Imagine you enter a hospital. You walk through the doors and find yourself looking for directions. It's a busy area, and there's a lot of signage, but you manage to find your way to the correct department. The lobby lights are bright, and the receptionist greets you. You take a seat in the waiting room and look at the small television broadcasting the news on mute. Not the most uplifting content, you think. The chair is cold and hard, practical, but not comfortable. You look around the room for a distraction, and your eyes land on medical posters with warning signs that incite worry and fear. You hear the doctor call out your name, and walk in for your consultation. The entire area looks sterile, each bay identical to the other. The decor is dull at best, and the lighting is fluorescent and stark. There is a smell of disinfectant in the air to accompany the sound of medical equipment. How do you feel?
This is what most of us have experienced when visiting a hospital or clinic – bland, sterile, and institutionalised. We have only recently started paying attention to studies that show how our immediate environment can directly affect mood and mental health, which can either help or inhibit our recovery and impact staff morale as well.
All over the United Kingdom, art strategies are now included as standard practice for new healthcare buildings. A significant change in the NHS design policy recognises that the mental wellbeing of patients, staff, visitors, and stakeholders are better supported in environments that include visual art, music, and well-designed interiors. We find that care is more compassionate, there is a reduction in painkillers, and patients are even discharged sooner.
So how do we go about making these changes to support mental health in everyday clinical settings? What is 'good design' when it comes to hospitals? A good place to start is with our senses, what we see, hear, touch, and smell.
Choice of colour can impact people both psychologically and physiologically. Bright colours and vibrant, engaging artwork can help create a positive and welcoming space for children. Anxious adults may benefit from calmer and more muted colours. Bold contrasting colours are favourable in dementia care environments where they can help differentiate surfaces and locations. Using colour wisely can be beneficial in recovery, help positively impact mental wellbeing, and play a crucial role in allowing patients to navigate the space well.
In addition to colour, it is well documented that access and proximity to nature can aid recovery. Although exposure to daylight, fresh air, and nature significantly reduce anxiety and alleviates symptoms of depression, these elements are either scarce or entirely missed in healthcare settings. The same positive impact can be achieved by 'biophilic design' that focuses on replicating the natural world in a constructed environment. We can accomplish this using raw materials such as wood, incorporating organic shapes within furniture design, lightboxes placed in ceilings to mimic skylights, soundscapes featuring birdsong, and mounted artwork of nature on display.
All this is also true of lighting. Our exposure to light can play a significant role in supporting our healing process. When used well, warmer tones can create a calm ambient atmosphere, and sensory lights such as coloured or twinkling lights can be a positive distraction in labour wards and children's waiting areas. Light even helps control our internal body clock, which synchronises many physiological and psychological functions on a 24-hour cycle known as our circadian rhythm. Our circadian rhythm helps regulate our daily sleep pattern, and the inability to do so can lead to several physical and mental health issues. So, hospitals with unnatural, bright, and harsh fluorescent lights can inhibit the normal cycle of rest and activity and have a detrimental effect on the patient's wellbeing.
Digital artwork is also on the rise, often used as a distraction in waiting rooms or treatment areas for children. Chelsea and Westminster Hospital commissioned the creation of the ‘digital zoo’. The ‘digital zoo' features digital moving portraits of 60 different animals ranging from gorillas to goldfish installed within the Children's Accident and Emergency Department. Results showed 79% reported improvement in their patient's perceived pain, and 67% reported progress on the time taken to complete a basic procedure. These are statistics that trickle up to not only lowering the strain on the child's wellbeing but alleviating parental anxiety to a large extent.
Alongside visual arts, we can also consider participatory arts within healthcare settings. Participatory arts can work across all art forms such as dance, music, film, visual arts, poetry, and crafts. Working with cultural organisations, activities in community and hospitals provide opportunities for people to engage with each other through their creativity which directly improves their sense of mental wellbeing. The arts can reduce stress and increase social engagement as well as provide opportunities for self-expression.
During my time at The Royal London Hospital, we invited the London Symphony Orchestra to play in the neonatal ward. As the musicians sang lullabies and played music to the babies, the nurses noticed that heart rates lowered and oxygen levels increased for some. This was not only beneficial for the babies, but the parents felt much happier and relaxed. According to the recent All-Party Parliamentary Group (APPG) on Arts, Health and Wellbeing 2017, engaging in participatory art workshops can dramatically improve physical and mental health. Singing has shown to alleviate chronic respiratory conditions and cystic fibrosis. Studies have found listening to music has beneficial effects on people with cardiovascular disease. There is also evidence that art therapies diminish the physical and psychological suffering of cancer and the side effects of treatment.
Over time, we have gotten used to bland and sterile clinical spaces, and we must change this. The idea that mental wellbeing is deeply related to physical wellbeing and recovery is not new, nor is their relationship with our immediate environment.
The quality of artwork and design in a space also subconsciously impacts the patient's perception of care and therefore experience, making it either a positive or negative one from the moment they walk through the door.
While we work towards acknowledging and learning more about the relationship between our physical and psychological health, there is so much we can already do to improve our spaces. We have taken some strides forward in the United Kingdom along with policy changes but there is so much scope for improvement and progress across the world. Perhaps we can start by making a conscious effort to enhance clinical settings with art and beauty and allow its positive impact on our mental health to speed up our physical recovery.