About the Arts in Health Institute

You have probably seen the clip. A man who has not spoken in months hears the opening bars of something, and his face reorganises itself, and he sings. Somewhere underneath it a caption says that music reaches parts of the brain dementia cannot touch, and several hundred thousand people share it, and a few of them are deciding, quietly, that this might be worth trying for their own father.

Here is the awkward part. Open the most recent Cochrane review of music based therapeutic interventions in dementia and the table does not say what the caption says. It reports a small effect on depressive symptoms, at moderate certainty. On agitation and aggression, which is the outcome most often claimed for music in dementia, it reports moderate certainty evidence of essentially no effect. And it finds nothing to suggest any benefit persists four weeks after the sessions stop.

Both of those things are true at once. The man in the clip really did sing, and the trials really do say what they say. This site exists in the gap between them, and the whole editorial approach follows from refusing to close that gap in either direction: not by talking down what happens in a room, and not by borrowing a trial’s authority for a claim the trial does not make.

Who writes this

I am Miriam Halstead. My father had vascular dementia for six years, and the afternoon a visiting musician got two verses out of him is the reason I started reading. When I did, I found a field that quotes randomised trials and unsourced percentages in the same breath, usually with the best of intentions, and a family in the middle of it with no way to tell which is which.

I went and got a postgraduate certificate in arts and health, which is real training and is not a protected qualification. I now run weekly singing and songwriting sessions in two care homes and on a stroke rehabilitation unit. That makes me a community arts practitioner, not a therapist, and it puts me on the unregulated side of the line this site spends most of its time explaining. It is a good place to write from. I am describing a distinction I sit on the wrong side of, not one I have anything to gain from defending.

Two people check the work. Dr Rhian Vaughan, a music therapist registered with the Health and Care Professions Council, is the reviewer for anything describing what a registered therapist does. Dr Anna Bergström, a public health researcher, is the reviewer for every number, design and certainty rating on the site.

What this Institute is, and what it is not

This section is here because “Institute” is a word that implies things, and most of them are not true of us. So, plainly:

• It is two reviewers and a practitioner, and a website. There is no building, no faculty, no students, no laboratory.
• There is no original research here. Nothing on this site is a study conducted by anyone connected to it. Every finding described here was produced by somebody else, and is named, dated and linked.
• It is not a charity and holds no grant funding. It is not a registered charity in any jurisdiction, and it does not solicit donations.
• It is not affiliated with anybody it cites. The World Health Organization, the National Centre for Creative Health, the National Academy for Social Prescribing, the Health and Care Professions Council, and every professional association named on this site are sources. Not partners, not endorsers, not sponsors. If a page cites them, it is quoting a document, nothing more.
• It does not deliver clinical services. Nobody here can assess, diagnose, refer or treat you, and nobody here will comment on a named practitioner or a named patient.
• It is not neutral about the evidence. Where a widely repeated claim does not survive its own source, this site says so.

What is covered

The site is organised around five areas, and the same question runs through all of them: is this a regulated therapy or a community activity, and how good is the evidence for what is being claimed.

• Music therapy, which has the most trial evidence behind it, and the most exaggeration attached to it
• Art and drama therapy, including the results that the field does not put on its posters
• Dance and movement, from Parkinson’s classes to what the depression research actually reports
• Arts on prescription, which is how most people get to any of this, and who pays for it
• Arts in hospitals and care, including consent, which is a harder problem here than anywhere else on the site

How claims are graded

Every efficacy claim on this site carries one of three labels: supported, promising but limited, or practice and anecdote. What each one means, and what evidence a claim needs to earn it, is set out on the editorial policy page. It is the most important page here, and the one to read if you only read one.

Getting in touch

Corrections are genuinely welcome, particularly on a number. If a figure on this site is wrong, or is right but described badly, the contact page explains how to say so and what will happen next. Please read the health disclaimer first: nothing here is a reason to change anything about anyone’s treatment.