Arts and Culture

Executive Summary

Information in this executive summary was correct on 19.12.16.

This chapter identifies six main groups of residents (across the full age range from children and young people to older people) at risk of not accessing high quality and relevant arts and culture activities in Surrey that could enhance their health and wellbeing.

It also provides links to in-depth international research linking arts and culture activities to health and wellbeing.

It seeks to:

    • outline services in relation to need in Surrey (and provide contact information for relevant programmes and services/organisations)
    • demonstrate what is working well
    • identify gaps in services in relation to need
  • make recommendations for services and commissioning.

Introduction

There is a great deal of current national and international research evidencing the positive impact of arts and culture on health and wellbeing. For example, a research study by Mowlah, Niblett, Blackburn & Harris for Arts Council England in 2014 demonstrated “…arts and cultural activities can have a positive impact on the symptoms of conditions, for example improved cognition, physical stability, or self-esteem, and the ability of people to manage them, for example through changes in behaviour and increased social contact.”

The Heritage Counts survey (Historic England 2016) concluded that “Heritage plays an important part in our wellbeing and quality of life”. At a personal level, 93% of residents say that local heritage has an impact on their quality of life, and that Heritage activity (such as visiting, volunteering and heritage membership) is a driving factor for wellbeing (Heritage Lottery Fund report 2015 “20 years in 12 places”).

Surrey County Council (SCC) places emphasis on health and wellbeing in its Corporate Strategy (renewed in 2016). It also continues to promote, support and utilise its Cultural Services – which includes Surrey Heritage, Surrey Adult Learning, Surrey Libraries and Surrey Arts – with all residents.

SCC Cultural Services constantly seek to work in partnership with other local, regional and national organisations to develop the success and efficiency of a relevant offer to residents. An example of partnership working in this way is Surrey Music Hub which has adopted an inclusive approach to ensuring all young people receive access to music education.

Inclusion and equity of opportunity is the focus of arts and culture provision in Surrey, ensuring that the offer supports the health and wellbeing of all residents. Therefore, instead of assigning cause and effect of single art forms/cultural engagements upon individual health and wellbeing issues, this chapter seeks to demonstrate the impact of arts and culture on health and wellbeing as a holistic approach, based on the Six Core Principles for meeting health and wellbeing needs as proposed by Public Health England in 2015. The chapter draws upon international research, local case studies and approaches in Surrey, and identifies where further work is required to continue to improve services. Additionally, contributors felt it vital to signpost readers to arts and culture activities in Surrey using an interactive version of the 2013 South London & Maudsley NHS Foundation Trust Wheel of Wellbeing which can be found in the What Works section of this chapter.

Who’s at risk and why?

This chapter celebrates the holistic approach arts and culture services and organisations in Surrey adopt to support residents’ health and wellbeing, and to that end demonstrates the breadth of activity on offer to all residents. However, contributors also wished to present a view of the tailored programmes and activities established in Surrey based on research and needs analysis of the community, which includes those at risk of not engaging with arts and cultural activities. Table 1 shows the broad spectrum of residents that are at risk of not accessing relevant and challenging arts and culture activities in Surrey:

Table 1

The level of need in the population

Drawing on the assertion made by Public Health England (2015) that health needs change dependent on age, this section draws on demographics, research and current practice about the two broadest identified groups of Children and Young People and Older People shown on Table 1, to demonstrate the reasons for their identification of being ‘at risk’ in Surrey. Later sections will demonstrate where and how arts and culture can (and do) play a part in supporting these ‘at risk’ groups.

Children & Young People

According to the 2015 Public Health England report, the UK’s 9.9 million young people have poorer health outcomes than those in many other developed nations.

We know from Bowcock’s 2012 Hidden Surrey report that whilst Surrey is an affluent county there are a number of pockets of deprivation that are ‘hidden’ due to their proximity with areas of prosperity and high living standards. In some cases, these pockets are amongst the most deprived areas in the country. ‘The exclusion from school of those with special needs are twice the national average’ and the South East ‘has the highest rates of sickness absence in the country, with mental and stress related illnesses the greatest factors.’ The report summarises that because of the huge social economic spectrum in Surrey ‘there are very stark contrasts in the circumstances and in the prospects for young people who are growing up here’. Matthew et al. (2016) report that whilst nationally providing appropriate activities for young children is the reason a large number of parents engage in arts and culture activities, heritage engagement is the activity most affected by socio-economic status. It states that those in deprived families were less likely to visit heritage sites and those in wealthy homes were more likely. The correlation was not as stark for other art and culture activities.

