Cultural Activities in Mental Health Care: Ordinary Participation to be in and of the Community

Abstract

My thesis presents the findings of a research study looking at what impact taking part in sporting and arts, or cultural, activities has for the social lives of people with severe and enduring mental distress. I held three interviews with 30 people in contact with mental health services over a two year period. The activities researched were all offered by organisations in the arts and sporting sectors, but were funded by mental health services. I found that taking part in the cultural activities offered through mental health services led to increases in most people’s social contact. In addition, the majority of people benefitted from social support given by others taking part, who were also experiencing mental distress, and by support workers and staff providing the group activities. However, how far people experienced increased social contact depended on a person’s mental health and also on what processes in activities helped social contact. Some people had been recently hospitalised or experienced severe episodes of mental distress and for them the cultural activities helped them overcome symptoms, such as crippling social anxiety, because the groups were supportive spaces and ‘level playing fields’ in the community, where they knew they would fit in and not feel excluded. Some activities created more opportunities for social interaction than others and groups that included time for talking, such as the walking groups and football groups, were viewed as helpful opportunities to socialise and also for some people created important close friendships. However, because I looked at people’s social contact over time, I also found that when activities were short-term the impact from taking part was temporary. When activities ended, the contacts that had been made were lost and some people were left isolated again. My findings emphasise the importance of activities that are long-term and continuous. They not only had a greater impact on people’s social contact, as might be expected, but, they also allowed people’s attendance to fluctuate depending on their mental health. People could stop and start taking part again when they felt able, which helped them overcome feelings of anxiety. These types of funded group activities have been developed by several organisations across the country, but they are not yet part of national funding plans for mental health services. I argue that this is due to claims that long-term changes to people’s social contact from taking part has not been proven. However, I show that those looking for proof are expecting outcomes that are not appropriate for those taking part. Too often taking part in society is understood as full-time paid employment. When taking part socially is understood as employment, then only the football groups were associated with this outcome, because the football programme offered people paid opportunities and qualifications that helped people get jobs elsewhere. However, when people described what taking part socially meant for them, then most activities were shown to benefit their social lives. Furthermore, by listening to the stories of those taking part over time, I found that cultural activities helped people’s social lives not only by increasing their social contact, but also by changing people’s perceptions of how far they were socially included. The cultural activities ‘on prescription’ offered people opportunities to take part in activities that ‘normal’ people did in ‘ordinary’ places, but in supportive spaces where they fitted in and belonged and so they felt socially included.

Date of Award	1 Aug 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Andrew Miles (Supervisor) & Wendy Bottero (Supervisor)