The art of being mentally healthy: a study to quantify the relationship between recreational arts engagement and mental well-being in the general population

A systematic review of literature examining the application of a social model of health and wellbeing

BACKGROUND

Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking.

METHOD

Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set.

RESULTS

The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health.

CONCLUSION

The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare.

The Mystery Arts Box Project: a qualitative exploration of the experiences, benefits, and challenges of participating in a remotely delivered art and craft project for British veterans with visual impairment

INTRODUCTION

The clinical application of the arts among military personnel and veterans has been well documented, particularly in relation to service-related mental health difficulties. However, the impacts of engaging recreationally with art activities on general well-being remain underexplored and even more so among those living with visual impairment (VI). This pilot explored the artistic experiences of veterans with VI participating in a remotely delivered art and craft project during continued COVID-19 restrictions in Spring/Summer 2021.

METHODS

Six participants received a mystery arts box (MAB) containing a selection of materials, collated to encourage experimentation with unfamiliar techniques. Participants were asked to journal their process as they developed a final piece/pieces. They were invited to join group video calls to share work and ideas and seek guidance. Semistructured interviews were run with participants at the end of the project. Journal and interview data were thematically analysed.

RESULTS

Analysis identified 11 themes relating to initial and ongoing responses to the MAB and creative and journalling process. Several benefits were identified, including artistic learning, trying something new, and social, cognitive and emotional experiences. The value of the activity to participants' lives within the context of the ongoing pandemic was also considered. Challenges were associated with the use of unfamiliar materials, impacts of sight loss and the limitations of remote delivery.

CONCLUSION

This pilot brings to the fore the everyday artistic experience of veterans living with VI and considers the benefits, challenges and well-being implications of a remotely delivered arts activity. Findings illustrate the importance of ensuring accessibility of artistic activities to those for whom disability might limit participation and highlight the ongoing role that remotely delivered arts activities might play in meeting the social and recreational needs of individuals beyond the COVID-19 pandemic.

Comprehension of informed consent and voluntary participation in registration cohorts for phase IIb HIV vaccine trial in Dar Es Salaam, Tanzania: a qualitative descriptive study

BACKGROUND

Informed consent as stipulated in regulatory human research guidelines requires volunteers to be well-informed about what will happen to them in a trial. However, researchers may be faced with the challenge of how to ensure that a volunteer agreeing to take part in a clinical trial is truly informed. This study aimed to find out volunteers' comprehension of informed consent and voluntary participation in Human Immunodeficiency Virus (HIV) clinical trials during the registration cohort.

METHODS

We conducted a qualitative study among volunteers who were enrolled in the registration cohort of HIV clinical trials in Dar es Salaam, Tanzania. A purposive sampling strategy was used to obtain twenty study participants. The data were collected between June and September 2020 using a semi-structured interview guide. In-depth interviews were used to collect the data to obtain deep insights of the individual study participants on the comprehension of informed consent and participation in the clinical trial. A thematic analysis approach was used to analyze the data. Themes and subthemes were supported by the quotes from the participants.

RESULTS

Volunteers described comprehension of informed consent from different perspectives. They reported that various components of the informed consent such as study procedure, confidentiality, risk and benefits were grasped during engagement meetings. Furthermore, the volunteers' decision to participate in the registration cohort was voluntary. However, trial aspects such as health insurance, free condoms, and medical checkups could have indirectly influenced their reluctance to withdraw from the study.

CONCLUSION

Engagement meetings may increase the comprehension of informed consent among potential participants for HIV clinical trials. However, trial incentives may influence participation, and thus future research should focus on the challenges of giving incentives in the study. This will ensure comprehension and voluntary participation in the context of HIV clinical trials.

The impact of arts-inclusive programs on young children's mental health and wellbeing: a rapid review

BACKGROUND

This review evaluated the existing literature exploring the effects of arts-inclusive programs (AIPs) on the mental health and wellbeing of young children. AIPs include activities, programs, or interventions containing creative arts.

METHODS

Literature searches were conducted across three databases (SCOPUS, psycINFO, and ERIC). The search was restricted to studies reporting outcomes of children 0-6 years.

RESULTS

Nine studies were included in the review (3,671 participants). Three key themes were identified: music-related (n = 4); artmaking (n = 3); and storytelling/drama (n = 2). All included studies reported positive outcomes on children's wellbeing following engagement in AIPs.

DISCUSSION

This review found emerging evidence demonstrating positive impacts of arts engagement on the wellbeing of children aged 0-6. However, most studies were low quality and used varying outcome measures. The review is one of the first to highlight the lack of high-quality studies on the relationship between AIPs and wellbeing in young children.