Surrey has around 1,200 children and young people on local authority care orders and a further 400 classified as care leavers (between 18 and 25 years old). Dillon’s 2010 report for Youth Music says that:
‘The poor outcomes experienced by children who have been in care when compared to their peers are well documented. They are apparent across a range of areas in their lives, including: educational achievement; employment status; contact with the criminal justice system; mental health well-being; experiences of homelessness; and substance misuse. The factors that contribute to these poor outcomes are complex and reflect looked after children’s pre-care and care experiences, as well as their personal needs. Alongside a range of other activities and interventions, music-making has been identified in both government and other published evidence as having a role to play in meeting these young people’s needs.’

The 2015 Public Health England report (p8) suggests that recognising the specific needs of disadvantaged groups means we can provide ‘a range of activities for young people including opportunities to participate in local communities, support interventions that build young people’s strengths and life skills, rather than just tackling individual health issues, make sure education is a positive experience for all young people and builds self-esteem , promote good employment practice in the youth labour market, and recognise that employers value ‘’soft skills’’ such as communication’. Arts and culture hold a firm place in contributing to these provisions. For example, Dillon (2010) wrote for Youth Music that music-making can contribute to the development of a wide range of social and personal development outcomes for children and young people in challenging circumstances. Among those identified were:

  • Improved negotiation skills and co-operative working developed through group work
  • Learning to trust peers by relying on and supporting others in the course of the project
  • Developing both a capacity to express themselves and a stronger sense of self-awareness through music-making, particularly by writing lyrics
  • Increased levels of self-discipline and a sense of responsibility for their actions
  • A sense of achievement attained through developing new music-making skills, the production of high quality musical outputs and performing
  • A positive sense of belonging and shared identity with other young people in care, which supported their understanding of the context in which they were living
  • Making friends through a positive activity
  • Developing positive relationships with adults (music leaders and carers) who modeled constructive ways of both working with others and dealing with conflict, and who live a life engaging in a positive activity such as music-making
  • Having the opportunity to have fun and ‘escape’ their problems through a positive activity
  • Cutting across all of the outcomes was increased confidence, both on a personal and skill-based level
  • Increased self-esteem and sense of self-efficacy.

Older People

The population in Surrey is rising across all age groups, with a predicted rise of older people (aged 65+ years) from 18.5% to 25% of the total population from 2015 to 2039, constituting the largest rise in population in the county. According to the 2011 census this steadily rose by 13% between 2001 and 2011, with the number of over 85s increasing by 25.7%. In 2011 31% of those lived in households alone, compared to only 4.4% living in a communal establishment.

There is an increasing raft of work being undertaken nationally to develop the use of arts and culture activities for older people. For example, Arts for Health Cornwall report that ‘older people that have taken part in our previous dance projects have reported making new friends, feeling happier and looking forward to each session’. It is the creative approach taken on by those who lead the seated dance provision in Surrey (currently funded by Active Surrey and Woking Borough Council) that best supports the wellbeing of the older people and those suffering from dementia taking part. In addition to general fitness, the participants have the opportunity to bond and share stories, movements and songs. Using this person-centred approach, the dance practitioners leading the sessions are able to support the individual needs of Surrey’s older people.

There are 850,000 people living with dementia in the UK. This is predicted to rise to 1,000,000 by 2025 and 2,000,000 by 2050.

Gordon-Nesbitt’s longitudinal study (2015: 40) states that:
‘In humans, arts engagement has been shown to have a cognitive effect, and studies are increasingly being dedicated to unravelling the neural basis for this. Different parts of the brain have been found to respond to the rhythm, tone and timbral complexity of music, which becomes differentiated during free improvisation. In a study of people with dementia, singing and listening to music were found to improve mood, orientation, remote episodic memory and general cognition, while singing has been seen to enhance short-term and working memory.’

This builds on the work of Clift et al. (2008) who critically evaluated literature and research into the benefits of singing for adults and older people with regards to health and wellbeing, finding very positive results across the range.

Services in relation to need.

