Institutional Perspective: Setting the Scene for Arts and Health

Nils Fietje, WHO Regional Office for Europe

Opening the webinar, Nils Fietje provided an overview of the growing international momentum around arts and health, highlighting that “the evidence for arts and health has largely been made.” He explained that WHO’s landmark 2019 report has since been reinforced by a rapidly expanding body of systematic reviews, meta-analyses and new international research demonstrating that arts and cultural participation contribute to health promotion, disease prevention, treatment and management across the lifespan.

Looking ahead, he introduced two major WHO initiatives: a forthcoming Lancet Series on Arts and Health and an updated WHO evidence review, which will make the case that cultural participation itself should be recognised as a health behaviour capable of improving population health, even beyond specific clinical interventions.

Beyond the evidence base, Fietje stressed the growing economic argument for investing in culture and health. He referred to recent UK research estimating that investments in culture and heritage generate around £8 billion annually in improved health, wellbeing and productivity, demonstrating that cultural participation delivers tangible societal returns.

He also highlighted the strong public demand for greater integration between culture and health, citing recent Eurobarometer findings showing that 87% of Europeans—and 89% of young Europeans—believe cultural participation enhances emotional and physical wellbeing.

Finally, Fietje argued that current public health challenges require moving beyond purely biomedical approaches. Referring to WHO Europe’s recent work on loneliness, social connection and health promotion, he noted that issues such as loneliness cannot be solved through medication alone but require stronger community-based and cultural interventions. He also highlighted WHO’s recent work linking culture, health and climate change, arguing that “the climate crisis is also a cultural crisis.” Overall, he positioned arts, culture and social prescribing as essential components of more preventive, socially connected and people-centred health systems.

Arts on Prescription for Mental Health: The Greek National Model

Nikos Stefanis, National and Kapodistrian University of Athens / Eginition Hospital

Nikos Stefanis presented Greece’s national Arts on Prescription programme for mental health, describing it as the most ambitious and complex initiative his team has undertaken. Developed through a collaboration between the Ministry of Culture, the University Mental Health Research Institute, community mental health services and major cultural institutions, the four-year programme has now become a national policy milestone.

He explained how multidisciplinary teams of mental health professionals and artists co-designed three-month programmes delivered within cultural institutions, covering theatre, music, photography and other artistic disciplines. Considerable work was required to establish entirely new referral systems, safeguard participants, train professionals, develop digital platforms and create common working methods between the health and cultural sectors.

The programme involved 21 major cultural institutions, one fifth of Greece’s community mental health services, created 118 new positions for artists and mental health professionals, and enrolled more than 1,000 participants living with mental health conditions.

Stefanis presented findings from one of the largest randomised controlled trials on Arts on Prescription conducted in Europe. Participants showed statistically significant improvements in depression, anxiety and overall wellbeing compared with treatment-as-usual groups. Importantly, the programme successfully engaged individuals living with severe mental illnesses—including schizophrenia and bipolar disorder—as well as socially disadvantaged populations who often face significant barriers to cultural participation.

Beyond the clinical outcomes, he highlighted the exceptionally positive participant feedback and high completion rates. Participants consistently identified the three-month duration as too short, demonstrating strong engagement throughout the programme.

The presentation concluded with a landmark announcement: since 10 March 2026, Arts on Prescription has officially become part of Greek legislation. Psychiatrists across Greece can now formally prescribe participation in cultural activities as part of mental healthcare, with the Ministry of Culture committed to supporting the programme’s continuation and future expansion into other medical specialties, including oncology and neurology.

Arts on Prescription for Mental Health: The Baltic Sea Region

Stine Eskesen Keiding, Programme Leader, Kulturregion Fyn, Denmark

Stine Eskesen Keiding introduced the Arts on Prescription in the Baltic Sea Region project, implemented by 13 partners across seven countries. While evidence supporting Arts on Prescription was already emerging, the project recognised that many initiatives remained small-scale pilots without sustainable funding or implementation models.

