Mental Health and Arts Participation: The State of the Art in England
Hacking, Sue, Secker, Jenny, Kent, Lyn, Shenton, Jo, Spandler, Helen, The Journal of the Royal Society for the Promotion of Health
Arts; mental health; social inclusion
Although participation in arts activity is believed to have important mental health and social benefits for people with mental health needs, the evidence base is currently weak. This article reports the first phase of a study intended to support the development of stronger evidence. Objectives for the first phase were to map current participatory arts activity, to identify appropriate indicators and to develop measures for use in the second phase of the research. A survey of participatory arts projects for people with mental health needs aged 16 to 65 in England, identified via the Internet and relevant organizations, was carried out to map the scale and scope of activity and to establish the nature of current approaches to evaluation. The results indicate that the scope of activity, in terms of projects' settings, referral sources, art forms and participation is impressively wide. In terms of scale, however, projects reported low funding and staffing levels that may have implications for the feasibility of routine evaluation in this field. Current approaches to evaluation were limited, but entailed considerable effort and ingenuity, suggesting that projects are keen to demonstrate their benefits. The survey has enabled us to build on the best evaluation practice identified to develop a measure for assessing the mental health, social inclusion and empowerment outcomes of arts participation for people with mental health needs. For the second phase of the study we will work with arts and mental health projects, using the measure alongside qualitative work in a realistic evaluation design, in order to identify the characteristics of effective projects.
In 2004, the Social Exclusion Unit (SEU), located in the UK Office of the Deputy Prime Minister, produced a report addressing social exclusion and mental health.1 The report identified the causes of exclusion as lying in large part in the stigmatization of mental ill health and in a focus on medical symptoms at the expense of enabling people to participate in their local communities. Over a third of respondents to the SEU's consultation identified access to recreational activities, including participation in the arts, as essential to promote social inclusion, and promoting access to arts opportunities is a key recommendation of the report. However, it was acknowledged that the evidence base for arts participation is currently weak. As part of a 27-point action plan the Department for Culture Media and Sport (DCMS), in partnership with the Department of Health (DH), was therefore charged with undertaking research to establish the health benefits and social outcomes of participation in arts projects and the characteristics of effective local projects.
'Mental health, social inclusion and arts: developing the evidence base' is the study commissioned by DCMS and DH in fulfilment of that brief. It builds on a comprehensive literature review undertaken by the Centre for Arts and Humanities in Health and Medicine at the University of Durham.2 The dual aims of the study are to carry out an evaluation to assess the mental health and social inclusion outcomes of arts participation, and in doing so to develop an evaluation tool for routine use by participatory arts and mental health projects. Specific objectives are to identify appropriate indicators of mental health and social inclusion outcomes, to develop evaluation measures based on those indicators, and to use the measures, alongside qualitative work, in a realistic evaluation design,3 in order to identify the characteristics of effective participatory arts and mental health projects. The study relates to participatory arts and mental health work in England with people with mental health needs aged 16 to 65 and does not therefore include art therapy. The research is being carried out in two phases. The first phase, reported here, comprised a survey of arts and mental health projects in England to map the range of activity, establish what evaluation data projects already collect, and develop indicators and measures for use in the second phase of the study. …