Social Prescribing – what does it mean for the arts?

Health Secretary Matt Hancock pushed the arts up the health policy agenda over the summer by announcing £4.5m investment in GP Social Prescribing. Two conferences explored the subject in November: Engage’s ‘A Social Prescription‘, and the Kings Fund’s ‘Social Prescribing: Coming of Age‘, at which the Health Secretary was a keynote speaker. CVAN South East would like to hear your examples of arts, health and wellbeing projects in our region.

Emma Drew, Director of the HERA project at Brighton Health and Wellbeing Centre shares her experience of working in this field.

“Social prescribing is, in essence, a non-clinical intervention in someone’s life that should enable improved health and wellbeing. But the term is not unproblematic: it implies that someone expert does something to someone else to ‘fix’ them, in the manner of medical or surgical treatment. It really is not that – or it shouldn’t be. Social prescribing can be any activity that a person enjoys that supports their ability to manage their health – from football and walking to painting and dance to volunteering.

“Few people who work in the arts would be surprised at the idea that engagement in cultural activity can improve your wellbeing – your sense of self, your confidence, your dialogue with the world around you, your expressiveness, your skills, your insights. Some of the ideas we routinely work with are now finding their way into the health domain. There is a great deal of evidence to show that music, literature, visual arts, drama, dance can all support measurable improvements in health conditions, from immunity and healing to mood and mobility. And what appeals to policy-makers is that arts interventions are often less expensive and just as effective as medical ones.

“It is also fair to say that a large number of medical interventions are unnecessary, or come with their own sometimes huge challenges – the current opioid crisis in the US derives from the invention of new drugs by the pharmaceutical industry to meet the demands of doctors for stronger painkillers: the ‘solution’ has turned out to be worse than the original problem. And the nature of evidence behind some medical and surgical treatments is not always as strong or reliable as you might think.

“This is not to denigrate important clinical knowledge, but to help contextualise it. Arts and culture nourish and support both patients and clinicians as members of society, as whole people – we cannot be reduced to just our symptoms, and the arts can help to restore our battered humanity.

“I work with a team of artists and clinicians across a range of art forms on the HERA Project in Brighton and Hove. We have received funding from Arts Council England, the Sussex Community Foundation and a range of other donors to build on a pilot scheme to deliver professional arts activities in primary care. HERA stands for ‘healing, expressive and recovery arts’, and we are one of very few arts projects engaging patients in a GP setting. We participate in the annual Artists Open Houses scheme, and run a year-round programme in visual arts, music, literature, photography, singing, dance and creative coding.

“We believe that primary care is important – that is where 90% of patients present, and we can engage with people right across the life course. Almost everyone in the UK has a GP, so this context is almost uniquely accessible. And unlike hospital or residential settings, if people don’t like what we do they are free to walk away! That means that quality of our work, and critically the quality of the relationships we enjoy with patients, are of the highest importance.

“Arts-in-health work is not for everybody – as well as commitment to your own practice, you also need to be flexible and empathetic in a way that can support people who may be very vulnerable. You also need to be ok about working in an environment which can at times be frenetic, or emotionally charged. We provide clinical supervision for artists to enable them to process some more challenging aspects of the work.

“Who pays is also clearly important. For any artist working in a health setting, I would want to emphasise the importance of having your professionalism recognised. There is a very uneven picture across the country about how engaged clinical commissioners are in arts for health – Gloucestershire Clinical Commissioning Group has done some fantastic work, for example, while other CCGs are not event talking about this yet. There is a lot of interest in using culture to support health, and initiatives are as likely to come from doctors themselves as they are from commissioners. Some organisations are supported by trusts, foundations and community fundraising, others by public sector commissioning. The HERA programme grew from the commitment of a team of artists and doctors working together – we made it happen.

“Some people are sceptical about the quality of evidence behind arts in health – I argue that there is plenty of evidence now, and the NHS’s Head of Personalised Care, James Sanderson, agrees with me. Innovation is not always technical, and in this instance it is behavioural, systemic and cultural. If you think there may be an opportunity to use your artistic practice to support health, open the conversation. On the other hand, if you think this may be a convenient way to earn a living to support your artistic career, I would advise caution.

“HERA’s work is not the same as art therapy or music therapy – the focus of what we do is not clinical, but artistic. For me that is where the joy is, and is what turns patients into participants, and participants into a community of practitioners.”

Emma Drew
Director of the HERA Project, Author of The Whole Person Recovery Handbook
November 2018

Image: Still from a film by Rosaria Garcia and Fiona Geilinger, courtesy of HERA.