Public Health England (2015) suggest that achieving a balance between providing universal services to all young people as well as focusing additional resources on vulnerable and marginalised groups is the key to supporting everyone. Surrey’s arts and culture activities offer both universal and tailored programmes encompassing a range of health and wellbeing needs and providing for identified groups through a holistic approach. For this reason, this chapter does not seek to discuss the place of arts therapy in accordance with McLellan et al (2014: 5) who say ‘Arts therapy approaches in various disciplines tend to concentrate on individual symptoms and needs, focusing on diagnosing and then treating a specific health or medical problem.’

Table 2 shows a list of current services, providers, projects and programmes in Surrey aimed at the groups and needs identified earlier. In order to provide useful information for readers, links and/or contact details have been provided where possible. These are provided in addition to universal programmes and projects offered across the county.

Table 2

Project/Programme/
Support
Who for? Provider/Organisation/Service Contact details
DAiSY Festival People with Special Educational Needs and Disability; all ages Arts Partnership Surrey (lead partner Surrey Arts, SCC) Karl Newman:
Karl.newman@surreycc.gov.uk
Vitamin G Isolated older people Arts Partnership Surrey with local communities Karl Newman:
Karl.newman@surreycc.gov.uk
Medical Access to Education Children and young people in hospital Surrey Music Hub (lead org: Surrey Arts, SCC) Jim Pinchen:
James.pinchen@surreycc.gov.uk
Music in Mind Children and young people with mental health issues Surrey Music Hub (lead org: Surrey Arts, SCC) Jim Pinchen:
James.pinchen@surreycc.gov.uk
One Handed Musical Instrument project Children and young people with upper limb disability Surrey Music Hub (lead org: Surrey Arts, SCC) & OHMIT Derek Jones:
Derek.jones@surreycc.gov.uk
Breaking the Bubble Children and young people with Special Educational Needs and Disability & adults who they work with Southern Music Hub Alliance (incl. Surrey Music Hub) Jim Pinchen:
James.pinchen@surreycc.gov.uk
UP! Orchestra Children and young people with Special Educational Needs and Disability & adults who they work with Surrey Music Hub (lead org: Surrey Arts, SCC) Jim Pinchen:
James.pinchen@surreycc.gov.uk
Creative Seated Dance Older People & those suffering from dementia Surrey Arts & Inclusive & Intergenerational Dance Karl.newman@surreycc.gov.uk
Art for All (incl. The Big Issues) Various The Watts Gallery learningcoordinator@wattsgallery.org.uk
Writing your memoir is easy Adults & older people Brooklands Museum Virginia Smith on 01932 857381 or virginiasmith@brooklandsmuseum.com
Passport to Wellbeing 19+ yrs with mental wellbeing difficulties SCC Adult Learning Paul Hoffman:
Paul.hoffman@surreycc.gov.uk
Carers Choirs Carers of older people with dementia Surrey Music Hub (lead org: Surrey Arts, SCC) Nancy Gillio-Terry:
Surrey Arts
Nancy.gillioterry@surreycc.gov.uk
Living Well Week Older people Waverley Borough Council www.waverley.gov.uk/LivingWellWeek communities@waverley.gov.uk 01483 523088
Learning on My Doorstep Children and Young People Surrey Museums Partnership (lead org: Surrey Heritage, SCC) Haidee Thomas:
Surrey Heritage
Haidee.thomas@surreycc.gov.uk
Making Keepsake Boxes All Farnham Maltings Kath Boddy, Arts & Health Programmer on 01252 745406 or kath.boddy@farnhammaltings.com
Meet me at the Maltings All Farnham Maltings
Take Care Dementia carers Farnham Maltings
Chaos Choir New parents Farnham Maltings
Arts & Elders Older people Farnham Maltings
Lakers Words Various The Lightbox heather.thomas@thelightbox.org.uk
Phone 01483 737815
Muslim Voices The Muslim Community The Lightbox
The Ingram Collection: Skyscapes Adults with learning difficulties The Lightbox
Stitching your memories All The Lightbox
Art & craft 4 wellbeing Those in hospices The Lightbox
Open Mind Adults with emotional and mental health issues The Lightbox
Art in Mind People living with dementia and their carers The Lightbox

Table 3 shows additional organisations offering a complete service to residents in need of health and wellbeing support through arts and cultural activities and support.

