Art in Universal Healthcare
In the first week of November, British Health Secretary Matt Hancock released a statement about a currently developing process to implement new, preventative treatments as part of the U.K.’s universal health care system, the National Health Service. This new initiative would focus on art or hobby-based treatments for a variety of afflictions, ranging from dementia to lung conditions to mental health issues, and much more. The U.K. government is calling this new treatment “social prescribing,” which, as Hancock puts it, focuses on “prevention and perspiration” and will combat “over-medicalizing people.” These treatments are part of a larger preventative health scheme which will create a new branch called the National Academy for Social Prescribing that will allow general practitioners to guide patients to hobbies, sports, and arts groups.
However, this new initiative raises the question of exactly what health benefits come from art-based treatments. The Aging and Mental Health Journal published a study in 2016 that found the effects of community-based arts on cognition in people with dementia. The study defines cognition as “a number of higher mental processes including perception, memory, language, problem solving, and abstract thinking.” Though it focused specifically on dementia, this definition of cognition can be applied to a wide array of medical ailments included in programs like the N.H.S.’s social prescribing. They performed a literature-based study that looked at seventeen prior studies that focused on the impact of literary, performing, and visual arts on cognitive processes. All prior studies were considered with respect to sample size, participant demographics, location of intervention, method measures, and results. Ultimately, they identified seventeen studies, three of which were related to literary arts, seven of which were related to performing arts, and 7 of which were related to visual arts.
The three studies focusing on literary arts implemented storytelling programs, either through a reflective diary, seeing pictures that prompted collaborative storytelling, or open discussion in response to literary material. While the level of improvement varied depending on the study and the stage of dementia in the subjects, all studies showed a degree of increase in memories retrieval, attention, curiosity, and communication.
The studies focusing on performing arts varied from caregiver singing, group singing, background and live music, participatory dance, and dance performance. The studies concerning live music found an increase in communication, social contact, and higher degrees of engagement and participation showing maintained attention. One study that focused on rhythm, song, and storytelling differentiated between two different kinds of growth--interaction and professional growth. Growth in the interaction category found greater communication and reactivated memory, whereas growth in the professional category surrounded the improving relationship between the subject with dementia and their caregiver due to greater communication. Studies that focused on both group and caregiver singing found improvements in mood, orientation, episodic memory, attention, executive function, and general cognition. Finally, the studies that focused on dancing found the experience “awoke various emotions in older person. The emotional experiences were closely associated with the memories of personal emotions and the self.” The subjects awakened both generational and personal memories by dancing and watching dancers.
Finally, the studies focusing on visual arts considered art-making, art-education, and art-viewing. As a result of interacting with art, they found an increase in communication, sustained attention, alertness, high participation, memory stimulation, and verbal fluency.
The studies in this review showed a positive impact across all fields with varying degrees of success, depending on the stage of dementia in the respective subjects. Since this study took place, many more have emerged as art therapy has become more popular. Hancock’s new initiative is not alone in the global health community. On November 1, 2018, Canada launched a similar campaign with Medecins francophone du Canada, which handed out 50 prescriptions to patients and limits guests to enter Quebec’s Montreal Museum of Fine Arts for free, rather than paying the normal 18 USD fee. The British program will implement similar and more expansive activities, including cooking classes, playing bingo, gardening, library and museum visits, concerts, and other culturally focused outings. Hancock says they hope to launch this program nationally by 2023 so it reaches all communities and is not limited by socioeconomic factors. Mental Health Foundation chief executive Mark Rowland said, “Our concern is that social prescribing options… aren’t being accessed by the poorest in our community. If we’re going to make the biggest difference to prevention and recovery, the government needs to show how it will reach those most at risk.”
These trends towards art-based treatments in universal healthcare programs raise questions about the moves the United States is making in its own health care program and President Trump’s changes to the Affordable Care Act (ACA), more colloquially known as Obamacare. In the most recent midterm elections that took place earlier this month, immigration and healthcare were the two most important issues to voters. While the ACA largely remains in place, Trump’s call to repeal it has left many Americans questioning its rightful place in American government