The art of aging well: a study of the relationship between recreational arts engagement, general health and mental wellbeing in cohort of Australian older adults

Introduction

Evidence of the benefits of arts engagement to community wellbeing has been mounting since the 1990s. However, large scale, quantitative, epidemiological studies of the "arts-healthy aging" relationship, or the types of arts older adults voluntarily choose to engage in as part of their everyday life, for enjoyment, entertainment or as a hobby (vs. therapy or interventions) are limited. The aims of this study were to describe older adult recreational arts engagement via the Busselton Healthy Ageing Study (BHAS) cohort, and to determine if there was an association between arts engagement, general health and mental wellbeing.

Methods

Overall, 2,843 older adults (born 1946-1964) from the BHAS cohort (n = 5,107) who had completed a supplementary arts survey (n = 3,055, 60%) and had data on required variables were included in this study (93% of those eligible). The dependent variable was general health (SF12) and subjective mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale, WEMWBS). The independent variable was hours engaged in recreational arts in the last 12 months. A descriptive analysis followed by a linear regression analysis was conducted.

Results

The prevalence of recreational arts engagement in the last 12 months was 85% (mean = 132 h/year). Older adults engaged in the arts in a number of ways including attending events (79%), actively participating/making art (40%), as an arts society/club/organization member (20%), by learning about the arts (13%) or by volunteering/working in the arts (non-professional, 11%). When general health was assessed via the SF12, the average physical component score (PCS) was 50.1 (SD 8.9) and the average mental component score (MCS) was 53.6 (SD 8.3). When mental wellbeing was assessed, the average WEMWBS score was 54.9 (SD = 8.6). After adjustment for 12 demographic and lifestyle covariates, it was found that older adults who engaged in any recreational arts in the last 12 months had significantly higher WEMWBS scores and higher SF12 physical component scores than those who did not engage in the arts (0 h/year).

Discussion

Evidence of an arts-health relationship was found in this study. The suitability of the arts as a population based, healthy aging strategy to influence the mental wellbeing and general health of older adults should be investigated further.

Parents' Perspectives of an Arts Engagement Program Supporting Children with Anxiety

Arts engagement programs (AEPs) are non-clinical, structured programs led by artists and educators to support mental health and wellbeing. While evidence demonstrates positive mental health outcomes in adult AEPs, studies of childhood AEPs remain sparse. We created a gallery-based AEP (Culture Dose for Kids) for children with anxiety based on a successful arts engagement pilot for adults with depression. We questioned whether our tailored-for-children adult program would effectively and feasibly support children's mental health. Through parents' perspectives and feedback, this study tested the program's acceptability, feasibility, and effectiveness with children with anxiety. Quantitative and qualitative measures were used to determine whether the program was an effective and acceptable mental health support for children with anxiety. Our findings revealed that the program positively and significantly impacted parental perceptions of their child's anxiety. Our findings illustrate depictions of improved mood, confidence, and sense of empowerment in the child, qualities associated with resilience and mental wellbeing. Open-ended activities provided opportunities for connection, creativity, and experimentation-sources of strength for improving mental health. This study adds to the small but growing evidence base supporting the role of arts-based community care in youth mental health and wellbeing.

The role of arts engagement in reducing cognitive decline and improving quality of life in healthy older people: a systematic review

In recent years, arts engagement has been proposed as a non-pharmacological approach to reduce cognitive decline and increase well-being and quality of life in specific populations such as the elderly or patients with severe disease. The aim of this systematic review was to assess the effects of receptive or active arts engagement on reducing cognitive decline and improving quality of life and well-being in healthy populations, with a particular focus on the role of arts engagement in the long term. A comprehensive search strategy was conducted across four databases from February to March 2023. Ten studies with a total of 7,874 participants were incorporated in accordance with the PRISMA guidelines. Active and receptive arts engagement was found to be an effective approach to reduce cognitive decline and improve well-being and quality of life in healthy populations. The role of the positive effects of arts engagement could be determined by the combination of several factors such as exposure to cultural activities and the group effect. There is limited evidence of the protective effects of active arts engagement over a long period of time. Given the increasing demand for preventive programmes to reduce the negative effects of population ageing, more research on arts engagement should be conducted to identify its mechanisms and long-term effects.

