The event was chaired by Carole Truman, Professor of Health and Community Studies at Bolton University, and an opening address on the ONS consultation process was given by Stephen Hicks, Assistant Deputy Director of the Measuring National Wellbeing programme, Office for National Statistics.
Whilst I’ll make brief reference to them, I can’t aim to cover all the speakers’ contributions here, but want to give a taste of what I crammed into my far-too-brief 5 minute overview; some of the questions raised and some thoughts that didn’t have time to be aired.
|An exhausted Clive tries in vain to keep his fellow panellists riveted.|
‘Well-being is most usefully thought of as the dynamic process that gives people a sense of how their lives are going, through the interaction between their circumstances, activities and psychological resources or ‘mental capital.’1
He went on to outline the coalition governments commitment to better understand of well-being and how it can be ‘measured’, expressing a clear understanding that subjective measurements of well-being fall outside the traditional ‘market model’. John Howarth talked about the intensity of work and family commitments and its impact on work/life balance. Gillian talked eloquently about the importance of personal resources in dealing with the stresses of life and the importance of positive social relationships.
Mike talked about faith communities as being ‘gold-mines’ of resources for community well-being; a point I’d agree with, but in my opinion he over-egged the point that well-being and spirituality are inseparable and can only be achieved through a belief in God. For me his comments about the ‘myth of the happy poor’ could warrant a full debate in itself, particularly when one considers the doctrine of some organised religion that places an emphasis on suffering in this life to gain eternal salvation. Rachel gave a full and rounded picture of the very real impact of the work of youth work and sporting activity on the well-being on children and young people as an investment in tomorrow’s citizens.
For my part, I used a number of stories in an attempt to paint a picture of how the arts/cultural engagement can impact on individuals and communities, by opening up new opportunities and offering a means of transformation. Here I’ll make reference to the points I made, and some I didn’t have opportunity to expand on.
Because this was a public event, I spelt out some clear messages: that this agenda went beyond murals on hospital corridors and that I was not a therapist, but grew as an artist within a tradition of community and participatory arts.
I shared the story of a man marginalised by learning disabilities in a long-stay hospital I worked at in the 1980’s, and how the arts enabled him not only to express his individualism, but impose some order on his chaotic life. For me, this was a significant stage in my understanding of the transformative impact of the arts.
Making sense of this individual story in relationship to wider community impact, I shared research findings from the Invest to Save: Arts in Health Project2 which illustrated not only the reduction in symptoms of ill-health, depression and anxiety in the participants of robust arts/health projects; but the increased well-being, evidenced through environmental mastery, autonomy and social connectedness. In fact, much of what are commonly referred to as the 5 Ways to Well-being3.
I discussed the range of questionnaires used, but emphasised the importance of story in making wider sense of this work and talked briefly about the importance of the arts/health community getting better at telling a richer story, of how we create value. I wanted to stress the importance of both longitudinal studies in the field, as well as embracing some of the ideas posited by John Knell and Matthew Taylor around Contingent Value and Social Return on Investment4; a point I later laboured with Stephen, and one that should be taken seriously by the ONS and the coalition government. These are areas that I would be keen to explore with partners in the field.
I spent some time equating the reported rise in anti-depressant prescribing in England over the last four years by over 40%, with consumerism and the pathologising of our day-to-day anxieties and worries, in our bid to be ‘happy’, and as Pascal Bruckner observes, “unhappiness is not only unhappiness, it is worse yet, a failure to be happy.'5
Whilst the World Health Organisation tell us that over the next 20 years, depression will become the single biggest burden on society6, I see some of the social and economic issues affecting society, married with our blind faith in well-marketed pharmacology, as contributing to high levels of social disconnectedness and isolation.
Previous editor of the BMJ, Richard Smith comments, ‘More and more of life’s inevitable processes and difficulties—birth, sexuality, ageing, unhappiness, tiredness, and loneliness —are being medicalised, and we are growing the budget of health care to tackle them. But medicine cannot solve these problems, and…I believe…that the humanities can help us with a problem as pressing as that of attitudes to death (and) climate change. Scientists have long identified the problem, but we have failed to act effectively– largely, I believe, through our evolutionary flaws of selfishness and lack of imagination.’7
I did find time to describe yet another story of people whose lives had been turned around through organizations like START in Salford8, that not only give people a sense of community and pride, but through challenging art experiences give opportunity make informed choices and flourish.
If time had allowed, I would share some of the remarkable work that I’m engaged in with Derbyshire Community Health Services, where we have evidenced astounding changes in the lives of people affected by dementia; where again, engaged in challenging art activity and not soporific reminiscence, we have evidence sentience in a number of people, who’s prognosis is in itself, the biggest discriminator. On the basis of this early work, we are embarking on an action research process to better understand this remarkable affect of the arts. And this work is not about finding a magic-bullet cure, but is focused on the quality of our existence in our later years.
It seems that the backlash to current NHS reforms has encouraged the coalition government to enter a ‘listening exercise’, and I hope that the arts are seen as a valuable way of exploring issues around health, education and well-being. We know that the arts contribute hugely to the UK economy and according to a DCMS report in 2008 the creative industries employ 2 million people in Britain and contribute £60 billion to the economy each year, 7.3 percent of UK GDP.9
Sceptics of the arts/health agenda still call for a cold measurement of impact, holding up the Randomised Controlled Trial as the ‘gold standard’. Stephen and the panel seemed to agree that measuring well-being is far more subtle than this, and I illustrated how the figures can be manipulated, citing an article in the BMJ that showed drugs manufacturer Pfizer, chose to hold back back 74% of patient data from the clinical trials of the antidepressant Reboxetine, that showed that it is, ‘overall an ineffective and potentially harming antidepressant’.10 As Jonah Lehrer in Proust was a Neuroscientist quips, ‘…measurement is always imperfect, and explanations are easy to invent.’11
I’m not going to suggest that it’s wrong to attempt to measure well-being, or indeed the way that the arts may, or may not, contribute to this agenda. I’d go so far to say that statistics, and what we can garner from mass observations, are incredibly useful to society and knowledge. What I’d like to do though, is raise the level of this debate and the profile of our work. We observe that the arts connect people; encourage activity, learning and imagination, and through active engagement with high quality arts experiences, there is the potential to impact on public good and civic society.
The participatory arts offer us potential to flourish as humans and I urge us all to think less about illness, and disease and more about salutogenesis; the focusing on the factors that create health and well-being. I suggest to you that the arts offer us all, a way of making sense of the world, communicating our aspirations and facilitating change.
Please feed your comments into the Office for National Statistics, Measurement of National Well-Being @ http://www.ons.gov.uk/well-being
5. Perpertual Euphoria: On The Duty To Be Happy, By Pascal Bruckner