The potent arts

"What role can the arts play in supporting mental health in individuals and communities," ask NESTA Fellows Mike White and Mary Robson.

Creativity crucial to wellbeing

A 2002 editorial in the British Medical Journal called for one half of one per cent of the health budget to be diverted to the arts because "if health is about adaptation, understanding and acceptance, then the arts may be more potent than anything medicine has to offer."

If the shift in funding that the BMJ looked for had magically occurred it would have increased Arts Council England's budget by 70%. It would have radically changed our view of the role of art in society, and established participation in creative activities as a fundamental of social wellbeing.

A factor which drives such a radical proposal is that the World Health Organisation predicts that by 2020 mental ill-health will be the single greatest cause of debilitating illness in developed nations, and the Mental Health Foundation already estimates that one in five children will develop a mental health problem by the time they reach adulthood.

Last year the London School of Economics published The Depression Report, highlighting that one in three families at some point will have a member requiring treatment for depression, while only 2% of the NHS budget is spent on this service.

The LSE calls for 10,000 more therapists to be trained, as a proven successful alternative to medication, and has done some persuasive math to justify the cost benefits.

But is the medicalised intervention of therapists the only approach to a growing epidemic of distress? Given the BMJ's encouragement, what role can the arts play in supporting mental health and wellbeing in both individuals and communities?

The economics of wellbeing

The most commonly cited benefits by participants in arts in health projects are that accessing their creativity developed confidence and self-esteem and provided social connections - factors which epidemiological research has demonstrated are key determinants of health.

In this respect the arts are not just jolly add-ons to healthcare but rather orientate people on pathways to recovery, building the creative capacity that many in public health consider to be central to wellbeing.

The growing interest in an economics of wellbeing in the policy arena could re-shape our care services to span health, education and culture-led regeneration.

The Healthy Schools Standard, for example, is now mandatory and some schools in deprived areas are developing innovative partnerships with the arts sector to give substance to that standard.

For example, Southwick Primary in Sunderland is in the midst of an area that has been undergoing radical regeneration. A large proportion of the local housing stock has been demolished, displacing hundreds of people and splitting up extended families that have long lived near to each other. The staff of Southwick recognised that self-esteem in their community - both individual and communal - was very low.

There was a perceived need to re-energise the community. As a focus and symbol for this, the first annual Southwick lantern procession took place in 2003.

It involved some 150 children and their families, and has become the inspirational centrepiece in year-round work in the school addressing the emotional health of children.

Nurturing arts in health

Our research centre in Durham has had a pro-active role in nurturing arts in health projects that pioneer this cross-sector approach to improving the health and wellbeing of children and their families.

At a primary school in West Yorkshire, artists and teaching staff work closely together on Roots and Wings, a project that uses the arts to foster social and emotional development in children.

Many of the pupils live with violence - whether verbal, physical, emotional, domestic or media - on a daily basis. There is a substantial body of evidence to chart the impact such exposure to violence has on the brain.

The project has developed a programme of arts activity that includes the creation of new traditions to celebrate rites of passage and transition.

The children have been guided along a searching journey focussing on self, emotions, expression of emotions, and different ways to depict such complex messages through a range of art forms.

Roots and Wings puts children in the driving seat to help change some aspects of local culture, prevent mental ill-health and set the scene for a more nurtured generation.

A deeply held belief that an emphasis on unconditional positive regard will lead to children gaining a perceptive understanding of alternative ways of behaving, and enhance their ability to learn pervades every nook of the project and is beginning to bear fruit. These children need different choices for adulthood and some need better memories of childhood.

Healthy culture for a healthier nation

So how can the arts be 'more potent than anything medicine has to offer' with regard to young people's mental health? The arts can simultaneously identify and address health needs for both the individual and the community.

They deal in imagination, and imagination can be stronger than willpower. In harnessing the imagination, arts interventions can influence change in health patterns and help establish a healthy culture in a healthier nation.

NESTA Fellows Mary Robson and Mike White work at the Centre for Arts and Humanities in Health and Medicine, University of Durham.

Published March 2007