Music Activities and Mental Health Recovery: Service Users' Perspectives Presented in the CHIME Framework

When the time is right: Men's experiences of recovery in self-harm

Previous research has mainly focused on self-harm among women, defining what it is, what functions it has, how to manage and prevent self-harm, and how to recover from it. A recent review of the literature on self-harm among men concluded that research need to consider both clinical and personal aspects of recovery and pointed out the need to explore recovery from men's point of view. This study aimed to describe men's experiences of recovery in self-harm. Data were collected in Sweden in 2020 using semi-structured interviews. Eleven men who had recovered in self-harm were interviewed. Interviews were analysed using an abductive approach to qualitative content analysis. The analysis involved the application of an established framework for personal recovery in mental illness: connectedness, hope, identity, meaning, and empowerment (CHIME). The analysis identified one main theme: when the time is right, and five sub-themes: finding support in others; trusting that change is possible; getting to know yourself; reaching a new understanding; and developing new strategies to manage life. While the cessation of self-harm might both be a sign of and contribute to recovery, it is not the defining feature of recovery. Mental health professionals should be persistent in providing person-centred, recovery-oriented care for men who self-harm. The CHIME framework can be applied in the context of men's recovery in self-harm. This study is reported in accordance with the COREQ guidelines.

Self-perceived relations between artistic creativity and mental illness: a study into lived experiences

Aim

To explore the self-perceived relationships between experiences of creativity and mental illness and to understand the meanings behind these relationships.

Background

The idea that mental illness and artistic creativity are somehow related dates back to ancient times. There is some evidence for an actual correlation, but many questions remain unanswered on the nature and direction of the relationship. Qualitative contributions to the debate are scarce, and mainly focus on the potential benefits of participation in the arts for people with mental illness.

Design

An explorative, interpretive study.

Methods

Twenty-four professional and semi-professional artists with self-reported experience with mental illness, were recruited purposively. Unstructured in-depth interviews were conducted and transcripts were subjected to interpretive analysis, guided by a hermeneutic phenomenological frame.

Results

Participants experience a range of interactions between artistic creativity and mental illness. Three constitutive patterns describe what these interactions look like: "flow as a powerful force"; "ambiguous self-manifestation"; and "narrating experiences of suffering."

Conclusion

The findings show that both the concept of creativity and the concept of mental illness, as well as their interrelationships, are layered and complex phenomena that can take on different meanings in people's lives. The findings provide starting points for further research that goes beyond the polarized academic debate. Understanding the experiences of artists with mental illness can help shape the role of art in public mental health and mental health care.

"Beyond laughter": a systematic review to understand how interventions utilise comedy for individuals experiencing mental health problems

Introduction

There is evidence for the impact of comedy and humour for mental health and wellbeing. Existing systematic reviews have concluded laughter has a positive impact on wellbeing, however other potential benefits of comedy interventions have remained under explored. The aim of the current study was to synthesise current evidence for comedy/humour interventions and evaluate mechanisms through which comedy interventions may impact upon the recovery of those experiencing psychological distress, using the Connectedness, Hope, Identity, Meaning and Purpose and Empowerment (CHIME) framework.

Methods

Five electronic databases were searched for studies exploring the impact of interventions using comedy on wellbeing and mental health recovery, from earliest record until January 2023. Grey literature was obtained via contacting experts in comedy interventions for mental health and supplemented by an internet search for comedy interventions. To be eligible for inclusion, studies had to include primary data, published in English or German, and explore a population of adults, with self-reported distress or a self-reported/diagnosed mental health condition. Studies included only explored interventions which utilised comedy as the main intervention and aimed to induce 'simulated' laughter, in response to a stimulus. 17 studies were included in the review.

Results

Studies were found to have positive impact on mental health symptoms and several mechanisms of the CHIME framework for recovery, including connectedness, hope, identity and empowerment. Potential theorised mechanisms for change included confidence in new skills, promotion of social skills, opportunities for social interaction, laughter, vulnerability, and cognitive flexibility. The current review found that comedy/humour interventions are beneficial for mental health recovery and wellbeing and found preliminary evidence for a range of mechanisms through which comedy may have positive impact.

Discussion

Further research should focus on qualitative exploration of the mechanisms by which comedy interventions may have impact on wellbeing and mental health recovery for specific populations and within different settings. It is concluded that there is a need for transdisciplinary collaboration in research on comedy interventions, which brings together the expertise of comedians delivering/developing interventions, those with lived experience of mental health issues and researchers from both health sciences and humanities disciplines.

