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.

Fig 1 Examples of approaches, projects, and disciplines in arts in health practice

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,[1] [2] [3] in addition to specific effects of individual programmes.[4] [5] 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.[1] [2] 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.[3] Of course many relevant outcomes, such as fostering hope and rebuilding identities, are hard to capture but come through strongly in interview studies.[6]

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.” [7]

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.”[8] Possible mechanistic explanations include enhanced social capital, psycho-neuroimmunological responses, and epigenetic phenomena.[8]

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)

  • Attend an event such as Medicine Unboxed [Link] or Creativity and Wellbeing Week [Link] , to meet those involved in the field

  • 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,” [9] and the Arts Council’s evidence review [10] 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.

Fig 2 Evidence base for enhanced health and wellbeing from cultural activity

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.

References

  1. Bygren LO, Konlaan BB, Johansson SE. Attendance at cultural events, reading books or periodicals, and making music or singing in a choir as determinants for survival: Swedish interview survey of living conditions. BMJ  1996;313:1577-80. [Link]   [Link] .
  2. Bygren LO, Johansson SE, Konlaan BB, Grjibovski AM, Wilkinson V, Sjöström M. Attending cultural events and cancer mortality: a Swedish cohort study. Arts Health  2009;1:64-73 [Link] .
  3. Iwasaki Y, Mannell RC, Smale BJ, Butcher J. Contributions of leisure participation in predicting stress coping and health among police and emergency response services workers. J Health Psychol  2005;10:79-99. [Link]   [Link] .
  4. Särkämö T, Tervaniemi M, Laitinen S, et al. Cognitive, emotional, and social benefits of regular musical activities in early dementia: randomized controlled study. Gerontologist  2014;54:634-50. [Link]   [Link] .
  5. Petrie KJ, Fontanilla I, Thomas MG, Booth RJ, Pennebaker JW. Effect of written emotional expression on immune function in patients with human immunodeficiency virus infection: a randomized trial. Psychosom Med  2004;66:272-5. [Link]   [Link] .
  6. Spandler H, Secker J, Kent L, Hacking S, Shenton J. Catching life: the contribution of arts initiatives to recovery approaches in mental health. J Psychiatr Ment Health Nurs  2007;14:791-9. [Link]   [Link] .
  7. Department of Health. Report of the review of arts and health working group. 2007. [Link] .
  8. Gordon-Nesbitt R. Exploring the longitudinal relationship between arts engagement and health. 2014. [Link] .
  9. Waller S, Finn H. Enhancing the healing environment: a guide for NHS trusts. 2004. [Link] .
  10. Arts Council England. The value of arts and culture to people and society: an evidence review. 2014. [Link] .

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

Cite this as BMJ Careers ; doi: