Reflections on researching creative engagement in anti-stigma work

Sustainable funding can unlock the transformative power of creative engagement for tackling stigma.

Stigma casts a long shadow over health and social care, acting as a barrier to access of vital services and worsening outcomes for individuals experiencing mental health challenges, substance use issues, long-term conditions, and more. During my placement with the Health and Social Care Alliance (the ALLIANCE) I engaged with their Reducing Stigma, Emphasising Humanity initiative. The report advocates for inclusive, human-centred approaches to tackling stigma. My research  focused on exploring one of the recommendations to look at the potential of creative engagement methods to amplify diverse voices and foster inclusivity. Through qualitative interviews with stakeholders involved in anti-stigma initiatives, I examined how these approaches could challenge both public and self-stigma while offering new avenues for connection and understanding. The report ‘Developing a picture of creative engagement in anti-stigma work’ highlights key findings and recommendations from the research.

Shifting the Lens on Impact and Evaluation

One key finding  from the research was that reducing stigma is about system change, and system change is rarely linear. Outcomes often emerge gradually, through ripple effects that unfold over time in context-specific ways. Traditional evaluation methods, which focus on measurable outputs and short-term results, often fail to capture nuanced shifts in power, participation, or attitudes. Furthermore, they risk reinforcing inequities when funder-driven metrics overshadow the insights and priorities of those with lived experience. To address these challenges, evaluation frameworks must evolve to embrace participatory, reflective, and adaptable approaches. These methods align with the transformative nature of system change and ensure the voices of those most impacted are at the centre of  both process and outcomes.

The Funding Paradox

Reflecting on this work, I am struck by how much the impact of creative engagement initiatives—and the success of my report and recommendations—hinges on the availability of sustainable funding. Creative engagement requires time and resources to build trust, foster meaningful participation, and enable long-term change. Yet, in the current funding landscape, short-term, outcome-focused projects often take precedence, making it challenging to advocate for process-driven initiatives.

For example, an arts-based mental health project can  involve participants creating visual narratives about their experiences with stigma. The process itself—engaging in creativity, sharing lived experiences, and forming supportive communities—can significantly impact self-stigma and social isolation. However, traditional evaluation models may prioritise immediate, quantifiable results, such as attendance numbers or final outputs, rather than the gradual shifts in empowerment, confidence, or attitudes that define true change. This creates a structural barrier: despite their transformative potential, creative engagement initiatives often struggle to secure long-term investment because their impact does not fit neatly into existing evaluation frameworks. This contradiction is the funding paradox: while creative engagement holds immense promise for addressing systemic issues, its effectiveness is often undermined by the very structures that limit its implementation. Funders’ emphasis on short-term deliverables overlooks the slower, deeper changes these methods foster. Without sustainable funding, creative engagement remains an underutilised tool, unable to fully contribute to dismantling stigma and fostering inclusivity.

To unlock the full potential of creative engagement, funders and policymakers must commit to sustained investment in process-driven initiatives. Long-term funding would not only allow these projects to flourish but also support the systemic, context-specific change required to dismantle stigma and build more inclusive health and social care systems.

This opinion forms part of a specially commissioned series by the Health and Social Care Academy which reflects learning and insights from the ‘Developing a picture of creative engagement in anti-stigma work’ report. This research builds on previous work undertaken by the ALLIANCE as part of the series ‘Reducing Stigma, Emphasising Humanity’.

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