3. Arts and Health: Austria
3.1. Basics of the health care system in Austria
A fragmented picture
Austrian health policy is fragmented among many actors. The reform efforts of the past few years have attempted to achieve a better coordination of responsibilities. The formulation of the 10 health goals, the introduction of primary care centres, and, since 2020, the piloting of social prescribing are developments from which Arts for Health initiatives could benefit.
3.2. Social Prescribing
Thoughts on the Implementation in Austria
The concept of “Social Prescribing” was implemented for the first time in Austria in a pilot phase from June to December 2021. The rediscovery and strengthening of the biopsychosocial health model associated with it is to be welcomed.
Central to the approach of “Social Prescribing” is the consistent orientation on health-promoting activities and the dialogical search for people’s strengths and interests – who, thereby, have the opportunity to change from the patient role to a user role at eye level.
The offer is broadly diversified: art and culture, further education, sports, exercise, leisure time, nature, nutrition and social activities are equally suitable for “Social Prescribing”. On the part of the link-workers, this requires a willingness to reduce pathologizing
and to orientate themselves more towards salutogenetic aspects. What keeps people healthy? It requires, among other things, training and practice in interviewing and a comprehensive knowledge of the local and regional networks.
3.3. “Arts for Health” – on prescription?
A commentary from the perspective of a lawyer
As a lawyer, I am used to looking at whether there are legal claims of the individual against society (= legally the state). An example of this is the right to health care for people who are insured under the Right to Health Care Act and covered by social security in Austria. If such individually enforceable claims do not exist, there is still the broad area of a “soft” right, which under certain circumstances, may also define additional tasks of the public sector. An example of this second area would be the promotion of the arts, to which there is no individual legal entitlement.
There is basically also no entitlement to preventive and health-promoting services. However, health insurance providers are already called upon to be active in this area. Thus, theoretically, there is a chance for providers of demonstrably effective cultural measures to “do business” with public authorities. A ground-breaking example of closer cooperation between health with art and culture seems to be the project „Aufatmen, a breathing and music program for people with Long Covid“.
3.4. Cultural policy priorities
From traditional cultural funding to sustainable concepts
Cultural policy in Austria mainly relates to the cultivation, development and dissemination of the arts, arts education (universities), and the protection and preservation of cultural heritage. Cultural promotion is regulated by law at the federal and provincial levels. The Federal Arts Promotion Act stipulates that promotion has to be mainly directed to contemporary art, its spiritual changes and its variety and lists the fields to be supported by way of production, presentation, dissemination and preservation of works and documents.
The provincial organization of cultural policy and administration provides for different regional priorities. Explicit cultural development concepts with civil society participation have been realized at the level of the federal states and cities since the early 2000s. Even if interfaces with areas such as education, science and social affairs are mentioned intentionally, the desire for increased cooperation in crosscutting issues is not easy to implement due to the legal basis.
3.5. Music Therapy
Definition and legal situation in Austria
In Austria, as the only country worldwide, music therapy (including the training path) is regulated by law (MuthG, valid since 2009). Other art therapies are not included in this law. Within the framework of Arts for Health, it is, therefore, essential to consider the valid regulations and to differentiate music projects accordingly.
3.6. Arts & Health for Children and Youth
Focus: Competence Enhancement
Participatory artistic processes for and with the target group of children and young people are offered, carried out and evaluated in different formats and settings. The promotion of health is seldom the top priority. Mostly it is about competence enhancement in the individual, social and/or societal spheres, well-being as an expression of joy or physical activity in the context of sport and exercise.
The focus on health literacy in children and adolescents in Austria is given. To broaden the view on the promotion of health and well-being through artistic interventions and to think about the positive influences of artistic processes would only be a small further step.
3.7. Art meets science
From STEM to STEAM
Although the focus of this book is on the practice and research of arts and health, it should also be noted that the social significance of arts and culture goes beyond the health and social sectors. The current debate surrounding the expansion of STEM to STEAM (Science-Technology-Engineering-Arts-Mathematics) illustrates the relevance of the arts to a wider range of scientific disciplines.
With the STARTS Prize, the European Commission is sending out a ground-breaking signal to promote alliances between technology and the arts practice. This trend has also been recognized in Austria, with the establishment of the “Circus of Knowledge” at the Johannes Kepler University as an essential component of future-oriented and sustainable, humanistic education.
3.8. Policy Recommendations
Of mutual benefit to the arts, health and social services
The policy proposals for the implementation of arts and culture in the Austrian social and health care system are based on the considerations in the WHO report about the role of arts and culture on health and well-being, as well as the examples of the countries presented in this book. They are the first suggestions for a broader discourse for the creation of meaningful synergies of several basic systems – the health, the social and the arts sector – towards a sustainable foundation for health and well-being for the people living in Austria.
The objectives are to recognize the growing evidence and added value of artistic and cultural participation for health, to acknowledge the arts as a crosscutting issue, and to build or expand structures. We are also formulating strategic measures for policy development, raising awareness, networking, education and training, project funding, research and evaluation.