Cultural policy as a governmental proxy tool for improved health: the Swedish National Board of Health and Welfare’s collaborations with cultural workers 1970–1975

ABSTRACT

This article highlights cultural policy as a governmental proxy to address political matters beyond the cultural domain – here civil health – and the need to problematize and historicize ‘arts in health’ policies. The article centres on the Swedish National Board of Health and Welfare’s collaborations with cultural workers 1970–1975, framed by three contextual developments: politicization of the cultural sector, call for innovative governmental information, and changing character of health information. Theoretically, the article draws from the field of cultural policy research, with an emphasis on historiographical perspectives. The result shows that despite interdependence, the collaborations were an arena where interests clashed. The main conflict lay in what art should seek to change for the better: society or its citizens? However, the conflicts were also due to a mixture of roles: the agency suddenly found itself a patron of the arts, and the cultural workers producers of governmental information.

KEYWORDS:

• Cultural policy
• Sweden
• health information
• arts in health
• participatory documentary

Introduction

In July 1971 a young drug offender, incarcerated at the Hällby correctional facility near the Swedish town of Eskilstuna, finds himself standing, unguarded, on the other side of the 20-foot concrete wall usually separating him from the outside world. On the call for ‘action’, he franticly runs toward the nearby forest. Trying to keep pace behind him is a documentary filmmaker carrying an 8 mm camera. After running half a mile through the rough terrain, they calmly walk back into the pen, having cinematically re-created the beginnings of a recent actual getaway scenario. This unusual event, resulting in the short film The Breakout (Flykten), was part of a number of state-funded projects implemented in the early 1970s by Swedish healthcare and treatment agencies, in which more or less professional cultural workers were engaged to create new forms of imaginative health information material, as well as finding ways to use cultural creative activity to therapeutically counteract drug abuse. Employing cultural policy as a government tool for improved civil health was, however, far from friction-free.

The idea that cultural activities can be used as a tool to improve people’s health is today a heated topic, sometimes referred to as ‘arts in health’ (e.g. Cox et al. 2010; Hartwell 2013; Hamilton et al. 2014; Fancourt 2017; Sonke et al. 2018). Research in this field often centres on practically oriented perspectives. For instance, rehabilitative aspects of using art experiences in healthcare services, the measurability of whether the experiences of consuming art – reading novels, going to the cinema, listening to music, etc, – has an effect on the patient’s health, and how to define best practice (e.g. Sigurdson 2015; Dewey Lambert and Sonke 2019). Such practically oriented research has a value in its own right. However, we argue that there is also a need to historicize and problematize the potentially conflicting values, goals and outcomes that might occur in the merger between policymakers and health authorities on one side, and the cultural workers utilized by policymakers and authorities on the other. A historical perspective is here useful to show that things we today might take for granted – clowns in children’s hospitals, handcraft workshops in elderly care, painting classes for interns – are not given but historical constructs, often preceded by discussions and negotiations between the actors concerned.

The aim of this article is to critically study how Swedish cultural policy was used as a government tool to address other political matters beyond the strict cultural-artistic domain – in this case the issue of improved civil health. Furthermore, the article aims to highlight how government agencies not primarily associated with cultural policies and/or cultural practitioners still used such policies and practitioners as a way to operate. The research problem revolves around the assumption that actors within the state healthcare and treatment sectors, and practitioners within the cultural sector are not necessarily driven by the same set of motives, ideals and objectives. Collaborations between these sectors can thus be delicate and generate negotiations and potential conflicts. Such disagreements can, in turn, influence the results in decisive ways, sometimes thwarting the original purpose. Based on these assumptions we draw theoretically from the field of cultural policy research, with an emphasis on historiographical perspectives to inform our qualitative analysis. As an illustrative empirical study object, the article primarily focuses on the Swedish National Board of Health and Welfare’s (Socialstyrelsen) collaborations with cultural workers, more specifically visual artists and filmmakers, between 1970 and 1975.

The time period in question constitutes an important and formative phase in regard to three contextual developments. Firstly, as an effect of the radicalization of society, the cultural sector was heavily politicized and many artists perceived art as a tool for social critique and change (Östberg 2008, 343). Secondly, the period is characterized by an escalation and implementation of renewed governmental information policies, which called for increased and more innovative information about laws and recommendations from state agencies to citizens (Norén 2019a, 38–47). Thirdly, health information was changing in character, away from presentations of strict medical research, at the same time as the perspective of what constituted health broadened to include various social phenomena (Sundin 2005, 428). We argue that these contextual developments were crucial to why the actors included in this study considered it beneficial to collaborate. Based on these starting-points, the article tries to answer the following research question: What kind of agreements, conflicts and results were generated by the collaborations between the state healthcare and treatment sectors and Swedish cultural workers?

For the analysis, two case studies represent different approaches regarding how cultural workers were used in the service of civil health improvement. The first study concerns how the National Board collaborated with visual artists as a means to produce creative public health information. The second focuses on how the same agency, in liaison with the Swedish Prison Service (Kriminalvårdsstyrelsen), collaborated with filmmakers in a non-public project that enabled incarcerated prisoners to collectively make films with the therapeutic purpose of improving their individual health. However, the two diverse approaches shared an overarching informative and behaviour-changing goal: to make citizens reflect on, and improve, their individual lifestyle and health.

Empirically, this article mainly utilizes archive material from the National Board that relates to the collaborations with cultural workers during the early 1970s. This material includes correspondence as well as internal reports and meeting minutes. Due to scarcity of historical documents from the actual events, the analysis is also based on reconstructions of the collaborations written a few years after the events (especially found in the National Board’s journal H-rapport from 1978). This, and the use of the agency’s own archive, creates a historical bias that, to some extent, lacks a comprehensive perspective from the cultural workers’ point of view. However, complementary material such as newspaper articles and artistic outputs such as films, posters and photos of exhibition material have also been integrated in the analysis. Furthermore, for the second part of the analysis, we have used the private archive of one of the filmmakers. The methodological approach resembles an argumentation and idea analysis as a way to unearth and make sense of explicit and implicit patterns and statements that highlight positions and actions taken by cultural workers and health bureaucrats (Boréus and Bergström 2012; Bergström and Boréus 2012).