Determining the role of music attitude and its precursors in stimulating the psychological wellbeing of immigrants during COVID quarantine - a moderated mediation approach

Based on social cognitive theory (SCT), the purpose of this study is to examine the role of music attitude and its essential precursors in stimulating the psychological wellbeing of immigrants in isolation (quarantine) during the COVID pandemic. This study employed quantitative methodology; an online survey was administered to collect sufficient data from 300 immigrants who traveled to China during the pandemic. Data were collected from five centralized quarantine centers situated in different cities in China. Additionally, the valid data set was analyzed using structural equation modeling (SEM) via AMOS 24 and SPSS 24. The results indicate that potential predictors such as cognitive - music experience (MEX), environmental - social media peer influence (SPI), and cultural factors such as native music (NM) have a direct, significant, and positive effect on music attitude (MA), which further influences immigrants' psychological wellbeing (PW) during their quarantine period. Moreover, in the presence of the mediator (MA), the mediating relationships between MEX and PW, and NM and PW, are positive, significant, and regarded as partial mediation. However, the moderated mediation effects of music type (MT) on MEX-MA-PW and NM-MA-PW were found to be statistically not significant and unsupported. This study contributes to the literature on the effectiveness of individuals' music attitude and its associated outcomes, focusing on mental health care in lonely situations such as quarantine during the COVID pandemic. More importantly, this study has raised awareness about music, music attitude, and their beneficial outcomes, such as mental calmness and peacefulness for the general public, particularly during social distancing, isolation, and quarantine in the COVID pandemic situation.

Exploring the Lived Experience on Recovery from Major Depressive Disorder (MDD) among Women Survivors and Five CHIME Concepts: A Qualitative Study

OBJECTIVE

Depression is estimated to be the leading cause of disease by 2030 and is already the leading cause in women worldwide. In Malaysia, nearly 2.3 million people have experienced depression at least once. Yet, this problem has not been thoroughly investigated and addressed. Thus, a study exploring the lived experience of the survivors needs to be carried out. With most Major Depressive Disorder (MDD) patients being women compared to men, this study focused on women MDD survivors to understand their journey to recovery. Survivors or also called 'People with Lived Experience' (PWLE) have a range of first-hand experiences with treatment and recovery, making them an expert by experience.

METHOD

A qualitative study was conducted using purposive sampling of four women survivors. This method was able to explore the experience of informants rigorously as it gave flexibility and encouraged discussion between researchers and informants. The data from in-depth interviews conducted were then analyzed using thematic analysis, focusing on the key concepts of CHIME conceptual framework of recovery.

RESULTS

This study found four major themes with fifteen subordinate themes: survivor's efforts, challenges, social support, and hopes. The findings of this study were then integrated with CHIME framework, also known as the guiding philosophy of recovery for mental illness patients.

CONCLUSION

These findings contributed to a better understanding of the recovery process and supports needed for MDD patients to recover. In addition, this study also gives hopes that MDD patients can recover, therefore breaking the social stigma still prevalent in the community. Based on these first-hand experiences shared by the survivors, it is hoped that the present interventions conducted by related organizations and caregivers can yield improvements so that the current patients who are still struggling with MDD can recover faster holistically. Limitations and implications for future research have also been discussed.

Implementation and Strategies of Community Music Activities for Well-Being: A Scoping Review of the Literature

The benefits of community music activities for promoting well-being have been well recognized in previous literature. However, due to their wide variability and flexible approaches, a comprehensive understanding of the research and practice of community music activities for well-being promotion is sparse. The purpose of this scoping review was to synthesize published literature pertaining to community music activities for well-being promotion and identify key implementation characteristics and strategies to inform future practice and research. Studies of community music activities that investigated well-being outcomes in participants of all ages and conditions were eligible for inclusion. Through electronic database and manual searches, a total of 45 studies were identified and included in the analysis. The main findings showed that community music activities for well-being were characterized by a wide range of populations and applications, collaborative work, an emphasis on social components, and musical accomplishments. However, this variability also revealed a lack of consistent and thorough information as well as diversity in well-being conception across studies. The review offers practical recommendations for future research and practice based on the current findings.

Psychiatric care and education understood from a student perspective: Enhancing competences empowering personal and social recovery

BACKGROUND

During the last decades, a recovery-based approach has called for a change in mental health care services. Several programmes have been presented, and the need to develop student and professional competences in education and clinical practice has been documented.

