Improving our Economy and Society using Creative Arts.

Cardiff Metropolitan University Cardiff School of Art and Design Bachelor of Arts (Honours) Fine Art.

    Conference Paper:

Improving our Economy and Society using Creative Arts.

     Lianne Morgan-Davies

Conference Paper:

Improving our Economy and Society using Creative Arts.

Lianne Morgan-Davies

Submitted for: BA (Hons) Fine Art, Cardiff Metropolitan University

 

 

 

Content.

Abstract  

                 Introduction                 

The Benefits of Creative Art within our Society 

The Financial Impact of Health Issues and Disorders within our Society 

Case Studies on Creative Arts Facilities and Projects 

Evaluating Measurement Systems of Creative Arts Projects 

Conclusion 

Discussion 21

Bibliography 23

Abstract.

Society is under pressure; we are experiencing an ever growing population and extended life expectancy. Currently, this is creating problems such as housing shortages and lack of employment opportunities. As a consequence, our government and society are having to manage the impact on the population such as mental health, youth offending and conduct disorders, to name but a few.

The financial impact of managing these disorders is so wide-ranging, that many research bodies such as NICE (National Institute for Health and Care Excellence) and Kings Fund have conducted extensive research into this area. The NHS and social care systems are under financial pressure to meet the needs of mental health issues, conduct disorders and young people with needs.

Providing creative arts projects is an effective resource in providing additional support for people with mental health issues, conduct disorders and young people in need and could reduce the financial pressure on the NHS and social services. It is demonstrated within the research found that there is a need within our society to provide additional programs and support for mental health suffers, young offenders and conduct disorder sufferers in order to create a healthier and financially stable society.

Creative arts have been used as an additional therapy in mental health issues as far back as the 1930’s. It is used to provide a form of communication to people suffering from communicative problems, improve their social inclusion, promotes their self-awareness, reduces their stress and anxiety and restores their emotional balance. There are many forms of creative art such as movement, dance, drama, acting, storytelling, poetry, script writing, filmmaking, animation, music, songwriting, singing and painting. Creative art programs to aid mental health issues and other health issues have been documented in activities that range from wheelchair dance, sing for your life,  painting and mark making.  There is evidence documenting the health and wellbeing outcomes of participants involvements in a creative arts projects such as the ones listed, but research has found that there is a lack of comprehensive evidence. Data mainly collected is base line information regarding numbers of participants, age, location, and health issues. 

Evaluating the outcomes of a project is challenging given the complexity of variables. Many creative art projects have failed to create evidence that demonstrates the financial impact that providing a project would have on the NHS and care services. Developing a comprehensive content evaluation system to recording outcomes is beneficial to the success and longevity of the creative arts project.

Achieving funding in order to provide creative arts projects within the community has become increasingly difficult as there has been a significant downturn in grants and funding availability, particularly within the creative arts sector. It is to be considered that funding for the creative arts has been reduced in response to the lack of contextual evidence produced on projects. Creativity arts program and intervention programs need to develop evaluation methods that include financial performance as well as patient outcomes with comprehensive detailed content in order to inform government funding bodies of the importance and value of creative arts projects.

Introduction.

Historically art has been viewed as a recreation, something partaken only for enjoyment and pleasure. For the lucky few art has been a professional occupation and has no predetermined limits of earning. In today’s society, creative arts is viewed as additionally having health and well-being value, and is used alongside health treatments for people suffering from life-changing and threatening conditions such as mental health problems and learning difficulties. The creative arts was first used as a therapy to help improve health and wellbeing in Victorian mental health institutes back in the 1930’s and since then it has been used successfully alongside additional treatment for mental health patients. In recent times the NHS, social, and educational services have begun to recognize the health and wellbeing benefits that taking part in a creative art project can have on an individual. Art therapy has been recognized as a professional occupation since 1991, Stuckley and Noble (2010, p. 255). Research papers and case studies found within this paper have demonstrated positive outcomes from participation in creative arts projects on the health and well-being of participants. I have delivered various creative art projects within the community since 1998 and I have witnessed the positive impact that participation in creative arts programs have had on an individual, their support network of family, friends and carers and their surrounding environment. Research has demonstrated that there is a lack of comprehensive evidence to support the financial efficacy of providing creative arts programs. We evaluate how other projects have recorded their outcomes and discuss how to improve the evaluation process and successfully record outcomes to including financial efficiency.