Table 3

Organisation/Service Links
SCC Libraries Service https://www.surreycc.gov.uk/people-and-community/libraries
SCC Heritage Service https://www.surreycc.gov.uk/your-council/council-services/legal-democratic-and-cultural-services/cultural-services/surrey-heritage
Arts Partnership Surrey http://www.artspartnershipsurrey.org.uk
Halow http://www.halowproject.org.uk/
Challengers http://disability-challengers.org/
The Freewheelers Theatre Company http://freewheelerstheatre.co.uk/
Orpheus Centre http://www.orpheus.org.uk/
Dramatize http://www.dramatize.co.uk/
Stop Gap Dance Company http://stopgap.uk.com/
Surrey Choices http://www.surreychoices.com/
Art Matters http://www.artmatters-richmondfellowship.org.uk/
Wheel of Wellbeing – database of activities https://www.wheelofwellbeing.org/search/node/surrey

Unmet needs and service gaps

Needs Analysis

There is a wide array of activities, programmes and support available in Surrey to support residents with health and wellbeing considerations through arts and culture. A great deal of this provision has been constructed based on the evidence base within international research demonstrating the place of arts and culture in addressing health and wellbeing needs.

Some evidence was also found of local needs analysis within individual arts and culture services and/or organisations, e.g. Surrey Music Hub (lead organisation Surrey Arts, Surrey County Council). However, there does not appear to be a cohesive approach to needs analysis from the arts and cultural sector across the county and this would be valuable in ascertaining unmet needs and service gaps.

Social Deprivation

Bowcock’s (2012) work researching ‘Hidden Surrey’ highlights social deprivation (and the health and wellbeing implications for people experiencing social deprivation) as a set of needs that are ‘hidden’, suggesting greater work needs to be done in working with these parts of the community to ensure they are in receipt of high quality and relevant arts and cultural activities:
“Surrey’s dominant cultural identity of affluent commuter towns and a highly educated population conceals not only hidden deprivation but also greater complexity at a localised level. For example, within the Sheerwater Maybury area of Woking, one third of the population are non-white, almost 40% have very low literacy and 38 different languages are spoken at the local school. This county houses a relatively high number of prisoners, including two women’s prisons with the implications this brings for rehabilitation and the problems of poor mental health amongst offenders. It is known to harbour particularly high levels of domestic violence. It has the fourth largest population of Travellers and Gypsies within Britain.”

Whilst there is a vast body of provision across all age groups (including both universal and targeted offers) social deprivation is an issue that will face members of Surrey’s communities and is a suggested focus area for collaborative work (including an array of new and existing partners) with the arts and culture sector and health and wellbeing sectors.

Specific examples identified for developed work include Youth Offending and (at risk of becoming) NEET (young people not employed or in education or training). An evidence review from Youth Music suggests the place of music for young people in these at risk groups:
“By providing disaffected young people with a platform and scenarios in which to nurture / showcase their skills, broaden their horizons and conquer their self-doubt, it appears that music-making projects can successfully encourage young people to view themselves – and learning – more positively.”

Similarly, a report commissioned by the National Foundation for Music (2011) consulted extensively with international and national organisations and found ‘a wide range of outcomes for participants in music projects in youth justice settings including: increased engagement with learning and employment, improved skills, increased confidence and self-esteem, improved communication, interaction and relationships, improved attitudes and responsibility, increased awareness, enhanced capacity for reflection and expression of feelings, and improved self-discipline and behaviour.’

What works

Basic information to enable residents and commissioners to access arts and cultural activities for health and wellbeing was provided in Table 2. However, this section seeks to demonstrate detailed information about specific projects and their impacts in Surrey, through the Wheel of Wellbeing (© 2016 – South London and Maudsley NHS Foundation Trust, created using the National Lottery Funding’).

“All arts and culture activities are statistically significantly associated with happiness after controlling for a range of other factors. They all have a positive effect on happiness…’ and same for feeling relaxed” – Fujiwara & MacKerron (2015: 22)
1. Surrey County Council The Freedom Game

BODY

1. One Handed Musical Instrument Trust project: Surrey Arts (Surrey County Council) and the One Handed Musical Instrument Trust
This project has enabled 11 young people (who would not otherwise have been able to) to access learning a musical instrument.
2. Creative Seated Dance: Surrey Arts. Working with older people and taking a person centred, creative approach to dance, programmes of Creative Seated Dance are being led by trained dance artists in day centres and care homes across Surrey and are very successful in engaging people in storytelling and in mental and physical activity.
3. The Freewheelers Theatre Company (including involvement in DAiSY Fest with Arts Partnership Surrey and Surrey County Council)

