It was nearly 10 years ago that UNSW Professor Christopher Poulos first heard the term “art for prescription” at a UK gerontology conference.

Poulos, a rehabilitation physiotherapist who works with people following serious injuries and the director of the Centre for Positive Ageing at HammondCare, is always looking for new ways to help older people with functional decline.

“It was in the UK that my partner [UNSW Associate Professor Rosyln Poulos] and I came first across this model of ‘art prescription’,” he tells Cosmos.

The idea of arts on prescription has been known in the UK to health professionals and the government for more than a decade, but the notion that arts could act as a sort of “shadow” health sector in Australia was – and still largely is – anathema.

Poulos was intrigued, and the more he looked into it, the more he and his partner realised that the field was backed by serious evidence. So they applied for a Commonwealth Government grant to run a first-of-its-kind in Australia Arts on Prescription program targeting older people living in the community who were suffering from a wide range of health and wellness needs.

“We were already working in that field, and had a ready group of older people we could include… who have physical and mental health problems such as anxiety and depression, and suffer from social isolation,” Poulos says.

Modelled on a UK program but targeting an older demographic, the pilot – which started in 2018 and ran for two and a half years, with classes held weekly for 8 to 10 weeks culminating with a final work or performance – was a resounding success.

Older people found out about the program through their healthcare practitioner, and Poulos and his team made a concerted effort to employ professional artists to carry out the creative activities, be it dance and movement, visual arts, photography, drama, singing or music.

…examine the impact that learning art can have on the brain, particularly visuospatial cognitive skills and memory

Sharon Naismith

Afterwards, the Pouloses, as well as a host of other researchers, analysed data from 127 participants aged over 65, and found that not only did the participants report increased social connections, mental wellbeing, and a sense of purpose and direction, but they also reconsidered their creativity with positive reinforcement from the artists.

“While we structured the way the program would be run and trained the artists in how to manage people who are frail, have cognitive issues and so on, we left it up to our artists to run their own programs,” Polos adds.

“We wouldn’t have come up with so much variety and innovation if we controlled for everything.”A

Art meets science

Since then, Australia has seen a smattering of arts on prescriptions programs, including a 2016 initiative between the Brain and Mind Centre, the Museum of Contemporary Art (MCA) and Alzheimer’s Australia NSW, which used trained artists to engage with people diagnosed with dementia in a gallery setting.

The aim of the program was to “examine the impact that learning art can have on the brain, particularly visuospatial cognitive skills and memory,” in people with the disease, said the Head of the Centre’s Healthy Brain Ageing Program, Professor Sharon Naismith, at the time. 

In 2022, the ABC ran an experimental program called Space 22, which followed seven Australians through different creative outlets such as photography, painting and singing to judge what benefits these activities can provide.

The Black Dog Institute also ran a study randomly “prescribing” arts to people with mild to moderate depression (against a control group).

A 2017 literature review looking at five years of studies evaluating the role of arts in health (mainly looking at the effect of listening to music on patients) found in most cases statistically significant results, with positive effects on blood pressure, heart rate, respiratory rates and a reduction of anxiety and stress levels.

Another study looking at healthcare professionals’ perceptions of the value and impact of the arts in healthcare settings found the majority of staff supportive and keen to incorporate some arts prescription into their practice.

The notion has also taken hold in other parts of Europe. In 2022, Brussels Minister for Culture,  Delphine Houba, launched a pilot “museum for prescription” project which granted psychiatric patients from Brugmann Hospital access to one of the city’s five museums for six months, free of charge.

Houba told Cosmos that care was taken to ensure the patients received an “unaltered, stigma-free reception”, with museum staff not told ahead of time who was part of the program. The results, she says, are still being collated, but they’re positive enough to continue with the program.

“The project has been co-constructed with the team in Brussel University Hospital Brugmann, and more specifically with their Psychiatry Department, which has been using art therapy for the last 40 years,” she says.

“And while we are collecting some data, our goal was never to conduct a scientific study, [as] the beneficial impact of art on our health has been proven by a report conducted by the World Health Organization in 2019, which has a database of 900+ case studies.” 

Will art on prescription become mainstream in Australia?

Yet, unlike in the UK and Canada, where these programs have support from government and are slowly being enmeshed in broader healthcare settings, the smattering of initiative in Australia tend to be the efforts of individuals. 

While Poulos continues to seek funding for his projects, he says Australia’s medical funding model, combined with a “very reactive healthcare system”, means arts may have to remain a fringe benefit for some time.

“Medicare’s fee-for-service model, which allocates a unique item number to each therapeutic service, doesn’t cover anything to do with the arts, and has some limited health interventions,” Poulos says.

The financial structure of the UK’s health system – the National Health System (NHS)  – on the other hand, is quite different, and far more amenable to innovative health interventions.

“In the UK the general practice is funded as a whole, which means the doctors within that practice have more discretion in how they use the funds and more incentives to try and do things than in Australia,” Poulos says.

Paul Crawford, Professor of Health Humanities at the University of Nottingham, has been developing ideas around “creative public health” for years.

One of his initiatives, which received $3m (£1.5m) from the UK government, was a creative campaign made up for a series of short films aimed at young people aged 17 to 24, addressing the most common issues impacting young people today: loneliness, perfectionism, competitiveness, independence and social media.

“Until relatively recently, arts and science have been on a parallel journey,” he says. “For too long people have ignored the role of creative practice as part of the broader health story, which has been dominated by health professional’s ideas of health and recovery.

“Let’s cast out minds back to the lockdowns: just imagine how people would have gotten through these without painting,reading, acting online, crafting, baking, knitting. The arts is cheap, and it’s there – and people need to know it works when it comes to getting better and staying well,” Crawford says.

For Poulos, doing more arts is a no-brainer: with Australia having one of the highest antidepressant prescribing rates in the world (about one in seven Australians take  antidepressants) and climbing.

“Everyone can learn to be creative. You just have to get the right artist to encourage you,” he says. “The recent focus on art on prescription suggests there are alternatives – if only Australia was willing to embrace them”.