ORIGINAL ARTICLE QUALITATIVE RESEARCH

“Looking for the blue, the yellow, all the colours of the rainbow”: The value of participatory arts for young people in social work practice

Amber Walls, Kelsey L. Deane, and Peter J. O’Connor University of Auckland, Aotearoa New Zealand

ABSTRACT

INTRODUCTION: Emerging from a flourishing field of practice overseas, the growing evidence base for participatory arts engagement demonstrates numerous benefits for young people’s health and wellbeing. In Aotearoa New Zealand, participatory arts engagement is under-valued and under-resourced despite local practice examples suggesting that it deserves further attention.

METHODS: Focusing on a case example from an Auckland-based creative arts participation project geared to promote the positive mental health and wellbeing of marginalised young people, two focus groups were conducted to explore how participants felt arts engagement contributed to their wellbeing. Participatory arts activities were integrated within the focus group process to enable creative expression of their voices.

FINDINGS: The youth voices unearthed through this research indicate that an arts-based approach can be used as a powerful tool in promoting youth wellbeing and this offers a significant promise for addressing local policy priorities.

CONCLUSION: We suggest that participatory arts engagement deserves further investment and research to explore further application in social practice in Aotearoa New Zealand.

KEYWORDS: participatory arts, youth, mental health, wellbeing, Aotearoa New Zealand

Participatory arts engagement can be used Putland, 2012; Secker, Hacking, Spandler, as a powerful evidence-informed approach Kent, & Shenton, 2007; White, 2009) that in social work practice. We suggest that it could be utilised to address policy priorities is an under-developed and under-utilised and practice gaps in the local context. area of practice in Aotearoa New Zealand, in In this article, we focus on policies and comparison with many other nations where practice pertaining to youth mental health participatory arts engagement has been the and wellbeing, an issue of national concern subject of research, investment and policy and the subject of current investigations AOTEAROA leadership and has flourished over the last exploring new ways of working to better NEW ZEALAND SOCIAL two decades (Pegasus Health, 2014). We meet the needs of our youth population WORK 28(4), 67–79. argue that there is a growing and credible (Youth Mental Health Project, 2012). evidence base, and a wealth of practice CORRESPONDENCE TO: examples (Clift & Camic, 2016; Macpherson, In the absence of an established local Amber Walls Hart, & Heaver, 2015; Pegasus Health, 2014; research base, this article first provides a [email protected]

VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK 67 ORIGINAL ARTICLE QUALITATIVE RESEARCH

brief overview of the international picture of this article, which focuses on youth mental participatory arts in mental health practice health and wellbeing, we primarily draw and highlights key conclusions drawn from the research base represented under the from the international evidence base. We arts in health and wellbeing banner. However, then focus on a local case study project in the practices are by no means exclusive central Auckland—Express Yourself—that to healthcare environments. In fact, they uses arts participation to promote positive are described as taking place largely in outcomes for marginalised young people community settings addressing complex in alternative education, mental health and social, cultural and economic determinants at addictions services. We draw on findings both individual and systemic levels (White, collected from two focus group discussions 2009). Further, this practice is synonymous with participants to demonstrate the with a social inclusion, empowerment and ways through which arts participation social justice lens (Clift, 2012), committed to has enhanced their lives and conclude transformative processes and seeks to build with important considerations for others relationships and alliances for personal and interested in using participatory arts in social social changes (White, 2009). work practice in Aotearoa. The international picture of arts in Participatory arts engagement and health practice its many forms The rapid growth of arts in health practices Participatory arts are being used successfully in the West over the last two decades has to improve wellbeing throughout advanced been described as a “small-scale global Western economies. Substantial growth phenomenon” (White, 2016, p. 41), and is in this area of activity over the last two supported by a growing interdisciplinary decades, particularly in the United Kingdom, workforce, regional and national networks the United States of America, Canada and and a thriving academic community (Clift & Australia (Clift & Camic, 2016), has been Camic, 2016; White, 2009). Between 2013 accompanied by the emergence of a diverse, and 2014, thirteen international conferences evidence-informed body of practice (Clift, exploring emerging practices were held 2012; Clift & Camic, 2016; Department of across Australia, Europe, Scandinavia, Health, 2011; Hacking, Secker, Spandler, the United States of America, Canada, Kent, & Shenton, 2008; Macpherson et al., South Africa and the Middle East (Clift & 2015; Pegasus Health, 2014; Putland, 2012; Camic, 2016). In the United Kingdom Secker et al., 2007; White, 2009; Wreford, and Australia in particular, the field has 2016). The power of the arts and creative flourished and continued to attract public expression as a tool for youth engagement investment despite global recession and and development has been a particular area an overall reduction in arts funding. In the of growth, inspiring localised and national United Kingdom, arts in health practice is initiatives across education, youth justice, well established across national provider social, health and community environments networks and is acknowledged as a credible (Clift & Camic, 2016). health-promotion tool in terms of public policy and financial investment priorities The field is diverse and is represented by (ACE, 2014; Department of Health, 2011). many related terms including: community The last decade has seen a number of large arts, participatory arts, arts in justice region-wide arts in health and wellbeing settings, arts in health and wellbeing, initiatives, in London and the Northwest, in socially engaged arts, community cultural particular. Arts on prescription schemes (i.e. development and applied arts. The referral to arts programmes via GP practices, variations in term are often the result of primary and secondary care providers) have the location or context. For the purpose of flourished, and are described as now being

