A Rapid Review of Designing a Code of Practice for the Music Industry and Mental Health

Abstract

The contemporary music industry is composed of numerous therapeutic resources, small-scale interventions, technological solutions, triage services, and more. The aim of this rapid review is to identify the mental health issues that members of the music industry may experience, and what will inform the development of a music industry “code of practice” for mental health. Research undertaken internationally within the music industry since the 2016 “Can Music Make You Sick?” study has identified that members of the UK music industry community experience negative mental health symptoms notably more than other industries. Negative mental health symptoms within this review can be defined as panic attacks and/or high levels of anxiety and/or depression. A code of practice is a set of written regulations issued by a professional association or an official body that explains how people working in a particular profession should behave. A code of practice helps workers in a particular profession to comply with ethical and health standards. A code of practice within the contemporary music industry would provide a framework within which music industry members can work. Music industry members are defined herein as anyone involved in and/or working in the music industry. It is important to make this clarification, as many of the studies around mental health in the music industry focus on musicians, whereas all roles in the music industry have the potential to struggle with their mental health. The literature identified fundamental problems relating to mental health and the music industry. Help Musicians’ “Can Music Make You Sick?” study from 2016 found that from over 2,000 respondents, 69% of musicians suffered from depression. In Canada, a small study of 50 respondents found that 20% disclosed suicidal thoughts.

Keywords

Addiction mental health mental health and the music industry mental health interventions music industry

Introduction

The contemporary music industry is composed of numerous therapeutic resources, small-scale interventions, technological solutions, triage services, and more (Rodwin et al. 2022). The aim of this rapid review is to identify the mental health issues that members of the music industry may experience, and what will inform the development of a music industry “code of practice” for mental health. Research undertaken internationally within the music industry since the 2016 “Can Music Make You Sick?” study has identified that members of the UK music industry community experience negative mental health symptoms notably more than other industries. Negative mental health symptoms within this review can be defined as panic attacks and/or high levels of anxiety and/or depression. A code of practice is a set of written regulations issued by a professional association or an official body that explains how people working in a particular profession should behave. A code of practice helps workers in a particular profession to comply with ethical and health standards (Jennings, 2018). A code of practice within the contemporary music industry would provide a framework within which music industry members can work. Music industry members are be defined herein as anyone involved and/or working in the music industry. It is important to make this clarification, as many of the studies around mental health in the music industry focus on musicians, whereas all roles in the music industry have the potential to struggle with their mental health.

The literature identified fundamental problems relating to mental health and the music industry. Help Musicians’ “Can Music Make You Sick?” study from 2016 found that from over 2,000 respondents, 69% of musicians suffered from depression (Gross & Musgrave, 2016). In Canada, a small study of 50 respondents found that 20% disclosed suicidal thoughts over the past few weeks (Gordon, 2019). One issue cited was going away for months and then having to come home and fit into everyday life. Lack of money, poor working conditions, and substance abuse are also referenced. An investigation of the psychosocial work environment among musicians and in the general workforce in Norway found that musicians suffer from physical and mental health symptoms more frequently than the general population (Detari et al., 2020). This study identified that, although their specific demands and challenges have been researched increasingly in the past, explanations remain somewhat unclear. A total of 1,607 Norwegian Musician's Union members with a national sample of 8,517 employees from the general Norwegian workforce were used. Compared with the general population, musicians reported that they felt less supported and acknowledged in their work, work–family conflicts were more frequent, and they felt less motivated. Members perceived their work as more demanding compared to the general workforce.

Regarding interventions to support members of the contemporary music industry community, the literature provided an insight into what was accessible. Help Musicians set up their Music Minds Matter service as a response to their survey in 2016. They state on their website that the new service will offer advice, signposting, emotional support, clinical pathways and professional therapeutic services, counselling, and cognitive behavioral therapy (CBT) to musicians and people within the music industry suffering with mental health issues. The charity Music Support have set up a 24-hr helpline dedicated to the music industry and employ trained and music industry-experienced staff to make referrals to rehabilitation facilities and other appropriate services. They also have a directory of counsellors to whom they refer their members when necessary. While there is no specific therapy for musicians, most available therapies seem to be effective with music industry professionals. In an interview in 2020, Years and Years singer Olly Alexander stated that he had therapy once a week and did mediation and exercise to counter anxiety (Kaplan, 2020). Other musicians have been candid about their use of medication and in speaking with psychiatrists about their mental health, leading to alternative treatments (Berg et al., 2018).