We discuss business structures and ways to providing financial support to enable the longevity of a project. Assessment is made in regard to the positive and negative influence of public or private funding. Creative arts projects are experiencing a reduction in the availability of funding and grants. We deliberate the reasons for the funding cuts and discuss ways to eradicate further cuts. Comprehensive evidence is needed in order to support these claims and inform governments, funding and grant bodies of the financial impacts that creative arts projects can have. This will ensure that the relevant importance is placed upon them when government budgets are devised.

The direct costs of mental health issues in England in 2008 were £22.5 billion a year, not including the costs to the criminal justice system and loss of employment. Since then there has been an unprecedented increase in costs over the years. The rise of dementia patients alone is projected to increase the NHS costs from £15 billion in 2007 to £24 billion by 2026, (McCrone et al., p.15). Healthcare funding began to slow down in 2010/11 and 2015/16. To address the NHS financial pressure they have been given instructions to make saving of £22 billion by 2020/21 that is the equivalent of decreasing overall costs by 3% every year, (Robertson et al., 2017, p.16). Research in this paper provides further evidence that financial pressures exist within the NHS and social services and highlights the need to provide additional support services such as intervention programs, projects and charities. Statistics suggest that issues such as managing, supporting and treating mental health sufferers are dominating a large proportion of the NHS budget. We evaluate how creative arts projects can assist alongside NHS and social services in the care and support of sufferers. Evidence of the financial impact of providing support and treatment for mental health issues, conduct disorders and young people with needs has been discussed in order to evaluate and demonstrate the financial impact that providing creative arts projects can have on social, health, education and justice system.

The Benefits of Creative Art within our Society.

Art is the theory of physical expression outside ones self, it can take the form of poetry, music, performance, sculpture, filmmaking, painting, and architecture.

There has been extensive research from philosophers, artists, intellectuals, and poets over the years trying to create awareness on the undeniable value of the creative arts and as a society maintaining our cultural value. ‘Instrumentalism’ is, as a matter of fact, 2500 years old, rather than a degeneration brought about by Britain’s New Labour. The arts have been used as a tool to enforce and express power in social relations for as long as the arts themselves have been around. We would argue, in fact, that the first lucid, cogent and systematic theorization of instrumental cultural policy can be found in Plato’s Republic’.(Belfiore & Bennett, 2007, p.140).

The creative arts provides cultural value and informs our visual, audible and emotional world. It has an impact on our economy, education, society, health and wellbeing. ‘The links between creativity and what has been referred to as ‘cultural improvisation are helpful in understanding that the arts and wellbeing are profoundly linked in a way that ‘people construct culture as they go along and as they respond to life’s contingencies’. For example, change, responsiveness, flexibility and fluidity are dispositions strengthened through arts practice’ (Wright and Pascoe, 2015).

Art and creativity is a universal language, it crosses social and cultural barriers and can be used to inform, raise awareness, educate and express a variety of issues, whether they be topical, historical, or personal.

Creative arts is often viewed as a curriculum or activity that only financially privileged and highly social standing individuals will have the opportunity to take part in, but in fact it has been used for many years as a therapy to help improve health and wellbeing. ‘In the early 1930s, formal classes started in Victorian mental health hospitals based on the concept that occupying the hands and minds of patients in productive ways could prove to be therapeutic.

During the 1950s and 1960s, a dual emphasis developed on encouraging patients to express themselves through creative arts such as drawing, painting and writing (for example, in hospital magazines) as well as giving patients experience of industrial-type work. The development of these two streams was driven by Dr Eric Cunningham Dax, Chairman of the Mental Hygiene Authority (later the Mental Health Authority) from 1952 to 1969’. (Westmore, 2012).

