Young people’s mental health is a pressing issue worldwide. The great majority of mental disorders have their onset in adolescence and early adulthood (Kessler et al., 2005) and it is estimated that around 20% of individuals in this age group live with a mental disorder (Canadian Institute for Health Information, 2022; Gore et al., 2011). The end of adolescence and the transition to adulthood is a period marked by significant transformations and developmental challenges with which mental disorders may interact to cause serious consequences in the short and longer terms (Leebens & Williamson, 2017; Malla et al., 2016). Providing effective strategies to help limit the psychosocial impacts of mental disorders in young people is essential to promote their recovery and positive development, yet only a small proportion of youths in need do receive help (Malla et al., 2016). Services that specifically aim to foster the well-being and psychosocial adjustment of young people with mental health issues are still too scarce and often ill adapted to this population, which is especially affected by stigmatization and is often reluctant to receive services form conventional care facilities (Das et al., 2016; Munson et al., 2018; Ward, 2014). Evidence suggests that arts-based approaches may represent effective and more acceptable and attractive avenues to support the well-being and psychosocial functioning of youths with mental health issues (Coholic, Schwabe & Lander, 2020; Van Lith, Schofield & Fenner, 2013). Over the last few decades, there has been growing interest for arts and health initiatives around the globe, which was reflected by a widening in practice, an acceleration in research and even the transformation of public policies in some countries (Fancourt, 2017; Boyce et al., 2018). A review commanded by the WHO (2019) concluded that the arts could play key roles in the promotion of good health, the prevention of ill health, and the management and treatment of a range of different conditions, including mental disorders. “Arts and health” can refer to a broad area spanning from everyday life cultural activities having secondary benefits for health to therapeutic arts programs delivered by arts therapists (Bungay, Chatterjee, & Hogan, 2021; Dow et al., 2023). In between both ends of this continuum fall participatory arts programs (PAPs), which refer to individual and group arts activities intended to improve and maintain health and wellbeing in health and social care settings and community locations (Gordon-Nesbitt, 2017). Unlike art-therapy, PAPs are mostly run by non-therapist artists or art instructors and thus do not rely on psychotherapeutic processes but on the engagement in creative activities, which is believed to have therapeutic value in itself (Macnaughton, White, & Stacy, 2005). PAPs are generally strengths-based, person-centered, and normalizing, which makes them particularly well-suited to the principles of mental health recovery and often more appealing and acceptable to service users than therapeutic interventions (Khoury, 2020; Van Lith, Schofield & Fenner, 2013). This may have special relevance to young people, who are especially sensitive to the stigma associated with mental health services (Lamb, 2009; Moses, 2015). Involvement in PAPs has been associated with a variety of positive outcomes in adults and children with mental health issues, such as improvements in different aspects of socialization, self-perception, affective well-being, and global functioning (Boyce et al., 2018; Jensen & Bonde, 2018; Van Lith et al., 2013).
Despite these promising results, the empirical knowledge base on non-therapeutic artistic interventions remains limited. Published research on such initiatives still mostly rely on observational studies based on relatively small samples (Bungay et al., 2021). This can be largely explained by the very nature of these interventions, which are, by essence, eminently complex, fluid, and adaptable, and thus hardly amenable to experimental protocols (Howarth, 2017). Another limitation that is consistently pointed out is the lack of details provided about the programs being studied (Bungay et al., 2021). This shortfall is less easily explicable and published works should systematically provide detailed information about at least the type of activities, the delivery context, the specific objectives being pursued and participants’ characteristics so that promising strategies can be disseminated, and studies can be replicated (Karkou et al., 2022; Warran, Burton & Fancourt, 2022). Finally, research on arts-based approaches, as well as interventions to support the mental health of adolescents and young people more broadly, tend to lack consideration for individual and contextual variables such as age, gender, and geographic settings, and studies reporting differential effects according to such variables are strongly encouraged in order to build an understanding of the factors influencing response to intervention and go towards more individualized and tailored strategies (Das et al., 2016; Karkou et al., 2022; Zarobe & Bungay, 2017).
In this study, we used such a differentiated approach to study the changes associated to participation in the Transition Space (TS) program, a multi-centric PAP that was especially developed to foster the well-being and psychosocial functioning of adolescents and young adults living with mental health issues. We examined the evolution of three dimensions of psychosocial adjustment following program participation and investigated its variation according to participants’ demographic and clinical characteristics.
Objectives
Our study objectives were 1) to assess the evolution of participants’ subjective well-being, global self-esteem, and perceived social functioning between pre- and post-program and 2) to examine how this evolution varies as a function of participants’ age, gender, migration status, geographical setting, and severity of functional impairments due to mental health problems.