Circus Activities as a Health Intervention for Children, Youth, and Adolescents: A Scoping Review

Circus activities are emerging as an engaging and unique health intervention. This scoping review summarises the evidence on this topic for children and young people aged up to 24 years to map (a) participant characteristics, (b) intervention characteristics, (c) health and wellbeing outcomes, and (d) to identify evidence gaps. Using scoping review methodology, a systematic search of five databases and Google Scholar was conducted up to August 2022 for peer-reviewed and grey literature. Fifty-seven of 897 sources of evidence were included (42 unique interventions). Most interventions were undertaken with school-aged participants; however, four studies included participants with age ranges over 15 years. Interventions targeted both general populations and those with defined biopsychosocial challenges (e.g., cerebral palsy, mental illness, or homelessness). Most interventions utilised three or more circus disciplines and were undertaken in naturalistic leisure settings. Dosage could be calculated for 15 of the 42 interventions (range one-96 h). Improvements in physical and/or social-emotional outcomes were reported for all studies. There is emerging evidence of positive health outcomes resulting from circus activities used in general populations and those with defined biopsychosocial challenges. Future research should focus on detailed reporting of intervention elements and increasing the evidence base in preschool-aged children and within populations with the greatest need.

VisualEars: How an immersive art exhibit impacts mood during the COVID-19 pandemic

This paper explores the positive impact of viewing a virtual art exhibit on mood during the COVID-19 Pandemic. During global lockdowns, depression, anxiety, and the burden of other mental illnesses have increased even among prior psychiatrically healthy individuals. Art and music-based interventions have shown to be effective clinical interventions in individuals with mental illness. The VisualEars project explored whether a virtual activity involving vision and auditory stimuli could improve positive and negative affect. Eight musical pieces were selected, and 28 visual artists from around the world visualized two musical pieces. A total of 56 works of art were created and hung in eight 3D virtual rooms. Visitors were randomly selected to either view the art exhibit without music (non-immersive) or view the art exhibit while listening to music (immersive). Visitors were asked to complete a positive and negative affect schedule (PANAS) in three languages (English, French, and Farsi) pre and post their virtual visit. A total of 160 participants completed baseline PANAS, 58 of which completed the follow-up PANAS. Linear mixed-effects models found that older participants had lower negative affect scores overall (b = −0.3, p = 0.003), while male participants had lower positive affect scores overall (b = −0.27, p = 0.02). Following the virtual exhibit participants of both conditions had higher positive (b = 0.17, p = 0.03), and lower negative affect scores (b = −0.19, p = 0.007). We found that the virtual art exhibit increased positive affect and decreased negative affect in participants, suggesting an overall improvement in mood attributable to the virtual exhibit. This suggests that virtual exhibits may serve as a beneficial and accessible intervention to improve mood during a pandemic.

Can a Brief Interaction With Online, Digital Art Improve Wellbeing? A Comparative Study of the Impact of Online Art and Culture Presentations on Mood, State-Anxiety, Subjective Wellbeing, and Loneliness

When experienced in-person, engagement with art has been associated—in a growing body of evidence—with positive outcomes in wellbeing and mental health. This represents an exciting new field for psychology, curation, and health interventions, suggesting a widely-accessible, cost-effective, and non-pharmaceutical means of regulating factors such as mood or anxiety. However, can similar impacts be found with online presentations? If so, this would open up positive outcomes to an even-wider population—a trend accelerating due to the current COVID-19 pandemic. Despite its promise, this question, and the underlying mechanisms of art interventions and impacts, has largely not been explored. Participants (N = 84) were asked to engage with one of two online exhibitions from Google Arts and Culture (a Monet painting or a similarly-formatted display of Japanese culinary traditions). With just 1–2 min exposure, both improved negative mood, state-anxiety, loneliness, and wellbeing. Stepdown analysis suggested the changes can be explained primarily via negative mood, while improvements in mood correlated with aesthetic appraisals and cognitive-emotional experience of the exhibition. However, no difference was found between exhibitions. We discuss the findings in terms of applications and targets for future research.

The Experiences of Parents and Infants Using a Home-Based Art Intervention Aimed at Improving Wellbeing and Connectedness in Their Relationship

