Can arts based interventions improve the culture of care and population mental health? A call for more research and evidence.

 The UK Government’s Forsight reports on mental capital and wellbeing [1] included a review of ‘The Effect of the Physical Environment on Mental Wellbeing’. The following main issues were identified:

  • Sensory stimulation influences our wellbeing.
  • Access to nature and the ‘natural’ environment are significant contributors to individual mental capital and wellbeing.
  • Designers and developers should refer to the evidence available to design and manage the environment better for mental capital and wellbeing.

However, there was little comment on arts, performance, and the influences on individual or population health and wellbeing. A nice review by Daykin[2] concluded that aspects of art, design and environment can affect health, including physiological, psychological, clinical and behavioural effects, and that architectural design is important in mental health settings, especially for patients with conditions such as dementia. Exposure to art in healthcare environments reduces anxiety and depression. Environment features also affect staff, and improvements in visual and acoustic conditions may reduce risks of errors in some care settings. However, arts interventions do not necessarily address the lack of control exercised by patients in healthcare environments.

These studies begin to raise questions about how arts based interventions might influence public mental health and wellbeing, perhaps through distraction, or perspective gathering, perhaps through challenging the mundane and experiencing how beauty and visual and auditory sensations can induce states of contentment and well being.

There is little neuroscientific research, perhaps as the methods of research and of intervention are complex and do not easily fit the types of study designs that are available in public health and medicine.  A Cochrane review suggested that randomized studies are possible in this field.[3] And that further evaluation of art therapy for serious mental illnesses is needed as its benefits or harms remain unclear. Why do we consume literature, art, theatre so avidly? Common sense notions are that it provides pleasure and we rehearse meaning and alternative realities and possibilities, we dream but in doing so we reconsider our own lives and work through common dilemmas and adversity facing all human beings. Perhaps it is now time for a life sciences approach to art, to consider the biological, genetic, and physiological alongside the evidence base from arts, humanities and social sciences.

We need more research and more evidence, so please share your experiences and evidence.

Prof. Kam Bhui

[2] Norma Daykin The impact of art, design and environment in mental healthcare. JRSH 2008;128(2):85-94

[3] Ruddy R, Milnes D. Art therapy for schizophrenia or schizophrenia-like illnesses. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD003728. DOI: 10.1002/14651858.CD003728.pub2.

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