Creative art therapy is extensively used within the healthcare, community and educational settings, and within institutions such as prisons and hospitals. Stuckley and Noble (2010, p. 255) commented ‘It has been recognized as a profession since 1991’.  Brodzinski and Munt (2009) stated that back in 2009 government agendas were promoting creative arts within the health and care services, they were encouraging policy makers, providers and end users to engage within creative arts projects. NHS Next Stage Review (Darzi, 2008) highlighted the need of creating and providing more personalized services of care, this would include programs such as creative arts.

There are many ways of engagement, using creative art therapy such as sand play, dance movement, wheelchair dance, drama, filmmaking, animation, drawing, painting, storytelling, poetry, music and songwriting. In a review paper focusing on the connection between art, healing and the public health (Stuckey and Noble, 2010) specify there is evidence that creative art therapies can improve mood, emotions, reduce stress, depression, alleviate chronic health diseases and help in the management of chronic pain. Access to music therapy outcomes have shown a significant reduction in anxiety levels and the restoration of emotional balance. Evidence has shown that music provides auditory stimulation which has helped in pain control. 

In a case study of participants suffering from life-threatening diagnosis visual art was provided to patients giving them the medium in which they could explore past, present and future, thereby integrating their diagnosis into their life story. This helped them recognize and accept their new diagnosis and helped to contribute to maintenance and reconstruction of a positive self-image, (Mc Murray and Schwartz, Mirman. 2001). Movement and dance based creative art therapy is a physical motor activity, it is a nonverbal expression. A dance and theatrical intervention program was delivered to 124 elderly people and on the evaluation of the program, it was found that their cognitive and psychological measurements had improved Intervention to enhance cognitive and effective functioning in older adults (Noice et al.,2004, pp562-585).

Creative Arts programs provide empowerment, education, information and inspiration. They create a purpose and sense of belonging within a community and provide opportunities for an individual to communicate and express themselves using creativity and assist in creating engaged citizens.

Art and creativity provides a form of communication and expression for the patients and helps improve their feelings of connection with the environment around them. Creating opportunities for mental health, young offenders, and conduct disorder suffers to participate in a creative arts program within their communities, will improve their relationship within their community, and increase their self-worth, which in turn will improve their well being, health and reduce the financial pressure on our healthcare systems. Participants who have taken part in creative art projects have reported promoted feelings of confidence, self-esteem, improved health and well-being, social relationships with fellow participants, and feeling valued within their community, (Argyle and Bolton, 2005, p.351).

The Financial Impact of Health Issues and Disorders within our Society.

Mental Health (including Dementia).

Mental Health issues are costing the NHS, and our social care systems billions of pounds per year. The conditions and disorders included under the umbrella of mental health are depression, anxiety, schizophrenia, bipolar, anorexia, personality disorders, child and adolescent mental health and dementia. It is reported by (McCrone et.,al 2008, p.35) that by 2026 dementia patients will be the predominant mental health issues problem within England. 12% of the NHS total budget accounts for mental health issues.

  • Mental health in England alone is costing the NHS and other social care providers £22.5 billion a year.
  • Dementia patients costs are projected to rise from £14.85 billion to £35.79 billion by 2026 (figure including inflation).
  • Anxiety disorders will cost NHS £14.19 billion by 2026.
  • Personality disorders will cost £12.29 billion.
  • The cost of Mental Health sufferers unemployment adds £28.1 billion onto the already large financial costs to our society and governments.
  • It is recorded that by 2026 there will be 2.56 million people suffering with some form of anxiety disorders, this will place a financial cost of £14.2 billion

All bullet points taken from (McCrone et.,al 2008, p.35).

Image from: Curtis, L. (2013) Unit costs of Health and Social Care 2013

Conduct Disorders.