During the period of COVID-19 restrictions, we offered vulnerable families with 0 to 3 year old children boxes of art resources and guided creative activities to do together at home. This paper explores families' experiences of this intervention, highlighting their perceptions of change in wellbeing and attachment. There is a developing case for the social benefits of art, including the impact of arts on mental health and on the wellbeing of children. However, we know that social factors impact upon arts participation, and existing inequalities and mental health difficulties have been exacerbated in the context of the pandemic. This project aimed to adapt to restrictions, to provide a meaningful remote intervention, supporting parent-infant dyads to have positive interactions through art making. We sought to explore the benefits of this intervention for infants and parents with a view to understanding more about the psychological benefits of art participation and about ways to engage families into art making, as well as thinking about how best we can evidence these kinds of arts in health interventions. Preliminary findings showed promising outcomes from the art boxes and this paper brings together the full results, primarily based on interviews with sixteen parents and four referrers alongside collected feedback. We highlight potential mechanisms for change within the intervention and detail the perceived impact of the art boxes in supporting attachment. Parents felt that the art-boxes facilitated changes in their own wellbeing that would make them more available to connection, and recognised changes for babies that reflected their increased capacity to mentalise about their child. Importantly, there were also concrete changes for the dyad that represented improved connection, such as more playful time together and increased shared attention and eye contact. Our observations suggest that the quality of the parent-infant relationship benefited from home-based art intervention, and we speculate about the potential efficacy of this approach beyond the pandemic.

Social alignment matters: Following pandemic guidelines is associated with better wellbeing

Background

In response to the Covid-19 pandemic, most countries implemented physical distancing measures. Many mental health experts warned that through increasing social isolation and anxiety, these measures could negatively affect psychosocial wellbeing. However, socially aligning with others by adhering to these measures may also be beneficial for wellbeing.

Methods

We examined these two contrasting hypotheses using cross-national survey data (N = 6675) collected fortnightly from participants in 115 countries over 3 months at the beginning of the pandemic. Participants reported their wellbeing, perceptions of how vulnerable they were to Covid-19 (i.e., high risk of infection) and how much they, and others in their social circle and country, were adhering to the distancing measures.

Results

Linear mixed-effects models showed that being a woman, having lower educational attainment, living alone and perceived high vulnerability to Covid-19 were risk factors for poorer wellbeing. Being young (18–25) was associated with lower wellbeing, but longitudinal analyses showed that young people’s wellbeing improved over 3 months. In contrast to widespread views that physical distancing measures negatively affect wellbeing, results showed that following the guidelines was positively associated with wellbeing even for people in high-risk groups.

Conclusions

These findings provide an important counterpart to the idea that pandemic containment measures such as physical distancing negatively impacted wellbeing unequivocally. Despite the overall burden of the pandemic on psychosocial wellbeing, social alignment with others can still contribute to positive wellbeing. The pandemic has manifested our propensity to adapt to challenges, particularly highlighting how social alignment can forge resilience.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13130-y.

Engaging the Arts for Wellbeing in the United States of America: A Scoping Review

There is increasing interest today in how the arts contribute to individual and community wellbeing. This scoping review identified and examined ways in which the arts have been used to address wellbeing in communities in the United States. The review examined 44 publications, with combined study populations representing a total of 5,080 research participants, including marginalized populations. It identified the types of artistic practices and interventions being conducted, research methods, and outcomes measured. It highlights positive associations found across a broad spectrum of psychological, physical, and social outcomes, including improvements in self-esteem and identity formation, cognition, physical balance, and physical conditioning. It also reports negative outcomes of arts interventions that may be underreported. The study identifies the need for core outcomes sets and reporting guidelines for advancing evidence synthesis in this area.

Arts activity and well-being for visually impaired military veterans: a narrative discussion of current knowledge

OBJECTIVES

The objective of this study was to offer an overview of literature relating to the topic of arts as activity within the context of military and veteran health and to consider the implications of current knowledge on future research with visually impaired veterans.

STUDY DESIGN

A search for literature addressing the topic of visual art activities with visually impaired veterans was undertaken. No research addressing this topic was identified. A review of literature on the related topics of mental health and well-being in military veterans, visual impairment and mental health and well-being, and art therapy for veteran populations was carried out to offer an overview of current knowledge.

RESULTS

While there is growing evidence of the benefits of arts engagement among both general and military populations, the role of the visual arts in the everyday lives of broader veteran samples, and the impact of these activities on holistic well-being, remains underexplored. The current article highlights the need for art as activity to be differentiated from art as therapy and argues that the former might offer a tool to positively impact the holistic well-being of visually impaired veterans.

CONCLUSIONS

Future research relating to the use of visual art activities in the context of veteran health and well-being should endeavour to explore the potential impacts of engagement on holistic well-being. Research is needed to build on anecdotal evidence of the positive impact of arts engagement on visually impaired veterans by systematically exploring if, and how, holistic well-being in this population may be impacted by engagement with visual art activities.