Collaborations between cultural workers and state agencies became common as an information strategy in Sweden during the 1960s and 1970s. However, research about these activities is sparse. One exception is Ingrid Ryberg’s (2018) study of two late 1970s amateur film projects – emanating from the lesbian and gay liberation movement and backed by the National Board – and how the projects were shaped by the official sexual policy-making in Sweden at the time. Another example is Lars Diurlin’s (2019) study of how the Swedish International Development Authority sought to enhance public opinion regarding its foreign aid policy by supporting Swedish films about aid-receiving countries. Fredrik Norén’s (2019b) case study about how the state utilized, among others, various cultural actors and organizations to promote the changeover to right-hand traffic in 1967 is a third example.

The article will continue with a section that discusses theoretical research perspectives on cultural policy, with a particular focus on Sweden. Thereafter, the article moves on to elaborate on the three contexts – cultural climate, governmental information policy and health information – from which the collaborations between the state healthcare and treatment sectors and Swedish cultural workers should be understood. In the analysis, the two empirical cases of collaborations with visual artists and filmmakers are discussed in regard to what conflicts, understandings and outcomes the collaborations generated.

Cultural policy research and cultural policy in Sweden

Research on cultural policy is often described as an interdisciplinary field. Disciplines within the social sciences, for example, tend to focus on such policies’ economic role, modes of implementation and differences between regions and countries. A cultural studies perspective instead emphasizes issues of representation, cultural identities and the role of culture in society in general. Cultural policy research that stems from the humanities, as a last example, often emphasizes the history and historiography as a means of understanding present and future policies (Scullion and Beatriz 2005, 122). Belonging to the third category, this article aims to contribute to the history of the field by presenting a neglected research angle: cultural policy as a government proxy tool to solve non-cultural issues, in this case improved health. Furthermore, we are informed by critical cultural policy research, which takes an interest in how policies might produce different and unexpected outcomes, rather than focusing on the implementation process and policies that have succeeded (Lewis and Miller 2003, 2). We also share Roger Blomgren’s call to implement more critical cultural policy studies that further scrutinize the supposedly arm’s length distance between institutions, organisations and cultural workers in welfare states (Blomgren 2012, 528).

In their book Cultural Policy, Toby Miller and George Yúdice define cultural policy as ‘the institutional supports that channel both aesthetic creativity and collective ways of life’ (Miller and George 2002, 7). More concretely, the cultural policy could be described as various governmental strategies to promote production, dissemination, marketing, consumption and preservation within the cultural industries (commercial and non-profit), the humanities, as well as the cultural heritage sector. Cultural policy is often associated with the fostering of good (national) culture, explicitly or implicitly (Mulcahy 2006, 320–322). This is by no means a non-controversial or neutral matter. On the contrary, as Peter Duelund has put it, the cultural policy field is a constant ‘clash of interests between different strategies and motivations in society in general and in the cultural field in particular’ (Duelund 2008, 11). The development of cultural policies thus always reflects ongoing debates regarding different values, ideas and methods that are thought to be important in shaping such policies.

In the Nordic countries, especially since World War II, cultural policies have been characterized by governments that promote art and culture as a means to establish and uphold artistic freedom and so-called cultural democracy – that is, the idea that everybody should have the ability to enrich their life with ‘good’ art, as defined by governmental cultural institutions (Blomgren 2012, 519). These goals should be understood as included in the general mission of a subsidizing welfare state (Mulcahy 2001, 3–4). This model, often distinguished by social-democratic rule, has further been shaped by corporatism between the governmental sector and the cultural sector (Mangset et al. 2008, 1). Regarding the 1960s and 1970s, Duelund argues that cultural education of citizens rose to a national interest, and thus ‘[f]unding the arts and similar cultural activities was seen as an instrument in the hands of politicians’ (Duelund 2008, 14).

In Sweden, the period between 1932 and 1976 was dominated by social-democratic governments, step-by-step, constructing a ‘hegemonic Folkhem model’ – as Anders Frenander (2007) describes it – which had a major influence on the formation and implementation of cultural policies. It should be mentioned that we are informed by the argument put forth by My Klockar Linder that the Swedish term for cultural policy (kulturpolitik) is an unstable category, containing a multitude of usages and meanings, and should therefore be studied empirically and historically. Hence, what was meant by kulturpolitik in the 1970s was not necessarily the same as in the 1930s (Klockar Linder 2014, 164–167).

During the inter-war and immediate post-war years – which can be categorized as a pre-history regarding the establishment of Swedish cultural policy with a slowly escalating formative debate on cultural issues – the social-democrats nourished a rather conservative attitude towards cultural heritage. Emphasis was put on adult education and distributional aspects to increase citizens knowledge of, and access to, a supposedly better and more refined (and paradoxically high bourgeoise) cultural life (Larsson and Svenson 2001, 87; Frenander 2007, 394, 2014, 75–102). Still, people’s cultural practices and preferences were generally considered an individual matter, detached from politics. The social-democratic thesis was that people would automatically engage in cultural activities once their finances were secure and leisure life extended (Frenander 2007, 399, 2014, 119).

In the midst of the construction of the welfare state in the late 1950s, however, the credo of increased public engagement in cultural activities was rudely refuted, as both commercial popular culture and public service television entered into the equation. The government about-faced and gathered it had to intervene, and initiate support for the production of ‘quality’ culture, as well as including its national artists and cultural workers in the same social safety net that had been designed for industrial workers. Hence, the cultural sphere was to be integrated with other societal affairs. During the following decade, several essential cultural policy enterprises were launched such as artist grants and various protective institutions. Cultural workers needed what was labelled ‘institutional recognition’ so that the welfare state could ‘provide for its own radical critique’ – as chief social-democratic cultural policy initiator Roland Pålsson phrased it in 1967 – prescribed to socially balance an inferior and mind-dulling commercial culture (Pålsson 1966, 18, 1967, 10; Diurlin 2017, 137–143). The cultural policy discourse of the 1960s, therefore, came to emphasize new and often experimental forms of contact between artists and citizens, where art was to have more of a utilitarian social function, somewhat overriding its potentially aesthetic values. These views of cultural balance, participatory outreach, and focus on local and amateur activities later came to constitute the foundation behind the so-called new cultural policy of 1974, containing a broader concept of culture and that of ‘cultural democracy’ (Larsson and Svenson 2001, 88; Frenander 2007, 400–401; Duelund 2008, 15–16; Blomgren 2012, 527).

