26 Nov Unlocking Creative Health

Creative health – arts and creative activities which deliver physical or mental health benefits – are now seen across academia, public health and local government as a viable method for health improvement and demand management.  But creative health is still a tiny part of the health system in terms of provision and access. Why is that?

The issues

Our conversations with practitioners from across the country with backgrounds both in arts and in health highlight four challenges.

1. How much evidence is enough: Leaders of creative health initiatives are still being asked for more proof, despite a wide a growing evidence base linking engagement with arts and creativity with improved health and wellbeing.
2. De-coupling advocacy from objective learning: The pressure some arts organisations feel to show their initiatives work, can lead to them prioritise advocacy and good-news, over objective learning about what works and what does not. Unless learning can be de-coupled from advocacy it could become a problem in terms of credibility.
3. Generalised wellbeing versus condition-specific outcomes: It is easier for commissioners to see the funding case for interventions which deal with symptoms of specific conditions (e.g. Alzheimer’s, heart disease) where effectiveness is more straightforward to measure. However, many creative health interventions deliver generalised wellbeing benefits which are far harder to measure and attribute.
4. Lower cost does not mean free: Health and care commissioners see creative health as a way to relieve waiting list pressure which is cheaper than clinical treatment. But cheaper does not mean free; artists and venues need to be paid, and programmes need professional oversight. Added to this, commissioners are prone to wishful thinking, and providers lack experience in setting transparent unit costs.

How can understanding these issues take the sector forward?

Spending on creative health is starting to grow – not least through the NHS’s recruitment of creative health champions in every English region. But arts organisations and local authorities can accelerate the discussion in a number of ways:

• By building their own knowledge of existing evidence, to frame their activities in the context of previous research – this will help address “enough evidence” challenge.
• By looking rigorously at what could have been improved or adapted to increase impact, and developing an “inquiry mindset” in relation to things which fall short or don’t go as planned. This is vital for credibility and also part of the “enough evidence” challenge.
• By focusing on proxy measures of wellbeing such as increases in skills, and improved sense of community and connection to place. These are easily measured using established national metrics, and there is good evidence showing that improving these factors leads to better health outcomes. This is far more achievable than trying to measure wellbeing.
• Being clear that creative health interventions may be cheaper than clinical intervention, but they are not free. Good quality arts activities, like good quality clinical help, requires expertise, time, and coordination – and while arts practitioners’ salaries might be less than clinicians’ there is still a cost.

You can read how these issues play out in practice in our evaluation of Eastbourne ALIVE – a ground breaking “creative immersion” programme initiated by East Sussex Public Health to accompany the Turner Prize 2023 being hosted in Eastbourne.

If you would like to know more about the work that we do around creative health or have any other questions, please email Ben.Lee@sharedintelligence.net.