To address this, partners developed a transferable Arts on Prescription model that municipalities and regions can adapt according to their own contexts. Alongside the model, the consortium produced a practical implementation guide covering governance, financing, evaluation, cross-sector collaboration and programme design, together with evaluation frameworks and twinning opportunities for regions wishing to replicate successful approaches.

The project piloted 24 Arts on Prescription programmes across Denmark, Germany, Latvia, Poland and Sweden, working with diverse target groups including young people, older adults, migrants, people experiencing loneliness, women, people with disabilities and other vulnerable communities.

Keiding described the project’s structured referral pathway, where participants are referred through healthcare, educational or community services, supported by trained link workers, and participate in group-based artistic activities led by professional facilitators over eight to twelve weeks. Throughout the process, emphasis is placed on strengthening social connections, improving mental wellbeing and supporting long-term participation in community life.

She stressed that while healthcare can address medical needs, Arts on Prescription creates meaningful social relationships and community belonging that medicine alone cannot provide.

Inga Surgunte, Culture and Arts Institute of the Latvian Academy of Culture

Building on the Baltic Sea model, Inga Surgunte focused on how participating regions are translating pilot experiences into long-term policy and practice.

She explained that all project partners developed action plans following the pilot phase, many of which are already being implemented. Examples include the establishment of the Bremen Centre of Expertise for Arts and Health, the creation of the Culture and Health Latvia Association, and the development of museum-based prescription programmes supported through European funding.

Surgunte also highlighted Latvia’s newly established Interministerial Working Group on Culture and Health, which aims to strengthen collaboration between ministries and support national policy development.

Several regions have already secured sustainable continuation models. In Sweden’s Norrbotten Region, for example, Arts on Prescription has received political approval for expansion across all municipalities between 2026 and 2028. Other partners are integrating Arts on Prescription into existing museum programmes, municipal services and social inclusion initiatives.

Reflecting on sustainability, Surgunte argued that future implementation should rely on mixed funding models combining municipal budgets, cultural institutions, social services and European funding, rather than depending on a single funding source. She also emphasised that advocacy, policy dialogue and knowledge exchange remain essential for embedding Arts on Prescription within health and cultural systems across Europe.

Italian Framework: Health and Cultural Sector Collaboration

Annalisa Cicerchia, Cultural Welfare Center, Italy

Through a recorded contribution, Catterina Seia presented the results of Italy’s first national survey on Arts and Cultural Prescription, conducted by the Cultural Welfare Center with support from Fondazione Compagnia di San Paolo.

The mapping identified 918 organisations operating at the intersection of culture, health and wellbeing across Italy, including museums, libraries, performing arts organisations, healthcare providers and social services.

The survey distinguished two complementary models. The first, described as social prescription units, is more closely connected to healthcare organisations and formal referral systems. The second, cultural welfare units, is rooted in cultural institutions and community organisations delivering culture-based wellbeing initiatives, often without formal health referrals.

Seia presented important findings regarding referral practices, showing that psychologists, social workers, teachers, paediatricians and psychiatrists all play significant roles in prescribing cultural activities. By contrast, general practitioners currently play a relatively limited role, reflecting the absence of structured referral infrastructures.

The survey also demonstrated very high programme completion rates, widespread improvements in mental wellbeing and social relationships, and growing evidence of long-term benefits.

However, Seia identified several structural barriers limiting wider implementation. These include insufficient long-term funding, the lack of recognised and trained link workers, fragmented governance and the absence of regulatory frameworks supporting formal referral pathways.

She concluded by calling for stronger referral infrastructures, enabling policy frameworks and more systematic investment to allow Arts on Prescription to become an integrated component of Italy’s health and social care systems.

Regional Implementation and Policy Actions: Flanders Region

Kato Vanpoperinghe, Flanders Region

Kato Vanpoperinghe presented the current policy landscape in Flanders, where numerous initiatives linking culture, arts and wellbeing already exist but remain fragmented, project-based and insufficiently coordinated.

