“There has been a shift in perspective when it comes to how we can give patients access to culture. Just hanging something on the wall of a health centre, for example, is not enough. By using different presentation methods, the patient can gain a deeper, more enriching experience of art.” says Max Liljefors.

In 2019, the UN’s World Health Organisation (WHO) published the largest compilation of research findings to date, showing the positive and tangible effects that culture has on people’s health. According to WHO, your existential health influences how you experience your physical, mental and social health. But as far back as the mid-nineteenth century, Florence Nightingale was thinking along the same lines – that an aesthetically stimulating environment helped the sick in their healing process.

“The WHO report has caused ripples and raised awareness of the fact that fine art can have health benefits such as reduced need for doctor’s visits, fewer and reduced doses of medication, and faster recovery. But most of all, more joie de vivre and a better quality of life,” says Max Liljefors.

There is a long tradition of displaying art in healthcare environments. But if art and culture are to be a natural element of healthcare and social care, contributing to the wellbeing of patients, relatives and staff, a more effective model is needed. How can fine art help patients feel involvement, empathy and wonder, and in so doing help them to cope better with anxiety, chronic pain or the isolation that illness can bring? That is a question that animates Max Liljefors.

Needs to be well grounded

Region Skåne has a vast collection of artworks – almost 34,000. That is equivalent to a large municipal or regional museum. Yet unlike an art museum, which shows only a small percentage of its works to visitors since the rest is in storage, the majority of Region Skåne’s artworks are on display out in patient-facing organisations.

If you are looking to integrate art, more than it just hanging on the wall, that requires grounding and expertise among the staff.

“This is a huge resource that Region Skåne has invested in over the years, yet does not exploit to its full potential,” Max Liljefors suggests.

Region Skåne selected six different healthcare facilities which Max Liljefors then visited with an open mind to analyse how artworks are displayed and how this could be improved. The region’s Konstservice (Art Service) is responsible for buying art, curating and placing works with great consideration. A piece that might be appropriate in a psychiatric unit for children and young people may not be at all appropriate for a palliative care ward. But, when it comes to creating bonds between artwork, patients and staff, in a health centre for example, Max Liljefors sees great potential for improvement.

“If you are looking to integrate art, more than it just hanging on the wall, that requires grounding and expertise among the staff. Taking care of the artworks should be fun, there needs to be time for that and a clear structure to the work.”

Flexible model

Max Liljefors has produced a flexible model in three stages, which better captures the art, creating some interaction between patients, relatives and healthcare staff. First of all: what potential is there to see the artwork, to stand or sit in front of it? How are the premises used, where can patients stop a while, what do the waiting room and corridors look like? Where is there lighting, and where is there shadow? Based on these conditions, you can get a sense of what art is appropriate and where it feels natural to place it. Konstservice has expertise in these areas and this expertise needs to be combined with the other skills out there in the organisations.

“Circumstances differ. A health centre, for example, has a stream of patients who are there for a relatively short time, unlike an old people’s home.”

Step two: once the art has been placed in the right locations, some form of context is required. That could be as basic as a sign bearing the artist’s name, a more in-depth text or an audio guide that can contain both facts and reflections about the piece. Konstservice creates thematic collections, grounded in a holistic view of the organisations and their patient groups. This theme can and should be communicated to both staff and patients in an efficient way.

Arouse interest

The third step in the model is to present the art experience, to arouse interest in, and engagement with, the artwork. Max Liljefors feels that this is where the expertise of the healthcare staff and the art educators needs to be combined. The knowledge that healthcare staff already have in terms of interpreting and understanding patients’ signals and needs is very important, and that has to be activated in the exploration of the art.

“There is also a need for general development of those skills among healthcare staff. There will always be enthusiasts here and there. It is important that there is a long-term perspective and that healthcare facilities systematically integrate methods enabling staff to talk about art with their patients, according to the conditions in the various organisations. This is also raised in Region Skåne’s new strategic plan for culture and health from 2022-2030.”

Max Liljefors has also been involved in creating a unique contract education course that gives participants a better and deeper understanding of art, culture and aesthetics as an important resource in health and social care work. It is a course that has attracted a lot of applicants. Nurses and other healthcare staff as well as art educators learn about how creative and aesthetic experiences can be related in practice. Max Liljefors sees potential in the healthcare sector learning from the culture sector, and the other way around.

“Put simply, we want to bring our expertise in humanities together with the expertise they have within medicine and social care.”

Well-thought-out aesthetic design

As part of his work for Region Skåne, Max Liljefors visited the Forensic Psychiatric Centre in Trelleborg. Aesthetic qualities were central even during the building stage of this secure facility, which was inaugurated in 2016.. How do you create variety in sensory expression? Its physical form today is a well-thought-out flow of space, light and meetings with the natural world outside. The staff’s administrative accommodation faces towards the town and the sea, while the patients’ areas face the large courtyard as well as the open fields beyond. The aim was to follow the course of a day and the seasons of the year while the patients are able to have their privacy and not feel they are being controlled.

“The sense of space indoors and out, the field of vision – these aspects are part of the care that the inmates receive. It feels even more important since these people spend a long time in an environment in which they are locked up,” Max Liljefors explains.

In palliative care too, Max Liljefors has seen how attempts are made to create spaces for conversation and places to feel safe. The thoroughness with which one approaches the object and looks at each piece separately in terms of its colour and form.

“Pieces are of course perceived differently, depending on the surroundings in which they are placed.”

And at the psychiatric unit for children and young people, artwork had been chosen that represented dreams and freedom, rather than feeling secure.

“I feel optimistic when I actually see how the interest in, and understanding of, how art benefits health is increasing. The knowledge that culture and health go hand in hand is nothing new, but I can certainly see a greater awareness now, and more considered investments as a result.”