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Wednesday, 21 September 2016

Arts on Prescription (or Arts on Referral) FACT SHEET




What is Arts on Prescription - based on a Frequently Asked Questions format we hope to provide you with answers and signposting for further research.

What is Arts on Prescription?
Arts on Prescription, sometimes known as Arts on Referral, is a type of social prescribing. In social prescribing there is a referral process whereby health or social care practitioners refer people to a service or a source of support. Arts on Prescription schemes provide arts and creative activities for participants, usually for people experiencing mental health problems and social isolation. The purpose of such schemes is not to replace conventional therapies but rather to act as an adjunct, helping people in their recovery through creativity and increasing social engagement. Although the schemes are varied in their approaches and settings, the common theme is that there is a referral process.

The first scheme which used the name was Stockport Arts on Prescription, which has been running for more than 10 years. The continuing success of Stockport Arts on Prescription has largely stemmed from its securing mainstream Primary Care Trust funding, retaining its highly skilled and committed artists and the support of Health Care and Arts & Health organisations.

What is the evidence?
There is a body of evidence that supports the notion that active involvement in creative activities can provide a wide range of benefits, including the promotion of well-being, quality of life and health, increased levels of empowerment, positive impacts on mental health and social inclusion for people with mental health difficulties

Research specific to Arts on Prescription schemes is limited. Examples include:

The Stockport Arts on Prescription evaluation found that participation in creative activities raised self-esteem, provided a sense of purpose, helped people engage in social relationships and friendships and enhanced social skills and community integration

The Time Being project, established by Healing Arts on the Isle of Wight, was evaluated by interviews, focus groups and questionnaires. The reports from the project will be available on the new Healing Arts website in 2011. The site will also include short film/video sequences with the participants, clinicians, artists, and researchers commenting on the programme.

The Arts on Prescription pilot project delivered by Cambridge based arts and mental health charity, Arts & Minds, aimed to establish whether there was a demand for the service in Cambridgeshire and whether it would be of benefit to participants experiencing mild to moderate depression, anxiety and stress. Josie Aston conducted the evaluation which included the GAD-7 (Anxiety) and PHQ-9 (Depression) scales commonly used in primary healthcare

Other published evaluations make some reference to or are relevant to Arts on Prescription. The study ‘Mental Health, Social Inclusion and Arts: Developing the Evidence Base’ reports that the results provide sufficient evidence of mental health, social inclusion and in particular empowerment gains to justify support for arts and mental health work. You can download the full study from the website of the International School for Communities, Rights and Inclusion (ISCRI), at the University of Central Lancashire

A report on the Art in Mind community arts initiative to promote mental health, in Nottinghamshire, is available in the Journal of Public Mental Health.

You can also download a case study for the Arts on Prescription scheme led by Art in Mind in partnership with Nottingham City Council.

How do you go about evaluating an Arts on Prescription scheme?
To build a body of evidence it is essential that any new schemes are rigorously evaluated. If you decide to evaluate your scheme in line with national recommendations for Primary Care you should, in discussion with your health colleagues/partners, consider working with a professional researcher or university and refer to the information in the Quality and outcomes Framework guidance for General Medical Services (GMS) contract 2009/10. The GMS contract is the UK-wide contract between general practices and primary care organisations, for delivering primary care services to local communities. The three suggested depression severity measures validated for use in a primary care setting are the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale.

When and how are patients referred?
Often referral or recruitment of participants is a significant challenge. The aim may be to target ‘hard to reach’ individuals but inevitably there are many barriers to participants finding out about or accessing such services. Partnership working is key, particularly with service user groups or forums, social care and health charities and health care professionals and services.  The most common referral route is through GP’s.  Arts on Prescription schemes can be perceived by GP’s as a valued additional ‘offer’ for patients they see regularly, who may suffer from isolation, depression, anxiety or stress. GP’s vary in their knowledge of, support of, and interest in such schemes. There are a number of different schemes in the South West and they use different methods of referral.  Schemes rely on advocates and champions amongst GP’s and other health care professionals; GP Practice Managers are important ‘gatekeepers’ and may be a barrier to communication with GP’s.  Leaflets and posters are often used. The wording is very important with regard to challenging stigma and it is advisable to develop them in conjunction with health care staff and/or service user groups or forums.  Participants may be able to self-refer via a website. Access to self –referral is often desirable but may be hard to manage regarding numbers. Where participants self-refer it is important to consider screening to make sure the course/service is suitable for their level of need.

How do artists get involved?
Generally, artists would be required to have some experience of working with people with mental health issues and/or be prepared to do some training as part of the Arts on Prescription scheme. Scheme managers are likely to have a number of artists they work with regularly and can build relationships with, develop their skills etc. As with any employment of artists there might be a call out for artists, followed by an application and interview procedure. These would be advertised in the usual places including on the Arts & Health South West website www.ahsw.org.uk

ARTS ON PRESCRIPTION SCHEMES IN THE UK
There are several arts on referral schemes.

Artshine is delivered by Bristol Public Health Directorate, funded by Bristol City Council. Started in 2010 it delivers arts on referral to 8 inner city GP practices
Contact: Louisa Newman, Arts on Referral Project Manager, NHS Bristol

Arts for Health Cornwall and the Isles of Scilly has delivered arts projects within GP surgeries although does not provide an ongoing Arts on Prescription scheme.

PETROC in North Devon is a further education college which has provided an Art on
Prescription service since 2005. Following a successful tender to the Learning Skills
Council in 2008 a pilot ‘blended learning’ programme was delivered. This involved
reduced numbers of visits to a classroom and a specially designed workbook which can
be used at home.
Contact: David Baker, Programme Manager for Arts and Health in Community Education

REACH Dorset was one of four regional arts and health partnerships
REACH Dorset provided an art on referral scheme in conjunction with the Improving Access to Psychological Therapies service in West Dorset. A charity is being set up with the aim of providing arts on referral to GP’s across the county.
for more information.

Art Lift offers drama, music, singing and visual arts workshops across Gloucestershire.
Participants are referred to the scheme by their GP. It is currently funded by NHS Gloucestershire. The Walnut Tree GP Practice in Dursley, Gloucestershire has an arts in health toolkit available on their website

For more information or to send in relevant information please contact:
Alex Coulter, Director of Arts & Health South West: alex@ahsw.org.uk

Arts & Minds Cambridgeshire
47-51 Norfolk Street, Cambridge CB1 2LD or phone 01223 353 053




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