She explained that the Department of Culture, Youth and Media is now working together with the Department of Care to develop a shared policy framework around culture, health and wellbeing. The objective is to establish a common language between sectors, strengthen governance structures and support more sustainable implementation of existing initiatives.

Current work includes mapping existing programmes, analysing funding needs and bringing together policymakers, researchers, practitioners and cultural organisations to co-create a long-term shared vision. Vanpoperinghe stressed that stronger policy coordination can help transform many successful grassroots initiatives into structurally embedded practices capable of delivering lasting health and wellbeing benefits.

Regional Implementation and Policy Actions: Central Denmark Region

Mikkel Ottow, Central Denmark Region

Mikkel Ottow shared the experience of the Central Denmark Region, where arts and health has progressively evolved into a strategic area of regional expertise over the past decade.

Initially established through a single cultural development role, the region now employs a dedicated team supporting municipalities, hospitals, cultural organisations and policymakers across a wide range of initiatives, including dance programmes for people living with Parkinson’s disease, reading groups, artistic workshops in psychiatric care and music programmes in hospitals.

Ottow stressed that one of the region’s most important roles is acting as a bridge-builder between sectors. Rather than delivering programmes directly, the regional team supports local actors by translating international evidence, adapting successful practices to local contexts and strengthening cooperation between health, culture and social care professionals.

He also underlined the importance of communication in advancing the field, arguing that effective storytelling, strong visual communication and collaboration with organisations such as WHO and European partners help build political support and increase awareness of arts and health among both decision-makers and citizens.

Regional Implementation and Policy Actions: Cross-border Cooperation in the EGTC GO Area

Ezio Benedetti, EGTC GO – European Grouping of Territorial Cooperation

Ezio Benedetti presented the experience of the EGTC GO cross-border territory between Italy and Slovenia, where health cooperation has become a central element of territorial integration.

He described how the region has built upon the legacy of psychiatrist Franco Basaglia, whose work on mental health reform began in Gorizia, through the redevelopment of Parco Basaglia, a major cross-border investment supporting community use, cultural participation and social inclusion.

Benedetti also highlighted the experience of the first cross-border European Capital of Culture, shared by Nova Gorica and Gorizia, which placed culture, creativity and mental health among its strategic priorities. The initiative demonstrated how culture can contribute not only to wellbeing but also to cross-border cooperation, social cohesion and regional development.

Looking ahead, he presented ongoing work within the Sanitas project, which seeks to strengthen cross-border health cooperation between Italy and Slovenia while exploring how cultural actors can contribute to emergency preparedness, community resilience and health promotion.

He concluded by emphasising that, despite many excellent local initiatives, stronger institutional coordination remains necessary to overcome fragmentation and fully integrate culture into cross-border health policies.

Take-away Messages and Closing Reflections

Kornelia Kiss, Culture Action Europe

Closing the webinar, Kornelia Kiss reflected on the discussions by emphasising that Europe already benefits from decades of successful grassroots initiatives connecting culture and health. The challenge now is to complement these bottom-up experiences with stronger political leadership and institutional commitment.

She stressed that Arts on Prescription should not be viewed as an additional expense but as a smarter investment capable of improving prevention, reducing secondary health conditions, supporting return to work and generating long-term savings for health systems.

Kiss also highlighted the need for stronger collaboration between health and cultural sectors, encouraging health professionals and policymakers to actively engage with cultural organisations when designing community-based health strategies. As countries increasingly move towards more biopsychosocial models of care, she argued that existing cultural infrastructures represent an untapped resource that can contribute significantly to prevention, social connection and community wellbeing.

Finally, she noted that arts-based interventions can also benefit healthcare professionals themselves by helping address burnout, improving wellbeing and strengthening human connections at a time when health systems are facing workforce shortages and increasing digitalisation.

The webinar concluded with a shared recognition that stronger partnerships, supportive policy frameworks and sustained investment will be essential to scaling Arts on Prescription and embedding culture more firmly within Europe’s future health systems.