Arts in Health and Social Contexts
Submitting InstitutionYork St John University
Unit of AssessmentMusic, Drama, Dance and Performing Arts
Summary Impact TypeSocietal
Research Subject Area(s)
Medical and Health Sciences: Public Health and Health Services
Studies In Creative Arts and Writing: Art Theory and Criticism, Performing Arts and Creative Writing
Summary of the impact
This case study describes the impact of practice-led research in health
and social care settings. There are three main areas of impact to this
- Arts and Mental Health. Through Converge, Rowe has developed, applied
and evaluated new approaches to arts and mental health practice. This
work impacts directly on participants and on mental health policy and
provision through close partnership with NHS staff and managers.
- Arts in a hospital environment, particularly in renal dialysis.
- The performance of personal stories in playback theatre. Rowe's book
has been translated in to Arabic and Korean and is recommended by the
International Playback Theatre Network.
Research undertaken by Dr Nick Rowe (Senior Lecturer in the Faculty of
Arts and the Faculty of Life and Health Sciences) is the focus of this
case study. His work addresses the following questions:
a) How do we document and measure the effectiveness of arts and health
b) What constitutes safe and ethical practice in arts and health
c) What are the demonstrable benefits of arts and health practice?
Specifically relating to the three areas of impact described above:
1. Arts and mental health
A major ongoing practice-led research project directed by Rowe is
Converge, which since 2008 has offered education opportunities in the arts
(specifically theatre, music and dance) to people who use mental health
services. The research seeks to locate reflective practice alongside the
development of person centred methodologies that utilise `distance
travelled' to map the impact of arts participation (particularly over
time) on mental health service users. Converge operates in close
collaboration with Leeds and York Partnership NHS Trust with mental health
service users participating as students and artists within a university
context. Research into the impact and efficacy of this practice describes
how such arts projects can challenge the corrosive effect of the mental
illness label. Rowe's research also analyses how sustained contact with
mental health service users in a theatre context reduces discrimination
(see section 3.2, 3.3, 3.6 below). Recent work looks at the students'
attitudes toward mental illness and how this may be influenced by contact
in Converge (3.6)
2. Arts in a hospital environment
`Forgetting the Machine' (3.4) presents research conducted with the
medical team at York Hospital and was designed to explore patients'
perceptions of engaging in art work in a renal dialysis unit. The research
found that while `absorbed' in art making, patients are for a time able to
`forget the dialysis machine' and the reality of their illness. The study
finds that engagement in artwork is more than just a distraction from the
uncomfortable experience of dialysis. Art making engages patients
intellectually, creatively and socially. It gives purpose to the time on
dialysis, a sense of contributing to a joint task and promotes social
3. The performance of personal stories through playback theatre
Rowe's research in Playback Theatre interrogates key ethical questions
within the practice of telling, representing and bearing witness to
autobiographical narratives. His research developed new understandings of
the conditions in which Playback Theatre can be conducted in a manner that
is both ethically `safe' and valuable to its audience. This research
relates to the use of Playback both with individuals in particular social
contexts (for instance in hospital with mental health service users) and
References to the research
3.1 Rowe, N. (2007). Playing the Other: Dramatizing personal
narratives in playback theatre. London, Jessica Kingsley (translated
into Korean by Biblio Drama)
3.2 Rowe, N. (2011). Border Crossings: Arts and health work in a
university. Journal of Applied Arts and Health, 1(3), 241-250.
3.3 Rowe, N. (2010). Bridging the Divide: Supporting people who use
mental health services to enter higher education. In M. Cooper (Ed.), Changing
the Culture of the Campus: Towards an Inclusive Higher Education — Ten
Years on. London: European Access Network.
3.4 Rowe, N., Jones, C., Seeger, L., Greaves, G., Holman, C., &
Turner, H. (2011). Forgetting the Machine: Patients' experiences of
engaging in artwork while on renal dialysis. Journal of Applied Arts
and Health, 2(1), 57-72.
3.5. Rowe, N, and A Pendle. (2010). Beyond dramatic truth: theatre within
the therapeutic encounter. Research in Drama Education: The Journal of
Applied Theatre and Performance no. 15 (1):89-102.
3.6. Rowe, N and Forshaw, N. (2013). Return to Ordinariness: An
Investigation into theatre students attitudes towards people with mental
illness. Journal of Applied Arts and Health (in press).
Key Research Grants
1) An investigation into the lived experience of haemodialysis patients
participating in art work. 2009. The Yorkshire Kidney Research Fund.
2) Building Bridges. 2010-11. HEFCE and UnLtd Social Entrepreneurship
3) Studentship funding. Mapping Impact of Affect and Effect in Arts and
Mental Health. 2013-17. Leeds and York NHS Trust. Period of Grant.
Details of the impact
The research presented in this case study has multiple impacts. First, on
institutions and professionals delivering health services; and second, on
individuals, particularly mental health service users, engaging in arts
and health projects. This impact is evidenced in a number of ways.
1. Arts and mental health
In the context of initiating change in the delivery and understanding of
arts and mental health services, an indicator of the significance of the
impact of Rowe's research is the sustained partnership with Leeds and York
Partnerships NHS Foundation Trust around Converge. In 2013 the Trust is
contributing a total of £20,500 toward Converge practice and research,
including part- funding a PhD student to work alongside the project from
2013-17. This is an indication of recognition from a major mental health
provider that Converge is an excellent example of contemporary
recovery-orientated mental health work. The Trust also provides a senior
occupational therapist to provide clinical support, as well as funding an
occupational therapist to support service users to progress through arts
activities provided by Converge. The Trust's recent `transformation plan'
for mental health services in York includes mention of Converge as a
Converge has impacted through public performances undertaken by Out of
Character, a theatre company consisting of mental health users, and the
Converge Choir. These include:
- May 2010: Out of Character performance at The Living and Learning,
Learning and Teaching: Mental Health in Higher Education
Conference organised by National Mental Health in Higher Education at
- July 2010: Out of Character performed Tales from Kafka at York
Theatre Royal to approximately 400 people over 4 nights.
