Art in Hospitals: Potentials and Pitfalls

Shane Strachan reflects on the creation, installation and facilitation of arts-based interventions in Aberdeen Royal Infirmary.

The critical medical humanities is a relatively young field, which has repeatedly demonstrated how artist interventions within biomedicine can impact on how clinicians think about and deliver their work. Specifically, arts-based research incorporates new ways of seeing medical practice through the lens of the humanities encouraging an increasingly rounded, holistic approach towards patients rather than hierarchal, clinical categorisation as well as other improvements to medical practice and procedures. However, the impact of art and design on the physical environments in which medical practitioners work is far more established and generally accepted as positive for health and wellbeing, with numerous studies providing evidence of this benefit over the years (see Nanda et al. 2012 and Nielsen et al. 2017).

I have seen this first-hand through working as a creative writer and consultant on multiple projects across 2015 to 2022 for Grampian Hospitals Art Trust (GHAT). GHAT is a sector leader supporting the installation and creation of art in hospitals across North East Scotland since 1985. Over three decades, GHAT’s services and projects have grown to include various creative workshops for patients, visitors and staff, a purpose-built gallery in the Aberdeen Royal Infirmary, and the consultation and implementation of design features within hospital spaces, such as improved wayfinding. Their collection includes over 4000 artworks with a heavy weighting towards landscapes and nature scenes, which aligns with the findings of Fudickar et al. (2022) and Lankston et al. (2010) on patient preference for these forms and subjects. Yet, as these studies and another by Reddy (2019) show, it cannot be taken as a given that art on display in hospital environments is always positive or impactful. Working with GHAT has emphasised for me that being critical of these assumptions around the benefits of art in hospitals could lead to a deeper and more meaningful engagement with the hospital environment for patients, staff and visitors – as well as a deeper engagement with art.

The latest GHAT initiative I worked on was their Shared Collective Heritage project. This work celebrated the artistic heritage connecting people and place in North East Scotland – and GHAT’s role in this – and brought the art collection closer to those who use the hospital. Early in the project, it became apparent why this particular aim was necessary when a GHAT staff member admitted that they had contemplated removing all of the artworks on display in the main hospital corridor overnight to show hospital staff they’d been taking them for granted. After many years on display, the GHAT staff member felt that the artworks become part of the furniture for many of the long-term NHS staff and even some patients, simply blurring past in their peripheral vision. The potential negative impacts of this were evident in the damage to some of the artworks, with one artwork composed of multiple framed pieces having been permanently damaged by a trolley.

This provoked reflection for me on what happens years after a creative project has taken place and the initial stakeholders and audience have moved on, yet the outcomes remain behind. Who checks that the artworks are still relevant, safe, practical and of interest to users and audiences years later? In many cases, there are no clearcut answers when public art is damaged, stolen or needs moved as is often the case with public art in outdoor settings. This was a key driver for Art UK’s major sculpture digitisation project, which sought to photograph all outdoor public sculptures in the UK and make them publicly available online as a permanent digital record. GHAT, however, is unique in being a long-standing and well-embedded charity within the hospital space that can react to the threat of time and change through projects like Shared Collective Heritage. With the support of the project manager, Lesley Thomson, I was able to take several different approaches to (re-)engage hospital users with the art in Aberdeen’s hospitals through creative interventions which I believe are worth sharing for anyone creating, commissioning or displaying art in other hospitals or community spaces.

Firstly, I met with existing hospital staff to discuss the art currently on display in their work environments and asked them how they felt about it. The majority felt positive or neutral towards the works on display, but there were instances where it was clear that some artworks were no longer appropriate for a certain space. For instance, one staff member commented that the artwork installed in their consultation room had a stark use of red paint which some of their patients felt had disturbing or upsetting associations. This is in line with earlier research by Jacobs and Hustmeyer (1974) and Jacobs and Suess (1975) on the physiological effects of seeing different colours: red and yellow was found to induce a higher state of anxiety, heart rate and respiratory rate compared with blues and greens.

In follow up to these initial meetings, staff were invited to select alternative works for display in their buildings, choosing works which they felt would be suitable for their co-workers, patients and environments. In some cases, particularly with abstract or complex works, I would then have a final session with staff through which I’d share my own research into the artist’s original intentions and creative process followed by an opportunity for staff to respond to it through creative writing. Staff often commented that they felt better equipped to engage patients and visitors in discussions about the artworks thereafter and no longer felt intimidated or too inexperienced to do so.

Unfortunately, the COVID-19 pandemic disrupted further opportunities to rollout this process with more staff. Hence we decided to create two films – ‘Reading Art’ (2021) and ‘Writing Art’ (2021) – which could be used not only by NHS Grampian staff, patients and visitors, but by anyone looking to overcome feelings of inadequacy or intimidation in discussing art.

