Art, nature and mental health: assessing the biopsychosocial effects of a ‘creative green prescription’ museum programme involving horticulture, artmaking and collections

Abstract

Aims: To assess the biopsychosocial effects of participation in a unique, combined arts- and nature-based museum intervention, involving engagement with horticulture, artmaking and museum collections, on adult mental health service users. Methods: Adult mental health service users (total n = 46 across two phases) with an average age of 53 were referred through social prescribing by community partners (mental health nurse and via a day centre for disadvantaged and vulnerable adults) to a 10-week ‘creative green prescription’ programme held in Whitworth Park and the Whitworth Art Gallery. The study used an exploratory sequential mixed methods design comprising two phases – Phase 1 (September to December 2016): qualitative research investigating the views of participants ( n = 26) through semi-structured interviews and diaries and Phase 2 (February to April 2018): quantitative research informed by Phase 1 analysing psychological wellbeing data from participants ( n = 20) who completed the UCL Museum Wellbeing Measure pre–post programme. Results: Inductive thematic analysis of Phase 1 interview data revealed increased feelings of wellbeing brought about by improved self-esteem, decreased social isolation and the formation of communities of practice. Statistical analysis of pre–post quantitative measures in Phase 2 found a highly significant increase in psychological wellbeing. Conclusion: Creative green prescription programmes, using a combination of arts- and nature-based activities, present distinct synergistic benefits that have the potential to make a significant impact on the psychosocial wellbeing of adult mental health service users. Museums with parks and gardens should consider integrating programmes of outdoor and indoor collections-inspired creative activities permitting combined engagement with nature, art and wellbeing.

Can Social Prescribing Foster Individual and Community Well-Being? A Systematic Review of the Evidence

“…The social prescribing projects studied include a total of 41,641 participants (aged 18 or older). Thirty-six studies employ a pre/post design [ 26 , 27 , 37 , 38 , 39 , 44 , 55 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ], 8 report case studies with evidence taken at one point in time [ 26 , 42 , 70 , 74 , 78 , 83 , 85 , 86 ], 16 studies conduct surveys [ 27 , 37 , 55 , 57 , 58 , 60 , 62 , 63 , 68 ,…”

“…The impact of social prescribing on social isolation is therefore particularly under examined, although it is one of the more common reasons for referral to a social prescribing programme (see Supplementary Table S1 ). Of the 20 studies with a stated interest in assessing social isolation, 2 use interview quotations and analysis to gauge impact [ 66 , 82 ], 2 conduct thematic analyses [ 88 , 92 ], and 4 conflate the concept with loneliness [ 26 , 66 , 78 ] or connectedness [ 64 ] and believe they measure it using the same indicator/metrics. Nine either do not report how they assess social isolation or do not report how their assessments were designed or chosen [ 36 , 42 , 43 , 58 , 59 , 61 , 70 , 74 , 75 , 94 ].…”

“…Forty-two of the studies are concerned with well-being. While 14 studies rely on either the long [ 26 , 38 , 42 , 59 , 63 , 66 , 67 , 70 , 71 , 73 , 77 , 81 ] or short [ 80 , 83 ] version of the Warwick–Edinburgh Mental Well-being Scale (WEMWBS), others employ measures such as the UK Office for National Statistics 4-question (ONS4) measure [ 68 , 76 ]; the University College London (UCL) Museum well-being measure [ 82 , 85 ]; interview and survey questions designed for the purposes of a particular programme [ 64 , 65 , 69 , 75 , 78 ]; the Kessler Psychological Distress Scale (K10) and the World Health Organisation Quality of Life score (QoL) [ 37 ]; self-determination theory [ 44 ]; psychological measures of depression and anxiety [ 60 ]; the Medical outcome profile (MYMOP) [ 61 ]; the Investigating Choice Experiments for the Preferences of Older People Capability Measure for Adults (ICECAP-A) capability-based measure [ 57 ]; or tests for components of well-being, such as self-confidence, strength, resilience, joy, and vitality [ 27 , 28 , 33 , 37 , 72 ]. Nine studies do not provide details of how well-being is assessed [ 36 , 47 , 53 , 57 , 62 , 68 , 70 , 82 , 87 ].…”

“…Fourteen studies consider connectedness [ 24 , 25 , 26 , 27 , 55 , 66 , 75 , 76 , 79 , 82 , 83 , 84 , 90 , 93 ]. Of these, three conflate the concept with loneliness [ 26 , 55 , 66 ] and four either do not report how they assess connectedness or do not report how their assessments were designed or chosen [ 75 , 76 , 84 , 90 ].…”

“…Of these, three conflate the concept with loneliness [ 26 , 55 , 66 ] and four either do not report how they assess connectedness or do not report how their assessments were designed or chosen [ 75 , 76 , 84 , 90 ]. Other studies use measures such as the UK Adult Social Care and Public Health Outcome Framework [ 55 ], the UK Campaign to End Loneliness measure of social networks [ 66 ], surveys [ 27 , 79 ], interview quotations [ 82 ], or survey/interview questions developed for the purposes of a particular programme [ 24 , 25 , 83 , 93 ].…”