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Understanding wellbeing outcomes in primary care arts on referral interventions: a mixed method study

Samantha Hughes, Diane M Crone, Rachel C Sumner, Mark Redmond

Abstract


Background: Arts on Prescription programmes are designed to support the mental health and wellbeing of patients with a variety of clinical needs within the community. Despite a number of studies reporting benefits, there are some patients that do not see improvements in their wellbeing. Yet, there is limited research investigating the reasons for this. The present study aimed to address this deficit.

Methods: Using a sequential mixed-methods design the present study sought to understand why some participants (N=312) experienced an increase in wellbeing and others did not (N=95) after attending an Arts on Prescription intervention based in the South West of England between 2009 and 2016.

Results: Quantitative comparisons between the 2 groups identified little differences, aside from age and baseline wellbeing (WEMWBS scores), with those that improved being slightly younger and having lower wellbeing at the outset compared with those that did not improve. A process model depicting the perceived facilitative and inhibitive factors of attending the programme was developed from the qualitative findings. This model suggests that the social aspect of the course may be implicated in the participants differential outcomes with those that showed a decrease in wellbeing reporting difficulties in interacting with others during the intervention. Further, the participants who reported an increase in wellbeing felt vulnerable to “relapse” when finishing the course due to uncertainties regarding future support and their ability to maintain their wellbeing without the provision of the programme.

Conclusions: The results of our research suggest a need to promote communication among groups in such interventions with the hope that this will provide a more facilitative environment for all participants to benefit. Also, such programmes should consider follow-on options to ensure the participants feel supported and confident in managing their wellbeing once the course comes to an end. Our findings are pertinent to those commissioning primary care art interventions, ensuring that referral policies and pathways are designed for optimal effectiveness and for potentially tailoring social prescribing programmes to suit the participants’ specific needs.

Keywords


Arts for health, holistic health management, mental health, mixed methods, person-centered healthcare, primary care, social prescribing, wellbeing

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References


Centre for Mental Health. (2010). The Economic and Social Costs of Mental Health Problems in 2009/10. Available at: http://www.ohrn.nhs.uk/resource/policy/EconomicandSocialcostofMI.pdf.

Mental Health Foundation. (2016). Fundamental Facts About Mental Health 2016. London: Mental Health Foundation. Available at: https://www.mentalhealth.org.uk/sites/default/files/fundamental-facts-about-mental-health-2016.pdf.

NHS England. (2014). Five year forward view. Available at: https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf.

Public Health England. (2017). Commissioning for value mental health and dementia pack. Northumberland: England: Public Health England. Available at: https://www.england.nhs.uk/wp-content/uploads/2017/07/cfv-northumberland-mhidp.pdf.

The Mental Health Taskforce. (2016). The five year forward view for mental health: A report from the independant Mental Health Taskforce to the NHS in England. London: NHS England. Available at: https://www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf.

NHS England. (2019). The NHS long term plan 2019. Available at: https://www.longtermplan.nhs.uk/.

All-Party Parliamentary Group on Arts HaW. (2017). Creative health: The arts for health and wellbeing. Available at: https://www.culturehealthandwellbeing.org.uk/appg-inquiry/.

Naylor, C., Das, P., Ross, S., Honeyman, M., Thompson, J. & Gilburt, H. (2016). Bringing together physical and mental health: A new frontier for integrated care. The Kings Fund. Available at: https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Bringing-together-Kings-Fund-March-2016_1.pdf.

Brandling, J. & House, W. (2009). Social prescribing in general practice: Adding meaning to medicine. British Journal of General Practice 59 (563) 454-456.

Chatterjee, H.J., Camic, P.M., Lockyer, B. & Thomson, L.J.M. (2017). Non-clinical community interventions: A systematised review of social prescribing schemes. Arts & Health 10 (2) 97-123.

Mossabir, R., Morris, R., Kennedy, A., Blickem, C. & Rogers, A. (2015). A scoping review to understand the effectiveness of linking schemes from healthcare providers to community resources to improve the health and well‐being of people with long‐term conditions. Health & Social Care In The Community 23 (5) 467-484.

Bungay, H. & Clift, S. (2010). Arts on Prescription: A review of practice in the UK. Perspectives in Public Health 130 (6) 277-281.

Clift, S., Camic, P.M., Chapman, B., Clayton, G., Daykin, N., Eades, G., Parkinson, C., Secker, J., Stickley, T. & White, M. (2009). The state of arts and health in England. Arts & Health 1 (1) 6-35.

Daykin, N., Byrne, E., Soteriou, T. & O'Connor, S. (2008). Review: The impact of art, design and environment in mental healthcare: a systematic review of the literature. Journal of the Royal Society for the Promotion of Health 128 (2) 85-94.

Van Lith, T., Schofield, M.J. & Fenner, P. (2013). Identifying the evidence-base for art-based practices and their potential benefit for mental health recovery: A critical review. Disability and Rehabilitation 35 (16) 1309-1323.

Crone, D.M., O'Connell, E.E., Tyson, P.J., Clark-Stone, F., Opher, S. & James, D.V.B. (2012). 'Art Lift' intervention to improve mental well-being: An observational study from UK general practice. International Journal of Mental Health Nursing 22 (3) 279-286.

