Children and young people (CYP) are experiencing a significant mental health (MH) crisis that is threatening their future. Deeply rooted health inequalities perpetuate this crisis and call for immediate action. This project will promote easy access to best practice in local arts activities that support the diverse MH needs of CYP and thus enable them to take better control of their lives. By supporting the MH of CYP the project will meet an important NHS priority contributing towards tackling the health inequalities affecting their lives. We will build on successes from Arts for the Blues (AH/W007983/1), a project that received funding from AHRC for phase one of this programme and successfully scaled up the use of an evidence-based creative psychological intervention in the North West. We will also draw on a track-record of 25+ years of engaging CYP in arts activities, and on our extensive co-production experience. Co-creation will therefore become central to this work. We will focus on CYP aged 9-13, a group at significant risk of developing MH problems whilst transitioning from childhood to early adolescence. They will be encouraged to act as co-researchers developing skills they can use after the completion of the project, ensuring direct benefits. We expect that co-creation will lead to meaningful engagement of CYP with this study that aims to generate new, scalable evidence concerning: (A) how to access arts activities that best support the MH of CYP; (B) how to evaluate arts activities that meet the diverse MH needs of CYP; (C) how to maximise the benefit of arts activities for as many CYP as possible. We will create a digital platform where evidence-based local arts activities will become easily accessible for CYP, their families, relevant organisations and services. We will do this by identifying good local arts practice that addresses the diverse MH needs of CYP, especially those who are often under-represented. Six CYP Creative Health Associates will be employed to work in areas with marked health inequalities and establish local collaborations between community partners and existing social prescribing link workers. They will also work with the research team to provide easy and sustainable access to arts activities and thus, bypass local barriers. The active involvement of Integrated Care Boards (ICBs) (e.g., Lancashire and South Cumbria and Cheshire and Mersey Care), medical leads and medical directors of CYP's MH, NHS trusts, schools and community organisations will encourage collaboration within and across systems, enabling the development of an agreed evaluation framework of best practice in arts activities. This will support streamlining access to therapeutic uses of the arts as well as scaling up and adopting the outputs from the study in the North West and beyond. Finally, we will develop and share the project outputs with our 46 non-academic national and international collaborators, making an active contribution towards tackling health inequalities that benefits the MH of CYP wherever they live.

We know that taking part in art, culture and other creative activities is good for our health but, currently, we don't know the best way to make it part of our health and care services. Our project aims to address this problem by developing a new model - the 'Creative Health Board' - that will find new ways to fund these activities, link them more closely with health and care services, and make them available to people in communities with the highest risk of poor health. Creative Health Boards will be led by community assets - local charities, community groups, museums and theatres - and involve representatives from the NHS, councils and the private sector to work collaboratively to raise awareness of the health benefits of art, culture and creativity. The objectives of our project are to identify and share learning about the key elements of a successful Creative Health Board through collaborative research with community assets that: Demonstrates how art, culture and creative activities can be made more accessible for people at most at risk of poor health. Tests new approaches to funding, delivering, and measuring the impact of art, culture and creative activities provided by community assets. Builds the skills and confidence of community assets to carry out their own research and use evidence and digital technology to improve how they work. Develops new tools and guidance, including a Creative Health Handbook, so that art, culture and creative activities can become a key part of health and care services across the UK. Our project will be delivered by a team of leading community assets, academics, and representatives of health and care services. Together, we have extensive experience of delivering art, culture and creative activities in communities and undertaking research with people with lived experience of ill-health. Our goal is, by the end of the project, to have established six new Creative Health Boards across the UK. We will share our learning widely so that in the future, arts, culture and creativity can be more easily accessed by people wherever they live. Our project will have the following impacts: Health and care services will know about Creative Health Boards and what makes them effective. This will help them to prevent and tackle ill-health in communities where the risks are greatest. Community assets will be able to use the Creative Health Board model to work more closely and effectively with health and care services. They will also develop new knowledge and skills to carry-out their own research and to use evidence and digital technology to improve their work. Finally, they will have access to better funding models that can help them grow and develop the activities they offer. Individuals and communities at risk of or experiencing poor health will benefit from having a wider and more accessible range of art, culture and creative activities provided by community assets. In the long-term this will lead to better health and wellbeing for everyone involved.