Aim

To provide a rapid review of the literature to inform the design of a code of practice around mental health in the contemporary music industry.

Objectives

The objective of the rapid review as of May 2023 is to establish the following:

Evidence that members of the contemporary music industry are struggling with their mental health.

The reasons for this.

Interventions that contribute to an improvement in mental health in the music industry.

Methods

The development of a code of practice associated with mental health in the music industry will focus on anxiety and depression as the principal symptoms. The existing research within the field defines mental health “struggles” as panic attacks, anxiety, and depression (Gross & Musgrave, 2016). Attempting to identify interventions equated with anxiety and depression through a rapid review could potentially benefit the larger therapeutic community, in particular health practitioners working within the creative industries. Despite a growing number of studies in the field of mental health and music, there is very little evidence illustrating what music industry members need to support them, a shortfall that this rapid review aims to address.

The inclusion criteria for participants used in the following studies featured are contemporary musicians and/or music industry members who have struggled with mental health issues due to being involved in the music industry.

The exclusion criteria for participants featured in the following studies include non-contemporary music industry members, participants who have not had any mental health issues as a result of their involvement in the music industry, and participants who have long-standing mental health issues that are not solely related to the music industry.

In May 2023, Sage Journals, PubMed, PsycINFO, ScienceDirect, Google Scholar, and the Cochrane database of systematic reviews were searched for key terms. The key search terms below were created based previous experience researching mental health in the music industry.

Key search terms were:

Mental Health Music Industry, Addiction and Music Industry, Performance Anxiety, UK Music Charities, Music Industry Code of Practice, Contemporary Music Industry and Mental Health.

Literature was then categorized into three research areas based on the proposed research questions. The three categories were:

Issues regarding mental health and contemporary music industry community members.

The potential catalyst for these issues

Interventions that may help

Results

Searching the key terms revealed over 28,000 results, which were screened to yield 272 articles; from these, 51 pieces of literature were incorporated into the rapid review. Out of the 51 pieces of literature found, 27 were data-providing studies.

Literature on mental health in the contemporary music industry can be found online and is evidently of global interest. The 28,000 results were explored for relevance to the key terms. The majority of the literature cited music therapy rather than “music and mental health” specifically. Therefore, with three exceptions, those articles were disregarded. Remaining were the 51 pieces of literature citing the key terms stated above (Figure 1).

Figure 1.

Prisma flow diagram – a code of practice for mental health in the music industry.

Mental Health in the Music Industry

Research in Canada identified some of the reasons why mental health is suffering so prolifically within the music industry. Keeping “weird” hours for little money, traveling incessantly, and receiving constant pressure from record companies were some of the reasons cited (Raine, 2019).

Help Musicians’ “Can Music Make You Sick?” study from 2016 found that from over 2,000 respondents, 69% of musicians suffered from depression (Gross & Musgrave, 2016). A similar study was carried out in Sweden of over 1500 musicians and found that 73% of musicians had struggled with some sort of mental illness (Record Union, 2019). In Canada a small study of 50 respondents found that 20% had disclosed suicidal thoughts over the past few weeks (Gordon, 2019). One cause cited was touring issues, such as going away for months and then having to come home and fit into everyday life. Lack of money, poor working conditions, and substance abuse were also referenced. The “Can Music Make You Sick?” authors (Gross & Musgrave, 2016) set out to investigate the effects of certain policies on the music industry and the concept of the “gig economy”: inconsistent, temporary employment rather than a stable, permanent job; precarious work; inconsistent financial strains; and the further strain on personal and business relationships. This environment makes for an incredibly difficult situation for musicians to navigate.

A Brazilian study attempted to assess the presence of psychopathologies in musicians and find connections between sociodemographic and clinical variables (Barbar et al., 2014). Overall, 24% of musicians had MPA (music performance anxiety) indicators, 19% had indicators of social anxiety, and 20% of depression. The figures were even higher in comparing professional and amateur musicians, where the rates doubled.

