Co-developing a method for assessing the psychosocial impact of cultural interventions with displaced people: Towards an integrated care framework

Stories of displaced people, migration and immigration continue to occupy headline news here in the UK and abroad. Less well documented are the huge efforts being made by displaced people and associated relief agencies to deal with the challenges of displacement and migration. There are a host of temporary 'pop-up', as well as more established arts, heritage and cultural programmes which are aimed at displaced people who are currently in transition, for example in camps, and those refugees who have reached their resettlement destination. The impact of these programmes on participants' health and wellbeing has often been overlooked in relation to their overall health and how such cultural programmes contribute to recovery, adjustment and other challenges associated with displacement. By working in collaboration with a UK based arts and mental health charity and a Palestinian refugee camp in Jordan, we wish to better understand the role of creative arts and cultural activities in improving the health and wellbeing. We will also explore the potential for the arts to play a central role in improving issues associated with resettlement, employability and learning new skills, and consider how this could feed into relevant policies such as those related to immigration.

New research shows how damaging displacement is for people's physical and mental health, overall wellbeing and opportunities to flourish, such as employability. Along with issues such as the loss of a sense of belonging, identity and isolation, research shows that refugees and displaced people are more likely to experience mental health problems, such as major depression and Post Traumatic Stress Disorder. These problems arise from the trauma associated with exposure to violence and difficulties encountered in the migration journey, as well as migration-related difficulties in their countries of resettlement such as issues with immigration, employment and income.

Jordan hosts the highest number of Palestinian refugees of all five fields of United Nations operations. Those 1.95 million registered Palestinian refugees constitute over 40% of all registered refugees in the Near East. The first Palestinian refugee camps in Jordan were established almost 60 years ago following the 1948 Israeli-Arab war. Since then, the refugees had to craft their lives away from their homeland and traditional support systems. The current situation of refugees is complex as the new generations suffer limited access to resources, poverty and poor environmental conditions while at the same time continue to live a non-ending temporary situation inside camps. The frustrations of alienation and poverty have led to depression, anxiety and frustration. This has been addressed through interventions in camps, usually partnering with local organisations, addressing mental health through arts or culture. However, these activities are usually conducted without a systematic assessment of process or impact. Similarly, in European camps and refugee organisations, the impact of arts programmes has not been assessed in relation to overall health and wellbeing.

To understand the impact of creative and cultural activities we will collect evidence from displaced people by working closely with them and charities and organisations in the UK and Jordan. We will use this information to inform the development of a new method for collecting evidence which takes into account the health and wellbeing of displaced people and we will co-produce a toolkit which has a more integrated and holistic approach to care. This toolkit will be made widely available and will have relevance for anyone working with vulnerable audiences. We will also create a range of other outputs, including a short film to be produced by displaced people and refugees, which will provide an opportunity for them to decide which stories are told and to take back ownership of their own journeys of displacement.

The research will offer societal, cultural and economic impact across a number of spheres.
Societal impact: For those members of the community who are at risk or vulnerable, due to displacement, migration, social isolation, mental ill-health or physical impairment, the research will provide evidence of how the arts, creativity and culture play a role in improving health and wellbeing. The research will also help identify the benefits of learning new skills which may be helpful for employability, building a sense of community, social capital and resilience, which in turn will bring about economic benefits for those individuals engaged in creative or cultural activities, but also for those communities and organisations supporting displaced people and refugees. In Talbiyeh and other Palestinian camps for example, the benefits will include gender empowerment, as the project is sponsored locally by the Women Programs Center, a trusted organisation for women and youth activity, which will facilitate female participation and training in an otherwise very conservative community. Further, joint workshops with Zaatari Refugee camp (created by UNHCR in 2013 for Syrian refugees in Jordan) will build social ties among refugee communities and facilitate bonding, exchange of experiences and cooperation across the borders created by UN and host government.

Cultural impact: (1) Partners in the research will benefit from being involved in a high impact, university led research programme that will (a) provide evidence of the impact of the importance of creative and cultural participation on health and wellbeing and (b), help develop partnership working across sectors, camps and relief organisations.
(2) Artists, heritage and cultural professionals will benefit from the research in a number of ways including (a) training and advice regarding methods and audience development and partnerships with academic researchers; (b), participation in a project that will expand their programmes to meet the needs of their communities in a more practical and strategic way; and (c) the opportunity to co-develop a methods toolkit that has practical applications in their settings and can be shared across other settings.
(3) Society and the general public will benefit by being made aware of the links between creative and cultural participation and health and wellbeing. Similarly, the practical nature of the toolkit, developed in collaboration with partners in the UK and Jordan, means that it will be transferable across a range of organisations in different settings.

Third sector impact: Professionals and volunteers in organisations allied to migration and health promotion, including charities and support groups, NGOs and other not-for-profit organisations (e.g. Care4Calais, Citizens UK, Help Refugees, Humanitarian Aid & Wellbeing Association, International Organisation for Migration, Migration Museum, Good Chance Theatre, Hands International, Art Refuge UK, Counterpoint Arts, National Museums Liverpool International Slavery Museum, The British Museum, Arts Council England, UNHCR, UNRWA) will benefit from the development of a novel toolkit for assessing the impact of arts engagement for marginalised and vulnerable audiences which has been created through partnership working using a robust mixed-methods research framework.

Economic value for money: The research will provide a forum to expand the remit of arts and cultural organisations to play a more central role in supporting displaced people, refugees, asylum seekers and other vulnerable audiences. This will have knock-on effects for potentially reducing the cost of services supporting these audiences such as health and social care providers, refugee camps and other relief organisations.