Monday, 14 February 2011

Theo Stickley on the arts, health and evidence

I popped along to the admirably brisk School of Health research seminar today to hear Theo Stickley talking enthusiastically about the therapeutic value of the arts for health and wellbeing. I was worried, however, by an aspect of the tone of the talk surprising though this would clearly seem to my colleagues, judging by today.

There’s a shared worry about in the UK about just how drastic cuts to public services will be and this obviously forms the backdrop to any discussion of the use of the arts in mental healthcare. Theo suggested that, especially in that context, the question of the evidence of the benefits was often raised, unsurprisingly perhaps given the dominance of Evidence Based Medicine in the UK. But he reported that he had himself taken some time even to understand that question.

In fact, he argued, there was good evidence for therapeutic benefits, citing a study by Rosalia Staricoff. Further – and later in the talk – he cited the NEF’s report Five Ways to Wellbeing, suggesting that each of the five elements would be supported by the arts. So, so far, so evidence based (given that the Five Ways are).

But despite that, his main claim was that this was somehow missing the point. The connection between the arts and human wellbeing (although also mental suffering) was evident from the earliest historical records to the leisure pursuits of the middle classes. That connection was so obvious and fundamental that to ask for evidence of a benefit was otiose. There was much agreement from the audience.

Now I don’t want to play down the assumptions and choices which have already been made before one can undertake the kind of RCT that epitomises EBM and hence the possibilities of distortions and complications. Further, if a method or approach cannot be fitted within such a framework for whatever reason then the cultural dominance of EBM can itself seem to suggest that there is something wrong with that method or approach (rather than just there being limits to to what Mill’s Methods can be applied).

But it seems to me that one of the triumphs of the Enlightenment, of which EBM is surely a grandchild, is to draw attention to the falsity of connections which we might have thought to be obvious. Especially sitting in a university lecture hall, I found the idea that an appeal to evidence was, in itself, something of which right thinking people should be suspicious deeply disquieting.

PS: Some years later I have met Theo later examining a PhD thesis and found his questions penetrating, intelligent and sensitive both to the candidate and the interests of the people her thesis was about.