Cllr Liz Green: How does culture and leisure support children's mental health?

Cllr Liz Green Chair of the Culture, Tourism and Sport Board explores how culture and leisure can support children's mental health as part of our series of think pieces.

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As a veteran of local government and the LGA I have had the pleasure of holding various positions on several different policy areas. This has included being the portfolio holder for children's services and the deputy chair of the LGA’s Children and Young People’s Board, making children and young people’s (CYP) mental health an issue I know well and hold close to my heart. 

Coming in as the new chair of the LGA Culture, Tourism and Sport Board I am excited to bring these agendas together and to highlight the essential role culture and leisure services play in supporting good mental health in CYP and why this makes them a key partner to health services. 

It's positive to see much greater recognition and prioritisation of CYP’s mental health in national policy in recent years. Good mental health lays down the foundation for CYP to develop resilience and to cope with whatever life throws at them, supporting them to grow into well-rounded, healthy adults. However, despite the gains, NHS CYP mental health services continue to be overstretched - the Centre for Mental Health predicts 1.5 million CYP will need new or additional mental health support because of the COVID-19 pandemic and the number of CYP aged six to 16 in England with a mental health condition in 2021 has increased to one in six compared to one in nine in 2017. 

Yet despite research telling us that a quarter of mental health problems are preventable through early intervention in childhood and adolescence, there continues to be a lack of these essential services. 

Without funding into early interventions and a strong national policy message, local areas are left to do more with less. This presents an opportunity for partners to think creatively about what already exists in this space and how it can be harnessed to deliver more for CYP and families. 

This is where culture and leisure facilities and services play a key role. They are the vital public infrastructure in places that help to set the pre-conditions for good mental health and wellbeing. For example, they offer non-pressured spaces for young people to use as they want – whether that’s a quiet space away from a crowded house, or an informal alternative to the structured approach of school, or simply a different environment in which to relax, immerse in a hobby, learn a new skill or connect with peers.

Public libraries, leisure centres, swimming pools, museums, arts centres, and parks play a huge role in the prevention and early intervention agenda and could be co-commissioned to do much more to support the NHS to deliver its ‘five pillars of wellbeing’: connecting with other people; being active; learning new skills; paying attention to the present moment; and giving to others. 

Whether this is through connecting new parents as they bond with their child at baby Rhyme Time, maintaining green spaces and playgrounds for outdoor play and exploration, supporting children to learn to swim or providing families with free activities over the school holidays. Culture and leisure services perform a vital role in promoting good mental wellbeing. 

Culture and leisure: doing more with what we’ve got  

Councils spend £2.2 billion a year on culture and leisure services and are responsible for a wide range of assets, forming a low-cost network of universal provision across the country. For leisure alone, they run over 2,600 health and fitness facilities including 924 public swimming pools and 27,000 parks and green spaces. 

These assets provide low to no cost options for CYP and families to be physically and socially active and affordable venues for community sports clubs to operate in and engage with young people. They are at the heart of communities, offering affordable options for all to be active. This is important because being physically active improves our mental wellbeing. For children it can help them to self-regulate, learn social skills, and make friends, build self-esteem, lift their mood and aid learning. One UK study involving 86 primary school children showed that children who were more active performed significantly better in writing and mathematics than children who were less active.

Despite this, CYP, parents and carers are not always equipped with this knowledge. Finding ways to create a positive connection between being physically active and mental wellbeing early on can help to build resilience and decrease the likelihood of problems developing later. This can be perfectly illustrated by School nurses in Northamptonshire who took an innovative approach to children’s mental health when the COVID-19 national lockdown restrictions hit. Unable to meet students face to face, they came up with the idea of a socially distanced ‘walk and talk’ in local parks, enabling a more personal approach and better assessment of the young person’s mood. They found that the local parks offered a real sense of tranquillity, which really helped. Demonstrating the power our local assets can have on CYP’s mental wellbeing in a very simple way.

Councils also run around 3,000 libraries, and more than 350 museums as well as a wide range of public archives, numerous theatres and galleries, and many monuments and historic buildings.

The links between cultural engagement and mental wellbeing are well established.  Researchers have found that the positive relationship between arts, cultural or heritage attendance and wellbeing exists regardless of where people live. 

When it comes to libraries, LGA research has shown that they contribute significantly to a wide range of outcomes for children, including supporting better mental health, reducing isolation, providing links to health and social care services and enhancing pre-literacy skills. Libraries can provide books to support parents and children to understand how they are feeling, offer a safe and engaging environment to spend time together and form new connections, supporting learning for both parents and children. They also provide important access to computers and to information and support that allows families to access benefits, housing, skills and jobs, all underpinning a secure foundation for wellbeing. Rhyme Times in libraries are an invaluable tool for tackling maternal mental illness which is estimated to affect one in five mothers. LGA research of Essex libraries highlighted a (pre-pandemic) reach of 4,000 to 5,000 mothers a year, many of whom attended regularly. Of this number it is estimated 1,000 mothers experiencing mental health issues (based on the above figure) were being reached. The research shows a very noticeable improvement in the mothers’ moods after Rhyme Time, with the number describing themselves as ‘very happy’ more than doubling from 25 per cent to 59 percent in 30 minutes. 