Three contextual processes: (1) the cultural climate around 1970

A common description of how Swedish artistic and cultural life evolved during the course of the 1960s is that of a left-wing radicalization process from aesthetics to politics. The radical shift – in both cultural practice and its surrounding discourse – has been said to have taken place halfway into the decade (Lagerlöf 1975, 15; Frenander 1999, 138–144; Östberg 2008, 341). While an artistic manifestation in the early part of the 1960s usually commented on the artistic process itself, a cultural expression in the latter part was most likely engaging in social politics and/or seen through an ideological prism in the contemporary cultural debate climate. Not only a national phenomenon, this cultural politicization had its equivalent in similar global developments as the swedish discourse more or less fed upon issues high on the international agenda, such as the Vietnam war, civil rights, decolonization and Third World solidarity, and student activism for the democratization of education (Östberg 2008, 340).

As discussed by Klockar Linder (2008) and Frenander (2014, 144–146) in a Swedish context, one can even speak of a gradually transformed comprehension of what might be contained in the term culture, changing from a mainly aesthetic to a broader anthropological meaning – closer to ‘a whole way of life’ as Williams (1960, 344) famously coined it. Still, as has been pointed out by Nylén (1998, 17) and Christer Ekholm (2016), the two seemingly opposite cultural approaches dividing the 1960s also had significant similarities. Both shared a participatory focus, appraising and including the public in the cultural realm as part, and sometimes co-creator, of the work of art.

As the radicalization process progressed, cultural workers voiced a need to encounter and portray the everyday concerns of ‘real’ people in an ambition to use culture to build a better society (Bergman 2010, 47–50). Stemming from this approach of participatory outreach and highly symptomatic of the cultural climate during these years, a number of so-called centres were independently initiated from 1967 to 1970, such as Writers’ Centre, Visual Artists’ Centre, Film Centre and Theatre Centre. Two main objectives lay behind their creation (Lennerhed 2005, 18, 27; Östberg 2008, 343; Bergman 2010, 100). One was to evade the financial intermediaries in the preferably non-commercial reciprocal contact between artist and audience. The other was (somewhat paradoxically considering the first notion) connected to the grim labour market conditions for cultural workers. The centres were thus structured as independent labour agencies helping artists to find audiences as well as potential revenues. The objectives of the centres did indeed echo much of the abovementioned cultural policies being simultaneously elaborated by the incumbent social-democratic government.

The expansion of governmental information

Research shows that when the size and complexity of a democratic state increases, so does the flow of information between state and citizens (e.g. Higgs 2004, 149–157). This was especially true for the Swedish welfare state, which after 1945 experienced an extensive increase in social reforms as well as ambitious ideas regarding the state’s responsibility for its citizens. Here, information was perceived as an important governmental instrument to steer society in desired directions, but also as a tool for citizens to exercise their influence in society (Kjellgren 2002, 136–137).

During the 1960s and 1970s, several Western countries legislated information policies that, for example, stipulated the citizen’s right to access public documents, for example, the Freedom of Information Act in the US (Browne 1997). Sweden, however, and the other Scandinavian countries were historical pioneers regarding freedom of information laws, and governmental documents were thus already accessible (Anderson 1973). Instead, the formative public discussion on governmental information policies around 1970 centred on how Swedish state agencies should actively provide people with information about laws, regulations and recommendations, through campaigns, advertisements, brochures, etc. (Kjellgren 2002, 295–300). This discussion should be understood as part of a general discourse around demands for increased citizen participation in society, in which information was regarded as a tool for emancipation (Norén 2020). Similar arguments also echoed in countries where the discussion only centred on the accessibility of public documents, for example, in West Germany (Vismann 2017 [2001], 280).

Around 1970, information from government agencies was often criticized for being underdeveloped and old-fashioned. Hence, one widespread argument in the public discussions read that state agencies should align their external communication to citizens’ expectations of contemporary communication. Several public authorities did adapt their information policy, and in some cases even modified campaigns according to the principles of the advertising industry (Norén 2019a, 43–46). One such agency was the National Board of Health and Welfare.

The broadening of health information

Health policy was a growing political topic during the Swedish twentieth century, with increased state interventions in the healthcare sector, especially from the 1930s to the 1980s. Since issues regarding civil health were often situated within the voluntary sphere of politics, governmental education and information became a vital tool for the health authorities (Sundin 2005, 408–432; Palmblad and Eriksson 2014, 60–85). The strategies to present and disseminate health information did, however, change over the course of the century. In the first half of the century, health information was often presented as strict medical research. Later, in the second half, health information in Sweden – as in other welfare state-oriented countries – increased into a field of converging disciplines, with inspiration taken from, among other fields, psychology, pedagogy and marketing (Palmblad and Eriksson 2014, 184; Bergenheim et al. 2018, 6).

In the 1960s, Swedish health authorities made a similar discovery that had been made in the nascent field of cultural policy in the late 1950. People did not change their behaviour on account of exposure to scientific health facts (Palmblad and Eriksson 2014, 60–61), just as people did not automatically engage in ‘finer’ cultural activities once the welfare state had secured a more financially sound leisure life. During this time, lifestyle marketing was an emerging trend in the United States, gradually imported into Sweden and other European countries, resulting in health information becoming more focused on emotion-driven ways to promote a better way of life of the individual (e.g. Berlivet 2005; Pykett 2019, 54–55). A related aspect of this development was that the concept of health was (once again) broadened (cf. Sigurdson 2015, 13). The National Board of Health and Welfare’s production and distribution of health information saw its responsibility increase to include, for example, diet and exercise, as well as ‘sex and human relations’ (Norén 2018, 241). Furthermore, as a symbol of the broadened perspective on health – as well as of how medicine and the social field were interlinked – the National Board of Medicine merged into the National Board of Health and Welfare in 1968.

