Using arts to promote mental health: South Tyneside case study
Developing a multi-sector workforce for community-based arts in health promotion
South Tyneside has high levels of mental illness, therefore improving emotional health and wellbeing is a priority for the area. South Tyneside PCT commissioned Durham University to run a workforce development programme to bring together different sectors with an interest in using the arts to help deliver the Emotional Health and Wellbeing Strategy. ‘South Tyneside Common Knowledge' has stimulated new, joint ways of working to deliver arts-based solutions to mental health challenges.
Central and local government, the NHS, voluntary and community sector, education system and private sector, as well as individuals, families and communities, can all play a part in tackling the social determinants of health and reducing health inequalities. Establishing appropriate links between organisations to create partnerships and develop local integrated services is an important part of a whole-system approach.
The relationship between high levels of deprivation and high rates of mental ill health is well established: people on the lowest incomes experience much higher rates of mental illness. South Tyneside is an area of high deprivation with high levels of mental illness. The most deprived wards mirror the areas that experience the highest rates of mental illness.
Improving mental health is a priority for South Tyneside PCT, South Tyneside Council and other partners. NHS South of Tyne and Wear's Emotional Health and Wellbeing Strategy 2010-2020 and the PCT's action plan to implement it provide the framework for improving the emotional health and wellbeing of the local population.
The Centre for Medical Humanities at Durham University has worked to increase multi-sector capacity for arts-based approaches to health improvement since 2000. The ‘Common Knowledge' programme started as a four year long series of experimental projects and has evolved since then. ‘South Tyneside Common Knowledge' built on this earlier work. It was a one-year workforce development programme in 2010/11 for health professionals, council officers, voluntary and community sector organisations, artists and arts organisations in South Tyneside. It aimed to:
- build skills and confidence to try new ways of working to deliver community-based arts in health projects through joint working
- improve the emotional health and wellbeing of the people of South Tyneside, including those most at risk of mental illness.
Who was involved?
The PCT funded the £20,000 programme and provided additional support in kind, such as catering and use of premises. Other organisations made venues available free of charge, including The Customs House arts centre and the environmental regeneration charity Groundwork. The Centre for Medical Humanities project managed and facilitated the programme, and is carrying out the evaluation.
The problem and how it was tackled
Sharing learning between sectors
Because South Tyneside has been resistant to traditional approaches to health improvement, the health sector identified the need for retraining and the development of new services and teams to deliver new and different services.
Around 50 people in total took part in the workforce development programme, with a core group of 25-30. They represented the main sectors responsible for public health in South Tyneside in roughly equal numbers.
- council officers with a health remit, such as smoking cessation and exercise programmes
- PCT staff, including those with responsibilities for mental health, smoking cessation, diet and nutrition
- voluntary and community sector organisations, including representatives of the Happiness and Wellbeing Network
- artists and arts organisations experienced in community-based arts in health work.
They were joined by participants from a previous ‘Common Knowledge' programme at two joint seminars to share learning.
Those taking part in ‘South Tyneside Common Knowledge' felt the opportunity to share learning between sectors widened their horizons:
"I will tell others that if they take part in ‘Common Knowledge' they will be inspired and they will make lots of contacts and see the bigger picture."
Ensuring senior level buy-in
Evaluation of the first ‘Common Knowledge' programme showed success in changing how individuals work at delivery level but limited influence at strategic level.
To secure more senior level buy-in to the workforce development programme, participants had to get the approval of their line managers to take part. Their backing helped maintain attendance levels. This proved crucial at a time of considerable upheaval within the PCT and the Council, which made it increasingly difficult for staff to be released.
Providing a practical learning experience
Participants wanted practical experience of how to use the arts to improve health and wellbeing, so applied creativity was central to the development and delivery of the programme. Following an induction event, a series of six bi-monthly learning days explored different health topics using a combination of artist-led practical activity and facilitated debate. They included sessions focused on:lantern-making, alongside discussion about how the local government, health and voluntary and community sectors can bring people together in a community celebratory lantern procession and event to promote positive mental health:
- research and evaluation techniques, led by the Centre for Medical Humanities and Lodex, a company specialising in measuring wellbeing that works closely with the PCT
- arts organisations from outside the area sharing their experiences of community-based arts in health work
- international exchange of arts in health practice and research, involving 12 practitioners from across the world.
Although not originally planned, the programme incorporated support in dealing with recognition of the difficult time participants were experiencing at work.
Outcomes and impact
‘South Tyneside Common Knowledge' has made a clear impact on participants' decision making in the short term:
The Happiness and Wellbeing Network has changed the way it works. It has introduced arts-based techniques to help address the needs of the rapidly growing black and minority ethnic communities in South Tyneside and to recruit new members to the Network.
- New cross-sector collaborations have formed. Participants developed proposals for eight joint pilot projects to improve emotional health and wellbeing using arts-based approaches. These include a ‘transition' event for health sector staff to celebrate their work and help them cope with change.
Participants speak highly of ‘South Tyneside Common Knowledge' and describe how it has changed their thinking:
"I see the credibility of arts as a successful means of delivering health messages."
"I am surprised I have been able to apply the knowledge I have gained into a real project - I was sceptical at the start but now feel I could explain to colleagues the benefits of using the arts to promote health."
"I recognise creative elements in my work that are not necessarily about producing things but about the way I do things."
I have greater understanding of evaluation tools for capturing information to use for future development and partnership working to access funding. It's been a wonderful and enlightening experience."
The findings from earlier ‘Common Knowledge' programmes suggest that the workforce development will also have a long-term influence on participants, shaping the way they work, the decisions they make and who they choose to collaborate with.
Critical success factors to take the work further
Bringing together people from different sectors involved in health improvement was key to success. Participants valued the experience of practice-based learning with colleagues working in different fields and with different perspectives. It helped them understand the relevance of what each other does and recognise the potential to work together to use arts-based techniques to improve health.
The quality of the dialogue and the relationships that formed between participants from different sectors was crucial. It fostered a relationship-based approach that encouraged new, collaborative ways of thinking and working to apply creative practice to health.
Peer learning helped make the programme engaging and ‘real'. Participants from a previous ‘Common Knowledge' programme spoke about the impact it had had. They included artists explaining how their work had changed direction and teachers talking about the improved health ethos in their schools.
What could have been done better?
The policy and organisational changes taking place within the PCT and the Council proved a challenge to attendance and morale. Redundancies and redeployments meant some participants had to withdraw from the programme altogether, while others needed to make a considerable effort to continue taking part. Ensuring senior level buy-in and providing support in dealing with uncertainty and stress ameliorated the impact on the programme and helped maintain attendance levels.
Future programmes will incorporate an exchange of community views and a bigger international dimension by:
- involving community representatives, so local people become part of the learning process
- building regional, national and international links to explore the potential benefits of the arts in promoting emotional health and wellbeing across different cultures and healthcare systems.
Senior Research Fellow in Arts in Health
St Chad's College and Centre for Medical Humanities
24 February 2015