68 VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK ORIGINAL ARTICLE QUALITATIVE RESEARCH

commonplace (White, 2016). In Australia, (for example, engagement and cooperation) arts in health practice has also gathered in population level preventative practice. momentum around the community arts With at risk communities specifically, these movement and is championed by a National benefits were linked to improved mental Arts and Health Framework (NAHF), health, health literacy and healthy lifestyles released in 2013 and endorsed by all (resulting in reduced need for medication Australian regional arts and health ministers, and healthcare), and increased capacity an active national network, an annual for vulnerable people to make changes international conference and a rapidly in their lives (Putland, 2012). Notably, in growing research base (Wreford, 2016). the context of an international evidence- informed policy making environment The growing body of arts in health research that emphasises economic arguments, internationally highlights a wide spectrum the review notes the recent focus on cost- of positive social, educational and health benefit analysis in the United Kingdom, outcomes (Bungay & Vella-Burrows, 2013; the United States of America and Australian Clift, 2012; Clift & Camic, 2016; Department arts in health research. Importantly, the of Health, 2007; Department of Health, 2011; results of these analyses are favourable. Ings, Crane, & Taylor, 2012; Macpherson For instance, an Australian study found et al., 2015; Pegasus Health, 2014; Putland, that an arts-based approach in the treatment 2012; Secker et al., 2007; White, 2009; of depression yielded similar improvements Wreford, 2010). A recent meta-analysis of at cheaper financial cost than more the arts in health evidence base published traditional alternatives (Craemer, 2009). in the Journal of Social Work established the link between visual arts interventions and The local picture of arts in health improved mental health resilience in young practice people with complex needs. Accordingly, Macpherson et al. (2015) concluded that arts Despite this global growth in research and for health approaches offer much promise to practice, the use of participatory arts for social work practice. youth wellbeing is still described as being relatively under-resourced and lacking In Australia, a 2012 meta-analysis of recognition in social, health and cultural the international evidence case was policy (Clift & Camic, 2016). We suggest that commissioned to support the development this is particularly true in Aotearoa New of the National Arts and Health Framework. Zealand, where practice is considerably less It concluded that the evidence for the developed in comparison with Australia, the inclusion of arts in health was persuasive United States of America, Canada, United (Putland, 2012). This report is a useful Kingdom, Ireland and other European guide, highlighting evidence of impacts countries. Although excellent examples of across a continuum of known determinants activity exist, the field has not gained the of health and wellbeing. Of particular same momentum. relevance to this study, the report highlights evidence linking the relationship between Signalling growing interest among health community-based arts participation and providers, a recent report was commissioned personal development (for example, efficacy, by the Aotearoa New Zealand primary mastery, empowerment and quality of life); care group, Pegasus Health. The review transferable skills for relationships, health concludes that only a small number of literacy, coping and employability; physical localised arts for wellbeing projects are health improvements; social engagement funded through sustained sources (public and cohesion (for example, support, health or government contracts), and empathy, belonging, group identity, pride acknowledges the comparative lack of local and tolerance) and community building development in contrast to the promising

VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK 69 ORIGINAL ARTICLE QUALITATIVE RESEARCH

potential confirmed by the international on promoting youth mental health and evidence base. It suggests that a number of wellbeing, and has involved an extensive overseas studies are encouraging, including process of enquiry, programme theory- projects with at risk young people leading building and evaluation co-design with to significant benefits to psychosocial health, the project community (staff, participants, improved self-esteem, confidence, self- partner or stakeholder organisations). efficacy and overall quality of life (Pegasus We are intentionally seeking, through Health, 2014). this component of the research, to create knowledge which values the self-determined Although the Mental Health Foundation experiences, ideas and identities of youth and more recently Creative New Zealand participants alongside the established acknowledge the value of arts in wellbeing evidence base and, as it is beyond the scope and both host a number of online research of this article to capture all stakeholder and advocacy reports, these are almost perspectives, here we focus exclusively exclusively generated overseas. One of the on the methods and results involving the few areas of significant praxis development youth project participants. The objective of has been the use of applied theatre this study was to surface youth participant programmes in mental health promotion perspectives of the impact of experiences (Maunder, 2013), encompassing theatre offered through Express Yourself in view of work that takes a wide view of the social and the international evidence base, as well as political determinants of health (O’Connor, the specific features of the project itself. 2014). Nevertheless, unlike the environment described overseas where practice has The case example flourished with the support of a professional and policy infrastructure and strategic Express Yourself is a philanthropically leadership, in the local context, we lack this funded multi-arts project working across infrastructure and consequently practice has Auckland to promote positive mental health been fragmented and slower to develop. in vulnerable young people aged 13-24. It is delivered by Toi Ora, a non-governmental Current research organisation (NGO). In addition to participatory arts practice, Express Yourself We acknowledge the importance of is also informed by the theories and learning from overseas developments, but practice of Positive Youth Development also recognise the necessity of generating (PYD). PYD is an evidence-informed, contextually specific practice, which meets strengths and systems-based approach to the needs of communities in Aotearoa. We understand and work with young people offer here, as a practice example, some of that stems from developmental relations the initial learning we have gained from systems theory. Developmental systems research with an Auckland-based project— theory emphasises plasticity in human Express Yourself—that uses creative arts development as a result of ongoing and participation to promote positive outcomes reciprocal person-environment interactions. among vulnerable youth populations, When a person’s inherent strengths are including those in schools, alternative aligned with a resource rich context, positive education, mental health, addictions and development is supported (Lerner et al., community-based contexts. Express Yourself 2012). The primary focus when taking a PYD is the subject of an ongoing doctoral research approach is thus to build personal strengths study exploring creative arts engagement while connecting youth to an asset-rich as a tool in promoting youth wellbeing. The environment to reduce risks and ultimately overarching research project aims to produce promote thriving. Often, this is through a locally contextualised, culturally attuned structured youth development programmes model of participatory arts practice focussed (Lerner et al., 2012).

70 VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK ORIGINAL ARTICLE QUALITATIVE RESEARCH

Express Yourself works at both preventative The questions did not seek to solicit answers and intervention ends of the spectrum, about personal experience, but encouraged but always with populations who are participants to draw from their knowledge experiencing life challenges. Participants are of the project to hypothesise about its value referred into the project via specialist youth to young people broadly. Participatory arts mental health and addictions services. They activities were employed in both groups to are often struggling to cope with a variety enable young people to articulate responses of mental health conditions, and many are using a variety of media. struggling to cope with relationships, social environments, education or work. Express Ethical approval for this research was Yourself offers creative projects; one-to- granted by the authors’ institutional ethics one mentoring supporting individualised committee. We carefully considered how pathways into further educational, to create a safe environment for vulnerable training and employment; supported artist young people in a focus group situation. workspaces; youth internships and a platform Great care was taken to explain what for youth-led initiatives. It is facilitated by participation would entail and what a team of experienced youth development could and could not be promised in this and creative practitioners spanning visual, environment, including for example, the digital and literary arts, music, performance guarantee that other participants would not and dance. Express Yourself is described in breach confidentiality. project documents as setting out to inspire young people to grow, learn and deal with Focus group one: Participants and life challenges. It aims to do this by providing procedure a safe space, structure and creative processes to work alongside others to reflect on life The participants for focus group one were situations, build personal skills and resources, identified using a convenience sampling and draw from supportive networks to strategy. All participants who were achieve self-determined goals. registered in an Express Yourself project at the time of the workshop were invited. The first author visited the project in person Methods and described the research goals and Design participation process. Then, she distributed Participant Information Sheets outlining the Two focus groups were conducted with potential benefits and risks of the project and participants aged between 18 and 24 who the rights of each participant. Six out of eight had taken part in at least one of the Express young people aged 18-20 consented to take Yourself projects. Both focus groups aimed part. Participants self-identified as one male to elicit the youth participants’ authentic and five females; one Máori, one Pasifika, experiences of the creative projects they one dual heritage (Máori and NZ European), had been involved with so as to inform the one Asian and two NZ Europeans. All collective programme theory of change for participants had been introduced to Express the broad research project. Key questions Yourself via Community Mental Health or that were asked included: “What does Addictions Services. Express Yourself offer young people? What kind of person would benefit from coming to This focus group engaged in individual a project like this? What could they hope to visual art-making alongside group get out of the experience? What does Express discussion, including painting, collage and Yourself do to make these things happen? mask-making. Participants chose which of What are the most important aspects of the these media they preferred and represented project that help it to work or that stop it ideas visually and verbally, often using from working?” metaphor as a way of expressing difficult

VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK 71 ORIGINAL ARTICLE QUALITATIVE RESEARCH

emotions. They were invited to share broader environmental eco-system prompted interpretations voluntarily with the group as further exploration about wider societal they felt safe to do so. As most of the group conditions that affect mental health and knew each other well, they responded to wellbeing. each other’s comments and added their own perspectives. Analysis

Focus group two: Participants and The data collected from the two focus groups were analysed separately using procedure thematic analysis as described by Braun Focus group two was conducted 10 and Clarke (2013). The findings from each months later with a new group of five focus group were then cross-referenced to participants aged 20-23, who had taken identify overlapping themes. There was part in two different Express Yourself considerable consistency between the themes projects. Participants self-identified as two identified in each focus group, although the males and three females; one dual heritage second workshop gathered more individual (Máori and NZ European), one Asian and responses. three NZ Europeans. All participants had been introduced to Express Yourself via Findings Community Mental Health or Addictions Services, except one who self-referred. This The focus group data demonstrated that the focus group aimed to capture both the views young people benefitted greatly from their of a slightly older age group and explore creative engagement in Express Yourself. the project’s critical processes in depth Of note, the project conditions that enabled (i.e. not just what the project achieved their positive development were remarkably but how). The groups were invited by the different from those experienced in their first author via a visit to the group (focus day-to-day lives outside the project. The group one) and telephone (focus group two). emerging themes are represented by She followed up initial expressions of headings below. interest with the distribution of participant information sheets. Five out of the eight Arts participation: Relaxation, participants invited expressed interest, refuge, a legal high and providing with three being unavailable on the day purpose (one was out of town and the other two were re-admitted into hospital prior to the day). The most common motivation for participating in the project was to help The second youth focus group used a large with stress, anxiety and depression. Express two-metre high tree as a visual metaphor Yourself provided “a reason to get out of to explore the idea of healthy eco-systems. bed”. All participants agreed that arts The same questions were asked as in the participation was good for their wellbeing. first focus group, this time using additional Some described the process of absorption metaphorical devices to further illustrate in art-making as therapeutic and enjoyable, ideas such as watering cans, the weather, enabling time out from life chaos. Others roots, branches and fruit. Through a series described it as a useful aid for organising of exercises, participants were asked to and reflecting on thoughts, whereas add drawings and text to the tree as a means others said that they learned self-care of exploring broadly what Express Yourself strategies—“ways to manage my wellbeing”. offered young people and identifying This included, for example, “mindfulness the critical project practices and processes through art” or [having fun] not getting high. that enabled or prevented this from Individuals described feeling less anxious happening. Discussion about the tree’s when they left (Figure 1).

72 VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK ORIGINAL ARTICLE QUALITATIVE RESEARCH

Figure 1: Creative expressions from youth focus group: Arts as a therapeutic tool.

Creative experimentation and play: their life: “there’s no one to put you down, Fuel for the soul and liberation from tell you you’ve taken a bum photo”. Other shitty adult rules comments included “Here there are no right or wrong outcomes—just different” Both groups described intensive social and “it’s a positive space shared by pressures, either to do with paying rent, positive people”. The project was described surviving every day, “getting some peace” consistently as a sanctuary, a place of hope or “feeling like I don’t fit in”. The second and imagination, as explained by one focus group (with 20- to 23-year-olds) participant: [Express Yourself] “is for people collectively articulated an overwhelmingly with a different view on the world”. Others negative picture of wider society, claimed, “it gives me souljoy”, and “[it’s] attributing their stress to exclusionary and for people looking for the blue, the yellow, competitive social values. One participant all the colours of the rainbow… you can argued: [out there] “it’s all rules and you just look for the grey or you can look for can’t do that… [here] it’s all yes you can the blue”. do that”. Another said that “adults, they teach you life sucks, get used to it”. Another stated that “adult shitty rules [are] eating Creative storytelling and critical our souljoy” (Figure 2). Several participants refl ection: Finding a voice and described the creative art-making process reframing life stories as a liberating antidote to this. A key factor in this was articulated as the experimental Individual participants in both focus and playful nature of activities. Participants groups described how the mixture of said that they came to Express Yourself to critical reflective exercises used each week “play, have fun, splash colour around”, alongside creative storytelling (through experiment and “just create” without fear visual images, drama, animation or music) of failure. Both focus groups agreed that enabled them to reflect on life experiences the project offered a space that enabled and share challenging stories with peers in achievement in contrast to other aspects of a safe way. They explained that sometimes

VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK 73 ORIGINAL ARTICLE QUALITATIVE RESEARCH

Relationships: Reciprocal (ako), empowering, human and ‘youth- powered’ Participants unanimously described how relationships established in the project enabled them to feel valued and validated, for example, “I’m completely accepted for who I am here”. They felt the art-making processes where everyone was “doing it together” played a significant role in this, allowing everyone to feel equally valued, and enabling relationships to be transformed from client versus provider into co-learners or whánau, counteracting hierarchical and Figure 2: Creative expression from youth focus group: “Shitty adult rules are eating institutional barriers: “you do it with us […] our souljoy”. you take risks and look silly too so it makes me feel brave and I know no one will laugh”. Participants in focus group two agreed with this was done by externalising (for example, the comment “we are all artists here […] through a fictional character created for an no-one better or more important than anyone animation), and occasionally in a more open else”. One participant in this group stated way by sharing their personal experiences that everyone acts “human, not like some with the group. For one participant, Express robot who wants to tick off a form saying Yourself helped them “disrupt repetitive they cared”, while others agreed with the thought patterns”, while another said it comment that we are all whánau here. One helped them to “think about things in my participant said that it felt good when his life in different ways—especially working support worker attended the project too and with images”. Another said “I come to was asked to take part as an equal: “it made learn about myself and relationships”, her seem much more human”. while a different participant explained that “it teaches useful tips and ideas for Belonging and connection: A stigma dealing with things”. The creative process free, youth-friendly space was described as a safe way to reflect on, share and reframe negative life stories. Participants described how the project Doing this among peers in a supportive enticed them out of isolation, and supported environment enabled important peer them to face social anxieties and practice validation and support networks, and relationship skills. They universally modelling of pro-social behaviours. described a strong sense of belonging Importantly, individuals also talked about and connectedness to the Express Yourself how this process enabled them to be brave community. Whakawhanaungatanga and take risks and practice new confidence (relationship building and kinship) were or behaviours: “I didn’t like it but I gave identified as a crucial feature of the project, it a go and no one laughed”. Participants not just in reducing isolation, but also in were then encouraged to transfer this creating opportunity to spend positive time to other environments. A number of with people their own age “going through participants in the second focus group stuff too” (Figure 3). Discussion in both engaged in a discussion about how the groups revealed high levels of isolation and arts offer different ways of saying things social anxiety. Individuals talked about the enabling self-expression, especially in “lion face” or bravery required to participate. difficult situations. The arts practice and studio environments

74 VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK ORIGINAL ARTICLE QUALITATIVE RESEARCH

were both identified as strong enablers the project was “like stabilisers on a bike… in this process, either by allowing the yeah, that’s what it does… like it gives me participants to negotiate their engagement confidence to have a go and when no-one in a way that felt safe (for example, by being laughs I try again… and then, yeah, like I able to slip easily in and out of self-led or realise I can do it”. One participant explained group activity), or because they saw being that making his art had enabled him to “say part of an art group as less stigmatising it like it was… in his own voice… in his own than participating in other support services. way ‘[instead of]’ other people telling him Discussion revealed a common perception how he was and what should happen”. The that it was important to be able to share a comment was met with nods of agreement positive common interest first, and not be in the group affirming how much the labelled for perceived failure. opportunity to self-represent and tell their own stories using images, music, film and Participants also described how the low- poetry was valued. stress environment enabled them to reconnect with people, build confidence, Discussion learn new skills and get ready to enter or go back to education or work. Some participants This investigation into the youth voices described how they felt unable to attend of Express Yourself aimed to uncover the other groups or support services, which potential benefits of participatory arts in might achieve these goals, explaining that health practice and the specific practice the arts were more appealing and more able features that promote health and wellbeing to accommodate their personal needs. for young people in the Aotearoa New Zealand context. The intention was to assess if local Youth-powered: Enabling autonomy evidence would align with the favourable evidence produced overseas. The youth focus and self-determination group participants involved in our research Participants described how the project’s certainly perceived substantial benefits from youth-led philosophy and practice participation in arts activity, claiming that methodology enabled them to build their engagement in Express Yourself was skills and see themselves as people with therapeutic—it gave them a refuge from the something to offer, as leaders. One young stress and pressure they constantly face in person described how they were asked to other domains of their lives; it also made lead an arts activity and share their ideas. them feel valued, empowered and connected. They discovered that they were “actually Although it is beyond the scope of this study quite a leader”. Another stated that “I have to evaluate long-term impact, participants lots of ideas but no-one listens to them did speak about practising skills in the project usually”. One participant commented that for application in wider settings.

