The arts have a huge role to play in health and wellbeing. Jane Rich shares how creative practitioners can support mental health without being mental health professionals themselves.
To avoid domestic violence, Penny* moved home to a place where no one knew her. As well as managing PTSD and OCD she had a heart condition and was unable to work. Despite being safe she felt trapped and alone. She had always loved photography and discovered Cambridge Community Arts (CCA) on Facebook. She joined a photography course, working in a small group with an inspirational tutor.
Over a year Penny learned how to use her camera and plucked up the courage to leave the house for class and to take photographs. She met others who shared her love of photography. After the course, told us that she had gone out with a friend she met in class, something that she hadn’t done for many years. It was a major victory to go out alone and get a bus, and she now felt safe and confident enough to do so.
She is now a member of a club that provides photographic services free of charge to local charities and she has a long-term goal to hold her own exhibition. Her journey is a good example of our theory of change, moving people from being recipients of support to becoming empowered through their creativity, enabling them to contribute to and feel a valued part of society.
Building pathway for learners into creative employment
CCA uses arts and creativity to empower and connect people. We reduce social isolation and improve mental health working with adults in and around the county through a wide variety of arts courses. We prioritise people with health conditions. Nearly one in three people with a long-term physical health condition also has a mental health problem. We do not provide participatory arts or offer arts therapy.
Our unique approach brings together inspiration from talented artists and creative practitioners within a structured learning environment that has underlying support from an experienced team. We train artists to acknowledge and refer but not take the role of a mental health practitioner.
CCA run creative arts courses in many different art-forms designed to develop each individual artist. Some lead to a nationally recognised qualification. Accreditation validates individual achievement and contributes to improved mental health. It can also be an important stepping-stone towards employment.
We provide individual support for artistic and personal development once courses are over and have supported many people into work. Partnerships within the creative industries allow us to build pathways for our learners into creative jobs that they may have felt excluded from.
Demonstrating the impact of our work
Capturing the impact of our work has always been a challenge - we are still learning how to best do it. An initial mistake was to collect far more data than we could analyse. But the key tool we’ve used is the Warwick and Edinburgh Mental Wellbeing Scale (WEMWBS). This is a short questionnaire for learners to complete before and after their course that measures their sense of wellbeing.
We have consistent results that show an improvement in the mental wellbeing of our learners after taking a course. This is invaluable in demonstrating the impact of our work within a scientifically acknowledged framework. The other evaluation tool is the voices of our learners themselves. We involve them at all levels of the organisation providing numerous channels for feedback to ensure we continue to improve what we do.
According to Cambridgeshire and Peterborough NHS Foundation Trust (CPFT): “The CCA approach empowers people who have previously found it difficult to engage in social activities and situations. The individuals we referred have really flourished, improving their confidence and going on to continue building on those gains even after their courses finish.” (Personality Disorder Community Service, CPFT.)
We have good relationships within the mental health sector. Many of our learners are signposted to us by mental health professionals who value our role in their clients’ recovery journeys. But mental health services are under huge pressure. According to the Mental Health Foundation, every week 1 in 6 adults experiences a common mental health problem, such as anxiety or depression and 1 in 5 adults has considered taking their own life at some point.
Overcoming significant barriers
Physical health problems also significantly increase the risk of developing mental health problems, and vice versa. These are the people we work with, most of whom are also in poverty or on very low incomes and often don’t reach the threshold for primary mental care support.
There are many invisible barriers that stop people engaging with their own creativity and accessing the world of arts and culture. There may be financial constraints but more often it is a lack of confidence and self-esteem. Enabling people to overcome these barriers begins with a frank and honest conversation about what those barriers are.
From the start we are clear that our interest is people attending, engaging, and enjoying themselves. Our commitment to be person-centred and value based is important. This means that everyone working with us feels welcome, has empathy and understanding for each other, is inclusive and behaves with respect towards others.
This creates a strong and supportive community that has boundaries, but no hierarchy as might be found in other health or learning settings. It empowers people to grow and find inner strength through the development of their creative expression, whether that be music, painting, acting, or writing.
Understanding boundaries of responsibility
The notion of safe space applies not just in the classroom but to the entire working environment. Providing services for people with known mental health problems entails huge responsibility. All CCA creative tutors receive training and support to understand the boundaries of their work. It is important that they provide inspiration and tuition but also that they understand what lies outside their responsibility.
I am aware of bad practice where artists are left responsible for people with complex needs without any support or guidance. At CCA we provide group supervision with a mental health professional for all tutors, volunteers, and staff - as well as counselling when needed.
This maintains our resilience and allows us to learn from experiences that touch our own mental health. We also support the progression of creative practitioners and artists with lived experience of mental ill-health through training and work experience.
People blossom into more multi-coloured versions of themselves
There are many positive outcomes from our work: for example, we recently supported Betty to get her ‘dream job’ volunteering at a local wildlife sanctuary. Having mild learning disabilities, she was told at school that she would never get a qualification. At CCA she achieved a Level 2 Certificate in Skills for working in the Creative & Design Industries.
Colette told us that after her course she was a much better parent and played with her kids outdoors. CCA helped Maureen volunteer at a local gallery where she now has a permanent job. And, as a result of her drama course, Jen now has the confidence to ask for help in shops. The anecdotal list of outcomes is endless.
I founded CCA because my experience of working in the arts showed me how creativity can change people’s lives for the better. I have seen people blossom from shadows into stronger, more confident, and multi-coloured versions of themselves.
In the past seven years, we have worked with over twelve hundred adults empowering them with their own creativity to improve their health and future lives. We aim to help many more through our courses and by providing artists and creative practitioners with the skills needed to run successful and safe community mental health projects.
(*All learner names have been changed.)