The most common psychiatric disorder in children aged 5-10 is Conduct Disorder (DIC). Conduct Disorder is a condition where children suffer with disruptiveness and impulse control. Conduct Disorder commonly coexists with another mental health issue. In adulthood symptoms progress to anti social personality, which is associated with delinquency and criminality. 4.9% of children in the UK are suffers. If there are no intervention, prevention and support schemes available, such as parenting programs and family-based support programs the cost of caring and managing these children, and young adults on the healthcare, social care and criminal justice service costs can be as much as £150,000 per individual per lifetime for people suffering with conduct disorders, NICE (2013, p.6)

  • According to NICE (2013, p.6) the cost of an intervention program based on parent and child is between £900 and £1600, the potential life savings on the NHS and social services per person is between £4700 and £24,800, this increases when education and criminality is an additional issue to between £23,000 and £104,900.
  • Successful types of intervention programs that have been modelled in relation to young people are parenting interventions for children with persistent conduct disorders, social and emotional learning programmes to prevent conduct problems and educate parents in managing their child’s condition as well as programs such as school-based Anti Bullying creative arts programs that will help to educate, inform and empower young people to reduce bullying.
  • Recommendation of improving and managing antisocial and conduct disorders in children and young people aged 9-17 years of age, are child focused and multimodal interventions programs, NICE (2013). The creative arts and multimedia interventions programs are more popular with the addressed age group and are more likely to achieve successful attendance and participation.
  • According to the statistics found in NICE (2013), conduct disorder lifetime costs are reported to be as much as £150,000 and an intervention program such as parenting interventions for the prevention of persistent conduct disorders would cost a maximum of £1600 per program.
  • Estimated annual saving for NHS, social, education and justice services when a person suffering with conduct disorder engages with an intervention program is : age 5-10 is a saving £2225, age 11-16 saving of £2607, age 17+ is a saving of £1364. These figures are a calculation per person, per year, NICE (2013, p.36).
  • On the above figures sourced from NICE (2013) 10 participants aged 5-10 attending a parenting intervention program at the cost of £1600 would be a saving to the NHS, social, education and justice services of £20,650 per annum.

Young people.

According to The Office for Nation Statistics the population is set to rise to 69.2million by 2026, at present the population is 62.2 million and 20% is made up of 0-15 year olds, Randell (2017).  In September 2017 it was recorded that 790,000 16-24 year olds were not in employment, education or training, Petkova (2017).  Providing provisions for the age brackets 11-24 would benefit our society due to the statistics found. Local youth service programs provide intervention programs to improve, outcomes, education, and opportunities within young people aged 11-24.

The average age of a young offender’s first offense is 12 years of age considering this fact providing provisions for the age bracket 10 plus is of benefit to this particular group.

  • 1 in 5 young offenders have a learning disability, 55% of those young offenders suffer with depression, 31% of young offenders suffer with anxiety, 27% self-harm and 78% of young offenders are male. Many of young peoples emotional and educational needs are not being met via mainstream education due to the large numbers in classrooms. It can take up to 4 years for their educational needs to be recognized.The British Journal of Psychiatry, May 2006, 188 (6) p534-p27540; DOI: 10.1192/bjp.bp.105.010116 (Accessed: 02 Jan 2018).
  • According to Knapp, McDaid, and Parsonage (2011, p. 6) in England it can cost as much as £1.9m over a lifetime of an offender in social, health, education and justice service costs. From these findings, it would be beneficial to create an intervention creative arts program aimed at 11-16 young offenders age group to help educate, inform, empower and encourage positive social inclusion.
  • NHS children health services costs for the years 2012/13 for a child and adolescent with mental health issues range from £300- £1503 per week, Curtis (2013, p.85).
  • 2012/13 Social services costs to support children in need average £339.20 per week. Data taken from 337,500 case studies spread across 5 authorities. Curtis ( 2013, p.89)    

                               

Case Studies on Creative Arts Facilities and Projects.

Grassroots, Music, Film and Multi-Media Project in Cardiff City Centre.

Grassroots is a charitable organization located on Charles street in Cardiff. They provide projects in music production, multimedia, and other creative arts to 16-25 year olds. They have been running as a registered charity since 1990. From 1990 to 2015 Grassroots has largely been supported by funding from The Lottery, Arts Council, Welsh Assembly and Cardiff City Council.