Initiating collaborations between the National Board of Health and Welfare and cultural workers

A certain unit within the National Board of Health and Welfare was responsible for health information – the Delegation on Healthcare Education (Hälsovårdsbyrån). In 1968, as newly appointed Director General of the National Board, Bror Rexed gave an encouraging speech to the Delegation’s management team about the future direction of health information:

The human being knows how to improve her health and protect herself, but she does not make use of the knowledge she possesses. The Delegation on Healthcare Education’s task is to constantly convey the knowledge that exists and to convince of the necessity to utilize it, to make people understand the meaning of health information. [–] Therefore, we are in need of constructive, imaginative proposals regarding how to push the propaganda.¹

This rhetoric was an echo from the ongoing public discussions about improved governmental information (Norén 2020). One important reason for this approach, the Director General argued, was to show how health information could ease the increasing cost of healthcare. Rexed’s call for more creative health information should be understood as the beginning of an experimental era regarding what health information could be and do. This period reached a zenith in the first half of the 1970s, a period when the Delegation engaged in various campaign collaborations with for-profit and non-profit organizations (Norén 2018). One collaborating category was between the Delegation and cultural workers.

In 1970 Kjell E. Johanson was appointed administrative officer at the Delegation. A teetotaling devout Christian as well as an outspoken communist and a social commentator particularly engaged in the impact of narcotics and alcohol, Johanson became a key figure in the push towards the agency’s collaborations with cultural workers. During that year, the Delegation established contacts with representatives from the cultural sector, which can be seen as a step towards a merger between health policy and cultural policy. It was both a strategy to generate the new and potential ‘imaginative proposals’ that Rexed had called for, and to economically support unemployed cultural workers, in line with the social-democratic cultural policy of institutional recognition. A formative meeting was held in October where independent cultural organizations were invited to discuss collaborations related to the social impact of using alcohol and drugs. Among the participants were representatives from the newly formed centres.²

Several participants were positive towards collaboration with the Delegation, particularly in connection to how their work could contribute to the greater good of civil health. Bernt Rosengren, for example, an author representing the Writers’ Centre, later wrote an article for the National Board’s journal Socialnytt, in which he stated that the establishment of the independent centres had shown an urge from cultural workers to break their ‘isolation’ and contribute to society in new ways (Rosengren 1971). His line of argument is typical of the aforementioned desire among Swedish cultural workers of the 1960s and 1970s to be part of building a better society. Rosengren further claimed that an important step in that direction was the increased use of cultural workers in the production of governmental information, as a means to nuance complex social issues and to make citizens take a stance. In an interview with representatives from the Visual Artists’ Centre, conducted by the Delegation, they argued, with a similar logic, that artists should partake in societal development (Arenander 1971).

The shared desire to collaborate should be understood as a combination of mutual ideas and interdependence. Both saw the potential in how cultural expressions could serve the public good. Regarding the interdependence, on the one hand, the Delegation sought support to produce creative information. This was difficult, and to some extent ethically problematic for the agency to put together in-house. Hence, similar to other Swedish state agencies at that time, the Delegation saw a potential in using cultural workers as proxy information creators (cf. Diurlin 2019). The cultural workers, on the other hand, saw the Delegation as a patron that could provide vital funding for artistic projects. The latter also connects to the abovementioned tradition of cultural policy measures to provide for cultural workers in Sweden. However, and as the analysis will show, conflicting interests lurked beneath the surface.

Art as health information – collaborations with visual artists

The collaborations between the Delegation on Healthcare Education and the visual artists took shape as three separate projects: two poster projects (1971 and 1975) and one art exhibition (1973) – initiated and financed by the Delegation, sometimes in collaboration with other public agencies. The goal of the projects was to generate public campaigns aimed at promoting a healthier lifestyle among citizens.

The first poster project stems from a meeting at the Visual Artists’ Centre in Stockholm in late October 1970, led by Johanson from the Delegation. The meeting resulted in the idea of getting 10 artists to each make an A3 poster on the theme of the negative health impacts of drug use and alcohol consumption. In both poster projects, some 1000 copies were produced, distributed and used for educational purposes, for instance at courses and conferences, at information meetings and at youth centres (Nämnden för hälsoupplysning 1978, 3).

Early on, the Delegation gave the artists an autonomous mandate ‘with possibilities for a very broad interpretation’ of the topics in question.³ At the same time, however, the agency stressed three entangled causes behind drug abuse: the drug, the individual and the environment. This wide perspective echoed how the National Board of Health and Welfare framed the concept of health and conducted health campaigns in general (Norén 2018). Despite a mutually open dialogue between artists and health bureaucrats, this ambiguity also affected the outcome (Nämnden för hälsoupplysning 1978, 15; Johanson 1978, 27). In fact, if one is not aware that the project concerned the negative impact of drug abuse, it is very difficult to distinguish this theme in the finished posters. For example, the poster by Kerstin Abram-Nilsson showed a happy turtle along with the phrase ‘Take care of your sensibility’. Another, by Helga Henschen, featured a painted loving couple with the accompanying text ‘We have to hold each other so as not to fall’. The few posters more explicitly referring to narcotics strongly emphasized the third cause of drug abuse: the impact of the social environment. Anders Jirås’ poster, for instance, had the telling caption: ‘Mental problems – solution: Administering drugs?’ followed by ‘Social problems – solution: Drugging oneself?’

