Since the early 2000s it has been standard practice to consider the psychosocial properties of healthcare environments.  The King’s Fund’s Enhancing the Healing Environment programme, involving more than 250 health and care settings, put patients at the heart of design and highlighted the role that the physical environment can play in supporting innovation in service delivery and in improving patient experience.

The WHO Scoping Review provides evidence that artworks in hospitals can reduce stress whilst participatory ats activities in a hospital setting improve patient experience. Where artists are involved in design teams they can form connections between communities, patients and the hospital, helping create spaces and activities in which people can gather, reflect and connect.  Art and design in buildings can provide a positive distraction and increase a sense of calm. Bringing music, dance and poetry into clinical spaces can reduce anxiety. There is also evidence of increased retention of staff and reduced aggression towards them. Sacred spaces in hospitals and hospices provide respite from the medical, allowing stillness, reflection and contemplation, with artistic environments that provide a shelter for the spiritual aspects of humanity.

In support of the role of hospitals as anchor institutions, hospital arts programmes can connect with the wider community, form partnerships and provide patients with routes to social prescribing once discharged.

The reform of the Mental Health Act aims to provide for the protections and support for people with severe mental health needs, which will strengthen their voice, choice and rights, support the increased use of community alternatives to hospitals, limit the use of the Act for people with learning difficulties or autistic people, improve support for offenders with acute mental disorders, and reduce the racial disparities that have too long been part of the way the Act has been used.

Significant inequalities exist in experiences and outcomes of mental health services, which the NHS Advancing Mental Health Equalities Strategy aims to tackle, including the development of culturally appropriate advocacy through a competency framework aimed to improve ethnic minority community experiences of care in mental health services. There is significantly more use of the Mental Health Act for some ethnic minority groups, which is in part the result of barriers to seeking help at an earlier stage. 

Culturally-specific and targeted Creative Health programmes have been shown to be successful at engaging particular groups, enabling early intervention. A three-year study of an arts-based collaboration with Avon and Wiltshire Mental Health Partnership NHS Trust found that that the arts enhanced valued features and diminished negative aspects, and created opportunities for service users and staff to assert control and affirm non-stigmatised identities.

The Care Quality Commission encourages care homes to provide meaningful activity, in recognition of the need for older people to spend time purposefully and enjoyably. Creative activities can support many of the Skills for Care check list for achieving outstanding care, from introducing innovative ways to involve people and voice their opinions to embracing cultural difference, promoting independence and autonomy.

The report Arts and Culture in every care home? by the National Activity Providers Association notes that creative expression is essential in the lives of care home residents and integral to wellbeing. For instance during Covid-19 the creative arts were used to encourage connection and express loss and grief. In a report by the Baring Foundation: Creative Homes: How the arts can contribute to quality of life in residential care, the participatory arts were seen to help maintain physical health and flexibility as well as cognitive functioning and a sense of identity. A large number of museums and galleries deliver programmes with care homes to use heritage objects to engage people in reminiscence and tactile story telling, including for people with dementia. Arts organisations work with care homes to deliver training to staff to deliver creative activities with confidence, also benefitting staff wellbeing and retention.