Common mental disorders (CMD) and non-specific musculoskeletal pain have a major impact both on individual well-being and societal burden. Anxiety and depressive disorders are widespread, leading to high levels of sick leave, especially among women. Arts activities are increasingly recognised as a means of promoting health for individuals with CMD and of helping to manage long-term pain.

This thesis examines whether, and if so, how and to what extent Arts on Prescription (AoP) can serve as a health-promoting programme for individuals on sick leave due to common mental disorders (CMD) and/or non-specific musculoskeletal pain. It comprises three quantitative studies employing a quasi-experimental prospective design, with baseline assessments and follow-ups at 6 and 12 months, alongside one qualitative study based on focus groups.

Results in Study I showed significantly greater reductions in depression over time in the intervention group compared to the control group. However, this difference was not maintained after adjusting for sick leave. The within-group change over time for stress, anxiety, and depression was significant for both groups, with a larger effect observed in the intervention group compared to the control group, regardless of the adjustment for sick leave. The results of Study II indicated no statistically significant difference between the groups in the change in sense of coherence (SOC) strength over time. Both groups demonstrated statistically significant within-group increases in SOC, with the intervention group exhibiting an effect size that was double that of the control group. This reflected a medium effect size for the intervention group compared to a small effect size for the control group, regardless of whether sick leave adjustments were made. No statistically significant results were found in Study III regarding changes in general self-efficacy (GSE), either for between-group or within-group differences over time. The estimated effect size for within-group changes in GSE over time was small in both the intervention and control groups. Descriptive statistics on the effect of sick leave status revealed a significant difference in general GSE across various levels of sick leave. Participants on 25% sick leave had the highest GSE values, while those on full-time sick leave reported the lowest GSE values. Financial concern and educational level served as indicators of social determinants of health and health inequalities in the analyses. Descriptive statistics in Studies I-III revealed that participants frequently concerned about finances reported higher stress, anxiety, and depression levels (Study I), alongside the weakest SOC (Study II) and the lowest GSE (Study III). In contrast, those never concerned about their finances exhibited lower stress, anxiety, and depression, the strongest SOC, and the highest GSE. This difference encompassed all SOC sub-dimensions, Comprehensibility, Manageability, and Meaningfulness, while Meaningfulness remained stable in other analyses across Studies I-III. Conversely, educational level showed no significant effect. These findings suggest that financial concern can be a critical factor influencing mental health and well-being. In Study IV, the findings indicate that the participants' involvement in AoP fostered a sense of belonging, relief from daily demands, and a feeling of being moderately challenged through the arts activities. These challenges, when embraced, led to a sense of reward manifested as increased confidence and self-efficacy as the participants perceived they had successfully performed the arts activities. Together, these experiences contributed to health-promoting changes within the individual, such as transformed perceptions of their abilities, increased self-respect, and regained motivation and hope for the future