Creative Health Review - First Roundtable
Creative Health Review - Our first roundtable addresses the role of creative health in mental health and wellbeing
The All Party-Parliamentary Group on Arts Health and Wellbeing (APPG) and NCCH Creative Health Review held its first roundtable on 27th October 2022, looking at how creative health can help to tackle challenges around mental health and wellbeing. With the number of people experiencing poor mental health increasing and services under pressure to meet demand, this is a timely topic and one where creative health can have a real impact.
Experts with a range of experience and perspectives joined us to discuss how creative health can be used to support mental health and wellbeing, and considered what we need to do to ensure creative health approaches are available to those who most need them, and that providers of creative health are supported to provide these services sustainably.
The impact of creativity on mental health and wellbeing
The personal impacts of creativity for mental health were passionately explained by our NCCH trustee and advocate for creative health, Debs Teale, and by Rod, Georgina, Gabby and Gemma from the Horsfall Gallery and creative space at 42nd Street, a young person’s mental health charity based in Manchester. After many years of medication, Debs found that joining art classes offered a life changing opportunity to address her illness differently:
“The difference creativity made to me was because it focused on my wellness not my illness….the art was very different, it gave me the time and space to help me deal with things myself, in the way that was right in the time for me”
For Debs, creativity offered ‘hope’ that had been missing in previous services, and she now works to ensure others have the opportunity to feel the same hope through her advocacy from a lived experience perspective. Art classes offered the opportunity for social connection with the limited side effects of getting covered in paint! Through the classes she discovered a sense of identity and purpose, with positive benefits for her whole family, and now that she no longer needs to use medication, this comes with a significant cost saving.
These themes - the space to process thoughts and feelings, finding freedom in creativity and the importance of an alternative to clinical mental health services - were echoed by our guests from 42nd Street. Creative Producer, Rod Kippen, explained that the creative approaches offered were intended to be bespoke, allowing the young people to discover how creativity can work for them. It offers an alternative means of expression, where communication in the adult world, or talking therapies can rely on the ability to immediately process feelings and express them verbally. Creativity at 42nd Street can work as a distraction from everyday pressures, through the process of taking an action – something that can be difficult to do with depression - or through reflection and catharsis. It is available to young people 24/7 through their own sketchbooks and journals. Creative outputs can also help adults to understand the experiences of young people. Mental health practitioner, Georgina, explained that the drop-in creative space is purposefully designed to be different to a traditional mental health service. It provides young people the freedom to engage in creativity and build relationships in a relaxed environment, and is available to them as and when they need it. Gabby, who has used the space, found the approach to be ‘humanising’ and that in the supportive environment of the group ‘the help comes really naturally’. For Gemma, the opportunity to try out a range of creative approaches has changed the way she views art, and it has provided the tools to express herself in her own way. This has culminated in artworks that find her painting plates and then breaking them – a process that she has found empowering and has provided her with agency and the confidence to pursue other creative projects, gaining valuable transferable skills along the way. Gabby is now part of a creative collective at Horsfall, working with professional artists, displaying artwork not only in the Gallery but more widely across the city. She explained that this has given her a sense of control and confidence, and she is now working towards a career in the arts, supported by her peers in the collective. On finding the Horsfall, Gabby says;
“It was a life-changing moment, going from ‘I’m just doing counselling and that’s it’ to ‘I’m doing creative things, enjoying my time, and having space for myself’.”
Sue Stuart-Smith, psychiatrist, psychotherapist and author of The Well Gardened Mind found similar benefits from gardening as a form of creativity. Gardening can reduce some of the pressure of ‘creating’ but can engender similar feelings of pride and empowerment when a plant or vegetable grows, and community gardens can provide ‘sanctuary’ as a safe space, or setting for social connection. Sue returned to the sense of ‘hope’ and linked this to the cycles of nature, reminding people of the sense of regeneration and future.