AIM

The aim of this study was to explore how psychiatric care is understood seen from a student perspective (nursing students, masters nurses and a master in applied philosophy) with focus on their personal competences and the educational interventions empowering processes for users' personal and social recovery.

METHOD

A qualitative design with a phenomenological-hermeneutic approach based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through semi-structured interviews.

FINDINGS

All interviewees expressed that both theoretically and clinically students did not experience a recovery-oriented approach empowering users' personal and social recovery process. On the contrary, they experienced that both education and practice were dominated by a biomedical approach providing clinical recovery. However, several students were aware of their need of developing personal and relational competences to be able to support the users' personal and social recovery journey. The students expressed that there is a need for educational processes targeting personal competences in 'becoming a professional' supporting 'presentness and awareness' and thereby the development of relational abilities and the courage to engage. The results relate to two nursing schools and two universities.

CONCLUSION

A biomedical approach dominates and makes it difficult to develop students' personal competences during education in practice and theory vital to the development of personal and social recovery-oriented practices. It is recommended that educators-in practice and in school-accentuate presentness, awareness and creativity as crucial relational capabilities and incorporate this in their teaching and supervision method, supporting the education and formation of the students' (and teachers' and supervisors') personal development processes.

Me and us: Cultivating presence and mental health through choir singing

BACKGROUND

An increasing body of qualitative and quantitative research suggests that choir singing can improve mental and physical health and wellbeing. A recurring phenomenon is social agency and social and emotional competences. However, there is little consensus about the underlying impact mechanisms and the special nature of music as a medium for music-based social-emotional competence.

AIM

This research was carried out to explore how the participants experienced engaging and singing in the choir A Song for the Mind in order to understand the social and emotional aspects in relation to choir singing and mental health.

METHOD

Six women and two men were interviewed. The study involved open-ended interviews and applied Paul Ricoeur's phenomenological-hermeneutic theory of interpretation in processing the collected data.

FINDINGS

Two themes emerged-The Singing Me and Cultivating Us. Joining the choir, singing and engaging with the lyrics, helped the participants get in contact with complex feelings and visualise and express challenges. This formed feelings of connecting to oneself and opening up to become aware of the world such as nature, the other person and the choir. Songs, melodies, tones, lyrics-singing together-formed a relation between the participants and the other and the group. This was a meaningful, and to some, a life-changing experience, and an important learning process to the professionals. As the participants are sensing and connecting to themselves, there is an opening for growing a nascent presence and awareness.

CONCLUSION

Joining the initiative A Song for the Mind instils an attention to the other person(s). The singing process seems to evoke presence, leading to awareness towards relational aspects and solidarity. In a choir singing perspective, and health care practice in general, this can be seen as a budding and ground-breaking formation of cultural activities holding learning and empowering potentials instilling mental health.

A Systematic Review of Music-Based Interventions to Improve Treatment Engagement and Mental Health Outcomes for Adolescents and Young Adults

Mental health disorders and suicidality are rising among adolescents and young adults (A-YA) while rates of treatment engagement remain notoriously low. Emerging research supports the potential of music-based interventions to improve mental health, but their efficacy remains unclear for A-YA. This systematic review evaluates the evidence on music-based psychosocial interventions to improve engagement in treatment and/or mental health outcomes among A-YA. This review was prospectively registered with PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-six studies were extracted. There was heterogeneity of designs, populations, measures, and outcomes. A typology of music-based interventions emerged, which is characterized by combinations of three broad categories: 1) Somatosensory, 2) Social-Emotional, and 3) Cognitive-Reflective. Most interventions are Socio-Cognitive and Holistically Integrated (combines all three) followed by Socio-Somatic. All interventions involved Social-Emotional processes. Results indicate that most studies report significant effects for mental health outcomes related to social and emotional improvements and reductions of internalizing symptoms for adolescents. Few studies targeted young adults and effects on engagement were rarely measured. There is a need for more studies that use rigorous methods. This review illuminated a need for interventions that are developmentally and culturally tailored to subgroups. Finally, the field is ripe from more studies that apply experimental therapeutics to conceptualize, operationalize, and test mechanisms of change to improve the understanding of how and for whom music-based interventions work. Recommendations for embedding these innovative strategies into research and practice for A-YA are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10560-022-00893-x.