1. Art Lift Evaluation: Summary of Findings Frances Clark-Stone (NHS Gloucestershire) Dr Diane Crone, (University of Gloucestershire) 29 March 2012 Evaluation team: Dr Diane Crone (Lead), Elaine O’Connell, Prof. David James, Dr Phil Tyson, Frances Clark-Stone (NHS Glos).

2. “It helps me make sense of the world” - Artlift participant

3. Aim of Art Lift In Phase 1, to use art to help some patients with anxiety and depression In Phase 2, to improve the well-being of people with a range of needs, in a socially inclusive setting To embed the use of art in primary care, as an alternative or complement to medical treatment

4. Why promote mental wellbeing? Only 40% of the burden of mental illness is avertable, which means that “60% of mental illness remains unavertable by treatment” (Friedli & Parsonage 2008). Strengthening mental well being within communities can reduce the prevalence of mental disorders within that community (Huppert 2005). The economic rationale for Government intervention to improve mental capital and wellbeing is based on a combination of equity and efficiency arguments (Foresight report 2008).

5. Positive mental health Better outcomes in physical health, health behaviours, education and employment, and crime reduction. Subjective well being increases life expectancy by 7.5 years Protection from CHD comparable to smoking cessation In young people, significantly influences alcohol, tobacco and cannabis use Better outcomes regardless of mental health status

7. Evaluation questions 1.What is the impact of the 'Art Lift' project on the mental health and wellbeing of those patients who complete 'Art Lift'? 2.What are the associations between patient characteristics (age, gender, SES etc) and their progress through the 'Art Lift' project? 3.What are the experiences and perceptions of patients, health professionals and artists in relation to the ‘Art Lift’ project? Data Collection period February 2009-September 2010

8. Summary of findings Common referral reasons: – improve self esteem/confidence, –to reduce stress/anxiety/depression, –improve overall wellbeing. 28.2% referred but did not attend (approx 1 in 4) Completion rate of 49.5% (1 in 2). Those that completed significantly older. Wellbeing - statistically significant improvement pre and post intervention.

9. Schematic of pathway and results Number of all referrals (n = 255; initial = 202; re-referrals 53) Initial referrals (n=202) Initial referrals (n=202; 100%) Referred and attended (n = 157; 77.7%) Referred but did not attend (n = 45; 22.3%) Completed 10 week intervention (n = 100; 49.5%) Did not complete 10 weeks (n = 57; 28.2%) Re-referred for another 10 weeks (n=53; 26.2%) Re-referred for another 10 weeks (n = 17; 8.4%) Did not get re-referred (n = 36; 17.8%) Did not get re-referred (n= 47; 23.3%)

10. Comparison with other research Art Lift Scheme is attracting target group, MH. 77.7% of those referred attended. 49.5% completed. 77% women and 23% men referred; same % complete. Largest quantitative data set than other previous ‘arts for health’ published research Other research (exercise referral scheme) MH less likely to start and less likely to complete (James et al., 2007) 1/3 rd participated and between 12-42% completed (Williams, 2009). 80% drop out (Gidlow et al., 2005). Females more likely to start, but older men more likely to complete. Older people also more likely to complete than younger (James et al., 2007; Gidlow et al., 2007).

11. Qualitative Participants were asked about their experiences and perceptions Focus groups (3) One to one interviews (3)

13. Interviews Expectations and experience of the referral process Experience of the intervention including perceived benefits Primary care setting Funding and sustainability

14. Expectations and experience of referral process Some participants had a previous childhood interest in art, others did not Many had been experiencing mental health problems for some time Referral process was simple and straightforward Initial contact from the artist was appreciated Expectations included health improvement: “I was hoping it might lighten my mood a little”

15. Experience of the art sessions Enjoyable sessions, something to look forward to Positive personal challenges Variety Positive experience of the artist a key factor: “I think the artist made the whole thing for me really”

17. Perceived benefits Confidence and sense of achievement Social interaction and co-operation within the group New identity with family and friends Happiness, calmness Distraction and relief from problems, worries, pain “It’s rekindled my imagination and it’s given me hope”

18. Healthcare setting Sessions ran in consulting rooms, waiting rooms, meeting rooms, adjoining buildings Familiar and convenient Availability of space a problem for some Disability access a problem for some No strong views about settings, generally “If I can get comfortable and basically concentrate on what I’m drawing I don’t mind where I am”

19. Funding and sustainability Willing to pay small amount (£2-£5) Re-referral considered important Creativity at home - variable Follow on groups (eg. In other participants house) Progression into mainstream art classes Progression into volunteering Confidence to pursue other creativity

21. Conclusions Art Lift was an enjoyable experience - “I always came away feeling a great deal better than I had before I went in” Participants felt more confident and hopeful - “I’m beginning to do things I never thought I could do” Some found relief from problems and pain - “Sometimes it takes the pain away” Art provided a new interest and identity – “So it allowed me to talk a little bit to other people about art, to think about possibilities”

22. Conclusions The social aspect was very important - “four of us and the age range is amazing....ninety one and she’s sharp as a tack you know..it’s brilliant for us to learn from somebody of that age” The quality of the artist was a key factor – “Really really thoughtful and intelligent and appropriate” Re-referral an important option – “I felt that I had just got into something I was enjoying doing so why stop it now?”

23. Full report available from: http://www.glos.ac.uk/research/dse/ projects/Pages/artlift.aspx http://www.glos.ac.uk/research/dse/ projects/Pages/artlift.aspxwww.gloucestershire.gov.uk/artlift Thank you for listening! Any questions?