More doctors should engage with arts and health
Authors: Laura-Jane Smith, Damian Hebron
Publication date: 29 Mar 2016
Laura-Jane Smith and Damian Hebron argue that creative activity can support the wellbeing of patients and the wider public
Many doctors start medical school with an idea of medicine as cure. Most quickly realise that, despite phenomenal advances in science, cure is seldom possible. Over recent years there has been a growing recognition that by supplementing medicine and care, the arts can improve the health of people who experience mental or physical health problems. Engaging in the arts can also promote the prevention of disease, improve healthcare environments, and benefit staff retention. Arts in health practice includes a wide range of approaches, projects, and disciplines (fig 1). By facilitating front line health workers to become better equipped and engaged with arts in health, we can start to open opportunities for more individuals to reap the benefits of the arts, in all its forms.
What is the evidence for the impact of arts and health initiatives?
Many successful arts in health projects exist, with years of experience. There are numerous examples of the measurable impact of arts on health and wellbeing,   in addition to specific effects of individual programmes.  Some have included large sample sizes and found a positive impact on both all cause and cancer related mortality associated with involvement in cultural activities when adjusted for important potential confounders such as socioeconomic status.  There have been a number of interventional studies of people with dementia that explore different art and cultural activities. Both music listening and active singing classes have been shown to have long term cognitive, emotional, and social benefits. Of course many relevant outcomes, such as fostering hope and rebuilding identities, are hard to capture but come through strongly in interview studies.
In 2007, a Department of Health working group recognised this evidence base and stated that “the arts are, and should be, firmly recognised as being integral to health, healthcare provision, and healthcare environments.” 
A review of the evidence for the longitudinal effects of the arts on health has concluded that “the research demonstrates a positive association between engagement in high quality arts activities and life expectancy, disease resistance, and mental acuity.” Possible mechanistic explanations include enhanced social capital, psycho-neuroimmunological responses, and epigenetic phenomena.
How can you get involved in arts in health?
Seek out information on local arts in health projects and see them in action [Link] .
Read more about arts in health, and the evidence base for enhanced health and wellbeing (fig 2)
Consider how you could incorporate the arts and enhance teaching you already have responsibility for
Advocate for including the arts in service reviews, whether this be participatory projects, physical environments, or arts therapies. Use examples of other projects, including the King’s Fund’s “Enhancing Healing Environments,”  and the Arts Council’s evidence review  to help your case.
Visit the London Arts in Health Forum website [Link] and sign up for the newsletter to receive updates on a continuing professional development approved introductory course for health practitioners on the theory and practice of arts in health, launching in April 2016.
We have read and understood BMJ’s policy on declaration of interests and declare the following interests: DH is employed by the London Arts in Health forum as director, and also works as head of arts at Cambridge University Hospitals NHS Foundation Trust. L-JS is a trustee of the London Arts in Health forum, but receives no payment for this role. No other relationships or activities that could appear to have influenced the submitted work.
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Laura-Jane Smith clinical research fellow
National Heart and Lung Institute, Imperial College London, London, UK
Damian Hebron London Arts in Health Forum, London, UK