The Relationship Between Occupational Demands and Well-Being of Performing Artists: A Systematic Review

Health consultations at a performing arts health centre among classical music students based on electronic health record data: a cross-sectional study

Physical and mental health problems in music students are usually identified using self-reported data. The use of an Electronic Health Record database can avoid biases to give an overview of the extent of health problems in this population. Therefore, the aim of this study is to gain insight into both physical and mental health related issues in classical music students using this type of data collection. An Electronic Health Record database including five years of data from a Performing Arts Health Centre (PAHC) of a university or the arts, was used to analyze the number and characteristics of health consultations in music students. The total number of students, health consultations and the average number of visits per health consultation were calculated over five years. Furthermore, numbers and percentages of both physical and mental health consultations were registered. Also, the number and percentage of health consultations per instrument group were compared to the proportion of each instrument group within the specific sample. Over a period of five years, 230 students visited the PAHC and 417 health consultations were reported. 43.5% of the students who visited a health professional indicated at least one physical health consultation, 29.1% at least one mental health consultation and 27.4% at least one in both categories. An injury was the most frequently registered physical health consultation (40.2%), followed by performance improvement (9.8%) and stress (9.6%). Voice students registered relatively most health consultations. As far as we know, this is the first cross-sectional study using Electronic Health Record data from a PAHC to gain insight into both physical and mental health related issues in a population of classical music students. Looking at the variety of health consultations registered in the database, a multidisciplinary team and multidisciplinary approach are necessary to meet the needs of the students in terms of physical and mental health support and performance improvement.

The Mental Health of Elite-Level Coaches: A Systematic Scoping Review

BACKGROUND

Elite-level coaches are exposed to multiple performance, organisational and personal stressors which may contribute to reduced mental health and wellbeing. This systematic scoping review examined the current body of evidence to explore what is known about the mental health of elite-level coaches (i.e. wellbeing and mental ill-health), the risk and protective factors that influence coach mental health, and the relationship between mental health and coaching effectiveness.

METHODS

The review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was undertaken and updated in September 2022 using six electronic databases.

RESULTS

12,376 studies were identified and screened, with 42 studies satisfying the inclusion criteria. Despite the paucity of high-quality research, findings indicated that 40% of the included studies examined themes connected to wellbeing, with 76% assessing the nature or prevalence of mental ill-health in elite-level coaches. Among studies exploring mental ill-health, coach burnout was the primary focus, while scant research examined symptoms associated with clinical disorders (e.g. anxiety and depression). Overall, psychological outcomes for elite-level coaches were shaped by risk and protective factors operating at the individual, interpersonal, organisational and societal level. Preliminary evidence was also found to suggest that poor mental health may contribute to reduced coaching effectiveness. It is proposed that coaching effectiveness could therefore be employed as a 'hook' to engage elite-level coaches in greater consideration of their mental health needs.

CONCLUSION

Alongside the development of methodologically robust research, there is a need to examine dynamic individual (e.g. psychological skills), interpersonal (e.g. strong social supports) and organisational (e.g. workload) factors that aim to preserve the mental health and optimise the efficacy of elite-level coaches.

Effects of Psychological Interventions on Performance Anxiety in Performing Artists and Athletes: A Systematic Review with Meta-Analysis

Levels of state and trait anxiety are relevant for performing artists and professional athletes to obtain optimal performance outcomes. However, evidence-based knowledge regarding the effectiveness of psychological interventions on performance anxiety is currently minimal. Thus, the objective of this systematic review with meta-analysis was to characterize, aggregate, and quantify intervention effects on measures of state and trait performance anxiety in performing artists and professional athletes. A systematic search of the literature according to the PRISMA guidelines was conducted on the databases PubMed, Medline, SPORTDiscus, PsycInfo, Embase, and Web of Science from 1 January 1960 to 9 November 2022. The search only included controlled studies employing pre-post measures and excluded performing arts fields that do not depend on fine motor skills. Initially, 1022 articles were identified; after removing duplicates and assessing abstracts and full texts, 20 articles were used to calculate weighted standardized mean differences (SMDs). In terms of state performance anxiety, our results revealed a large overall effect (SMD = 0.88), a medium effect (SMD = 0.62) for studies using scales with total scores (i.e., MPAI-A, STAI), and large effects (cognitive anxiety: SMD = 0.93, somatic anxiety: SMD = 0.92, self-confidence: SMD = 0.97) for studies applying scales with sub-scores (i.e., CSAI-2R)-all in favour of the intervention groups. Regarding trait performance anxiety (e.g., SCAT), we detected a small effect (SMD = 0.32), also favouring the intervention groups. Interventions to reduce performance anxiety in performing artists and professional athletes revealed varying levels of effectiveness ranging from small (trait) to large (state). Therefore, future studies should investigate modalities to increase intervention efficacy, especially for the small-sized changes in trait performance anxiety.

Modelling arts professionals' wellbeing and career intentions within the context of COVID-19

The COVID-19 pandemic had a substantial effect on the creative and cultural industries in the United Kingdom (UK), as seen in our first snapshot of the HEartS Professional Survey (April-June 2020, Phase 1, N = 358). By analysing data collected one year later (April-May 2021, Phase 2, N = 685), the aims of the current study are to trace the contributors to (1) arts professionals' mental and social wellbeing and (2) their expectations of staying in the arts. Findings show that artists continued to experience challenges in terms of finances, and mental and social wellbeing. Over half of the respondents reported financial hardship (59%), and over two thirds reported being lonelier (64%) and having increased anxiety (71%) than before the pandemic. Hierarchical multiple linear regression models, using the Mental Health Continuum-Short Form, Center for Epidemiologic Studies Depression Scale, Social Connectedness Scale, and Three-Item Loneliness Scale as outcome variables, indicate that perceived financial hardship continued to be associated with higher depression and loneliness scores. As in our first study, more physical activity before lockdown was associated with higher wellbeing and social connectedness scores, and higher self-rated health scores were associated with higher wellbeing and lower depression scores. Similarly, increases in physical activity during lockdown, as well as older age, were still associated with higher wellbeing and social connectedness scores and with lower depression and loneliness scores. An ordinal logistic regression model indicated three contributors to artists' professional expectations of remaining in the arts: greater proportion of income from the arts pre-pandemic, continued maintenance of skills, and greater proportion of freelance work. The results suggest that the wellbeing patterns observed at the start of the pandemic remained consistent a year on. They point to possible strategies to support wellbeing and underline the importance of finances for expectations of remaining in arts professions.