Scaling-up Health-Arts Programmes: the largest study in the world bringing arts-based mental health interventions into a national health service

The Scaling-up Health-Arts Programme: Implementation and Effectiveness Research (SHAPER) project is the world's largest hybrid study on the impact of the arts on mental health embedded into a national healthcare system. This programme, funded by the Wellcome Trust, aims to study the impact and the scalability of the arts as an intervention for mental health. The programme will be delivered by a team of clinicians, research scientists, charities, artists, patients and healthcare professionals in the UK's National Health Service (NHS) and the community, spanning academia, the NHS and the charity sector. SHAPER consists of three studies - Melodies for Mums, Dance for Parkinson's, and Stroke Odysseys - which will recruit over 800 participants, deliver the interventions and draw conclusions on their clinical impact, implementation effectiveness and cost-effectiveness. We hope that this work will inspire organisations and commissioners in the NHS and around the world to expand the remit of social prescribing to include evidence-based arts interventions.

Art making and expressive art therapy in adult health and nursing care: A scoping review

Objectives

While receptive art engagement is known to promote health and wellbeing, active art engagement has not been fully explored in health and nursing care. This review is to describe the existing knowledge on art making and expressive art therapy in adult health and nursing care between 2010 and 2020.

Methods

Relevant studies and grey literature were searched and identified between March 17 and April 10, 2020 from EBSCO, CINAHL, Medline and ERIC databases and a general Internet search. Following data charting and extraction, the data (n = 42 papers) were summarized and reported in accordance with PRISMA-ScR guidelines.

Results

In the included papers, both art making and expressive art therapy were seen in different health care and nursing contexts: yet not the home care context. The emphasis of art activities were group activities for chronically or terminally ill residents, adults aged 65 years or older. A focus on personal narrative was often seen, which may explain why art activities appear to be linked to acknowledging and building new strengths and skills, making meaning of experiences, personal growth, symptom alleviation, and communication; all used to foster collaboration between patients, patients’ near-ones and health care professionals.

Conclusions

Art activities appear to be suitable for every context and can promote personcenteredness and the measurement of nursing outcomes, and they should be considered an essential part of health and nursing care, nursing education and care for health care personnel.

Teaching pursed-lip breathing through music: MELodica Orchestra for DYspnea (MELODY) trial rationale and protocol

BACKGROUND

Patients with chronic obstructive pulmonary disease (COPD) commonly experience dyspnea, which may limit activities of daily living. Pursed-lip breathing improves dyspnea for COPD patients; however, access to pursed-lip breathing training is limited.

METHODS

The proposed MELodica Orchestra for DYspnea (MELODY) study will be a single-site pilot study to assess the safety, feasibility, and efficacy of a music-based approach to teach pursed-lip breathing. Patients with COPD and moderate-severe dyspnea are randomized to intervention, education-control, or usual care control groups. Intervention patients meet twice weekly for eight weeks for melodica instruction, group music-making, and COPD education. Safety, feasibility, and efficacy is assessed qualitatively and quantitatively.

RESULTS

This manuscript describes the rationale and methods of the MELODY pilot project.

CONCLUSIONS

If pilot data demonstrate efficacy, then a multi-site randomized control trial will be conducted to evaluate program effectiveness and implementation.

Differential participation in community cultural activities amongst those with poor mental health: Analyses of the UK Taking Part Survey

Rationale. There is a growing literature on the benefits of arts and cultural engagement for mental health. However, whether poor mental health is a barrier to engaging in cultural activities remains unclear. Objective. To identify whether there are differential participation rates in community cultural activities amongst those with differing levels of mental health (specifically, feelings of anxiety and happiness) and identify potential explanatory factors. Method. We analysed data from 7241 participants in the Taking Part survey; a random face-to-face household survey conducted in England (2016–2017). Cultural engagement was measured using a four-factor variable of cultural participation derived from assessing annual attendance at 21 receptive cultural activities. Mental health was measured using two of the Office for National Statistics measures of subjective wellbeing: happiness and anxious feelings. Analyses were adjusted for demographic, socio-economic, geographic and behavioural factors. Results. There was no difference in participation amongst individuals experiencing high levels of anxious feelings, but individuals experiencing low levels of happiness were less likely to engage in ‘popular’ cultural activities (e.g., live music events/cinema), ‘high art’ cultural activities (e.g., opera/ballet), and crafts and literary cultural events (e.g., exhibitions/book fairs). Education and socio-economic status largely explained differences, but for ‘high art’ and ‘popular’ activities, differences persisted independent of all explanatory factors tested. There was no difference in participation in global cultural activities (e.g., festivals). Conclusions. Using behaviour change theory, our findings suggest that lower levels of physical and social opportunity and psychological capability may reduce levels of cultural participation amongst individuals with low levels of happiness, but other physical and perceived barriers still remain to be explored.

