although the research evidence is generally weak there is some evidence that using creative activities as part of a health-promoting strategy may be a useful method of increasing knowledge and positive behaviours in children and young people.

This article considers eudaimonic models of psychological well-being in relation to qualitative data previously gathered as part of Manchester Metropolitan University’s Invest to Save Arts in Health programme (2004–07).

The research draws from 21 interviews with participants involved in Invest to Save arts projects for older people and adults with a mental health diagnosis. Using a collaborative team approach, a hybrid thematic analysis was undertaken alongside an updated literature review framed by positive psychology and with a focus on well-being.

The analysis identified eudaimonic themes of autonomy/intrinsic motivation and challenge to be particularly pertinent to participants’ experiences of the scheme. Findings suggest that the programme provided a sense of purposeful occupation, cognitive and creative challenge and opportunities for autonomous self-expression and heightened concentration (flow). Many participants identified with the arts activities on offer and, while not necessarily aspiring to achieve any particular status, were intrinsically motivated to develop what they considered to be their innate creative potential. Some also reported that sustained engagement was important to their continued psychological well-being.

Arts and health researchers might usefully draw from theories of well-being from positive psychology. Both fields are compatible in that they share an interest in human flourishing and understanding of wellness as more than an absence of dysfunction or disease. Further research is needed to ascertain whether the limited results presented here are representative of other populations. What does seem evident is that arts projects have a broad appeal and can be highly inclusive, accommodating participants with diverse needs. More generally the investigation raises questions about the cultural scaffolds that are in place to support eudaimonic well-being across the lifespan, as well as the consequences of restricting such opportunities for individuals and communities.