Caring for the carers through the arts

The situation in Europe  

In Europe, the health of doctors, nurses and healthcare professionals is becoming an increasingly critical issue. Healthcare personnel are frequently expected to work extended shifts, to be continually on-call and to manage emergencies – as well as to handle both intensive workloads and emotional loads: a series of factors that demand a very high price, both psychologically and physically.

The MeND survey - one of the most in-depth on doctors’ and nurses’ mental health - was published in 2025 by the European regional office of the World Health Organisation. The survey received 90,171 valid responses across the 27 EU member states, as well as in Iceland and Norway, and raised concerns for the state of caregivers’ mental health. 

The results show that very long working hours – with one doctor in four working more than 50 hours per week – and episodes of aggressive behaviour from patients form part of the day-to-day experience of a significant number of professionals. Such conditions are closely associated with worsening mental health. About one operator in three reports symptoms attributable to burnout, anxiety or depression, and one in ten says they have considered self-harm. Doctors and nurses report twice as many suicidal thoughts as the general population.

Nurses: a category that is particularly exposed     

Nurses are one of the most vulnerable categories of healthcare workers. Symptoms of depression affect about 32% of nurses, slightly higher than for doctors. This is linked to the fact that nurses are the most numerous category within the healthcare workforce and spend more time in direct contact with patients, often in highly emotional circumstances.

Such symptoms fuel the desire to leave the profession, consisting of between 11% and 34% of those working in healthcare, with major repercussions for the healthcare sector: longer waiting times, reduction in the quality of care and a loss of essential skills. Forecasts indicate that, by 2030, in the absence of appropriate measures, Europe could be facing a shortfall of about 940,000 healthcare workers.

Looking after the mental health of healthcare providers is not just an ethical duty to professionals, but a priority to safeguard the effectiveness and efficiency of healthcare services. Within this context, the arts, often associated with patient care, are a useful tool for taking care of healthcare workers, supporting their emotional wellbeing and creating space for good sense in an environment that is overloaded with urgency, emergency, protocols and procedures.

As philosopher of care Elena Pulcini said: “Looking after oneself is a prerequisite to looking after others”.

How the arts heal (even doctors)  

The American Art Therapy Association points out that the use of the creative process, combined with approaches based on psychological and behavioural science, within a therapeutic relationship, aimed at promoting individual and collective wellbeing, can provide a safe space for emotional expression and regulation for healthcare workers.

A recent review published in 2024 by Kelly Sarah Barnett and Fabian Vasiu (Balance Medical Center, Vancouver) analysed the available knowledge of neural mechanisms through which the creative arts generate beneficial effects for mental and physical health.

The collected data indicate that, during active or passive creative engagement, brain circuits involved in adaptive emotional regulation are repeatedly activated. Specifically, this involves the medial prefrontal cortex (mPFC), an area associated with self-reflection, with controlling emotional responses and with the capacity to process experience, and also involves the amygdala, a key structure in the response to emotional stimuli.

This combination of brain activations is similar to that observed in the use of strategies for emotional regulation. All this suggests that creativity and emotional processing share common neural networks: when painting, dancing or listening to music, it seems the brain activates the same pathways that it uses to modulate intense emotions and give them meaning.

Specifically, artistic creativity is often associated with a significant reduction in the levels of cortisol, an indicator of stress, including in people with no particular previous artistic skill. Moreover, music therapy has been associated with an increase in the parasympathetic tone – that is, the “calming” component of the nervous system – and with a fall in inflammatory catecholamine and cytokine, substances linked to the body's stress response and to its inflammatory processes, respectively. This translates into the general effect of relaxing the body and reducing the state of physiological hyper-activation typical of chronic stress.

Studies confirm that the benefits are not only immediate, but also persist and sometimes increase over time, improving emotional intelligence – that is, the capacity to recognise, understand and utilise the emotions adaptively – above all in conditions in which emotional regulation is compromised.

The role of art therapy according to the scientific literature 

In 2023, a group of researchers from Queen Mary University, London (Megan Tjasink, Eleanor Keiller, Madison Stephens, Catherine Elizabeth Carr and Stefan Priebe) published a systematic review of art therapy-based interventions targeted at healthcare workers suffering from burnout or psychosocial distress.

The review included studies from thirteen countries over five continents, and a total of 1,580 participants, with nurses extensively represented (about 60%). Almost all the interventions were conducted in groups, with most carried out by qualified art therapists. Nearly half the studies were published during the last five years, evidence of the growing interest in this topic.

The long-term benefits of the arts on health   

An analysis of the results revealed considerable efficacy in three main areas: emotional exhaustion associated with burnout, work-related stress and mental health issues. Alongside the quantitative data, the accounts given by the participants shed light above all on a reduction in stress and an improved processing of emotions. The chance to “give shape” to emotional experiences through artistic language was found to be one of the key mechanisms for change.

Additional important aspects also emerged, such as the possibility of developing new perspectives of oneself and one's work, greater proactivity in implementing positive change and the perception that creativity encourages both personal intuition and the ability to actively address problems. In several cases, the participants described a regenerating effect and a reinforcing of self-healing practices, factors that help to explain the drop in emotional exhaustion. In some studies, the benefits endured over time, maintaining or further reducing levels of burnout at follow-ups over subsequent weeks.

A meta-analysis in 2024 on the efficacy of art therapy in enhancing the mental health of clinical nurses, conducted by a team from the School of Nursing, Health Science Center, Xi’an Jiaotong University (Na Zhang, Shuoxin Chen, Qing Li, Zhiqiang He and Wenhui Jiang), assessed the results of 19 randomised controlled trials (RCTs) involving 1,338 clinical nurses overall.

The quantitative analyses show that art therapy is associated with a notable fall in levels of anxiety, measured using the Self-Rating Anxiety Scale (SAS), along with reductions in symptoms of depression and in perceived stress, assessed using the Chinese Perceived Stress Scale (CPSS). It also emerged that art therapy can have a positive influence on nurses’ coping styles, reducing maladapted ones and reinforcing those that function well, helping to strengthen personal resources in addressing the challenges of clinical work. 

Embedding the arts into care services

To conclude, safeguarding the mental health of those working in healthcare should not be treated as a marginal or individual issue. Arts-based interventions are concrete tools to support professionals’ physical, mental and emotional health. In recognising their value, we must pave the way for policies and practices able to embed such experiences into healthcare contexts, addressing not only an ever more widespread malaise, but also the long-term sustainability of the treatment, relationships with patients and their families and the capacity to work in increasingly multidisciplinary teams.

By Catterina Seia (Presidente CCW – Cultural Welfare Centre) and Elena Rosica ( Cultural Welfare Center (CCW), Research Area)

Further reading: 

• Catterina Seia and Elena Rosica, Art and health: a proven connection, 25 April 2025;

• Catterina Seia and Elena Rosica, Graphic Medicine: a powerful health education tool, 27 February 2025;

• Catterina Seia and Marta Reichlin, CultureForHealth: 8 major social challenges that art and culture can overcome, 27 December 2022;

• Catterina Seia and Rossella Failla, Narrative medicine: from theory to clinical practice, 27 September 2022.