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Low levels of happiness are associated with lower levels of cultural engagement.

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Education level and socio-economic position explain some of these differences.

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Mental health is not associated with participation in global cultural activities.

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High levels of anxious feelings are not associated with lower cultural engagement.

Complex arts-based interventions for patients receiving haemodialysis: A realist review

Many patients with end-stage kidney disease require haemodialysis, a treatment that requires attending hospital three times a week for four hours each visit. This treatment impacts profoundly on mental health. Arts-based interventions for patients receiving haemodialysis could address the impact of this treatment; however, there is no consensus on methods of implementation and mechanisms underlying these interventions in specific clinical contexts. Using a realist approach, relevant articles were synthesised to inform theory relating to the mechanism and implementation of complex arts-based interventions for haemodialysis patients. The theoretical framework includes two implementation phases, firstly delivery of person-centred art activities during haemodialysis and secondly, display of completed artwork. This intervention triggers mechanisms including flow and social capital. Implementation is hindered by constraints of the haemodialysis unit and patients' lack of confidence in their artistic skills. These issues can be addressed through aflexible approach to implementation and support from healthcare professionals.

Naturalistic evaluation of a sport-themed mental health and wellbeing app aimed at men (MindMax), that incorporates applied video games and gamification

INTRODUCTION

While men display lower help-seeking rates than women, there is a lack of mental health interventions targeting men. To address this issue, we developed a smartphone app named MindMax, an Australian Football League (AFL)-themed app containing psychoeducational modules teaching strategies derived from positive psychology and acceptance and commitment therapy. MindMax also incorporates gamification, casual video games, and social connection and is intended to appeal to male Australians interested in AFL. This study reports results from a naturalistic trial intended to investigate whether using MindMax was associated with improved wellbeing, resilience, and help-seeking intentions.

METHODS

We conducted a naturalistic trial from July 2017 to May 2018, where participants were given access to MindMax to use as they wished, and asked to answer wellbeing surveys at multiple time points. As we employed a customised version of the General Help-Seeking Questionnaire (GHSQ), we conducted an exploratory factor analysis and extracted two factors that we interpreted as 'personal help-seeking' and 'impersonal help-seeking'. Mixed design MANOVAs were conducted with flourishing, resilience, personal help-seeking, impersonal help-seeking, relatedness, and sense of connection (self-group overlap) to the MindMax community to assess change between Day 1-30 and Day 1-60.

RESULTS

313 participants (174/313, 55.6% female; 131/313, 41.9% male) completed the survey at baseline and at least one follow-up survey. We observed significant 30-day and 60-day increases in impersonal help-seeking intentions and sense of connection to the MindMax community, and 60-day increases in flourishing. 30-day increases in sense of connection were highest in our male participants with high base wellbeing, present in our female participants, and not present in our male participants with low base wellbeing. 60-day increases in sense of connection were higher in high-wellbeing participants than in low-wellbeing participants.

DISCUSSION/CONCLUSION

Our findings are encouraging as they could be attributed to participants' exposure to MindMax. However, they could also be attributed to other factors that may also have motivated trial participation. Future research can consider investigating more explicitly the role of conformity to masculine norms and how that may affect uptake of mHealth technologies and help-seeking behaviour.

“Their story is a hard road to hoe”: how art-making tackles stigma and builds well-being in young people living regionally

Purpose

Remote and regional Australia have comparatively fewer mental health services than their urban counterparts, what is more, mental health remains profoundly stigmatised. This study aims to understand how, if at all, the process of group art-making then publicly displaying the artworks can contribute to stigma reduction for young people (YP) experiencing mental health challenges in regional Australia.

Design/methodology/approach

Interviews were conducted with six young artists who use regional mental health services and 25 people who viewed their displayed art using a thematic analysis of the coded interview data.

Findings

Findings of this study demonstrated how art-making as a process increased self-esteem, social interaction and artistic expression; while the viewers experienced an emotional connection to the art. The viewer’s response enhanced YP’s confidence in their abilities.

Originality/value

Incorporating art-making and exhibiting the art in public spaces could be incorporated into YP’s mental health services to support well-being and inform the perception the general public hold of mental health, thus reducing stigma.

Educating Australian musicians: are we playing it safe?

