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The hospital is seen as a community in which the arts have a role to play. Whilst the arts in hospitals have been perceived as adjunctive, there is now medical health research to support their practice, representing a shift in the paradigm between arts and health. We understand that adolescence is a period of transition and the arts provide a metaphor when language has not necessarily yet been found to articulate those changes. Set within a hospital, it is important to establish that the Youth Arts programme is seen as a normalizing process for its participants, and whilst not adhering to overt therapeutic models, contributes to well-being and continued development. Youth Arts reflects the health determinants of social inclusion and contribution valued as part of its core practice, offering the adolescent community a creative voice in a complex setting. This article explores the role of engagement in the practice of the Youth Arts programme, and how it contributes to individual well-being and the health of the hospital community.