Elsevier

Public Health

Volume 127, Issue 8, August 2013, Pages 727-734
Public Health

Original Research
Arts on Prescription: a qualitative outcomes study

https://doi.org/10.1016/j.puhe.2013.05.001Get rights and content

Abstract

Objectives

In recent years, participatory community-based arts activities have become a recognized and regarded method for promoting mental health. In the UK, Arts on Prescription services have emerged as a prominent form of such social prescribing. This follow-up study reports on the findings from interviews conducted with participants in an Arts on Prescription programme two years after previous interviews to assess levels of ‘distance travelled’.

Study design

This follow-up study used a qualitative interview method amongst participants of an Arts on Prescription programme of work.

Methods

Ten qualitative one-to-one interviews were conducted in community-based arts venues. Each participant was currently using or had used mental health services, and had been interviewed two years earlier. Interviews were digitally recorded, transcribed and analysed.

Results

For each of the 10 participants, a lengthy attendance of Arts on Prescription had acted as a catalyst for positive change. Participants reported increased self-confidence, improved social and communication skills, and increased motivation and aspiration. An analysis of each of the claims made by participants enabled them to be grouped according to emerging themes: education: practical and aspirational achievements; broadened horizons: accessing new worlds; assuming and sustaining new identities; and social and relational perceptions. Both hard and soft outcomes were identifiable, but most were soft outcomes.

Conclusions

Follow-up data indicating progress varied between respondents. Whilst hard outcomes could be identified in individual cases, the unifying factors across the sample were found predominately in the realm of soft outcomes. These soft outcomes, such as raised confidence and self-esteem, facilitated the hard outcomes such as educational achievement and voluntary work.

Introduction

This article is based upon in-depth interviews with 10 people who had been interviewed two years earlier about their experiences of participating in an ‘Arts on Prescription’ programme. This work was published previously in this journal.1, 2 When the participants were first interviewed, they were asked if they would be prepared to be interviewed in the future; each gave their consent and this article summarizes the findings from this follow-up research in terms of identifying hard and soft outcomes.3 In the previous research, 16 people took part and they experienced Arts on Prescription positively, both socially and psychologically. A number of participants claimed that they also found new opportunities for the future. The present study sought to discover the extent to which these ‘new opportunities’ came to fruition, and by identifying hard and soft outcomes, the authors were able to make observations about ‘distance travelled’.3

As observed in the previously published research on this programme,1, 2 little has been published in the peer-reviewed literature regarding the effectiveness of Arts on Prescription delivery. The one exception is a summary of a number of reports and accounts from 11 ‘arts and health’ programmes around the UK.4 To the authors' knowledge, no further reports have been published since 2010 directly related to Arts on Prescription programmes. This follow-up study may therefore contribute to the body of knowledge relating to this topic.

In brief, the participatory arts have been widely used in the promotion of health for many years, and the social value of engagement with the arts has been endorsed by the World Health Organization,5 who call for partnerships between health and other sectors to address social and economic problems, and recognize the role of the arts (p. 41), and the Royal College of Psychiatrists,6 who assert that creative activities may promote recovery (p. 28), as do the British Medical Association,7 the Arts Council,8 the Department of Health9 and the new economics foundation in ‘Five ways to wellbeing’.10 In the UK, Arts on Prescription is regarded (as the name suggests) as a form of social prescribing. This is a way of connecting patients of primary care services with community-based sources of support that are usually found in the voluntary sector. There is growing evidence of the effectiveness of such initiatives amongst people with mental health problems.4, 11, 12, 13, 14, 15 The aim of this study was to revisit the participants of the previous study, and to determine if continued engagement with the Arts on Prescription programme had any positive longer-term effects on those interviewed.

Section snippets

Methods

The authors' previous paper described a narrative methodology amongst people who had used an Arts on Prescription service. In this follow-up study, the authors were more instrumental in their approach, in that participants were only asked about their experiences since the last time they were interviewed (which was, on average, 24 months prior to the current study). Ethical approval was granted through a relevant ethics committee, and participants gave their consent to be followed-up at the

Results

Hard outcomes are identifiable in the follow-up research but these are relatively few. Both Alana and Nate had initiated their own arts groups, Ivan had gone on to achieve a BTec qualification in visual arts at college, Noah had commenced a Bachelor of Arts course, Alana claimed that she had increased in assertiveness and confidence, Ralph reported improved social contact, and Ron said that he was more motivated.

However, there was variation across the sample. For some participants, Arts on

Discussion

As noted on an individual basis in the vignettes, the narratives collected in this sample offer abundant evidence of distance travelled over the past two years, which can be articulated in terms of both hard and soft outcomes. Interviewees have, over this time, moved on to quantifiable achievements in education and training, narrated breakthroughs in their individual creative practices, taken on new social roles and responsibilities through voluntary work and community projects, and

Conclusion

The findings have illustrated unifying themes from the data whilst respecting the diversity and integrity of individual voices. Given the diversity in the ages, social backgrounds, genders and ethnicities of those who chose to participate in the study, and reasons for their initial referral to Arts on Prescription (ranging from long-term physical and emotional disability, to shorter-term personal life crises, to alcohol and drug dependency), it is to be expected that progress over a two-year

Acknowledgements

The Arts On Prescription is programme of work is delivered by City Arts Nottingham. Originally funded by the New Deal for Communities, it has also subsequently been funded by Lloyds TSB, The Nottingham North & East Consortium, NHS Nottingham City and the Hardship Fund (Office of the Third Sector), managed by the Community Development Foundation.

Ethical approval

Acquired through the NHS Integrated Research Application System and approved by an NHS research ethics committee.

Funding

University of Nottingham.

Competing interests

The first

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