Creative Alternatives

Creative Alternatives
Creative Alternatives
Creative Alternatives

Creative Alternatives is an ‘arts on prescription’ service offering a range of creative activities, events and outings to adults experiencing mild to moderate depression, anxiety and/or stress, with the aim to improve the participants’ mental wellbeing and health.

The service first commenced in the borough of Sefton, Merseyside, in late 2006 as a 3-year pilot project funded by Invest to Save. Following the pilot phase (during which the service demonstrated its positive impact through extensive mixed-methods evaluation), Creative Alternatives was sustained by funding from Sefton Council’s Public Health and Leisure Directorates. The service thrived and made a significant contribution to improving the lives of socially marginalised people in the borough - until 2016 when local authority funding was reduced and as a result most social prescribing provision in the borough was cut. Luckily, one year prior, in 2015, Creative Alternatives had rolled out to the borough of St.Helens, Merseyside, where it continues to this day, also funded by Public Health (as part of the ‘Cultural Hubs – Arts in Libraries’ Programme which is supported by Arts Council England).
Creative Alternatives is winner of the North West Public Health Award (2011) and the TEAM OF THE YEAR award by Trinity Mirror Foundation (2016).

Creative Alternatives Overview:

  • 0 years of service provision, including weekly arts workshops operating in four locations in Sefton and one in St.Helens, as well as taster workshops, outings and additional projects, events and exhibitions.
  • In total, over 650 participants have thus far completed the programme across Sefton and St.Helens. Many more people have attended public events and taster activities.
  • Estimate of cost per participant per hour (counting only those who have fully completed the programme):

Sefton: £17.50 (length of programme access: 9 months with approx. 60 contact hours)
St.Helens: £28.73 (length of programme access: 3 months with approx. 24 contact hours)

  • Once participants complete their time with Creative Alternatives they are invited to ongoing community activities and peer-led groups to maintain their sense of belonging and to support them with the continued management of their mental health and wellbeing.

Description of the arts activity

Creative Alternatives takes a multi-modal approach to arts provision, utilising a diverse team of experienced applied arts facilitators (many of whom have dual expertise in psychology, counselling, arts therapy and/or mindfulness-based interventions) and who take a person-centred approach to workshop planning and delivery. The activities provided are framed by the 5 Ways to Wellbeing as advocated by nef (new economics foundation).

Workshops combine relaxation and mindfulness practices with expressive multi-modal arts activity, featuring creative writing, visual arts and sculpture, photography, pottery and woodwork. One-off projects have included creative cooking and gardening, as well as drama and dance. Please visit our website for an outline of our vision, guiding principles and creative promise.

Details of the project participants

Creative Alternatives has catered for adults resident in the boroughs of Sefton and St.Helens, who are experiencing mild to moderate depression, stress and/or anxiety, as well as other mental and physical health conditions. A significant number are older and retired or long-term unemployed. Mental health in Sefton and St.Helens is worse than the national average. GP diagnosis of depression is 7.55% of adults in St.Helens and 6.82% in Sefton compared with 5.8% in England as a whole.  

Creative Alternatives operates through professional referral, utilising borough-wide networks of statutory and third sector organisations (from charities to GP surgeries to job centres) who promote the service to their clients. Individuals can also self-refer. We have refined referral procedures and criteria, ensuring the best match between participants’ needs and our provision. For details of referral, assessment and evaluation processes please see our programme reports listed below.

Project management

At its height in 2015, the Creative Alternatives team consisted of 13 people:

  • An arts officer and referral officer in each Sefton and St.Helens (day-to-day operations),
  • 7 artist facilitators (delivering across the 2 boroughs),
  • 1 project director (project leadership, commissioning and evaluation),
  • 1 art therapist as Reflective Practice Supervisor (emotional support & quality assurance)

Presently only the St.Helens branch of the programme is operational, commissioning a project coordinator and a support worker (responsible for day-to-day project coordination and referral), as well as the project director and 4 artists.   
The service has always been free of charge to residents in the boroughs. We follow thorough confidentiality and safeguarding policies. All team go through enhanced DBS checks. We also ensure that appropriate Public Liability Insurance is in place for all work and all activities are risk assessed. Quality assurance is protected through reflective workshop diaries, extensive participant feedback, reflective practice meetings involving the external supervisor, as well as through regular team meetings and steering group meetings involving the commissioners.

Evaluation methods and findings

Creative Alternatives has been extensively evaluated, combining quantitative and qualitative approaches and including participatory and arts-based methods. Links to programme reports are provided below. The most recent impacts can be summarised as follows (source: Creative Alternatives St.Helens, 2015-2016 pilot report):

  • Quantitative evaluation using the short Warwick-Edinburgh Mental Wellbeing Scale shows an average improvement of 3.6 points by week 6 and an average improvement of 5.2 points at programme exit in week 12.
  • Lifestyle evaluation (via in-house questionnaire) further indicates improvement particularly in levels of physical activity and social activity, as well as highlighting the reduction of GP visits, and the increased uptake of volunteering and education.
  • Qualitative evaluation (including focus groups, reflective arts activities, artist diaries and interviews) demonstrates that the programme encourages playful self-exploration and expression, leading to improved self-care, increased self-esteem and confidence, as well as enhancing family relationships and social networks and encouraging active citizenship.
  • The latest Social Return on Investment Analysis of Creative Alternatives, conducted by the Institute of Cultural Capital, indicates that for every £1 invested into the service, a total of £11.55 is returned in social value.

Project reports:

Bockler, J. & Lovell, E. (2009). Arts on Prescription in Sefton. Accessible here:

Bockler, J. (2012). A Social Return Investment Analysis of Sefton’s ‘Arts on Prescription’ Service. Accessible here:

Whelan, G., Holden, H. & Bockler, J. (2016). A SROI Analysis of Creative Alternatives St.Helens. (In the final stages of revision, will be uploaded to the Creative Alternatives website by end of August.)
Case studies and papers featuring Creative Alternatives:

Cultural Commissioning Programme (2015). Arts on Prescription: Arts-based social prescribing for better mental wellbeing. Accessible here:

Health Education England. (2016). Social prescribing at a glance: North West England. Accessible here:

University of York (2015). Evidence to inform the commissioning of social prescribing. Accessible here:

Wilson, K. (2015). The Art of Social Prescribing Informing Policy on Creative Interventions in Mental Health Care. Accessible here:

Supported using public funding by the Arts Council England