Effects of engagement in arts and creative activities on internalising symptoms and life satisfaction in adolescence: Results of a causal analysis in the #BeeWell study

Background: There is growing evidence of links between arts and creative activities and mental health, particularly in adolescents. However, methodologically stronger evidence is needed. Using causal inference methods, this study examined whether day-to-day arts engagement can improve adolescent mental health and wellbeing. Methods: The sample included N=13,058 (42.6% girls, 12-15y) individuals from the #BeeWell study, a longitudinal study of adolescents in Greater Manchester (UK). Inverse probability weighting with regression adjustment was used to assess the effect of engagement with six different arts and creative activities on subsequent internalising symptoms and life satisfaction, conditioning on baseline outcomes and covariates. Results: Engaging in any arts or creative activity several times or more a year led to increased life satisfaction. Going to the cinema or theatre (but not other activities) resulted in decreased subsequent internalising symptoms. Effects on both outcomes did not differ by the number of different activities young people engaged in or the frequency of engagement. No significant differences were observed across socio-economic status, gender, or ethnicity. Conclusions: Regular engagement with arts and creative activities can improve adolescent life satisfaction. Specific activities can reduce internalising symptoms. The absence of moderation effects across subgroups indicates these activities could confer universal benefit. Increasing opportunities to engage in arts and creative activities is an effective way to improve adolescent mental health and wellbeing without widening inequalities.