One Year on: The Impact of COVID-19 on the Lives of Freelance Orchestral Musicians in the United Kingdom

Before the drastic disruption caused by the sudden emergence of the COVID-19 pandemic, 85% of the United Kingdom’s 14,000 orchestral musicians were self-employed freelance workers, engaged in busy and varied portfolio careers comprising a combination of orchestral, West End theatre, chamber music, and commercial recording work. Between May and June 2020 we carried out a first study examining the impact of the pandemic on the lives of 24 self-employed orchestral musicians, all established freelancers. Twelve were mid-career and 12 were late-career (described in that study as “seasoned”). They all reported having lost their much-loved performing careers, missing music making and colleagues, and being anxious about the future of the music profession. However, there were some differences between the two groups: the late-career participants demonstrated greater financial and emotional resilience, while the mid-career musicians reported distress, confusion, and anxiety about their identity as musicians. In the present follow-up study, we aimed to examine the impact of the first year of the pandemic on the lives of 21 of the same musicians. We found that while all the mid-career participants remained committed to their performing careers, many late-career participants aged 54–59 had developed interests in non-performing music work, and the older late-career participants, aged 65 and over, feared that they might already, de facto, have retired. We discuss the findings with reference to the precarity of freelance orchestral musicians’ lives, lifespan models of musicians’ careers, self-determination theory and post-traumatic growth, and their implications for music colleges and musicians’ support organizations.

The Experiences of Mid-career and Seasoned Orchestral Musicians in the UK During the First COVID-19 Lockdown

The introduction of social distancing, as part of efforts to try and curb the spread of the COVID-19 pandemic, has brought about drastic disruption to the world of the performing arts. In the UK the majority of professional orchestral musicians are freelance and therefore self-employed. These players, previously engaged in enjoyable, busy, successful, portfolio careers, are currently unable to earn a living carrying out their everyday work of performing music, and their future working lives are surrounded by great uncertainty. The aim of the present study was to examine how established professional musicians are experiencing this period, and to look for similarities and differences between the experiences of musicians in the middle of their performing careers (aged 35-45), with those of older players (aged 53 and over). Single semi-structured interviews were carried out over Zoom with 24 freelance, self-employed orchestral musicians; 12 mid-career musicians aged 35-45, and 12 seasoned musicians aged 53 and over. Thematic analysis identified themes common to both groups: the loss of a much-loved performing career, missing music making and colleagues, and anxiety about the future of the music profession. It also identified differences between the two groups: challenges to their identity as a musician, the extent of their anxiety about finances, the extent of their emotional distress, attitudes toward practicing and engaging in collaborative music making, and confusion over future career plans. Findings are discussed with reference to lifespan models of musicians' career development, the PERMA model of wellbeing, and the concept of resilience.

The Effects of COVID-19 Lockdown 1.0 on Working Patterns, Income, and Wellbeing Among Performing Arts Professionals in the United Kingdom (April-June 2020)

This article reports data collected from 385 performing arts professionals using the HEartS Professional Survey during the COVID-19 Lockdown 1.0 in the United Kingdom. Study 1 examined characteristics of performing arts professionals' work and health, and investigated how these relate to standardized measures of wellbeing. Study 2 examined the effects of the lockdown on work and wellbeing in the respondents' own words. Findings from Study 1 indicate a substantial reduction in work and income. 53% reported financial hardship, 85% reported increased anxiety, and 63% reported being lonelier than before the crisis. 61% sought support on finances while only 45% did so on health and wellbeing. Multiple regression analyses, using the Mental Health Continuum-Short Form, Center for Epidemiologic Studies Depression Scale, Social Connectedness Scale, and Three-Item Loneliness Scale as outcome variables, indicate that perceived financial hardship was associated with lower wellbeing and higher depression and loneliness scores. Higher self-rated health was associated with higher wellbeing and lower depression scores. More physical activity before lockdown was associated with higher wellbeing and social connectedness scores, as well as lower loneliness scores, and an increase in physical activity during lockdown compared with before, as well as older age, were associated with higher wellbeing and social connectedness scores, and lower depression and loneliness scores. Thematic inductive analysis of 341 open responses in Study 2 identified five overarching themes characterizing the effects of Lockdown 1.0: lost or uncertain work and income, including canceled work, financial concerns, and uncertainties for the future; constraints of lockdown working, including challenges of working at home, struggles with online work and skill maintenance, and caring responsibilities; loss and vulnerability, including reduced social connections, lack of support, vulnerability, feelings of loss and grief, and concern for others; detrimental effects on health and wellbeing, including anxiety, low or unstable mood, poorer physical health, and lack of motivation; and professional and personal opportunities, including coping well or living more healthily, more time and less pressure, new possibilities and activities, enhanced social connections, and new skills. Lockdown 1.0 had profound effects on performing arts professionals, but our findings reveal some opportunities and compelling links between positive wellbeing and physical activity.