The effectiveness of health promotion through arts engagement, and the health benefits and social importance of music in particular, are becoming increasingly recognized. However, like sport, music-making is an athletic endeavour, one that often involves high physiological and psychological loadings on the bodies and minds of musicians. Research over the past 30 years has revealed alarming rates of injury among musicians, and has identified health risk factors associated with music performance faced by professional and student musicians. Australia lacks consistent provision of essential health education for musicians, and research shows an unacceptably high prevalence of performance-related health problems among musicians of all ages. This article advocates for effective health promotion to be embraced in the policies and practices of Australian music performance organizations and educational bodies. It argues that a cultural shift is required, recognizing that a settings-based approach to health literacy is as fundamentally important for musicians as it is for any other occupation or athletic activity. Embedding health education into the delivery of music education will not only help to prevent injury over the lifespan of Australian musicians, it will support and sustain their capacity to contribute towards societal wellbeing and public health outcomes.

Arts for ageing well: a propensity score matching analysis of the effects of arts engagements on holistic well-being among older Asian adults above 50 years of age

OBJECTIVE

To assess the frequency and intensity of arts engagement inclusive of active and passive engagements in arts, culture and heritage activities among Singaporean adults aged 50 and above, and examine the relationships between participatory art and holistic well-being.

DESIGN

Cross-sectional stratified household survey.

SETTING

All residential areas across Singapore's Central, East, North, North-East and West Regions.

PARTICIPANTS

1067 community-dwelling, Singaporean older adults between the ages of 50 and 95 years were recruited.

PRIMARY AND SECONDARY OUTCOME MEASURES

Respondents completed a self-reported questionnaire, consisting of standardised ad hoc items assessing the frequencies and durations of active and passive participatory arts engagement, as well as validated psychometric assessments on psychosociospiritual health including the primary outcome measure on quality of life, and the secondary outcome measures on physical, psychological, emotional, spiritual, and social well-being. sociodemographic information, as well as frequency and intensity of physical activity were also collected.

RESULTS

Passive engagement (60%) and active engagement (17%) in the arts were associated with better holistic wellness and social support. Specifically, findings from the propensity score matching and independent t-test analyses revealed that adults aged 50 and above who passively engaged in arts and culture-related events experienced higher quality of life (t(728)=3.35, p=0.0008, d=0.25), perceived health (t(728)=2.21, p=0.0277, d=0.16) and sense of belonging (t(728)=2.17, p=0.03, d=0.16), as compared with those who did not. Moreover, those who actively engaged in participatory arts experienced greater quality of life (t(442)=3.68, p=0.0003, d=0.36), self-rated health (t(442)=2.59, p=0.0099, d=0.25), spiritual well-being (t(442)=3.75, p=0.0002, d=0.37), meaning in life (t(442)=5.03, p<0.0001, d=0.50) and sense of peace (t(442)=3.72, p=0.0002, d=0.36), as compared with those who did not actively engaged in the arts.

CONCLUSION

This study provided robust evidence to support a significant causal relationship between arts engagements and holistic well-being. Recommendations for art-based public health and elderly care research, practice and policy are discussed.

Arts and Humanities Engagement: An Integrative Conceptual Framework for Psychological Research

Psychologists are increasingly interested in studying the psychological effects of engaging with various forms of the arts and humanities because of their significance and ubiquity in human life. There is, however, a lack of a robust conceptual framework to support a systematic and integrative approach to the study of the psychological effects of the arts and humanities. Through an extensive review of the extant literature on conceptual and operational definitions of the arts and humanities engagement from historical, institutional, and disciplinary perspectives, the present article further expands an initial conceptualization of the arts and humanities presented in Tay, Pawelski, and Keith. The implications and limitations of the integrative conceptual framework of arts and humanities engagement, as well as directions for future research, are discussed.

It's like another world: the perceived beneficial effects of an artistically designed multisensory environment

Self-management strategies have been identified as having a key role in supporting mental health and preventing mental illness. Evidence suggests that spending time in nature, experiencing or viewing artwork and accessing sensory rooms all support self-management and positive mental health among varied clinical populations. This evidence informed the design of the sensory-art space (SAS), an artistically designed multisensory environment, which drew on themes and images of nature.The aim of this study was to explore the experiences and perceived benefits of the SAS among members of a university community.A maximum variation approach to sampling was used, and 18 participants were included in this qualitative study. Data were gathered via semi-structured interviews, which were audio-recorded and transcribed verbatim for thematic analysis.The findings presented six themes. The two core themes were: it's like another world, and easy to focus and describe how the SAS produced the beneficial effects described in the four remaining themes of: emotionally nutritious, meditative effects, relaxation and therapeuticParticipants identified beneficial effects of the SAS that were consistent with the evidence for other self-management strategies. The identified benefits also aligned with existing theories suggesting that the SAS functioned as a restorative environment. This study is the first to explore the experience of art in a multisensory and multidimensional capacity, which further contributes to the growing field of receptive engagement with the arts for health outcomes.

