Impact of a Cultural Heritage Therapy Programme on the Mental Health of People Living With a Mental Illness; a Mixed Methods Evaluation Incorporating Economic Evaluation Methods.

BACKGROUND

Mental illness is a significant public health issue; with increasing prevalence, alongside associated co-morbidities and social exclusion. Social prescribing schemes, including those using cultural heritage resources, play an increasingly part in addressing this, yet the evidence-base underpinning them is weak with few long-term evaluations of health impact. Furthermore, there are, to our knowledge, no studies which include exploration of health and care resource use as part of evaluations of cultural heritage therapy programmes (CHTPs).

OBJECTIVES

The aim of the Scaling-up Human Henge project was to build and evaluate a viable social prescribing CHTP for people living with a mental illness.

METHODS

The evaluation used a sequential mixed methods design (n=18), a paper-based questionnaire (Short Warwick-Edinburgh Mental Wellbeing Scale, Personal Wellbeing Index-Adult, EQ-5D-5L, and health and care resource use) administered at four time-points (baseline, halfway through programme, end of programme, and six months after programme) as well as focus groups (end of programme). The significance of changes was assessed through related-samples Wilcoxon signed rank tests and published minimally important differences, using SPSS (V29) and STATA (V18). Qualitative data were analysed using thematic analysis.

RESULTS

Health-related quality of life, as assessed by EQ-5D-5L values, increased from baseline to mid-programme and again by the end of the programme but these improvements were not statistically significant. Well-being, as assessed by SWEMWBS values statistically significantly increased by the end of the programme and at six-month follow-up. Analysis of the qualitative data identified three themes 1) Living with a mental illness; 2) Connections; and 3) Impact.

CONCLUSIONS

The findings show that CHTPs provide benefits to people living with a mental illness. However, the study identified participants had significantly low levels of mental well-being, raising concerns that social prescribing was being used to mitigate current shortages in clinical mental health provision. This requires further exploration.