Since then Grassroots has found it difficult to source funding due to local government spending cuts. In June 2015 they set up a marketing campaign via Crowdfunder to raise £10,200 in order to retain their current staff, Crowdfunder (2015). They are proactive in raising funds via concerts, services and studio hire which alongside funding has enabled them to continue their services. Grassroots records their outcomes via calculating number of individuals that take part in their programs, their age, location, vulnerability status and health information. From my involvement with Grassroots and speaking with participants and staff they experience difficulties recording outcomes, due to the participants issues such as homeless, domestic abuse, and mental health issues, they are difficult to find once they have left the program or centre. Grassroots have a website where participants can post their story and experience of the program. There are online videos of interviews with participants. Even though this is a very good demonstration of outcomes, more needs to be documented from a financial outcome position. The recorded statistics of visitors and outcomes of participants are used as evidence to support future funding applications and achieving financial support within the community. You can find Grassroots online at: https://www.grassrootscardiff.com/

Community Music Wales

Community Music Wales deliver funding, projects, events, training and seminars based within the music sector across Wales. They have been a registered charity and trading since 1992. Their ethos is to empower disadvantaged groups and individuals through creativity and learning using the medium of music. Unlike Grassroots they do not have one location in a purpose-built building, they hire facilities to deliver their projects. They provide start-up musicians with grants and aid their development within the music industry. They actively market their projects and training and have successfully created a brand that most people within the music industry in Wales would recognise. As a recognised brand they are now utilising this and have developed a training and mentoring program from which they are receiving a regular income. Musicians pay for their training and become accredited via Agored and gain recognition within Community Music Wales. Their website and social media is active and constantly records and reports all outcomes. Keeping their profile active and social media up to date has given them a constant flow of funding, new pupils and participants. You can find CMW online here: http://communitymusicwales.co.uk/

Amilia Trust Farm

Amilia Trust Farm is a registered charity and they began in 1990. They provide projects within the creative arts, agricultural, music and media which they deliver at an educational countryside sanctuary. They have dedicated classrooms, music studio, dance and exercise studio, pottery and ceramics studio, agricultural land, barns and sheds, cattle, chicken sheds, and many other farm animals. They focus on providing an alternative educational provision for young vulnerable and disadvantaged young people where the traditional educational route has failed. Amilia Trust Farm’s financial stability is achieved from providing educational programs for young people that are paid for by local educational authorities. They hire their premises and facilities and their coffee shop trades commercially. The farm is a costly facility to run, so alongside their income from educational provisions they still rely on donations, fundraising and grants. They are not proactive on social media but their website is very informative, demonstrating their outcomes and provisions. Their website provides opportunities for your to donate towards their numerous appeals. You can find Amilia Trust Farm at : https://www.ameliatrust.org.uk/

IMMTECH Music and Media 

In 1998 I was employed by an educational facility called IMMTECH as a development officer, managing New Deal for Musicians (NDFM) contract. IMMTECH was formed to deliver programs in multimedia, music technology, music performance, and film production to young people aged 16-25. The facility was set up in a warehouse on Dumballs Road, Cardiff Bay, spread over 10,000 sq ft The facility had numerous classrooms, music studio, sound room, dance and rehearsal rooms, and cafe. They were the main music open learning provider for NDFM in South Wales. The NDFM was a program devised by the Labour government to assist and develop young people within the creative arts sector to get jobs, exposure, and education in music, film and creative industries.

  • The government were paying £600 per student per year under the program of New Deal for Musicians.
  • The NDFM contract was to provide 20 hours tuition per week and 12 student revues per year.
  • They received on average of 600 pupils per year via Job Centre and a further 200 from school leavers, word of mouth, and other providers.
  • 75% of students where NEETS (not in education, employment, training or support), 55% of them had additional learning needs, and 25% young offenders, 10% were suffering mental health issues. Outcomes were recorded via monthly student revues, which covered the student’s activity within the industry and their qualifications gained.

Running Costs:                                                          Incoming:

Rent and rates were £10,830 per month                  Equipment Hire £1320 pm

Wages                      £13,992 per month                  CD duplication   £700   pm

Misc. costs               £10,000per month                   NDFM contract   £30,000pm

                                                                                 School leavers   £6000pm

Costs/ outgoings      £34,822 per month                  Total                    £38,020pm

New Deal for Musicians was set up to reduce unemployment figures.