In this project we will develop a strategy for making the Arts for the Blues intervention easily available to adults and children struggling with depression, low mood or anxiety. This group therapy uses visual arts, music, dance, drama and creative writing to address psychological difficulties and strengthen resources for managing them. Participants are encouraged to actively engage with simple arts-making activities with a clear therapeutic intent. These activities may include: breathing exercises to manage anxiety, free writing to support self-expression; mirroring tasks to develop relationships, use of objects to share difficult stories, engagement in rhythmical connections to address isolation (see www.artsfortheblues.com for further details on the intervention and relevant audio-visual material). Evidence suggests that arts-based interventions are more accessible and attractive for people who find it difficult to talk about their problems or who are seeking an alternative to talking therapies. This could include adults and children from diverse backgrounds, refugees and migrant communities, and those struggling with loneliness and isolation. The Arts for the Blues intervention was first developed to address mental health concerns in inner city neighbourhoods in Manchester and has since been successfully piloted in charities and schools in the North West of England, an area faced with long standing health inequalities. Participants in the arts-based groups showed marked psychological outcomes including lower scores of depression and anxiety and improved wellbeing, life functioning and social communication. In this project we will therefore ask the question: How can the Arts for the Blues intervention be scaled up for integration within healthcare and cultural organisations to tackle depression and improve wellbeing in communities across the North West of England? In order to answer this question, we will bring together artists, health professionals, existing networks and partnerships in three events in order to co-create a strategy for making the intervention readily available across the region. We will also offer workshops, focus groups and training to at least one healthcare and one cultural organisation. Throughout the process we will work alongside our Patient and Public Involvement (PPI) group to ensure our target beneficiaries have a voice. The group currently includes people using psychological services who have attended Arts for the Blues groups and will be expanded to include PPI members from project partners. Methodologically, we will adopt a realist evaluation approach which will allow us to develop a strategy that is scalable, sustainable, aligned with systems thinking and promises to offer solutions to long-standing health inequalities in the region and beyond. Over the lifetime of the project, we will produce an online toolkit to include case examples and training materials, a film with the main findings and user testimonies, and a plan for the integration of this creative form of therapy in different settings.

Problems in life that affect how people feel cannot always be fixed with tablets or medication. For example, loneliness can lower people's mood, or worries about money can cause them to feel anxious. This may stop people looking after their health. A way of getting them help with such problems is through social prescribing. Social prescribing involves connecting people to 'community assets' - groups, organisations, services in their local area. Community assets can include exercise and arts classes, volunteering and advice services. Such connections can provide people with social, emotional or practical support. Link workers are a key part of social prescribing. They are employed (by the NHS, local councils or charities) to help people find such support. Older people might benefit from social prescribing. For example, if they have experienced a bereavement or lack purpose in life following retirement. Or they might have concerns about money as the cost of shopping, electricity and gas increases. As part of social prescribing, a link worker might connect an older person to support in the cultural sector; for example, to a dance or singing group, activities run at a museum or volunteering at a local theatre. Our previous research has highlighted that being connected to the cultural sector might: a) distract older people from concerns in life for a short period, b) help them make new friends, c) provide them with a space where they feel safe and welcomed, d) increase their confidence as they gain knowledge or skills through trying new things. Our previous research involved mainly talking to older people who described themselves as 'White British'. This new study will build on and expand what we learnt from the previous research. We will focus on cultural offers and opportunities that have been developed for or with people who may not have English as their first language and/or do not identify as White British. This will allow us to develop recommendations about producing accessible, acceptable and appropriate social prescribing cultural offers for older people [aged 60 and older] from ethnic minority groups. The research will: 1. Identify what is already known about creating cultural activities or events for older people from ethnic minority groups. We will do this by reviewing relevant literature. 2. Map what is provided by the cultural sector in the UK; things that link workers could refer older people from ethnic minority groups to as part of social prescribing. We will do this by contacting a wide range of cultural organisations and asking them to complete a short questionnaire. 3. Explore what we can learn from cultural organisations that have tried to provide cultural offers that appeal to older people from diverse backgrounds. We will do this by spending time at six organisations that complete the questionnaire for the mapping referred to above. They will become our 'cases'. We will watch what happens there. We will also talk to people who work for the organisation or older people from ethnic minority groups engaging with it. We will pick these six cases so they are varied in terms of a) where they are located in the UK, b) groups they aim to attract, c) type of cultural offer provided, d) size of the organisation/operation. We will compare and contrast what we learn from each case. We will explain differences that may arise across these cases. We will bring information collected from these three elements together; a computer programme called NVIVO will help us with this. We will develop an explanation of how, why and when cultural provision that could form part of a social prescription might be beneficial (or not) to the well-being of older people from ethnic minority groups. We will share what we learn via written documents, videos and conference presentations. We will also hold an end of project meeting to talk to interested people about what we have found from the research.