Challenges in mental health and the role for creative health
With the benefits of creative health so clearly articulated by those that have experienced them, our panel moved on to discuss the current challenges. Dr Daisy Fancourt, Associate Professor of Psychobiology and Epidemiology at UCL and Director of the World Health Organisation Collaborating Centre of Arts & Health, outlined the pressures on mental health services, with rising rates of mental illness, particularly in the aftermath of the pandemic and in the current economic climate. There are high thresholds to access support and long waiting times for services, during which mental health can deteriorate. These issues were recognised by all on the panel, including Professor Dame Sue Bailey through her work as Chair of the Centre for Mental Health, and as a psychiatrist and professor of Child and Adolescent Mental Health, who highlighted in particular the impact of poverty on mental health, and Anne Longfield who as Chair for the Commission on Young Lives and former Children’s Commissioner for England noted a decline in the mental health of young people, especially those from marginalised backgrounds, and the lack of access to support. From an NHS perspective, Deputy Chief Executive and Executive Director of Strategy and Change at South West Yorkshire Partnership NHS Foundation Trust Salma Yasmeen recognised the rising demand and pressures on the workforce.
A different approach?
Despite the challenges, the panel felt that the time was right to highlight creative health as a means to improving mental health, not only because of rising demand, but because the policy context and restructure of the NHS into Integrated Care Systems (ICSs) provides an opportunity to rethink how mental health is addressed and to develop place-based partnerships which can improve outcomes. Salma Yasmeen provided several examples of this in practice in South West Yorkshire, building on a long local history of implementing creative health. With strong leadership, commissioners can be given the confidence to fund differently, and explore how partnerships with cultural and VCSE providers can lead to better outcomes. This approach could also be used within healthcare settings, using creative approaches and activities to improve outcomes in inpatient settings. For Sue Bailey, ICSs provide an opportunity to shift to a preventative, public health approach to mental health, with creative health contributing to the development of flourishing and healthy societies through partnerships formed at local level. Daisy Fancourt’s research shows the need to take a holistic approach to mental health, and the importance of reducing stigma, providing people with choice and autonomy in their care. Creative health can be an important part of this process. However, research also reveals a social gradient in access to cultural and creative opportunities. We therefore need to ensure that the benefits of creative health can be experienced by everyone and that inequalities are not reinforced.
Creative health accessible to all
There are significant inequalities in mental health outcomes and in access to service provision. Kiz Manley, therapeutic researcher, facilitator and founder of Hip Hop HEALS, encouraged us to focus on whether creative health opportunities were reaching those who were most in need. We must ensure that creative health can be offered widely and in a culturally competent way. This extends to ensuring that the creative health sector is representative of the population and that all voices can be included in conversations around advocacy. David Cutler, from the Baring Foundation also underlined the importance of access to the arts as a human right beyond its medical application, with benefits to mental health outside of clinical settings through access, expression, storytelling and liberation. As a funder, David also highlighted the precarious situation for the majority of creative health providers, many of whom operate on a small, local level, with limited and project-based funding, which can be unsustainable and impact the mental health of the workforce. In order that creative health can support improvements in mental health we must also ensure that more sustainable funding structures can be established to allow the sector to thrive, and that the mental health and wellbeing of creative practitioners is taken into account.
Recommendations to government
The aim of the Creative Health Review is to make recommendations to Government. To help us, we asked our panellists to make their suggestions. These were:
- Present a framework to demonstrate to the Government that creative health can benefit the whole of society and result in economically flourishing communities.
- Prioritise the mental health of artists as citizens and community members.
- Beware of further future cuts to arts and culture and creative industries - cuts reduce the provision for helping people with mental health conditions but will also negatively affect the general health and wellbeing of the population. We should ringfence these assets as health promoting as well as creative and cultural assets.
- Implement solutions that are immediately available, and, whilst facing hard economic times, utilise community resources such as schools and unused spaces for creative activity that can improve individual and community mental health.
- Make sure people leading and championing creative health are representative of the population.
- Utilise trauma informed methodologies to inform how we manage mental health across the lifespan.
- Ensure the voice of lived experience is represented in policy decisions.
- Shift from an illness model to a wellness model of thinking about health. Investing in and enabling creative health models and partnerships in a sustainable way will improve health outcomes but can also be used to improve productivity in communities, particularly those we know are experiencing inequalities.
These suggestions, as well as the themes covered in the roundtable and the contributions from the audience in the chat will be fed back to our commissioners who will consider how they can be translated into a final set of recommendations to Government.
The roundtable is available to watch back here and we welcome your own thoughts in relation to mental health and wellbeing through our open call for contributions – find details of how to submit here.