It is claimed that 2,500 musicians found work within a 3 year NDFM trial period, the cost per year for the program was £4.5million, ‘Musicians to Benefit from Job Scheme’ 28th Jan (2003), BBC News, (accessed: 24 Dec 2017).

NDFM funded many welsh providers such as The Pop Factory in Porth, South Wales, Community Music Wales, Cardiff and many independent NDFM educators.

IMMTECH closed in 2002 due to their financial dependency on the NDFM contract.

Evaluating Measurement Systems of Creative Arts Projects.

In 1998 the NHS prioritized mental health services, they invested £700 million to create a national service framework for mental health (Smith, 1998). Creating this framework has enabled various care services and the NHS to calculate mental health patient costs. Having availability to these figures allows creative arts intervention programs to demonstrate how such programs can reduce costs to our economy with less burden on NHS, social services, and justice system. In the past many of the providers of creative arts programs have failed to demonstrate their outcomes from a financial frame of reference. A vast majority of programs create health and wellbeing baseline evaluation records, but these findings do not create evidence on how providing these projects will help reduce the financial impact on the NHS, justice and social care systems.

It has been discussed by Knapp, McDaid, and Parsonage (2011, p.13) that when mental health intervention programs took place on an individual and community basis it was extremely difficult to record the net economic impact due to the lack of data collected. Other creative arts programs that focused on the improvement of mental health and wellbeing had inadequate evidence and have not demonstrated their ability to reduce the financial impact on NHS, social, health and justice services. There is a shortage of data on medium to long-term impacts on mental health prevention programs and it is difficult in obtaining economic value to give evidence to the governing bodies that these intervention programs should continue within the communities.

Over the last decade, many creative arts organizations have made cases for investment and public funding on the prelude that they improve social and economic government goals, but many governing bodies still feel that many of these providers and projects fail to demonstrate their outcomes which has resulted in them devaluing creative arts projects. It should be considered that funding cuts we are now experiencing within the arts is a direct response to lack of evidence demonstrated on the financial value of creative arts projects. ‘Funding for and incorporation of the arts into mental health practices has been impeded by the claim that there is a lack of solid evidence-base’ (Lith, Schofield and Fenner, 2012, p.1310). In the context of the current economic climate and the government’s policy of austerity, there has been a reduction of funding and grants within the creative arts sector, health and social services (Crossick and Kaszynska, 2016, p.15). The result of these cuts have created financial pressure on the organizations who offer support to vulnerable young people and adults, mental health suffers, homeless, young parents, the elderly, young people and adults with learning difficulties, disabled people, and young offenders to name a few. As a result of these funding cuts, many creative arts projects, facilities and providers have been unable to provide projects and have closed down. It was reported by the chief executive of The Welsh Government that a welsh government white paper, reforming local government, be published detailing that the youth services within the Vale and Bridgend would merge their resources and become one provider. This was done to make savings in order to meet funding cuts in the name of efficiency, (Democratic.bridgend.gov.uk, 2017). Many of the youth and community center buildings and facilities within the Vale, Cardiff and Bridgend have and are now being sold and are no longer in use.

The latest research strongly suggests that the merge has had a negative impact and reduced the availability of these long-serving community services because their resources have been overextended. Research informs that there are more providers needed to continue to meet the needs of mental health issues, young and vulnerable people.

Argyle and Bolton (2005, p. 340 and p. 344) documented a case study of a creative arts intervention program within mental health groups. The project was delivered to single parents with an age range from 20 to late 50s, drug and alcohol addicts and the homeless with age ranges from 20 to late 60s, and teenage parents who were still in education. Recording the outcomes for this project was found to be difficult due to the participant’s unwillingness to allow their voices to be recorded and their non-participation in filling out and evaluation questioner. It was suggested that future projects would establish statistical data that includes social and psychological well being of the participant before and after their participation in the project. The project would create a baseline evaluation questionnaire. In response to the creative art funding cuts we are experiencing Crossick and Kaszynska (2016, p. 7,8, and 9) have created a report that demonstrates the outcomes that art and culture have on the economy, the individual, and society. The report includes extensive research into 70 creative art projects which make up the Cultural Value Project, new research, critical reviews of literature, specialist workshops and a wide range of literature from the UK and internationally.