Indeed, the outcome of the first poster project had a mixed reception and was interpreted in various ways by groups who were exposed to the images (Johanson 1978, 28). This was partly a consequence of the shared desire not to generate images that displayed the explicit horrors of drug abuse. For example, it was stated in an appendix that the posters ‘do not moralize; they are rather intended to inspire or contribute to, or deepen our awareness of, problems that obviously exist, problems whose solutions are not unambiguous’ (Lindberg 1978, 32). However, the mixed reception should also be understood as a result of the Delegation’s view that it was difficult, and problematic, to make clear distinctions between activities such as health information, advertising and opinion-making.⁴

During the second poster project, which also focused on drug abuse, tensions between the Delegation and the new group of visual artists were more palpable. This time the Delegation declared that the second campaign should be more grounded in the health expertise authorized by the National Board (Sjöstedt 1978, 33). Still, the agency required artworks that were ‘exciting, interesting and stimulating’, and which at the same time emphasized a comprehensive health perspective.⁵ The question of what causes drug abuse again became the main conflict in the collaboration. According to Johanson, several of the artists overemphasized the impact of ‘the economic structure of society’ (Johanson 1978, 29). Hence, from the artists’ perspective, it was society’s social structures that primarily caused problems, not the substances in themselves. This time the posters took an explicit political stand against capitalism, commercialization and the establishment in general – ‘Someone profits from your passivity’, ‘Addict = social product’ and ‘Attack the causes, not the people’ were some of the poster slogans targeting the problems related to drug abuse. This was a standpoint that the National Board could not accept, as it did not want to support a ‘mock debate’ on health.⁶

Still, the agency chose to continue with the project (although two artists withdrew) with the argument that each individual work represented an aspect of a comprehensive health problem. In retrospect, however, Johanson summarized the second poster project as ‘blatant, brimful of slogans. It presents ready-made answers for the audience’ (Johanson 1978, 30). The outcomes of both projects were marked by vague and contradictory terms between patron and supplier. Since the Delegation had taken a stance in favour of using interpretative and creative art in health information, it was difficult to completely dismiss the result even when it turned out to be questionable.

During the poster projects, the tension between the Delegation and the artists lay latent, surfacing just occasionally. However, frictions unfolded into an open conflict during the art exhibition on health in 1973. This project was initiated and financed by the National Labour Market Board (Arbetsmarknadsstyrelsen). The National Board – in collaboration with various local authorities – was delegated the task of creating and implementing the exhibition For Health Reasons (Av hälsoskäl), for which it would engage the services of 12 unemployed visual artists.⁷ The Delegation stated that it should provide ‘meaningful work for the individual artist’, which thus encapsulated the period’s social-democratic influenced cultural policy.⁸ That is, cultural workers should care about society, and society, in turn, should care about cultural workers.

On the one hand, the Delegation justified its engagement due to ‘the ever-increasing interest in cultural activities within society’. Furthermore, the agency stated early on that a goal for the exhibition was ‘an opportunity to bring new ideas and suggestions to the National Board’s informative or therapeutic activities’.⁹ Hence, cultural workers were implicitly regarded as a means to improve civil health by the two ways that we initially described in this article as the public approach (inform the public about health) and the non-public approach (improve the individual’s health). The main focus of the exhibition was that of the former, but it also bore elements of the latter. For example, the idea was to open the exhibition before it was fully completed, and then, in the participatory collective fashion of the times, encourage artists and visitors to continue to create artworks jointly as long as the exhibition lasted, adding a creatively therapeutic effect for both visitors and artists.

As in the poster projects, the Delegation gave the artists few, or rather vague and contradicting restrictions. An early memo presented the guidelines for the exhibition: ‘The artists are “unleashed” to make an exhibition on health. The content may be discussed but the artists should have a relatively free hand’.¹⁰ Anna Thott, one of the artists, later commented to a journalist that the Delegation had encouraged them to really make an artistic effort (Ekstrand 1973). Yet, in an echo of the poster projects, the agency stated in another memo that the exhibition ‘will reflect a holistic view on health issues’.¹¹ These ambiguous signals should, however, be interpreted as an awareness within the Delegation of a need to keep at arm’s length and delicately balance artistic freedom without compromising the agency’s own goals and values. In an attempt to secure its own interests, the Delegation made the artists participate in a course about social and health issues.¹² This, however, did not stop the exhibition from becoming a public controversy just prior to its opening.

The main conflict centred on two younger artists, Björn Jerkert and Karin Alfredsson, whose section ‘Health is freedom’ was withdrawn by the National Board only a few days before the opening (Jerkert and Alfredsson 1973). According to a pamphlet, their theme circled around ‘the increased societal control of people, with surveillance cameras in the city, registration of opinions, the newly enforced so-called terrorist law, etc’.¹³ Inspired by contemporary counterculture protest movements in the USA, the two artists had, among other things, made images of police officers with pig faces. Jerkert and Alfredsson explained their work to a journalist by stating that ‘We want to demonstrate the mental illness that exists in society. The bourgeoisie has built up its apparatus of violence and police officers abuse their power’ (Wall 1973). Rexed, who at that moment was in Switzerland, wired his decision to take down the pictures (Ekstrand 1973; Ribbing 1973). ‘We cannot have artists for whom we are responsible attacking another public authority’, the administrative officer Nils Östby from the Delegation explained to a reporter (Lindau 1973).

In retrospect, the conflict that came to surround the exhibition caused scepticism and suspicion within the Delegation. It further raised questions regarding the seemingly utopian promise of putting cultural workers in the service of the agency and its mission to improve citizens’ health.¹⁴ The mutual interests and interdependence between the parties led to negotiations regarding the form and content of the artworks, but also relentless and tiresome tensions. The Delegation often took a stance for artistic freedom and valued multiple interpretations of health. However, this ideal also generated outcomes that were difficult to cope with in relation to other ideals and responsibilities of the agency.