Crone, D.M., Sumner, R.C., Baker, C.M., Loughren, E.A., Hughes, S. & James, D.V.B. (2018). "Artlift" arts on referral intervention in UK primary care: Updated findings from an ongoing observational study. European Journal of Public Health 28 (3) 404-409.

Puetz, T.W., Morley, C.A. & Herring, M.P. (2013). Effects of creative arts therapies on psychological symptoms and quality of life in patients with cancer. Journal of the Association of American Medicine 173 (10) 960-969.

Kongkasuwan, R., Voraakhom, K., Pisolayabutra, P., Maneechai, P., Boonin, J. & Kuptniratsaikul, V. (2016). Creative art therapy to enhance rehabilitation for stroke patients: a randomized controlled trial. Clinical Rehabilitation 30 (10) 1016-1023.

Fleischer, S. & Grehan, M. (2016). The arts and health: Moving beyond traditional medicine. Journal of Applied Arts & Health 7 (1) 93-105.

Bickerdike, L., Booth, A., Wilson, P.M., Farley, K. & Wright, K. (2017). Social prescribing: less rhetoric and more reality. A systematic review of the evidence. BMJ Open 7 (4) e013384.

Sumner, R.C., Crone, D.M., Baker, C., Hughes, S., Loughren, E.A. & James, D.V.B. (2019). Factors associated with attendance, engagement, and wellbeing change in an Arts on Prescription intervention. Journal of Public Health doi: 10.1093/pubmed/fdz032.

Redmond, M., Sumner, R.C., Crone, D.M. & Hughes, S. (2018). ‘Light in dark places’: Exploring qualitative data from a longitudinal study using creative arts as a form of social prescribing. Arts & Health. https://doi.org/10.1080/17533015.2018.1490786.

Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J. & Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes 5: 63.

Department for Communities and Local Government. English indices of deprivation 2015. Available at: https://www.gov.uk/government/statistics/english-indices-of-deprivation-2015.

Quick, E.K. & Gizzo, D.P. (2007). The “Doing What Works” group: A quantitative and qualitative analysis of solution-focused group therapy. Journal of Family Psychotherapy 18 (3) 65-84.

Creswell, J.W. & Clark, V.L.P. (2011). Designing and conducting mixed methods research. 2nd edn. Thousand Oaks, CA: Sage Publications.

Braun, V. & Clarke, V. (2014). Using thematic analysis in psychology. Qualitative Research in Psychology 3 (2) 77-101.

Vogelpoel, N. & Jarrold, K. (2014). Social prescription and the role of participatory arts programmes for older people with sensory impairments. Journal of Integrated Care 22 (2) 39-50.

Secker, J., Hacking, S., Spandler, H., Kent, L. & Shenton, J. (2007). Mental health, social inclusion and arts: developing the evidence base. London: Department of Culture, Media and Arts.

Crone, D.M., O'Connell, E.E., Tyson, P.J., Clark-Stone, F., Opher, S. & James, D.V.B. (2012). ‘It helps me make sense of the world’: The role of an art intervention for promoting health and wellbeing in primary care - Perspectives of patients, health professionals and artists. Journal of Public Health 20 (5) 519-524.

Drinkwater, C., Wildman, J. & Moffatt, S. (2019). Social prescribing. British Medical Journal 364, l1285.

Spandler, H., Secker, J., Hacking, S. & Shenton, J. (2007). Catching life: the contribution of arts initiatives to recovery approaches in mental health. Journal of Psychiatric & Mental Health Nursing 14 (8) 791-799.

Hamilton‐West, K., Gadsby, E., Zaremba, N. & Jaswal, S. (2019). Evaluability assessments as an approach to examining social prescribing. Health & Social Care in the Community 27 (4) 1085-1094.

Woodall, J., Trigwell, J., Bunyan, A-M., Raine, G., Eaton, V., Davis, J., Hancock, L., Cunningham, M. & Wilkinson, S. (2018). Understanding the effectiveness and mechanisms of a social prescribing service: a mixed method analysis. BMC Health Services Research 18 (1) 604.

Barry, B. & Stewart, G.L. (1997). Composition, process, and performance in self-managed groups: The role of personality. Journal of Applied Psychology 82 (1) 62-78.

Ogrodniczuk, J.S., Piper, W.E., Joyce, A.S., McCallum, M. & Rosie, J.S. (2003). NEO-Five factor personality traits as predictors of response to two forms of group psychotherapy. International Journal of Group Psychotherapy 53 (4) 417-442.

Crone, D.M., Smith, A. & Gough, B. (2005). “I feel totally alive, totally happy and totally at one”: A psycho-social explanation of the physical activity and mental health relationship from the experiences of participants on exercise referral schemes. Health Education Research 20 (5) 11.

Russell, J. (2007). Conversations in colour: Evaluation of an Arts for Health Partnership programme 2005/6. Arts for Health Partnership. Available at: http://www.artsandhealth.ie/case-studies/arts-for-health-partnership-programme/.




DOI: http://dx.doi.org/10.5750/ejpch.v7i3.1768

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