There are measurement frameworks that are used within the UK and Europe Health Services such as EQ-5D which is a questionnaire for describing and valuing health states, HADS which is the hospital anxiety and depression scale, MRC which is the medical research council framers as documented by Gold (2002) and NICE Guidelines (National Institute for Care and Excellence). In many projects, there will be a baseline questionnaire that has been developed by project and charity but it would be beneficial for creative arts projects to record measurements using the health services measurement framework, in order to create a universal measurement system. Drawing from my own experience when recording outcomes of projects it is in my opinion that using these measurement tools within a project’s evaluation will add credibility and recognition to the project and improve the probability of achieving funding.

It is crucial as a provider, charity, and project to develop measurement tools, record and evaluate comprehensive data that will include financial performance to support the value of creative arts projects within our communities. A possible solution to the problem of recording outcomes would be to create a platform online that is open-source where all projects, providers can access universal measurement tools and systems, and input their project data.

Conclusion.

There is a lot of evidence to support that using creative art as a therapy or medium in which to connect, and support people suffering with mental health issues, conduct disorders, disabilities, homelessness, young families, young offenders and young carers has many benefits such as increase in self-worth, social inclusion, empowerment, education and opportunities. Programs such as these have reported people feeling more connected within their environments, better relationships within their network, improved health and feelings of well being, and having an improved image of self-worth.    

From the research and statistics discussed we have found that conduct disorders covering age range 9-17, and mental health suffers which includes dementia patients make up a large demographic of the vulnerable groups that need to be addressed. Creative arts programs and projects need to be created for these groups to provide opportunities of engagement and social inclusion, which will complement and decrease the need of support from NHS, social, educational and justice services. Our society, government bodies, schools, healthcare need to support and encourage the implementation of intervention programs in creative arts in order to help improve individuals health and wellbeing, confidence, education, social inclusion and improve their opportunities. It has been recorded by organizations such as The Nation Institute of Health and Care Excellence that the financial burden on health, social services and criminal services will be significantly greater per mental health sufferer when there are limited intervention programs available.

Charities, projects and programs that offer support to vulnerable young people and adults, mental health sufferers, the homeless, young parents, disabled people, young offenders, and young carers have managed to sustain themselves within the current economic climate have developed a finance model in which they are self-funding.

Charities, projects and programs can no longer expect to sustain their services within their communities if they are wholly reliant on funding and grants.

Funding cuts have taken place due to the lack of evidence recorded from charities and projects. It is evident that throughout the research found it is a common denominator projects continually reporting their difficulties in providing evidence and outcomes. Creative arts charities, providers and projects need to develop advanced and improved ways to measure their financial performance per project using guideline costs of mental health issues and conduct disorders etc. from governing bodies such as NICE and Kings Fund. Projects need to demonstrate that providing these creative arts projects and programs it has a positive financial effect on NHS, social, health, education and justice services.

Creative arts programs and projects need to focus on the importance of achieving and creating a successful evaluation and recording system. A universal approach to reporting, collating evidence and outcomes throughout all projects, charities, and programs could be achieved by using measurement frameworks that are used within the UK and Europe Health Services such as EQ-5D, HADS hospital anxiety and depression scale and MRC, if these were used projects would be able to demonstrate outcomes that are recognisable and understandable within our health, social, and educational systems. Creating an online data entry system using universal evaluation tools that could be used by all creative arts projects could create a solution to the problems faced in regard to lack of evidence and outcomes being recorded. Financial impacts, health and wellbeing reports and outcomes should be made accessible to a wider public domain and be accessible via projects website, this would support their economical value within society and encourage governments and funding bodies to continue and improve the funding availabilities within the creative arts sector.

From the listed case studies I conclude that Grassroots, Amelia Trust Farm and Community Music Wales have achieved their longevity providing projects, intervention, outreach support in creative arts for over 20 years within the community because they actively promote and create opportunities offering programs that are relevant and support the needs within the current climate of healthcare, social care and education. Their financing structure is made up of funding, grants, outsourcing their services to other organizations, sub-letting their facilities, ticket sales and raising awareness through events and concerts. They achieve additional public funding by using social media, local and internet marketing on funding platforms such as crowdfunder, gofundme, and justgiving.

