Effect of visual art on patient anxiety and agitation in a mental health facility and implications for the business case

Nanda, et al
Journal of Psychiatric and Mental Health Nursing
Volume 18, Issue 5, pages 386–393, June 2011

Accessible summary

  1. The study investigated the impact of different visual art conditions on agitation and anxiety levels of patients by measuring the rate of pro re nata (PRN) incidents and collecting nurse feedback.
  2. Visual art was displayed on a rotation basis on the walls of a small multi-purpose lounge for psychiatric patients in an East Alabama Hospital. Patients occupied this room during a 3- to 4-day stay while their psychiatric issues were addressed and diagnosed. The PRN data for the days on which different art conditions were displayed, was compared to the PRN data when no art was present. Interviews with the day and night shift nursing staff were conducted.
  3. Results showed that PRN medication dispensed by nurses for anxiety and agitation was significantly lower on days when a realistic nature image of a landscape was displayed as compared to days when abstract art, abstract or no
    art was displayed. Cost of PRN medication was compared for the different conditions establishing a financial case an annual cost saving of $US4000–27 000, depending on type of art selected.
  4. The study concluded that positive distractions, like visual art depicting restorative nature scenes, could help to reduce mental health patients' anxiety and agitation in healthcare settings. It also makes a case that the environment can have a powerful impact on healing and must be explored further for the mental health setting.


There is a growing body of evidence on the impact of the environment on health and well-being. This study focuses on the impact of visual artworks on the well-being of psychiatric patients in a multi-purpose lounge of an acute care psychiatric unit. Wellbeing was measured by the rate of pro re nata (PRN) medication issued by nurses in response to visible signs of patient anxiety and agitation. Nurses were interviewed to get qualitative feedback on the patient response. Findings revealed that the ratio of PRN/patient census was significantly lower on the days when a realistic nature photograph was displayed, compared to the control condition (no art) and abstract art. Nurses reported that some patients displayed agitated behaviour in response to the abstract image. This study makes a case for the impact of visual art on mental wellbeing. The research findings were also translated into the time and money invested on PRN incidents, and annual cost savings of almost $US30 000 a year was projected. This research makes a case that simple environmental interventions like visual art can save the hospital costs of medication, and staff and pharmacy time, by providing a visual distraction that can alleviate anxiety and agitation in patients.

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