3 Arts and Health: Austria

3.1 Basics of the healthcare system in Austria

A fragmented picture

Edith Wolf Perez 

Austrian health policy is fragmented among many players. Reform efforts in recent years have attempted to achieve better coordination of responsibilities. The formulation of the 10 health targets, the introduction of primary care centers and, from 2020, the piloting of social prescribing are developments from which "Arts for Health" initiatives could benefit.

3.2 Social prescribing

Thoughts on implementation in Austria

Christoph Redelsteiner 

The concept of "social prescribing" was implemented in Austria for the first time in a pilot phase from June to December 2021. The rediscovery and strengthening of the associated biopsychosocial health model is to be welcomed.

Central to the "social prescribing" approach is the consistent focus on health-promoting activities and the dialogical search for people's strengths and interests - giving them the opportunity to switch from the patient role to a user role at eye level.

There is a wide range of options: art and culture, further education, sport, exercise, leisure, nature, nutrition and social activities are equally suitable for "social prescribing". On the part of the link workers, this requires a willingness to reduce pathologization and focus more on salutogenetic aspects. What keeps people healthy? It requires, among other things, training and practice in conducting conversations and a comprehensive knowledge of local and regional networks.

3.3 Arts for Health - on prescription?

A commentary from a lawyer's perspective

Johannes Gregoritsch 

As a lawyer, I am used to examining whether there are legal claims of the individual against society (= legally the state). One example of this is the right to health care for people who are insured under the right to health care and are subject to social insurance in Austria. If such individually enforceable claims do not exist, there is still the broad area of a "soft" right, which can also define additional tasks of the public sector under certain circumstances. An example of this second area would be the promotion of the arts, to which there is no individual legal entitlement.

In principle, there is also no entitlement to preventive and health-promoting services. However, health insurance companies are already required to become active in this area. This means that there is a theoretical possibility that providers of demonstrably effective cultural measures can "do business" with the public sector. The project "Breathe easy, a breathing and music program for people with long Covid" appears to be a pioneering example of closer cooperation between health and art and culture.

3.4 Cultural policy priorities

From traditional cultural promotion to sustainable concepts

Anke Simone Schad-Spindler 

Cultural policy in Austria relates primarily to the cultivation, development and dissemination of the arts, artistic education (universities) and the protection and preservation of cultural heritage. Cultural funding is regulated by law at federal and state level. The Federal Art Promotion Act stipulates that funding is to be directed primarily towards contemporary art, its intellectual development and its diversity, and specifies the areas to be supported through the production, presentation, dissemination and preservation of works and documents.

The nationwide organization of cultural policy and administration provides for different regional focuses. Explicit cultural development concepts with civil society participation have been implemented 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 consciously mentioned, the desire for increased cooperation in cross-sectional issues is not easy to implement due to the legal basis.

3.5 Music therapy

Definition and legal situation in Austria

Oliver Peter Graber 

Austria is the only country in the world where music therapy (including the training pathway) is regulated by law (MuthG, valid since 2009). Other art therapies are not included in this law. In the context of Arts for Health, it is therefore essential to take the applicable regulations into account and to differentiate music projects accordingly.

3.6 Arts and Health for children and young people

Focus: expanding expertise

Gudrun Schweigkofler Wienerberger 

Participatory artistic processes for and with the target group of children and young people are offered, carried out and evaluated in various formats and settings. The focus is rarely on promoting health. In most cases, the focus is on expanding individual, social and/or societal skills, well-being as an expression of joy or physical activity in the context of sport and exercise.

The focus is on the health literacy of children and young people in Austria. Expanding the view on the promotion of health and well-being through artistic interventions and reflecting on the positive influences of artistic processes would only be a small further step.

3.7 Art meets science

From STEM to STEAM

Airan Mountain 

Although the focus of this book is on arts and health practice and research, it should also be noted that the societal importance of arts and culture extends beyond the health and social sectors. The current debate around the expansion of STEM to STEAM (Science-Technology-Engineering-Arts-Mathematics) highlights the relevance of the arts to a wider range of scientific disciplines.

With the STARTS Prize, the European Commission is sending out a pioneering signal for the promotion of alliances between technology and artistic practice. This trend has also been recognized in Austria and the "Circus of Knowledge" at the Johannes Kepler University has been established as an essential component of a future-oriented and sustainable humanistic education.

3.8 Policy recommendations

Mutual benefits for art, health and social services

The editorial team 

The policy proposals for the implementation of arts and culture in the Austrian social and health system are based on the considerations of the WHO report on the role of arts and culture for health and well-being and on the examples of the countries presented in this book. They are initial suggestions for a broader discourse on the creation of meaningful synergies between several basic systems - the health, social and arts sectors - towards a sustainable basis for the health and well-being of people living in Austria.

The aim is to recognize the increasing evidence and added value of artistic and cultural participation for health, to recognize art as a cross-cutting issue and to establish and expand structures. Strategic measures for policy development, awareness-raising, networking, education and training, project funding, research and evaluation are also formulated.