Greater Manchester is a devolved region of 10 boroughs, population 2.4 million, with a combined Health & Social Care of £6bn. Aims are to level health inequalities, by targeting collaboration, prevention, wellbeing, and innovation. Solutions in children’s services include:

• Increasing access and early help
• Clearer pathways of care for families and enhanced inter-agency collaboration
• Improved choice and shared decision making to empower families to find solutions that suit
• Assets-led, with a greater focus on place, communities and existing strengths.

The Arts, Culture and Mental Health program acknowledges that arts-led interventions can support moves towards the above, given arts and cultural options are versatile and offer multiple points of access, broadening the available repertoire of treatment options. In these ways clients choice & individuality can be promoted. Interventions can be designed to be mostly failure-free; important for self-esteem, achievement, pride & mastery. 

Cultural and arts-based interventions are multi-modal interventions due to their actions on a range of outcomes; from complex effects at an individual level, to community-based outcomes, to population health. For example, for the individual, studies show stress-relieving effects with positive impacts on inflammation and healing. Research shows the arts can reduce the use of pain-relieving medicines. Dance-led interventions are valuable tools in maintaining cognitive and motor skills and preventing falls.

At the community level, the arts can help promote a sense of belonging and combat loneliness – a major health concern. For public health, artists can help spread healthy behaviours. They may also counteract the over-medicalising of distress by attending to the environment, setting and messages around mental health, and minimising the nocebo effect. Empathy and awe are prosocial emotions that can increase a person’s and a population’s capacity to care for themselves and each other.

The effects of the arts:

• Are levelling: all have a role
• Support staff wellbeing
• Deliver no ‘side effects’ - the arts do not carry risks in terms of side-effects or mixing medicines
• Foster tranquil yet engaging environment
• Simultaneously alleviate negative symptoms and increase positive characteristics
• apply to healthy individuals and those with minor ailments, and can support wellbeing even in serious illness or prison contexts
• promote important components of recovery, for instance, agency, self-esteem, and control
• Increase agency & self-esteem
• target an underlying sense of well-being: non-specific

Recommendations:

• Support culture and the arts for mental health at the structural level
• Tackle stigma using the links between arts and mental health
• Increase everyday awareness of the links between culture and wellbeing
• Recommend a minimum weekly intake of the arts
• Catalyse active citizenship using empathy and awe
• Acknowledge that creativity is problem-solving and use it to aid complex care systems
• Support staff wellbeing with creative sessions
• Arts on Prescription and Social Prescribing to increase client choice and engagement
• Improve client experience via creative recovery-focussed approaches
• Develop criteria about what good practice looks like
• Invest in quality training