Art As Antidote: How Creativity Can Enhance Mental Health Recovery

“kiske sapne hai didi… jab kuch kehne ka haq hi nahin hai...”

(Who gets to dream didi? …when you don’t have the right to say anything…?)

what you wear,

who you meet,

who you speak to,

when you eat,

whether you can own a phone,

who you marry,

when you have children,

how many children you have…

when you can’t choose what you want your life to look like,

when someone else decides…

mann kaise acchha ho sakta hai…?

(how can you be mentally well?)

These questions were posed by Meeta, a participant I met at a capacity building programme that trains non-specialist health workers to offer peer support and counselling as early intervention services for young people in rural Uttar Pradesh. Meeta is in her 20s, with an infant by her side. During sessions, she breastfeeds her daughter, makes notes, participates in role plays and arts engagements, and oversees her daughter’s naps. Meeta is multitasking and has three more daughters at home. She is speaking about an individual’s freedom of choice and agency from her lived experience of being regularly denied this.

The examples Meeta used are those many take for granted. It is a snapshot of a single story, but reflects a larger reality facing young people, particularly women, and those from vulnerable and marginalised groups.

Freedom of choice and agency are often used interchangeably but remain distinct. Freedom of choice is the ability to select from available options, while agency is the ability to act on goals and intentions. Agency is limited by having (a) options and (b) the opportunity to choose. Agency is core to philosopher Martha Nussbaum’s capability approach, which prioritises individual dignity and recognises that shaping one’s life is integral to achieving wellbeing. The lack of agency affects mental health and wellbeing of both individuals and communities.

Through training, I asked myself the same question…

Who gets to dream…?

Whose voices are we centring?

How can we co-design rights-based, responsive, and participatory mental health services?

I considered the landscape of youth mental health in India. India has the world’s largest population of young people (aged 10-24), with 65 per cent in rural areas. Evidence indicates that less than one per cent of youth with mental illness receive treatment, and an even a greater number of people experiencing distress go unnoticed.

Suicide is the leading cause of death among those aged 15-24. Despite these statistics, youth mental health remains a neglected public health priority. Beyond the severe paucity of resources to bridge treatment gaps, several demand-side issues impede young people’s help-seeking and access to services.

Evidence from research and our own work across three states indicates that the key factors include youth preference for self-reliance and informal care networks, negative past experiences with mental health services, perceived ineffectiveness of treatments, and stigma. Given this context, a struggling young person is unlikely to reach out. Even if they do, they are frequently met with paternalistic, medical frameworks of care. The lack of choice and control over their daily lives due to the patriarchal culture worsens when seeking support. Young people often feel unheard and invalidated during care.

Says Radha, 17, “…I used to hurt myself… I used papa’s razor, or steel clothes pins... mummy found out—she took me to the medical college… the doctor asked me why, but just laughed at me when I said that my best friend left… I felt there was nobody for me anymore… and my marriage was also fixed… ‘Is that a reason? That’s just life’ he said…”

Over the last two decades, evidence confirms what we feel and know: the arts are a vital partner in advancing health, social cohesion, and wellbeing. Benefits span the prevention and treatment spectrum, with positive outcomes in prevention and promotion, as well as illness management and curative services.

In 2020, the Wellcome Trust funded our study on arts engagement as an active ingredient to reduce youth anxiety and depression. We found arts interventions reduce depression and anxiety, improve self-awareness, self-esteem, and self-efficacy; enhance problem solving; foster community spirit; increase pro-social behaviour; reduce stigma; and promote resilience.

In my experience, arts interventions are evidence-based and can be layered onto existing mental health and development programmes to ensure that social care and welfare needs are also met. They can be tailored to the local context to create a safe space for engagement and sharing. They can be facilitated by non-specialist health workers or applied arts practitioners, rather than mental health professionals. This enables a more equal, non-hierarchical relationship in the group—rather than one where an ‘expert’ position is assumed. The content can be conceptualised jointly by mental health professionals, young people and applied arts practitioners—thus ensuring young people remain at the core of intervention design and delivery. Content may range from relational skills, emotional awareness, psychoeducation, and grief support to navigate digital landscapes, intimate partner violence, executive function skills, and time management. The sessions can be multimodal, participatory, and co-led by young people, combining drama, movement, rhythm, and visual art. This inherent nature of the arts allows both verbal and nonverbal expression. This is particularly helpful with subjects that are taboo or traumatic. It provides a safe space for young people to explore their identities and relationships with themselves and their ecosystem.

Arts interventions enable freedom of choice for young people by offering a chance to curate, design and lead their own sessions. The freedom to decide when, how, where and how much to engage. It provides a non-judgemental platform for self-disclosure and strengthens collective resources. Over the course of multiple sessions, it enables participants to offer peer support and create an informal care system to rely on. The language around and within sessions is non-pathologising and avoids the medical gaze. Instead, it focuses on building localised emotional vocabularies, raising awareness of internal and external resources, enhancing empathy and connectedness, and finding power and solace in a collective. These elements inherently help mitigate the key demand-side challenges faced in improving access to care for the youth.

I do not assert arts interventions are a panacea for mental health and social care issues. Rather, I advocate the need for a fundamental shift in how youth mental health services are conceptualised and delivered. In settings where services are scarce and fragmented, we must look beyond conventional western therapeutic practices and specialist driven models. Several are not applicable to Indian and other low-and-middle-income country contexts, where barriers like gender, caste, class, poverty and homelessness compound mental health issues. It is imperative to challenge inherent structural health inequities and develop actionable services that adopt a wellbeing oriented, whole person approach that prioritises agency and choice.

Evidence shows that children and adolescents work best in relationships, and for therapeutic interventions to be effective, relationship building must be prioritised. Young people must be equal partners and drivers in service design and delivery. Mental health is intersectoral and a development priority. It requires a collaborative transdisciplinary approach. A broader, more expansive consideration of what constitutes mental health service provision can enable wider reach. There is a need to build localised care systems that focus on connection, conversation, and empathy without a diagnostic lens.

Says Manoj, 15, “…after she died… I felt there was no use in my living… I kept thinking about taking my own life… I didn’t want to come here… but didi called me many times—she saw my WhatsApp status message—and knew something was wrong... I came for her... first… but now I come because I can say how I felt that day... and I know that here, people notice me… and people care... then my friend here helped me… he helped me start studying again, and then didi helped me find a job…”

Arts engagement is a health behaviour that can address mental health inequities at individual, interpersonal, and community levels. Arts practices comprising music, song, rhythm, movement, drama, theatre, visual art, craft, poetry and writing are low-intensity, cost-effective interventions that can significantly improve wellbeing. Arts engagement offers the opportunity to augment current practices and improve mental health through an asset-based lens. They engender the possibility of connection, agency, trust in social capital, and the hope of a better future. The voice of a young person from Chennai exemplifies this better than I can.

Says Kalpana, 16, “…these sessions may not change my life entirely, I know most things are still not all fine—many are still not in my control, but just knowing I have this place to come to, that I can plan this session, and be here—makes me feel useful, less burdensome... I feel like I can plan better… it also makes me feel hopeful… like I can find my way out of this…”

(Names have been changed to protect identity)

(Views expressed are personal)

Kamala Easwaran is a mental health practitioner, therapist and researcher. She is the founder of sumunum—a social enterprise aimed at improving mental health and wellbeing through arts based practices