The arts may not always be good for us

In this special issue we celebrate the arts and how beneficial they can be for our health, however, it is important to remember that, like anything, we must engage with them in a safe and consensual way. Hilary Moss discusses the ways in which the arts can be experienced negatively.

Although my life’s work has revolved around promoting the health and well-being benefits of engaging in the arts, I also know that music can be harmful. The arts and health field tends to reinforce myths that need to be challenged, for example, that engaging in the arts does not necessarily make you a better person or always make you feel better. Music that is too loud, played repetitively or is politically offensive has previously been used as a form of torture and in concentration camps. ¹

Unfortunately, in my practice as a musician and music therapist, I have listened to descriptions by service users of well-meaning visiting musicians who have played at their bedside out of tune, too loudly, without asking permission and at an inappropriate time – in other words, musicians who have done harm, thinking they have done something good.

In 2019, Dingle et al. ² published a fascinating paper detailing the state of the field in singing and health research. Eighteen eminent researchers collaborated to produce a series of knowledge statements, issues and recommendations for future research regarding singing, health, and well-being. Current initiatives in my own research team in Ireland are reflective of international concerns.^3,4 Singing is known to have many health and well-being benefits, and a large body of high-quality work is growing in this area. The study by Dingle et al., ² along with the recent award-winning World Health Organization (WHO) report ⁵ on arts and health, is an example of rigorous, high-quality research in arts and health. However, what is rarely written about is the propensity for singing and music (and indeed any of the arts) to do harm or cause injury. Among hundreds of peer-reviewed papers on the health benefits of singing, only one was found in a recent review which offered negative associations with singing. ⁶

The beauty of music and arts in healthcare settings lies in their sensitive, appropriate use by highly qualified artists who adhere to standards of practice and ethical conduct. We need more guidance such as Dingle et al. ² to ensure that the arts are integrated into healthcare settings by qualified professionals and as part of a multi-disciplinary team approach. The arts can certainly improve health and well-being and are a powerful form of health promotion. In order to ensure sensitive, appropriate and optimum use for service users, staff, and informal carers, we need to be willing to explore and identify when the arts do not work or are used inappropriately and be prepared to do something about it.