Figure 3: Creative focus group expressions: Connection and belonging.

VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK 75 ORIGINAL ARTICLE QUALITATIVE RESEARCH

Importantly, their self-reported benefits YouTube, dance, magazines” (Hickey- converge with evidence-based indicators Moody, 2013, p. 1). In addition, the benefits of positive mental health and wellbeing that participants described clearly exhibit identified in the international literature. well-recognised outcomes targeted by PYD Putland’s (2012) meta-analysis, for instance, programmes such as confidence, competence revealed positive impacts of arts in health and connection (Lerner et al., 2012). Further, practice on sense of achievement, social the features of their arts-based experiences participation, belonging and transferable are evident in well-known PYD frameworks, skills. Young people’s suggestions about which emphasise the importance of why their experiences had an impact also supportive and empowering contexts and resonate with processes advocated in the caring, competency-enhancing relationships international practice. For example, what (Lerner et al., 2012). The connection of the works in designing stigma-free youth mental arts-based processes to PYD is notable health services according to Australian, given recent Aotearoa New Zealand-based Irish and United Kingdom researchers are evidence of the connection between PYD services that are optimistic, preventative practices and resilience in vulnerable youth and promote peer relationships and daily (Sanders & Munford, 2014). living skills such as stress management and self-worth (McGorry, Bates, & Birchwood, Study limitations and strengths 2013, p. 202). Evidently, this study was greatly limited Some focus group participants described in scope with its exclusive focus on one their arts participation as feeding their soul, case example and the inclusion of only signalling spiritual benefits that resonate 12 participants across 2 focus group with this critical dimension of the holistic discussions. We therefore acknowledge that wellbeing found in Máori and Pasifika any extrapolations of the findings to other models of health advanced by Durie (1985) participatory arts initiatives in the Aotearoa and Pulotu-Endemann (2001). Similarly, in New Zealand context should be undertaken discussing the features of the experience with caution. Further investigation is that enabled these outcomes, concepts needed to ascertain the generalisability that strongly reflected other Máori values of the effects. In addition, evaluating the such as whakawhanaungatanga (inter- long-term impacts of Express Yourself and personal connectedness) and ako (teaching other projects using similar participatory and learning reciprocity) were identified. arts processes is an area that could be Of note, many of these features were fruitfully explored. Participants in our focus inherently tied to the arts-based aspects of groups also described the significant factors the Express Yourself experience. This is not beyond their control in their wider socio- surprising given that the Pegasus Health ecological environment that negatively review also highlights synergies between affected their wellbeing, what we might the philosophical foundation of arts in consider factors driven by the dominant health and wellbeing and indigenous Máori neo-liberal ideologies of the current time. concepts of holistic wellbeing. They believed the valued processes in Express Yourself were an antidote to this, Findings are also consistent with the offering more open-ended, unpredictable, international youth engagement literature experimental possibilities. We are unable which reminds us that the arts are a to explore this further here, but would like powerful motif in young people’s lives and to acknowledge this finding as reinforcing a powerful tool for engagement (Ungar, the substantial systemic challenges facing 2013); that the arts are languages young vulnerable youth today and the need for people speak as everyday ways of belonging further research and action at the macro- to a community “through […] Music, film, level.

76 VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK ORIGINAL ARTICLE QUALITATIVE RESEARCH

These limitations aside, the convergence that is gaining momentum in Aotearoa of our findings with the international New Zealand (Deane & Harré, 2016), raise literature provides promise for the value of additional concerns with respect to the participatory arts engagement in Aotearoa evaluation of participatory arts endeavours. New Zealand. The creative approach The need to demonstrate that projects such employed to gather focus group data is as Express Yourself are evidence-based also seen as a strength of the research. Since is challenging when the narrow forms the process mirrored arts-based processes of evidence advanced within this global familiar to and valued by participants, who movement are acknowledged to stem from may otherwise struggle to express their ideas positivistic notions that are disconnected through a more traditional interviewing from methodologies that are better suited approach, rapport with the researcher to capture complex, culturally aligned and was enhanced and the participants were individualised approaches (Trickett, 2015) comfortable opening up. We suggest that found in participatory arts practice. We the availability of multiple media through therefore also require greater advocacy which their voices could be expressed also for creative and nuanced evaluation provided additional richness to the findings methodologies in the national evidence- (Figures 1-3). based policy making context.