Health information from the inside – the Hällby film group

At the initial meeting between the Delegation on Healthcare Education and the four centres, held in October 1970, the use of film as a suitable information medium for debating alcohol and narcotics-related issues was the centre of attention. When Rexed’s novel approach of constructing imaginative and experimental health information was raised, Film Centre representative and documentary filmmaker Carl Henrik Svenstedt immediately cautioned against any form of commissioned films dealing with social issues. Svenstedt stated that ‘no solutions served from above can have the same impact as when the people the information is supposed to be aimed at are activated, and where they themselves articulate what their situation is like’.¹⁵

Together with Film Centre colleagues Stefania Börje and Ulf Berggren, Svenstedt had recently visited the National Film Board of Canada, partaking in its sociological anti-poverty communication initiative Challenge for Change initiated in 1967. Challenge for Change was an ambitious state-funded effort using participatory documentary as a means to enhance participatory democracy, opening channels of communication in marginalized communities, such as rural areas and city ghettos, which were hard to reach through conventional information (Waugh, Baker, and Winton 2010). The filmmaker was to reject any artistic pretensions and become a ‘social animator’ in the service of society, only providing people with knowledge and technology, helping communities to define their own problems and solutions while documenting, and observing, themselves. It was consciousness-raising (governmental) information created by proxies from the inside. The Delegation showed such an interest in this revolutionary method of creating attitude-changing information that Johanson immediately asked Svenstedt to compose an article on the filmmaking method for the National Board’s journal Socialnytt, and a week later gave the Film Centre funding to develop a blueprint for a sociological film project in a Swedish drug-related context.¹⁶ Svenstedt, Börje and Berggren had already toyed with the idea of applying the Canadian method in a Swedish setting. Like the rural, isolated fishing villages of Newfoundland, featured in Challenge for Change’s renowned Fogo Island project (1967–68), it needed to be a socially marginalized, disenfranchised and underprivileged community with inherent communicational obstacles towards (and from) the outside world.

One of the most heated domestic social topics at the time was criminal policy. The prison-as-institution was under heavy fire from the left. The influential National Association for the Humanization of the Correctional System (Riksförbundet för kriminalvårdens humanisering or KRUM, established in 1966) spawned a comprehensive critique against the dominant ‘treatment ideology’ in which crime and drug use were seen as ‘individual’, ignoring structural issues of class and other social structures (Nilsson and Robert 2017, 110). The years around 1970 have been described as the most turbulent ever for the Swedish prison system, with multiple strikes and disturbances inside correctional facilities (Nilsson 2011, 91). Particularly since Svenstedt and Berggren had recently served time for being conscientious objectors, the leftist activist filmmakers had become devoted to issues of inmate unionization and news media representation of convicts, and were highly critical of the othering of drug users and the stigma following criminalized behaviour. Consequently, a prison was decided upon as a socially relevant and ideally isolated milieu for the project. To secure further funding from the Delegation it also needed to be thematically linked to drug-related health issues. The choice fell upon Hällby, a high-security correctional establishment for 80 young drug offenders, managed by the liberal warden Bengt Gabrielsson who, in line with the prevalent ‘treatment ideology’, showed an interest in the project’s possible therapeutic and individually preventative outcomes. Thus, at the initial stage of the project, three diverse agents/intentions can be discerned: (1) health information dissemination towards marginalized groups, (2) therapeutic behavioural treatment, (3) de-dramatizing prison life and unionizing inmates, supplying them with a voice.

During the spring of 1971, in dialogue with the Delegation and the Swedish Prison Service, the Hällby group drew up plans for a multi-part film project built around a Challenge for Change-inspired three-phase communicative method of ‘circles of interest’.¹⁷ During the first phase the filmmakers would work closely with a few selected convicts, representing the inner/non-public circle, teaching them 8 mm filmmaking. The workshops were to have a consciousness-raising effect, helping the group to define its own situation by re-watching their tentative efforts of formulation. This resulted in seven 10-min films during 1971–1972, funded mainly through Hällby’s therapy subsidies: Freedom in JailI (Frihet i fängelse), The Strike (Strejken), The Breakout, The Game (Matchen), The Mechanical Workshop (Verkstan), The Chicks (Brudarna) and The Guards (Plitarna). As the main idea, according to the filmmakers, was not to merely produce conventional films on social issues, but to produce social change, these films had no intrinsic value outside their specific context. Therefore, they were only allowed to be screened (as government-funded information aimed at a widened circle) in the presence of the filmmakers and/or the convicts, who were also given all copyrights to the material.¹⁸ The second phase was non-public as well, aimed at a ‘concerned’ circle of social and criminal workers. The outcome consisted of three half-hour 16 mm productions by Svenstedt and Börje: The Prodigal Son (Den förlorade sonen, 1972), funded by the Prison Service, was a materialist critique on the recent Christian salvation wave in Swedish prisons; Crime and Punishment (Brott och straff), funded by the Swedish Film Institute (but never finalized), featured interviews with European criminologists (including Michel Foucault); and Drug Sentence (Dömd för knark, 1972), funded by the Delegation, was a round-table conversation featuring Svenstedt and the inmate film collective in a no holds barred discussion on drugs, fencing, arrest procedures and media representations of narcotics and users. The final phase was aimed at the public circle. Here Swedish Television funded and broadcast the satirical Robbers & Bandits (Bovar and Banditer, 1972), which criticised the prison-as-institution, the ‘treatment ideology’ and the de facto existence of alleged ‘criminal’ individuals, by illustrating the changing, historical structures of criminality from a social-constructionist perspective.

The Hällby project thus involved a wide array of funding agencies, all with separate agendas. Traditional cultural policy issuers were only marginally represented. The archival absence of any correspondence with Swedish Television or the Swedish Film Institute is certainly a measure of their non-involvement in the project. Instead, it was other administrative bodies that took on the role of cultural patrons and main discussion partners, as in the earlier discussed cases of the visual artists. This can be seen as an illustration of the liminal demarcations between cultural policy and other policy areas in the welfare state when it came to cultural funding at the time, as Swedish cultural policy had yet to be more fully demarcated, something which the new cultural policy of 1974 had the ambition to outline. The fact that the Hällby group found it necessary to cross policy borders for funding is furthermore an example of how the Swedish Film Institute had locked itself into a commercial feature film matrix, due to the industry-based nature of the 1963 film reform, in many ways ostracising non-commercial and documentary filmmakers (Andersson and Sundholm 2014, 68).

