The arts and the health of the nation

By Philippa Cahill, Director

2017 has been a good year for those of us who are long-term champions of the role of the arts in health.

In October we were at the Arts in Health Westminster Hall debate, tabled by former Culture Minister Ed Vaizey. A number of MPs spoke about a growing evidence-base that demonstrates the value of the arts in the treatment and prevention of health issues. The debate followed publication in July this year of a comprehensive report, ‘Creative Health: The Arts for Health and Wellbeing’ by The All-Party Parliamentary Group on Arts, Health and Wellbeing. The foreword by the Rt Hon. Lord Howarth of Newport who Co-Chairs the APPG along with Vaizey, states that,

“The arts can help keep us well, aid our recovery and support longer lives better lived. The arts can help meet major challenges facing health and social care: ageing, long-term conditions, loneliness and mental health. The arts can help save money in the health service and social care.”

These two milestones have moved the discussion forward which is encouraging for us as much of our work is in this area. It may not be what you think of when you think of ‘public relations’, or ‘public affairs’, but for many years now some of us have been arguing that the arts and health fit together naturally, so it is good to see this argument gaining more traction with the concerted efforts of a number of organisations and stakeholders.

There is a wealth of evidence on the benefits that the arts can lend the areas of health and wellbeing. The APPG report argues that the arts can strengthen preventative strategies to maintain health, enable patients to take a more active role in their own health and care, improve recovery from illness, enhance mental healthcare, enable more cost-effective use of resources within the NHS and even relieve pressure on GP services.

What is striking is that there is a role for the arts at every life stage as different health and wellbeing challenges are faced. The report contains numerous case studies with anecdotal feedback and statistics from projects across life stages. So projects that are designed to help everyone from young children, teenagers and young adults, to working age adults, and the elderly and people at the end of their lives. And of course, we are not just talking about the individual, many arts based projects either directly or indirectly help wider groups, whether it is loved ones, carers, colleagues, or healthcare professionals, many of these schemes can benefit groups and not just individuals.

So what do we actually mean when we talk about the arts in health? We are talking primarily about the visual and performing arts, crafts, dance, film, literature, music and singing. The APPG report argues for the addition of gardening and the culinary arts, both of which can be seen as highly creative. The range of programmes and interventions that can come under the banner of arts and health is wide. There are specific arts therapies, and many other types of ‘participatory’ experience, and there are arts interventions in healthcare environments, i.e. hospital wards and GP surgeries.

And then there is the sphere of using art to reflect upon and articulate lived experience of an illness. As we have previously found, this can be validating for patients. It can also be integrated into healthcare professional training or continued professional development, to help them see patients in a different way.

And then there is public health education, another area of interest for us. The Royal Society for Public Health Special Interest Group on Arts, Health and Wellbeing was involved in the development of the report, which contains evidence as to how the arts can be used to tackle public health problems. What stands out for us with our social portfolio on childhood nutrition, is the potential for arts based schemes to increase the time children spend being active, or to communicate messages about nutrition and activity. In the fight against childhood obesity, this potential should not be underestimated.

There is even scope to look at the power of the arts to generally increase the wellbeing of the nation, preventing ill health and all its consequences. There is significant evidence to show that increased uptake of arts experiences in everyday life has a positive effect on wellbeing. Should we as a society therefore be increasing public access to the arts, especially perhaps for those who are most vulnerable? We need to be looking at systemic change, to bring the arts and culture to the fore. Of course that begs the question – should they be state funded, or should private enterprises be focusing on supporting them as part of their social purpose programmes.

We would argue that any organisation that has any business in the healthcare arena should be looking at this as part of their social innovation.

There are a couple of potential objections to this. The first is that for private enterprise to take this on will be letting others off the hook. There is no doubt that in order to achieve meaningful systemic change this has to be tackled at all levels of the health system, and national and local decision makers need to make changes. The APPG report recommended that,

“at board or strategic level, in NHS England, Public Health England and each clinical commissioning group, NHS trust, local authority and health and wellbeing board, an individual is designated to take responsibility for the pursuit of institutional policy for arts, health and wellbeing.”

It also recommended that ‘those responsible for NHS New Models of Care and Sustainability and Transformation Partnerships ensure that arts and cultural organisations are involved in the delivery of health and wellbeing at regional and local level.’

However, we believe that private enterprise initiatives can help build momentum and crucially contribute to the evidence-base that will help bring change about faster.

The second objection is that directing art pursuits towards health goals somehow ‘cheapens’ the art itself. There is a school of thought that art should stand alone, untainted by organisational or corporate interest. We do not believe that to be true. Art does not always have to have a social purpose, and nor should it. We do not have to revisit art that was created for its own sake and find a healthcare purpose, or deem new art inadequate if it does not ‘achieve’. But who would argue with the creation of more art, and more artists, that would otherwise not have existed? There might be some who recoil from the thought of untrained artists, amateur writers and performers expressing themselves, but as Ralph Waldo Emerson once said,

“Every artist was first an amateur”

One thing is for certain, all of us involved in arts projects should set out to do. We must make sure that we are evaluating our arts and health work to demonstrate the power it holds. One of the benefits of working with private organisations in this field is that they often have the resources to evaluate and prove their case. Ideally, evaluation should study clinical and financial endpoints. If we adequately prove that we can have an impact through art on the health and productivity of the nation and balance the books, then it will be difficult to construct an argument against this growing movement.

At the Westminster Hall debate, there was consternation at the lack of a ministerial presence from the Department of Health. Arts Minister John Glen attended and expressed support for a cross-government strategy on arts and health. He also confirmed that he was supportive of the APPG report’s recommendation for a national strategic centre for the arts and health.

We will be watching this space with interest.