Targeted provision

As well as providing core universal infrastructure for community wellbeing, culture and leisure services have a strong track record in offering targeted support to individuals or communities with specific needs. 

For example, The Illuminate programme, developed between Blackpool Theatre and Blackpool Council worked with children in care, learning about lights & sound at the Grand Theatre and creating dance, poems, banners and lanterns for Blackpool Illuminations. Using a ‘Story-Led Resilient Practice’ approach it built the capacity of young people feeling isolated and stigmatised and offered a safe space for children to be heard. It is hard to sustain friendships with school friends when living in care but over 70 per cent of the children said they had made new friends and had reconnected with them over the holiday period. And over 60 per cent of the children could describe ‘resilient skills’ and find new ways of coping individually and collectively.

The Libraries of Sanctuary programme, is a network of librarians, library staff, community groups and book lovers who are raising awareness of the issues facing people in the asylum system, offering support and participation opportunities, and contributing to a culture of welcome in the wider community. 

While public leisure provision builds in dedicated quiet times for children with SEND, specific sessions for LGBTQ+ and for women in its programming, offering discounted memberships for disadvantaged families, people with a disability and asylum seekers. For example, the London Borough of Waltham Forest offers a heavily subsidised weekly two hour SEND friendly swimming session. Annual membership for adults is only £10.30 and for juniors it is £3.10 a year and includes free swimming.

A call to action 

Councils already have a significant network of assets at their disposal to tackle the mental health crisis exacerbated by the pandemic. From leisure centres and parks to libraries and museums, our services can make a significant contribution to the early intervention and prevention of mental illness. 

As local leaders and decision makers we need to champion investment in culture and leisure, recognising it is an investment in the future of our communities and an effective way of managing demand for acute services. 

We must be bold and think outside the box and bring in new partners to help de-medicalise the current system, using the evidence base to set the direction and invest in services that address the wider determinants of mental ill health. 

And we must be ambitious - the Government’s new strategy for sport and physical activity sets a target to get over one million more children active by 2030. But why focus on physical activity alone? This is an opportunity to put what we know into practice to ensure that not only are one million more children active, but they are also equipped with the skills and knowledge to keep a healthy and resilient mind. 

We must improve our understanding of the impact of participation in physical activity and creative engagement and better educate young people and families. We need to ensure we evaluate interventions and equip ourselves with data on the return in investment (ROI) and social value to inform future investment decisions. Better integration of leisure and culture with other council led services like health visiting, school nursing, early years, public health and wider partners like schools, the NHS, social prescribing and voluntary and community sector will be key to achieving these ambitions. Along with developing a strong strategic vision underpinned by robust local plans developed with partners. 

When it comes to prevention, culture and leisure are frontline services that could be commissioned to do more. This sort of work is already underway. For example, in Bourne, Lincolnshire, South Kesteven District Council’s mental health and wellbeing cross party working group worked in collaboration with health partners, a mental health charity and a community arts provider to establish a local information resource to help reduce isolation and loneliness post Covid.

In my own Royal Borough of Kingston Upon Thames, Anstee Bridge, run by Kingston, Richmond and Windsor and Maidenhead Councils’ Achieving for Children service, has been supporting vulnerable young people since 2008. It works with school-recommended pupils from years 9-11 who have recognised social, emotional or mental health problems, bringing them into the service to work on creative projects in a safe and nurturing environment. They flourish because they are given the time to be creative, doing anything from circus skills to millinery, flower arranging to pottery, candle making to improv acting, whilst making new friends and recognising they are not alone.

In West Suffolk, Abbeycroft leisure centre is delivering StandTall™ an emotional resilience programme for 11-18 year olds, devised in partnership with Suffolk Mind. The programme supports young people to understand more about keeping a healthy mind and to experience the positive benefits of being active in a small social group and to improve low feelings, anxiety, stress or lack of motivation and improve concentration, confidence and self-esteem. The outcomes for the programme are very positive – importantly one young person said “I’m feeling happy, I feel more confident with my body”. Other outcomes show 87 per cent of participants said the physical activity had a positive impact on them and they felt able to take more control over their own wellbeing and 90 per cent experienced improvements with feelings of anxiety and depression by 13 per cent. The programme has produced a ROI of £58,002 pa from 2020 for eight courses.

I hope I’ve made the case to you - council provided cultural and leisure provision plays an important role in promoting and supporting positive mental health and wellbeing in CYP and families. Councils already have established networks of voluntary and community groups and assets that are well placed to provide early intervention and preventative services that are lacking in the current CYP mental health service. 

To change the landscape locally, we will need to increase the knowledge of our partners in health, schools, children and public health services and forge new ways of working, thinking and delivering CYP mental health support through for example co-commissioning and integration. 

Alongside this, strategic investment to build the capacity and resilience of leisure and cultural services to meet increasing demand for CYP mental health support is needed. And a strategic vision developed with CYP and families and backed by strong leadership and data that demonstrates the positive contribution leisure and culture provision makes to CYP’s mental health will be core to winning hearts and minds. These are all crucial steps in our journey to transform the way we think about and deliver support and perhaps most importantly how we improve the quality, breadth and depth of mental health support available to our CYP and families.