Implications Practice implications Our findings suggest that arts-based Policy implications methods offer unique qualities to address As illustrated earlier, participatory arts in current priorities in youth mental health, social practice has flourished overseas in specifically calls for accessible, youth- comparison to the local picture. We suggest friendly, culturally-attuned approaches; that this is largely due to an unfavourable prevention approaches and trialling youth practice and policy environment. In the development models which build resilience arts sector, national policy has historically and social connectedness (Youth Health emphasised art-form development rather Report, 2012). We argue that the arts offer than participatory practices, though more promising applications, which could be used recent developments at Creative New to bring new languages for communication Zealand (the national body for the creative and a youthful lens to more institutional sector) include initiatives designed to environments. For example, greater effort strengthen capacity to address social practice should be placed on allowing young people priorities. In the social sector, a historical to actively tell their own stories and share emphasis on medical model practices in ideas using images, music, film and poetry health (Ball, 2013) presents challenges in a manner that, as shown in this research, for arts-based practice. A shift to a socio- demonstrates commitment to rebalancing ecological perspective alongside interest adult-youth power dynamics. This may aid in more interdisciplinary and preventative to position youth as active partners rather youth development models is evident in than recipients in social interventions. Cahill current youth mental health policy (Youth and Coffey (2015) assert the importance of Mental Health Project, 2012). We hope positioning in change models, and suggest that this shift, along with further research that, in order to re-position young people to build on the evidence produced here from reluctant sites of change (clients, service will open new doors for participatory arts users and patients) into active agents in their practice. own change process, we need to be more attentive to positioning and offer meaningful The current neoliberal ideologies opportunities for critical engagement and underpinning the evidence-based movement critique of the factors at play.

VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK 77 ORIGINAL ARTICLE QUALITATIVE RESEARCH

Conclusion Department Health. (2007). Report of the review of arts and health working party. London, United Kingdom: The youth voices captured in this study Department of Health. suggest that participatory arts experiences Department Health. (2011). No health without mental health: A cross-government mental health outcomes strategy for offer specific qualities that resonate with people of all ages. Retrieved from: https://www.gov.uk/ young people’s needs in a way that stands government/uploads/system/uploads/attachment_data/ in stark contrast to their experience of file/213761/dh_124058.pdf other support services. In this way, their Durie, M. (1985). A Māori perspective of health. Social Science & Medicine, 20(5), 483-486. engagement in art-making can have a notable Hacking, S., Secker, J., Spandler, H., Kent, L., & Shenton, J. impact on their mental health and wellbeing. (2008). Evaluating the impact of participatory art projects Although these voices are contained within for people with mental health needs. Health & Social a single case example of participatory Care in the Community, 16(6), 638-648. arts engagement, their alignment with Hickey-Moody, A. (2013). Youth, arts and education: Reassembling subjectivity through affect. London, United the growing international evidence base Kingdom; New York, NY: Routledge. indicates that further investment in research, ICH (Institute for Creative Health) (2013b). Framework. policy and practice in this field is warranted Retrieved from http://www.instituteforcreativehealth.org. in Aotearoa New Zealand. au/resources/australian-national-arts-health-framework Ings, R., Crane, N., & Cameron, M. (2012). Be creative, References be well: Arts, wellbeing and local communities: An evaluation. London, England: Arts Council England. ACE. (2014). The value of arts and culture to people and society. London, England: Arts Council England. Lerner, J. V., Bowers, E. P., Minor, K., Boyd, M. J., Mueller, M. K., Schmid, K. L., … Lerner, R. M. (2012). Positive Ball, J. (2010). Review of evidence about the effectiveness youth development: Processes, philosophies and programs. of mental health promotion programmes targeting youth/ In I. B. Weiner, R. M. Lerner, A. Easterbrooks, & rangatahi. Auckland: Mental Health Foundation of New J. Mistry (Eds.), Handbook of psychology: Developmental Zealand. Retrieved from www.mentalhealth.org.nz/assets/ psychology, 2nd ed.(pp. 365-392). Hoboken, NJ: Wiley. ResourceFinder/Review-ofevidence-about-effectiveness-of- mental-health-promotion-programmes-targetingyouth.pdf MacPherson, H., Hart, A., & Heaver, B. (2015). Building resilience through group visual arts activities: Findings Braun, V., & Clarke, V. (2013). Successful qualitative from a scoping study with young people experiencing research: A practical guide for beginners. London, mental health complexities and/or learning difficulties. United Kingdom: Sage. Journal of Social Work, 16(5) 541-560. Bungay, H., & Vella-Burrows, T. (2013). The effects of participating in creative activities on the health and well- Maunder, P. (2013). Rebellious mirrors: Community based being of children and young people: A rapid review of theatre in Aotearoa New Zealand. Christchurch, New the literature. Perspectives in Public Health, 133, 44-52. Zealand: Canterbury University Press. doi:10.1177/1757913912466946 McGorry, P., Bates T., & Birchwood M. (2013). Designing Cahill, H., & Coffey, J. (2015). Positioning, participation, and youth mental health services for the 21st century: possibility: Using post-structural concepts for social Examples from Australia, Ireland and the UK. The British change in Asia Pacific youth HIV prevention. Journal of Journal of Psychiatry, 202, s30–s35. doi:10.1192/bjp. Youth Studies. 19(4), 533-551. doi:10.1080/13676261.2 bp.112.119214 015.1083960 O’Connor, P. (2014). Applied theatre: Applied social work in Clift, S. (2012). Creative arts as a public health resource: New Zealand. In W. H. Chiu (Ed.), School social work: Moving from practice-based research to evidence-based Current practice and research (pp. 77-92). New York, practice. Perspectives in Public Health, 132(3), 120-127. NY: Nova Science. doi:10.1177/1757913912442269 Pegasus Health Ltd. (2014). The arts and health: Evidence Clift, S., & Camic, P. (2016). Oxford textbook of creative arts, from the international literature. New Zealand: Pegasus health, and wellbeing: International perspectives on Health. practice, policy and research. Oxford, United Kingdom: Pulotu-Endemann, F. K. (2001). Fonofale model of health. Oxford University Press. Retrieved from http://www.hauora.co.nz/resources/ Craemer, R. (2009). The arts and health: From economic Fonofalemodelexplanation.pdf theory to cost-effectiveness. UNESCO Observatory Putland, C. (2012). Arts and health - A guide to the evidence. e-Journal, 1(4). Retrieved from http://education.unimelb. Background document prepared for the Arts and Health ACKNOWLEDGEMENTS edu.au/__data/assets/pdf_file/0003/1105815/craemer.pdf Foundation Australia. Retrieved from http://www. We would like to thank Deane, K. L., & Harré, N. (2016). Developing a thoughtful instituteforcreativehealth.org.au/research/arts-and- Toi Ora (our case study approach to evaluation: Values-driven guidelines for health-%E2%80%93-guide-evidence partner) and all the young novice evaluators. Evaluation Matters – He Take Tō Te Sanders, J., & Munford, R. (2014). Youth-centred practice: people involved in this Aromatawai, 2, 53-78. doi:10.18296/em.0011 Positive youth development practices and pathways research, without whom, Department of Health/Arts Council England. (2007). A to better outcomes for vulnerable youth. Children and it would not have been prospectus for arts and health. London, United Kingdom: Youth Services Review, 46, 160-167. doi:10.1016/j. possible. Department of Health. childyouth.2014.08.020