Shane Strachan explores the GHAT collection and in Aberdeen Art Gallery (video).

In addition to COVID-19 disruptions, the limitations on engaging with patients and their visiting families in a busy hospital setting pushed me to create optional “drop-in” interventions that could be left behind for hospital users to engage with in their own time. This included providing individuals with a space to respond to a series of coastal artworks in a waiting room. I asked people to write down what they had found washed ashore and where on the northeast coastline. Then later, responses were used to create a collage poem that I shared with those in the space.

Another way was simply displaying my own creative writing responses to artworks in the hospital space, offering a different route into the artwork for anyone passing by. One of these – a simple poem inspired by elements of an experimental cyanotype’s subject and composition – is now permanently installed in the main corridor of Aberdeen Royal Infirmary. Two years later, I still regularly get messages from people who have come upon the piece, saying how it made them stop, pay more attention and appreciate the work in a way that they may not have otherwise.

Shane Strachan’s poem responding to ‘Lost Mountain’ 2016 by Nicola Murray. Photo: Mike Davidson.

I also developed a series of public workshops in-person in the hospital and then online during COVID-19 lockdowns, which focused on these processes of reading and writing art with participants. This process of sharing and exploring led to many more creative writing responses which were displayed as part of a final Shared Collective Heritage exhibition, ‘Shop Local’: focused on Aberdeen’s built and cultural heritage. In the shadow of COVID-19, feedback on the exhibition and the Shared Collective Heritage project more widely showed why this renewed engagement with GHAT’s art collection was timely and important. Some comments include:

  • “Beautiful insight into the past of Aberdeen. Brilliant escapism while I’m admitted here. Only wish there was more.”
  • “Thanks for those lovely memories. I’m a current patient & love the peace & tranquillity in here. Thank you x”
  • “Visiting my dad, feeling glum – wandered in for some time to sit myself down + think your exhibition put a smile in my heart […] Thank you for cheering me up today when I needed it!”
  • “We loved this today. Nice break for us while we are here getting our son well again. Thank you.”

The combination of engaging hospital users and visitors in advance of the exhibition alongside providing alternative ways into the artworks through creative writing seemed to be a key part of the exhibition and project’s success. More widely, in addition to ensuring users’ input in the selection or commissioning of work and then the longer term evaluation of how the environment or staffing may change, the biggest takeaway for me was that hospital users’ previous experience, knowledge, confidence and awareness of art itself inform ways of thinking about art and medicine and these ways of thinking can help to break down barriers within hospital spaces. For me, this process was more effective than simply hanging it up in a space and assuming this will automatically entail (health) benefits for people in the hospital.

The methodologies described above are just some of the ways creative writing practice can be used as a tool to make change in medical environments and to also demystify the visual arts for those usually intimidated by art, whether in a traditional gallery or in a non-traditional space for art such as a hospital. You can learn more about the other ways the Shared Collective Heritage project sought to reengage hospital users with GHAT’s collection such as artwork conservation films and artist interview films on GHAT’s website alongside information on their other projects, commissions and exhibitions.

About the Author

Shane Strachan is a lecturer in Creative Writing at the University of Aberdeen. He was the National Library of Scotland’s 2022-23 Scots Scriever and has previously worked on medical humanities projects in Aberdeen and its Zimbabwean twin city, Bulawayo.

References

Fudickar, A., D. Konetzka, S.M.L. Nielsen, and K. Hathorn. (2022). Evidence-based art in the hospital. Wien Med Wochenschr 172(9-10): 234-241.

Jacobs, K.W., and F.E. Hustmyer. (1974). Effects of four psychological primary colors on GSR, heart rate and respiration rate. Percept Mot Skills 38: 763–766

Jacobs, K.W., and J.F. Suess. (1975). Effects of four psychological primary colors on anxiety state. Percept Mot Skills. 41: 207–210.

Lankston, L., P. Cusack, C. Fremantle, and C. Isles. (2010). Visual art in hospitals: case studies and review of the evidence. Journal of the Royal Society of Medicine 103(12): 490-499.

Nanda, U., C. Chanaud C, Nelson M, Zhu X, Bajema R, Jansen BH. (2012). Impact of visual art on patient behavior in the emergency department waiting room. Journal of Emergency Medicine 43(1): 172-181.

Nielsen, S.L., L.B. Fich, K.K. Roessler, and M.F. Mullins. (2017). How do patients actually experience and use art in hospitals? The significance of interaction: a user-oriented experimental case study. Int J Qual Stud Health Well-being 12(1).

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