For creative arts providers to be buoyant within the current financial climate, it is essential that they create a business model that is of a commercial nature and does not rely on government funding. It is essential for the projects social media to be active and engaging, have an up to date website displaying case studies, outcomes, and stories of participants. Providing an online presence as well as a facility, center, and project is another point of contact that strengthens the relationship between participant and project and source of funding and project.    

Discussion.

I have worked delivering and developing programs, and projects in the creative arts within the community since 1998. In my positions of employment, I have supported many young people from a variety of backgrounds with learning and health needs, and those who needed professional help within the music industry. Speaking to the young people I supported whilst in my position, I discovered that many suffered with issues such as anxiety, depression, eating disorders, other mental health issues, drug abuse, homelessness, and bullying. They expressed to me that music and creativity had helped them become more confident, socially inclusive, and gave them a positive focus in their lives. I have witnessed the wellbeing improvements that people achieved through taking part in creative arts projects first hand, this had been my only source of knowledge in regard to outcomes before I began my research in writing this paper. 

Numerous chapters within this paper includes extensive evidence supporting my experiences of the benefits that creative arts can have. The research I have collated throughout this paper is mainly focused on the benefits of creative arts on mental health, conduct disorders and young people in need, but there are many other groups of health issues that have not been discussed such as pain control, so I was interested when I came across a case study of a group of people suffering with severe pain levels, it was reported that they were able to manage and decrease their pain whilst listening to music, painting or taking part in another creative activity.     

I have recorded outcomes on well-being on projects I have managed but not included the financial impact on health and social services. On many of the programs, I have been involved in with Cardiff, Vale and Bridgend Youth Services we did base line evaluation forms with participants which would record their education needs and health. The found data would be put into a system called QES, which is a leading provider of electronic data management and communication solutions operating across all areas of the public sector, but as far as I am aware it is only used by the Youth services across Wales. The system was not successful due to the lack of data management and information was not updated. The information gathered was numbers and locations of participants and issues such as mental health, learning difficulty, the young carer, young parent, young offender etc.

Some projects have used a framework evaluation system that is used within the NHS, but some of the larger projects such as Youth Services only record the geographical data, age and issues. Working with the Youth Services, Councils, Educational Bodies, and other projects I have experienced that there is a lack of infrastructure and manpower available to manage the data input of much-needed evaluations, outcomes and revues of projects. The grants that are awarded for creative art projects is mainly spent on teachers, and professionals to deliver the projects and facility hire.

Issues that I have discovered from my research indicates that many of the creative art projects, programs and facilities evaluate their projects on a very basic level. There is a lack of evidence to demonstrate the impact that creative arts projects are having within their society and communities. This seems to be a common fault within programs in the creative arts sector in particular. It is my personal experience that informs my research the lack of evidence available to support the projects positive outcomes could be a response to the project structure having minimal admin staff. I did not find research or evidence that supports my own personal findings, but I feel this is a very important factor to consider. For projects to demonstrate their financial contribution to funding bodies, governments, and within their communities, it is imperative to place importance on creating financial, health and well-being evaluations to the projects. It would be advised to place importance on a project structure that includes a financial evaluation system managed by project manager, data input staff, and project delivery staff.

My development process when starting a creative arts program did not include research, nor did I research into statistical evidence of need related to health issues, age, demographic etc. My experience of researching for this paper has highlighted that young people suffering with conduct disorders, mental health issues, and the older generation suffering with dementia are the categories that benefit from the creative arts projects and are the most in need.

As past projects that I have been involved with did not require research or qualitative data collection I did not produce papers that included financial impact outcomes. My confidence in regard to outcomes came from witnessing first hand the impact creative arts projects had on participants. The research I have found whilst compiling this paper has demonstrated the importance of extensive research and creating a project to the categories needed, recording outcomes from not only a health and wellbeing approach but also demonstrating the financial impact that creative arts projects have on society.

Demonstrating the financial impacts of projects will help inform governments that they need to continue in providing grants and funding for these projects to provide support within their communities.

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