78 VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK ORIGINAL ARTICLE QUALITATIVE RESEARCH

Secker, J., Hacking, S., Spandler, H., Kent, L., & Shenton, J. (2007). Mental health, social inclusion and arts: Developing the evidence base. Chelmsford, England: Anglia Ruskin University. Trickett, E. (2015). Seymour Sarason remembered: “Plus ca change…”, Psychology misdirected, and “Community psychology and the anarchist insight”. American Journal of Community Psychology, 56(3), 197-204. doi:10.1007/ s10464-015-9744-9 Ungar, M. (2012). Ed. An interview with Arn Chorn-Pond: Helping children in Cambodia through the revival of traditional music and art. In M. Ungar, The social ecology of resilience: A handbook of theory and practice (pp. 99-108). New York, NY: Springer. VicHealth. (2003). Creative connections: Promoting mental health and wellbeing through community arts participation. Victoria, Australia: Author. Retrieved from http://artshealthnetwork.ca/resources/creative- connections-promoting-mental-health-and-wellbeing- through-community-arts-particip White, M. (2009). Arts development in community health: A social tonic. Oxford, England: Radcliffe. White, M. (2016). The means to flourish: Arts in community health and education. In S. Clift, & P. M. Camic (Eds.), Oxford textbook of creative arts, health, and wellbeing: International perspectives on practice, policy and research (pp. 41-54). Oxford, United Kingdom: Oxford University Press Wreford, G. (2016). Arts and health in Australia. In S. Clift, & P. Camic (Eds.), Oxford textbook of creative arts, health, and wellbeing: International perspectives on practice, policy and research (pp. 135-143). Oxford, United Kingdom: Oxford University Press Youth Mental Health Project. (2012). Retrieved from http:// www.health.govt.nz/our-work/mental-health-and- addictions/youth-mental-health-project

VOLUME 28 • NUMBER 4 • 2016 AOTEAROA NEW ZEALAND SOCIAL WORK 79