Why the Fonagy review matters for creative health
Creative health has a clear role to play in responding to the Independent review into prevalence and support for mental health conditions, ADHD and autism, published by the Department of Health and Social Care (DHSC) earlier this month.
Led by Professor Peter Fonagy, the review looks at why demand for mental health and neurodevelopmental support has grown so quickly in England, and how support could be better matched. The arts appear in its very first recommendation, and again in its evidence on schools and community support.
Making the arts part of prevention
Recommendation 1 calls for an ambitious approach to prevention and public mental health. One of its actions is to protect young people’s chances to rest, recover and develop well, by increasing access to the creative arts alongside sport, play and green spaces.
The review says the evidence for non-clinical approaches like these is “stronger than is sometimes recognised”. Research consistently links taking part in arts and creative activities with better mental health. There’s also moderate evidence that arts engagement improves adolescent mental health, particularly for girls, at a time when young women report the highest rates of common mental health conditions of any group.
Room to connect and recover
Young people have fewer places to belong, and the review links this to the rise in distress. Since 2010, many youth centres, libraries, parks and other community spaces have closed or scaled back. The review suggests belonging is the most important way this social infrastructure protects mental health, and many of these third spaces are also where community arts happen.
Inside school, the space for creativity has shrunk too. With more weight on exams and test results, entries to arts and design subjects have fallen and there’s less room for creative and vocational learning.
The review sees creative activity as one way young people recover from pressure, warning that fewer chances to play, be active, be creative and connect with others may leave them less able to absorb other pressures.
Need, connection and diagnosis
The review warns against treating every difficulty as a medical problem. A lonely young person who isn’t clinically depressed may benefit more from rebuilding social connection and participation than from antidepressant medication.
It calls for a system led by need alongside diagnosis, so support can start before, during and after assessment, with participation as a central measure of success. Participation is at the heart of how community arts work, making creative health a natural fit.
Where community support fits
Recommendation 3 asks commissioners to treat voluntary, community and social enterprise (VCSE) organisations as core partners, with stable and sustainable funding. The review also wants primary care to coordinate access to community, voluntary and social prescribing services, and neighbourhood teams to include the voluntary sector.
Youth social prescribing shows early promise, with pilots suggesting around £5 of social value for every £1 invested and less loneliness among participants. But the wider evidence for social prescribing is still relatively weak, the review says, with many UK evaluations at high risk of bias and people from minoritised ethnic communities under-represented.
NCCH is working to close that gap through the Creative Health Research Round-Up, which brings creative health research and evaluation from across the UK together in one place.
What this means for creative health
Most community arts and cultural activities don’t depend on a diagnosis, and people can be referred to them through social prescribing. So creative health can support autistic people, people with ADHD and those waiting for assessment now, giving them ways to connect, belong and take part.
With children and young people a focus for NCCH over the next four years, the review strengthens the case for creative health as part of prevention and early intervention. The government has said it will set out its response in a new mental health strategy later this year, and we look forward to seeing what place creative health has in it.