Sing Your Heart Out: community singing as part of mental health recovery

This paper reports on a qualitative evaluation of a Norfolk-based network of community singing workshops aimed at people with mental health conditions and the general public. The aims of the study were (a) to evaluate the effectiveness of the Sing Your Heart Out (SYHO) project and (b) to identify the key features which made the project distinctive. The study draws on 20 interviews with participants, two focus groups with organisers and workshop leaders, and participative observation over a 6-month period. Interviewees all reported improvement in or maintenance of their mental health and well-being as a direct result of engagement in the singing workshops. For most it was a key component, and for some the only and sufficient component in their recovery and ongoing psychological stability. SYHO was regarded as different from choirs and from most other social groups and also different from therapy groups, music or otherwise. The combination of singing with an inclusive social aspect was regarded as essential in effecting recovery. The lack of pressure to discuss their condition and the absence of explicit therapy was also mentioned by most participants as an important and welcome element in why SYHO worked for them. The combination of singing and social engagement produced an ongoing feeling of belonging and well-being. Attendance provided them with structure, support and contact that improved functioning and mood. We conclude that the SYHO model offers a low-commitment, low-cost tool for mental health recovery within the community.

Global perspectives on dementia and art: An international discussion about changing public health policy

In an era of global environmental deterioration and income inequity, public health faces many challenges, including the growing number of individuals, especially older people, with chronic diseases. Dementia is increasingly being seen not just as a biomedical problem to solve but as a public and community challenge to address more broadly. Concepts like prevention, brain health, and quality of life/well-being are receiving more attention. The engagement of community in addressing these challenges is being seen as critical to successful social adaptation. Arts programs are reinvigorating cultural responses to the growing number of older people with cognitive challenges. The humanities offer ways of understanding the power of words and stories in public discourse and a critical lens though which to view political and economic influences. In this paper, we report on a panel held in London on the occasion of the conference at the Royal Society for Public Health in March, 2017, in which the authors presented. Key issues discussed included problem framing, the nature of evidence, the politics of power and influence, and the development of effective interventions. In this paper, we review the rejection of two policies, one on dementia and one on the arts and humanities in public health, by the American Public Health Association; the emergence of policies in the UK; and some of the state of the art practices, particularly in training, again focusing on the UK.

Psychometric properties of the short Warwick Edinburgh mental well-being scale (SWEMWBS) in service users with schizophrenia, depression and anxiety spectrum disorders

Background

To establish the validity and reliability of the Short Warwick Edinburgh Mental Well-being Scale (SWEMWBS) in service users with schizophrenia, depression and anxiety spectrum disorders in Singapore and estimate SWEMWBS scores across socio-demographic and the three psychiatric diagnostic groups in the sample.

Methods

This secondary analysis was conducted using data from a study among outpatients of a tertiary psychiatric hospital. In addition to the SWEMWBS, socio-demographic data and current psychiatric diagnosis were collected. Service users were also administered the Global Assessment of Functioning (GAF), Patient Health Questionnaire (PHQ)-8, Generalised Anxiety Disorder (GAD)-7, Satisfaction with Life Scale (SWLS) and the Positive Mental Health (PMH) instrument. The SWEMWBS was tested for factorial validity, reliability and convergent and divergent validity.

Results

In total, 350 service users with a mean (SD) age of 39.1 (11.1) years were included in this study of which 39.4%, 38.9% and 21.7% had schizophrenia, depression and anxiety spectrum disorders, respectively. The single factor structure of the SWEMWBS was confirmed by confirmatory factor analysis (CFI = 0.969, TLI = 0.954, RMSEA = 0.029). The internal consistency reliability was high (Cronbach’s alpha = 0.89). The convergent and divergent validity testing revealed that the SWEMWBS scores had significant moderate to high positive correlations with GAF, SWLS and PMH scores and moderate negative correlations with (PHQ)-8 and (GAD)-7 scores. SWEMWBS scores were higher in married participants (22.2 (5.4) versus never married: 20.7 (5.3) and divorced/separated/widowed: 20.4 (5.1), p = 0.049) and among those with schizophrenia (22.8 (5.5) versus depression:19.6 (4.7) and anxiety spectrum disorders 20.9 (5.2), p < 0.001).

Conclusion

These results demonstrate adequate validity and reliability of the SWEMWBS in people with schizophrenia, depression and anxiety spectrum disorders in Singapore.