- June 2012: Out of Character performed Henry IV by Luigi
Pirandello at York Theatre Royal to approximately 300 people over 3
- May 2013: Out of Character performed their autobiographical show Speaking
Ourselves at the launch of the York Early Intervention unit for
- September 2013: Out of Character performed Speaking Ourselves
at the National Richmond Fellowship Conference in York.
- May 2013: The Converge choir was invited to perform at the launch of
the York Early Intervention unit for psychosis and in September 2013 it
performed at the National Richmond Fellowship Conference in York.
- October 2013: Out of Character performed to nursing students at York
Audience feedback from these events include the comment, `Inspirational,
actions are more powerful than words, which adds a creative dimension to
mental health understanding and getting a range of messages across a wide
The second strand of impact is at the very significant level of
individuals participating in the Converge project. This has made a
significant impact on mental health service users in the York area. In
2011-12, 84 people who use mental health services completed Converge
courses and the project achieved an 82% retention rate, which indicates
the value that participants put on the experience in transforming their
mental wellbeing. As Chris Butler, Chief Executive of Leeds and York NHS
Trust writes, Converge `gives people with mental health problems the
opportunity to explore and develop their creativity. For people with
mental health problems it can be difficult to have the confidence to
explore existing strengths or to discover new abilities and talents.
Service users described how this had simply transformed their lives
enabling them to achieve goals that at one time seemed impossible to
reach' (5.1). Other corroborations of impact include that from the Joseph
Rowntree Foundation (5.2).
Through dissemination events, Rowe's research has impacted on arts and
mental health practice, informing delivery in this area. As John White,
Pacific University, USA, writes, `Participants learned about theatre work
with people who use mental health services and discussed ways to
incorporate Nick's ideas into work with other populations. The
presentation emphasized methods through which community organizations and
educational institutions can work together for the benefit of community
members and university students' (5.3). Converge has also provided a case
study for the National Co-ordinating Centre for Public Engagement
(5.4) and the International Health Humanities Network (5.5).
2. Arts in hospitals
Research conducted with the medical team at York Hospital was designed to
explore patients' perceptions of engaging in arts work in a renal dialysis
unit. The research has impacted on the development of arts practice in
York Hospital. Dr Colin Jones, consultant on the renal dialysis unit at
York Hospital reports that the research into the impact of arts in a
hospital environment has `Increased people's realisation that the project
was transformative and enabling rather than just a "bit of pampering" and
that it has decreased cynicism amongst key players in the hospital and
helped with funding bids.' The development of art work at the Colon-rectal
unit is evidence of wider acceptance of arts approaches for in-patients at
the Hospital (5.6).
3. Performing personal stories in playback theatre
In the context of Playback theatre, the original publication Playing
the Other, also translated into Korean and Arabic, is a key text
used significantly beyond the HE sector for drama practitioners,
dramatherapists and health workers using drama in therapeutic settings. In
a review in Theater Journal, Linda Park-Fuller writes:
`With this book, Nick Rowe substantially addresses two lines of scrutiny
facing those who work with improvisational, audience-interactive, or
auto/biographical theatre: (1) the need to theorize the work's theatrical
values, and (2) obligations for the ethical deployment of materials that
come raw from everyday life. He does this by rigorously testing, then
blurring the binaries that undergird these dual demands. To illustrate
requires a review of playback theatre (PT) and an introduction to Rowe's
background and purpose'. (5.7)
The impact of the work is also evidenced through a range of `playback
theatre' dissemination activities given across a range of beneficiaries.
Specific examples include:
a) Presentation at the Developing Partnerships Conference, Middlesbrough
b) Playback Theatre in the Young Persons' Detention Centre, Wetherby,
c) Playback theatre in the Asylum Seekers' Centre, Middlesbrough (2009)
d) Playback Theatre performance for General Practitioner trainers in the
North of England (2011).
Sources to corroborate the impact
5.1. Chief Executive, Leeds and York NHS Trust Available: http://chrisbutlerlpft.blogspot.co.uk/2012/05/create-challenge-inspire.html
Statement from the Chief Executive of the Leeds and York Partnership NHS
Trust's blog about Converge on 14th May 2012:
5.2. Joseph Rowntree Foundation document: `How can universities support
disadvantaged communities?' available at: http://www.jrf.org.uk/sites/files/jrf/disadvantaged-communities-and-universities-full.pdf
5.3. Head of Occupational Therapy Department, Pacific University, USA.
Personal Testimony following key note address by Nick Rowe. Available at:
5.4. Converge provides a case study for the National Co-ordinating Centre
for Public Engagement: Available at: http://www.publicengagement.ac.uk/how/case-studies/converge
5.5. Converge provides a case study for the International Health
Humanities Network. Available at: http://www.healthhumanities.org/impact/view/28
5.6. Renal Dialysis Unit, York Hospital
5.7 Linda Park-Fuller from Arizona State University, USA http://muse.jhu.edu/journals/tj/summary/v060/60.2.park-fuller.html