Nicola J. Holt

Arts on Prescription (AoP) programmes occur within primary care and community settings. The aim of this study was to examine the impact of AoP delivered in secondary care, on patient wellbeing, social connection, and experiences of care. A mixed-methods design was used. Quantitative data were collected from 61 patients referred to AoP through secondary care outpatient services for cancer, chronic pain, weight management, breathlessness, or neuromuscular conditions. Wellbeing and loneliness were assessed pre- and post-participation in the AoP programme. Mood and loneliness were assessed before and after each arts workshop. Qualitative methods focused on experiences of AoP and were collected through semi-structured interviews and focus groups (n = 12) and analysed using thematic analysis. Wellbeing scores increased significantly over the course of the programme, alongside reductions in loneliness. Arts workshops increased relaxation, contentment, and social connection. Thematic analysis led to four themes: (i) Connection to others—feeling supported, inspired, and understood; (ii) Making space—providing relaxing, protected time; (iii) Becoming—renewed confidence, and opening to new opportunities; and (iv) Relationships with healthcare—reframing interactions with secondary care, validating referrals, and supporting the management of health conditions. AoP in secondary care demonstrates potential as an effective approach, replicating effects in primary care, including improved wellbeing and social connection. However, additional merits in this context relate to healthcare relationships, and using the arts to manage health conditions. Embedding AoP within secondary care may reduce burden on services by supporting psychosocial needs alongside medical care.

Background: Experience sampling methods (ESMs) have been used in clinical research to collect data on emotional and behavioral states in real-life contexts among different populations. Although the use of ESMs in mental health has increased, it has not been applied to larger samples of young people in disadvantaged urban settings. Objective: This study aimed to determine the extent to which mood status scores (happiness and nervousness) vary during a week, as a function of having or not having symptoms of depression or anxiety, in a sample of adolescents and young adults in the cities of Buenos Aires, Bogotá, and Lima. A secondary objective was to identify factors associated with mood scores, including sociodemographics, quality of life, and daily activities. Methods: This study was part of the Building Resilience and Resources to Reduce Mental Distress in Young People in Latin America research program, which focuses on mental health resources for young people. Participants (n=143) aged 15‐24 years completed daily ESM assessments over a week using the mobile app, resulting in 5246 reports. Data were analyzed using descriptive analyses with 2-tailed t tests and c hi-square tests, and multilevel linear regression was used to examine associations between depressive or anxiety symptoms, mood variability, and factors influencing mean mood. Finally, Spearman correlation assessed the relationship between happiness and nervousness. Results: The analysis revealed that depressive or anxiety symptoms were not significantly associated with increased variability in mood scores (happiness P=.40 and nervousness P=.84). However, males exhibited greater variability in happiness and nervousness scores (P<.001) than females. Additionally, young people showed higher variability in nervousness than adolescents (P=.02). Regarding average happiness scores, young adults reported higher average happiness than adolescents (β=.604; P=.003). Engaging in structured activities (eg, sports, music lessons, and dance classes) was associated with increased happiness (β=.266; P=.01). In contrast, instrumental activities (eg, cleaning, shopping, meal preparation, or taking medication; β=−.144; P=.02) and work-related tasks (β=−.205; P=.01) were linked to lower happiness and higher nervousness (β=.387; P<.001). Quality of life was positively correlated with happiness (β=.486; P<.001) and negatively correlated with nervousness (β=−.273; P=.005). Finally, as for average scores, a strong negative correlation was found between happiness and nervousness (rs=−0.92; P<.001). The simple multilevel analysis showed that for each point of happiness, nervousness decreased by 0.45 points (95% CI −0.48 to −0.42; t₃=−41.7; P<.001; SE 0.01). Conclusions: Our study reveals that depressive and anxiety symptoms do not significantly affect the variability in predicted happiness and nervousness scores. However, we observed that demographic factors, such as gender and age, play a role in emotional variability.

BACKGROUND Experience Sampling Methods (ESM) have been used in clinical research to collect data on emotional and behavioural states in real life contexts among different populations. Although the use of ESM in mental health has increased, it has not been applied to larger samples of young people in disadvantaged urban settings. OBJECTIVE This study aimed to determine the extent to which mood status scores (happiness and nervous) vary during a week as a function of having or not having symptoms of depression and/or anxiety in a sample of adolescents and young adults in the cities of Buenos Aires (Argentina), Bogotá (Colombia) and Lima (Peru). A secondary objective was to identify factors associated with mood scores, including socio-demographics, quality of life, and daily activities. METHODS The study was part of the OLA research programme, which focuses on mental health resources for young people. Participants (n=143) aged 15-24 completed daily ESM assessments over a week using the mobile App. Data were analysed using multilevel linear regression to evaluate associations between depressive/anxiety symptoms, mood status variability, and factors influencing mood average. RESULTS The analysis revealed that depressive and/or anxiety symptoms were not significantly associated with increased variability in mood scores. However, males exhibited greater variability in happiness and nervousness scores than females. Additionally, young people showed higher variability in nervousness than adolescents. Regarding average happiness scores, young adults reported higher average happiness than adolescents. Engaging in structured activities (e.g., sports, music lessons, dance classes) was associated with increased happiness. In contrast, instrumental activities (e.g., cleaning, shopping, meal preparation, taking medication) and work-related tasks were linked to lower happiness and higher nervousness. Quality of life was positively correlated with happiness and negatively correlated with nervousness. Finally, as for average scores, a strong negative correlation was found between happiness and nervousness. CONCLUSIONS Our study reveals that depressive and anxiety symptoms do not significantly affect the variability in predicted happiness and nervousness scores. However, we observed that demographic factors, such as gender and age, play a role in emotional variability. CLINICALTRIAL

This paper focuses on art productions by children participating in an art-based wellbeing intervention project in Kashmir. Drawing on feminist security studies, we conducted narrative analysis to explore how children represent in/security. The locations of in/security were the environment, the body, and the socio-political realm. Children articulated nuanced and complex representations of the natural and social world, influenced by local and global forces, and created their own meanings and practices of in/security.

The positive outcomes of engaging in the arts are increasingly reported in the research literature, supporting the use of the arts to enhance individual and community health and wellbeing. However, little attention is given to the less positive aspects of arts engagement. In some countries, healthcare practitioners and link workers can refer service-users experiencing mental health issues to social interventions such as Arts on Prescription (AoP) programmes. This critical review identifies problematic issues across such social prescriptions and AoP, including failures in arts and health projects, participants’ negative experiences, and an absence of ethical guidelines for arts and health practice. Furthermore, it is evident that there is a lack of awareness and knowledge within healthcare systems, leading to inappropriate referrals, failure to take account of individual preferences, and a lack of communication between the third sector and healthcare services. Significantly, it is also unclear who holds the health responsibility for AoP participants. This article raises more questions than it answers, but for AoP to be effectively embedded in healthcare practice, the issues highlighted need to be addressed in order to safeguard participants and support the effective implementation of programmes more widely.

Details findings from a project on the potential for arts activities and art therapy to support the mental health and wellbeing of children living in Kashmir.The intervention engaged 30 school chil...