It also becomes apparent, when studying the Hällby group’s correspondence with various collaborators, how the filmmakers customized their language depending on whom they solicited. In letters to the Delegation, and texts for the National Board of Health and Welfare’s journals, Svenstedt dwelled upon issues of governmental information, which was never the case towards other partners (Svenstedt 1972, 1973).¹⁹ In communications with the Swedish Prison Service, the focus was instead placed on the project’s therapeutic qualities.²⁰ This adjustment of aims and discourse also becomes evident in interactions with prison community representatives such as prison strike instigator and public figure Jalmar Tornklint, whom Svenstedt asked to become the project’s ‘ideologue’, playing his agitative speeches to stimulate inmate unionization.²¹ Writing to Tornklint, Svenstedt described Hällby as a hostile ground where ‘our mere existence is provocation enough’, while instead emphasizing the harmonious relations between guards and inmates to the financial patrons. Dissensions arose when the Hällby administration evaluated the 1971 activities and criticised The Breakout (which was based on the actual escape and subsequent capture of the inmate film collective’s soundman) for ‘highlighting, and encouraging, a successful escape’.²² Consequently, they asked the filmmakers to change course, hire professional actors and produce educational films that could convert convicts by ‘internalizing adequate behaviour’ in critical situations, such as ‘how to resist a pusher’.²³ Svenstedt sternly commented that they were documentarists and did not meddle with actors or theatrics. To the actual escapee, Svenstedt later wrote: ‘We really appreciated the breakout. I totally understand why you left’.²⁴

Overall, the outcomes of the Hällby project consistently took sides against the funding state representatives of the prison system and health administration, in favour of the individuals that society, according to the filmmakers, had merely labelled ‘criminals’. Robbers & Bandits, for example, blatantly likened alleged criminals to historical revolutionaries and political dissidents. The standpoint was further illustrated in the Delegation-financed booklet made to accompany Drug Sentence. It stated that ‘people are incarcerated randomly and arbitrarily and not as a result of individual conscious actions’, and further agitated to abolish the punishment process along with all prisons, as ‘we are all indoctrinated by mass media conceptions of what constitutes “criminal” activity’ (Socialstyrelsen 1972). As mentioned above, during the 1970s, the Delegation’s strategies against narcotics consistently put an equal weight on the three areas of individual responsibility, the drug and societal relations. Neither Drug Sentence, nor the booklet, mentioned the accountability of the lawbreaking subject or the drug as a health problem. The Delegation’s choice to attach a reference list of literature to the booklet, that accorded with their view, was deliberately countered by Svenstedt, who added the Marxist publication Kapitalism och knark [Capitalism and drugs] (Althoff, Ericsson, and Tabor 1971), which advocated outright revolution, describing the drug problem as a result of capitalist control of the poor.²⁵

When evaluating the project in 1973, Johanson bemoaned that the Hällby group saw the project ‘as a way to convey far-reaching social criticism, with concomitant demands of profound social and political change. Obviously, a state agency cannot be associated with such activities’.²⁶ Consequently, further funding from the Delegation, as well as from other agencies and organisations, was terminated that year.

Concluding remarks

In this article, we have demonstrated the importance of not studying cultural policy in isolation, and further stressed the significance in highlighting and problematizing conflicting values and aims that might influence the outcome when policymakers and cultural workers join forces. Set against a historical backdrop consisting of the Swedish post-war formation of cultural policy, we have studied how cultural policy, in the early 1970s, was utilized as a proxy tool by state healthcare and treatment sectors in an effort to solve a non-cultural issue – improved health.

Three contextual processes – the politicization of the cultural sphere, the call for increased governmental information, and a broadened concept of health – converged around 1970, creating a fertile ground for collaborations between governmental agencies and cultural workers. Furthermore, a consensus emerged between the social-democratic determination to institutionally recognize its cultural workforce, and they wish to be of use to society, which was advanced by the cultural sphere. The state and its cultural workers thus aligned.

The Centre organizations played an important role in this merging of motives. In 1978 Kjell Johanson from the Delegation on Health Education, pointed out that the centres ‘now constitute modern instruments for an aggressive artistic cultural policy and for outreach activities’, further emphasising that ‘nowadays, an understanding exists regarding the fact that artistic work must form alliances’ (Johanson 1978, 23). The most essential alliance obviously being the one between artists and the state. Importantly, this cultural policy-driven alliance did not constitute a one-way relationship. Our analysis shows an interdependence between the actors in question, where the Delegation saw the imaginative ideas and methods put forth by the cultural workers as strategically indispensable, if the agency was to reach and affect both majority and minority groups. The fact that the National Board of Health and Welfare repeatedly published articles by artists in their journals is an example of how the agency took the cultural workers’ input seriously.

Thus, the starting point for the collaborations was relatively unproblematic. However, when the actual art-cum-information solidified, problems arose. The Delegation’s goal was to promote a healthy lifestyle inside a functional social structure. For the cultural workers employed to perform this objective, the goal instead turned out to be to profoundly change the social structure in itself, since a ‘healthy lifestyle’ was not deemed possible within it. The main conflict between patron and artist thus lay in what the collaboration should seek to change for the better: society or its citizens? When the artistic information produced by the cultural workers turned around, biting the very hand that fed its creators, the governmental agencies deemed it necessary to either cease funding or suppress the most critical material. These conflicts can be seen as an illustration of what Duelund describes as the ‘clash of interests’ within the cultural policy field. However, this was not solely related to conflicting objectives, but also due to a confusing mixture of roles: the Delegation suddenly found itself a patron of the arts, and the cultural workers producers of governmental information.

