The Art of Social Prescribing: Informing policy on creative interventions in mental health care (2014-15)

Funded by the Arts and Humanities Research Council (August 2014 – July 2015), ‘The Art of Social Prescribing’ was designed to inform the future development of clinical commissioning policy on arts and cultural interventions in mental health care. More specifically, the project examined the decision-making processes behind arts-based social prescribing, and its professional efficacy in mental health care contexts. The research team included Kerry Wilson (Principal Investigator) and Gayle Whelan of the Institute of Cultural Capital; and Professor Rhiannon Corcoran (Co-investigator) of the Heseltine Institute of Public Policy and Practice.

The project was driven by an increased focus on social determinants of mental health; preventive non-clinical measures through joint strategic planning; and a shared desire for a more proactive, positivist promotion of mental health and wellbeing. Social prescribing provides a means for enabling primary care services to refer patients and service users with social, emotional or practical needs to a range of local, non-clinical services, often provided by the voluntary and community sector. Such non-clinical approaches are gaining added resonance within mental health care due to their proactive, preventive qualities, and the opportunities created to provide strategically ‘joined up’ services across a range of cross-sector organisations.

For the purposes of the project, arts-based social prescribing was defined as the process by which creative and cultural activities are prescribed by health care professionals, and other referral services, to adults experiencing anxiety, stress-related symptoms, depression or other mental health problems.

Within the Liverpool city region, there are many examples of effective arts-based interventions and initiatives in mental health care, spear-headed by project partners Mersey Care NHS Trust and leading arts and cultural organisations including National Museums Liverpool, Tate Liverpool, the Royal Liverpool Philharmonic and The Reader Organisation. The project sought to build upon the learning outcomes generated by these initiatives and associated research programmes to inform the strategic development of arts-based social prescribing in the city, including a co-produced policy framework for participating organisations, and an accompanying ‘how-to’ guide for applied research on the arts and social prescribing in mental health. Other project partners included the NHS Liverpool Clinical Commissioning Group, Liverpool Health and Wellbeing Board, and the Cheshire and Merseyside Public Health Service.

For researchers in the field, the project highlights an intellectual imperative to advance the role of arts and humanities research in public policy agendas and its complementary value to other disciplinary methods, including evaluative social science. As such the project represented a unique ambition to assimilate more closely ‘arts in health’ practice and the conventions of evaluation, with traditional disciplinary modes of arts and humanities research. The project sought to bridge the gap between different paradigms of current cross-disciplinary value and impact research in this area (improvement of symptoms and distress associated with mental health difficulties; psychological wellbeing; economic value) and to initiate meaningful debate on how this translates into future regional mental health care policy and strategy; arts and creative practice in the context of mental health care; and the active contribution of arts and humanities research to both sectors.

The research was undertaken in three iterative stages, including case study development via research methods including a review of the current social prescribing and arts on prescription research evidence base; observational site visits to existing schemes (nationally); interviews and research workshops with key stakeholders.

1. Social prescribing and arts and culture:

The first phase was led by arts collaborators in a ‘scene-setting’ capacity, providing examples of existing work in this area (creative interventions in mental health care and associated research); their relative learning outcomes in relation to their value (both actual and potential) as ‘socially prescribed’ interventions; and emerging questions or points for debate on their relationship with future policy and practice. This phase focused on the ‘lived experience’ of such interventions in order to fully appreciate the contextual relationship between research and practice, and to actively inform the development of subsequent research themes.

2. Researching arts and culture in mental health care:

The second phase was led by academic collaborators and considered the various practices and traditions in ‘independent’ academic research on the arts and mental health care, including examples of approaches from the arts and humanities (literature and reading; museums and heritage; participatory arts); the social sciences (sociology; psychology); and their relationship with different modes of ‘commissioned’ evaluation research. Researchers debated the power and persuasiveness of different approaches and any existing gaps – not just in the existing evidence and knowledge base but in the skills capacity of the research field – with a view to informing the future viability of research on the arts and social prescription in policy contexts.

3. Valuing arts and culture in mental health care:

The third and final phase considered the causal relationship between research, policy and practice, including working relationships between different stakeholders and professional communities; the role of service users; the power of advocacy and individual and/or collective voices; and how each of these relationships affect the way that value is articulated and understood. This phase was both policy and practice-led (mental health care community) in considering how we can more intelligently commission arts and cultural interventions in mental health care, including the more cohesive development of a community of practice that includes service –users, carers, ‘providers’, ‘commissioners’ and ‘researchers’.

In September 2015, the research team was delighted to co-host the national Art of Social Prescribing conference in collaboration with the Arts Council England-funded Cultural Commissioning Programme and New Economics Foundation.

The project forms part of wider programme of work under the ICC’s Cultural Value and Public Policy research strand, which explores the cross-sector instrumental value and leadership role of arts and culture in relation to critical public policy agendas. For more information please contact Kerry Wilson (PI) – k.m.wilson@ljmu.ac.uk

The Arts and Humanities Research Council (AHRC) funds world-class, independent researchers in a wide range of subjects: ancient history, modern dance, archaeology, digital content, philosophy, English literature, design, the creative and performing arts, and much more.  This financial year the AHRC will spend approximately £98m to fund research and postgraduate training in collaboration with a number of partners. The quality and range of research supported by this investment of public funds not only provides social and cultural benefits but also contributes to the economic success of the UK. For further information on the AHRC, please go to: www.ahrc.ac.uk.