This is the third in a five-part series examining the role of art in health care.
The arts rarely are positioned as service interventions within health-care and settlement systems. Yet, over the past four years in Toronto, The Hubs of Expressive Arts for Life (HEAL) Project has demonstrated how the arts can function as essential health infrastructure for newcomer women who have survived gender-based domestic violence (GBDV).
GBDV remains a significant public health issue in Canada. In the shadow of the COVID-19 pandemic, reports intensified across Canada. While services adapted rapidly, many survivors remained disconnected from culturally safe mental health support.
For newcomer women, the risks and consequences of GBDV are often compounded by structural barriers, including language, economic insecurity and social isolation. Safety is shaped not only by physical protection but also by trust, language access and cultural understanding. Expressive Arts Therapy (EAT), for example, offers an intermodal, trauma-informed approach that integrates visual art, movement, storytelling, music and ritual to support emotional regulation, identity exploration and relational healing. Grounded in principles of trauma-informed care, it emphasizes safety, collaboration and nervous system regulation, fostering mind-body attunement and a shift from survival toward thriving.
HEAL, led by Access Alliance and funded by the Public Health Agency of Canada, is a 12-session expressive arts intervention for 52 women across six cohorts, delivered in partnership with community and health organizations. Rather than beginning with narration, the HEAL program started with co-creation as participants engaged in movement, visual art, storytelling, music and collective artmaking. Trauma- and violence-informed principles guided every stage of program delivery and evaluation. Participants could engage at their own pace, without pressure to disclose details of abuse.
HEAL was implemented across six cohorts: Arabic-, Bengali-, Farsi- and Tigrinya-speaking newcomer women, as well as 2SLGBTQ+ and shelter-experienced participants. Sessions were delivered by interdisciplinary teams that included expressive arts therapists, settlement workers, mental health professionals and peer researchers. Structural barriers to access were reduced through childcare, interpreters, transportation assistance, art kits for home use and hybrid participation options.
A mixed-methods evaluation embedded throughout the intervention documented consistent improvements in emotional regulation, self-efficacy, confidence and awareness of rights. Participants described reduced isolation and strengthened peer connection. Group-based expressive arts functioned as a social infrastructure, fostering trust and belonging that extended beyond individual sessions.
As one participant expressed: “This program taught me that women have rights and a powerful voice. I also learned to express my emotions through colours and want to find ways to maintain lasting mental wellbeing.”
Healing was not limited to symptom reduction. Participants reframed themselves as agents, cultural creators and knowledge holders rather than passive recipients of services.
As a psychology PhD student supporting HEAL’s evaluation and knowledge mobilization, I approached the project with training in quantitative measurement and structured intervention design. I expected to focus on outcomes such as self-efficacy and stress reduction.
But what has stayed with me were the moments when participants described reclaiming imagination. Trauma constricts the future. In expressive arts sessions, participants experimented with colour, movement and narrative in ways that gently expanded that horizon. Collective paintings became shared testimonies without forced disclosure. Rituals of beginning and ending sessions created predictability and safety. Cultural practices were not treated as background context but as healing resources.
From a research perspective, this raised a question: why do we treat imagination as extracurricular when it demonstrably supports regulation, connection and agency?
If public health is concerned with preventing illness and promoting well-being, then imagination deserves a place in our frameworks.
Expressive arts programming offers a non-stigmatizing space where women can engage without immediate disclosure, navigate complex emotions at their own pace and learn about rights and supports in Canada. In this context, culturally grounded expressive arts are not supplementary to the GBDV response. They are a practical and accessible pathway to healing.
But HEAL was not designed solely as an individual-level intervention. It intentionally worked to strengthen organizational capacity and contribute to system-level change across the health, settlement and gender-based violence sectors. Over four years, the project delivered six training sessions, reaching more than 90 service providers, and developed more than 30 dissemination products, including toolkits, reports and training modules.
With Canada recently experiencing its highest population growth rate in decades, demand for culturally responsive services has intensified. At the same time, service providers continue to grapple with the mental health consequences of the COVID-19 pandemic and its effect on gender-based violence.
Short-term funding cycles and narrow evaluation frameworks often limit community-based programs’ ability to address long-term relational healing. If arts engagement improves mental health, reduces isolation and strengthens help-seeking, it meets the criteria of a health behaviour. Yet art remains marginal within mainstream health care policy.
Recognizing arts engagement as a health behaviour requires structural commitment. It means establishing stable funding streams for arts-based interventions within health care and settlement services. It requires integrating expressive arts practitioners into interdisciplinary teams.
The HEAL Project concludes in 2026, but its implications extend beyond its funding cycle. It has already been adapted across language groups, cultural contexts and organizational settings. The broader question is not whether art should replace existing systems of care. It is whether we are willing to integrate arts engagement more deliberately into them.
For newcomer survivors of gender-based domestic violence, expressive arts are not decorative. They are a practical, culturally responsive component of recovery.