Despite the conflicts generated by the collaborations, the projects did have an impact on questions of health and narcotics. For example, the Hällby films were screened frequently during the 1970s due to a substantial demand from organisations and youth centres. Not including the TV broadcast of Robbers & Bandits, and only counting up until mid-1974, the package was shown, with the filmmakers and/or the convicts present, at 113 venues to 3275 people.²⁷ Similarly, the visual artists managed to produce artistic information that was circulated and discussed – with mixed interpretations – in different groups in society. And during the first two days of the art exhibition on health, some 1200 attended the museum.²⁸

To conclude, the cultural workers had managed to bring about unique artistic and historical documents from their collaboration with the Swedish welfare state bureaucrats. Our analysis indicates that such activities tend to generate a mixture of desired, undesired and unforeseen outcomes that policymakers occupied in so-called ‘arts in health’ activities should be aware of. Perhaps more importantly, our findings point to the research gains stemming from studying the historical interconnectedness between the policy concepts of culture and information. Both have evidently been used by the Swedish welfare state as tools for education, cultivation, consciousness-raising, emancipation, citizen participation and health, but have rarely been analytically and historically juxtaposed and studied in relation to each other. Hence, our study constitutes a step towards further exposing the historical interconnectedness between the areas.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Lars Diurlin

Lars Diurlin has a PhD in film studies and works as a senior lecture at the Department of Film and Literature at Linnaeus University. Diurlin’s thesis, ‘The First Avant-Gardist of the Film Reform’: The Experimental Filmmaker Peter Kylberg, is as much an artist study as an examination of the productional conditions of experimental films and the artist’s role within the framework of the Swedish welfare state’s cultural policy. He is currently developing a research project on the Swedish International Development Cooperation Agency’s information strategies, focusing on the agency’s film support.

Fredrik Norén

Fredrik Norén has a PhD in media and communication. His research interests concern primarily two areas: governmental communication in the 1960s and 1970s and digital text analysis. Together with Emil Stjernholm, he has edited a volume on propaganda and information in the Swedish postwar era. Currently, Norén work as a researcher at Humlab, the digital humanities centre at Umeå University and participates two research projects: ‘Welfare State Analytics: Text Mining and Modeling Swedish Politics, Media & Culture, 1945–1989’ and ‘International Ideas at UNESCO: Digital Approaches to Global Conceptual History’.

Notes

1. Retold speech in protocol, 23/2 1968. A IV, Hälsovårdsbyrån (Hvud), Socialstyrelsen (Soc), Riksarkivet (Ra). All quotes, including poster phrases, have been translated from swedish by the authors.

2. ‘Liten sammanfattning från mötet mellan Soc. styrelsens HVUD och representanter från Konstnärscentrum, Teatercentrum och Filmcentrum, 8/10 1970.’ F IV a vol. 1, Nämnden för hälsoupplysning (Nfh), Soc, Ra.

3. ‘Möte med Konstnärscentrum den 28 oktober 1970,’ 28/10 1970. F IV a vol. 1, Nfh, Soc, Ra.F IV.

4. E.g. Kjell E. Johanson’s statement concerning SOU 1974:23 Reklam 5: Information i reklamen, 26/9 1974, p. 2. A I a vol. 1, Nfh, Soc, Ra.

5. ‘Synpunkter på en bildserie,’ 1/10 1974. E I vol. 13, Nfh, Soc, Ra.

6. ‘Synpunkter …,’ 1/10 1974. E I vol. 13, Nfh, Soc, Ra.

7. Protocol, 13/6 1973. A I vol. 1, Nfh, Soc, Ra.

8. ‘Användning av konstnärer inom Socialstyrelsens verksamhetsområde,’ 21/1 1973. F VII vol. 1, Nfh, Soc, Ra.

9. ‘Användning av konstnärer …,’ 21/1 1973. F VII vol. 1, Nfh, Soc, Ra.

10. ‘Ang konstnärer och 200.000 kronor’, 16/1 1973. F VII vol. 1, Nfh, Soc, Ra.

11. ‘Utställning kring temat HÄLSA,’ 25/2 1973. F VII vol. 1, Nfh, Soc, Ra.

12. ‘Projekt arbetslösa konstnärer,’ 11/2 1973. F VII vol. 1, Nfh, Soc, Ra.

13. ‘Kontroversiellt, tyckte socialstyrelsen om hälsoutställning på Liljevalchs,’ 1973, p. 25. F VII vol. 1, Nfh, Soc, Ra.

14. ‘Synpunkter …,’ 1/10 1974. E I vol. 13, Nfh, Soc, Ra.

15. ‘Liten sammanfattning … ’ F IV a vol. 1, Nfh, Soc, Ra.

16. ‘Samtal på Filmcentrum och Teatercentrum, 19/10 1970.’ F IV a vol. 1, Nfh, Soc, Ra.

17. Letter from Carl Henrik Svenstedt to Anne-Marie Dahlgren, Swedish Prison Service, 14/3 2009. Carl Henrik Svenstedt’s private archive (Chs).

18. Agreement between Hällby film group and Hällby internee council, 3/6 1971. Chs.

19. Cf. Letter from Carl Henrik Svenstedt to Kjell E. Johanson, 20/11 1971. Chs.

20. Letter from Carl Henrik Svenstedt to Sven Larsson, Swedish Prison Service, 2/2 1972; Letter from Carl Henrik Svenstedt to Owe Sandberg, Hällby Psychologist, 9/2 1972. Chs.

21. Letters from Carl Henrik Svenstedt to Jalmar Tornklint, 10/5 1971, and 3/7 1971. Chs.

22. Protocol. Meeting between the Swedish Prison Service, the Hällby facility and Carl Henrik Svenstedt, 1/2 1972. Chs.

23. Report on Hällby project by Bengt Gabrielsson, 12/12 1971. Chs.

24. Letter from Carl Henrik Svenstedt to Hällby internee, 19/7 1971. Chs.

25. Annotated draft to booklet Dömd för knark, 1972. Chs.

26. Kjell E. Johanson’s statement concerning SOU 1972:9 Samhället och filmen 2, 15/5 1973, p. 3. A I a vol. 1, Nfh, Soc, Ra.

27. Report on Hällby project by Carl Henrik Svenstedt to Film Centre, 7/12 1974. Chs.

28. Protocol, 13/6 1973. A I vol. 1, Nfh, Soc, Ra.