MIND

1. Surrey Adult Learning, Surrey County Council: Passport to Wellbeing
2. Art Matters
3. Take Care, Farnham Maltings
4. Music in Mind, Surrey Music Hub
5. Surrey Heritage, Surrey County Council: Working with Mind

SPIRIT

1. Surrey Music Hub (lead org. Surrey Arts, Surrey County Council): Carers Choirs
2. Surrey Music Hub & Rhythmix: countywide contemporary music programme in 6 Pupil Referral Units: music programmes deliver “new found creativity to build social bridges, increase aspiration, engagement and emotional wellbeing”. The same evaluation describes that when one young person integrated back into mainstream school he opted for GCSE music technology and “his behaviour, attendance and anxiety levels have improved radically in his new placement.”
3. The Diverse Cultures of Surrey: Surrey Heritage, Surrey County Council.
4. Volunteering opportunities with Surrey Heritage, Surrey County Council.

PEOPLE

1. Surrey Music Hub (lead org. Surrey Arts, Surrey County Council): UP! Orchestra
2. Chaos Choir, Farnham Maltings
3. Surrey County Council Libraries
4. Creative Seated Dance
5. Surrey Heritage connecting communities: Over 50 members of the Medhurst family from across the globe were connected and have now had gatherings at the Surrey History Centre through the “Surrey in the Great War” project.

PLACE

1. Arts Partnership Surrey (incl. Surrey Arts, Surrey County Council): Singing Picnics
2. Meet me at the Maltings, Farnham Maltings
3. Surrey Hills Arts: Inspiring Views (Surrey Arts and Surrey Hills AONB)
4. Creative Seated Dance
5. Surrey Heritage mapping the locations of LGBT history sites as part of the Historic England Pride of Place project.

PLANET

1. Arts Partnership Surrey (incl. Surrey Arts, Surrey County Council): Vitamin G
2. Surrey County Council Heritage and Conservation Team

Recommendations for Commissioning

Based on the differences between those identified as ‘at risk’ and ‘services in relation to need’, it is recommended that greater provision of arts and culture activity needs to be made for:

  • people identifying as black and Asian minority ethnicities (BAME)
  • youth offenders
  • children and young people excluded from mainstream education

In additional to greater and more cohesive needs analysis processes identified in ‘unmet needs and service gaps’ and in line with Davies’ (2016) conclusion about arts and health work in Australia (‘if the relationship between hours engaged in the arts and good mental health is found to be causal, there is potential for new and innovative ‘time based’ arts-mental health campaigns, such as those used to promote the health benefits of physical activity.’), the following actions are recommended:

  • continued investment into local research (potentially into causality as stated above) including longitudinal research. Gordon-Nesbitt, 2015: 7 states that ‘in the UK, scant consideration has been given to the ways in which health may be affected by engaging with the arts over an extended period of time’ and that longitudinal research into the relationship between arts engagement and long-term health outcomes has largely been centred on the Nordic countries
  • ongoing attention to national and international research into the links between arts and culture and health and wellbeing
  • a cohesive local campaign to strengthen the already-existing excellent work
  • developed communications around the impact of arts and culture for health and wellbeing

Key contacts

Chapter References

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Arts Council England. Proposed domains and headline indicators for measuring national wellbeing. 2012; Available from: http://www.artscouncil.org.uk/sites/default/files/download-file/ACE_response_measuring_wellbeing_FINAL__Jan_2012.pdf

Arts Council England. The infographic: key findings from the evidence review. Available from: http://www.artscouncil.org.uk/sites/default/files/infographics/Evidence_review_Infographic_March_2014.jpg

Arts Council England. The value of arts and culture to people and society. 2014; Chapter 5b. Available from: http://www.artscouncil.org.uk/sites/default/files/download-file/Value_arts_culture_evidence_review.pdf

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Clift, S., Hancox, G., Staricoff, R. & Whitmore, C. for Sidney de Haan Centre, Canterbury Christchurch University. Singing and Health: A Systematic Mapping and Review of Non-Clinical Research, 2008.

Clift, S., Skingley, A., Coulton, S. & Rodriguez, J. for Sidney de Haan Centre, Canterbury Christchurch University. A controlled evaluation of the health benefits of a participative community singing programme for older people (Silver Song Clubs), 2012.

Davies, C., Knuiman, M. & Rosenberg, M. The art of being mentally healthy: a study to quantify the relationship between recreational arts engagement and mental well-being in the general population. 2016. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2672-7

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Signed off by

Philip Trumble, Surrey Arts Manager