Rock and pop stars represent a unique opportunity to investigate a group with sometimes extreme wealth but frequently from poor backgrounds. Looking at pop star mortality and its association with adverse childhood experiences (Bellis et al., 2012), the researchers acknowledged that although stars are not usually accessible through traditional survey techniques, information can be found on them through biographical publications, news, and other media. They found a link between pop stars and prescribed psychotropic medication use, as well as personality disorders in early adulthood, which have been linked to fame-seeking.

Investigating psychosocial work environment among musicians and in the general workforce in Norway, Detari et al. (2020) found that musicians suffer from physical and mental health symptoms more frequently than the general population . They identified that, although their specific demands and challenges have been researched increasingly in the past, explanations remain somewhat unclear. A total of 1,607 Norwegian Musician's Union members were used alongside a national sample of 8,517 employees from the general Norwegian workforce. The musicians reported that they felt less supported and acknowledged in their work, work–family conflicts were more frequent, and they felt less motivated. Members perceived their work as more demanding compared to the general workforce.

In a study investigating the Australian music industry, it was found that participants were well educated, with all but two participants having graduated high school and college. Their mean annual income was $29,799 below the average yearly income of the general population, which the participants cited as a major cause of anxiety (Eynde et al., 2014).

During a further Australian study, researchers set out to learn how different aspects of being a musician relate to overall well-being and life satisfaction. The survey was looking at candidates who earn most of their income as a musician or are working towards earning most of their income as a musician. A total of 1277 participants were interviewed, and it was found that “many” participants had mental health concerns (MIRA, Survey of Musicians, 2019).

Music distributors The Record Union's “The 73% Report” (2019) found that approximately 73% of independent musicians experience mental health issues – approximately 7 out of 10 people. It identified an increase in mental health issues among younger musicians compared to previous studies. Most common issues were fear of failure related to “topping the charts” at 67% and financial instability at 59%.

Key Changes, a service set up in London that refers musicians and other music industry members to higher-step services such as rehabilitation facilities and hospitals was interviewed in 2017. Funded in part by the UK National Health Service (NHS), services such as counselling, training, and workshops for performance anxiety are provided. Focusing on the suicide of Linkin Park frontman Chester Bennington, the article discusses a rise of such services, including Key Changes and Help Musicians’ 24-hour helpline for musicians struggling with their mental health (Staff, 2017).

In a Norwegian study focusing on the personal and work-related demands and resources associated with the psychological distress in 1607 professional musicians, researchers concluded that further study was required. They stated: “We suggest emphasizing early development of sense of mastery and social support in music education and industry.” They found that job support and personal demands were among those issues affecting psychological distress within the music industry (Aalberg, 2019).

Finding that musicians suffer from physical and mental health symptoms more frequently than the general population, the study by Detari et al. (2020) supported the need for a potential code of practice. Four times as many participants as the “Can Music Make you Sick?” 2016 survey participated. The study, looking at improving the psychosocial work environment for musicians used a control of around 20,000 participants, filtering down to an eventual 8,000. Results indicated that classical and contemporary musicians were experiencing a less favorable psychosocial environment in terms of control, demands, and acknowledgment; orchestral players felt less control; and soloists felt less support.

The motivation to engage with music on a professional level is connected to a satisfaction gained from the music itself (Hallam et al., 2012), focused around the development of a “musical self.” Improvement in the instrument and development of social connections, success, and enjoyment were reported as the main components of building this self-concept and the motivation to decide to have a career in music (Schnare et al., 2011).

Exploring the experiences and impacts of working in the Australian entertainment industry, Executive summary Entertainment Assist is an Australian charity whose goal is to help people overcome the pitfalls of the Australian music industry (Eynde et al., 2014).

The study focused on “The Australian Road Crew Collective,” who had worked as roadies between 1968 and 1982. It was stated that at least 70 roadies have died, many from suicide due to feelings of abandonment. It was not only roadies who report physical issues, psychosocial struggles, and high rates of suicide. Similar concerning reports are emerging from others, such as industry online blogs that have been reporting on suicide and premature deaths of concert-touring lighting workers and production designers.

Looking at the physical demands of classical musicians, it was found that they battle high physical demands at work – repetitive movements, high arm-abduction angles, and forced, unnatural, asymmetrical body postures (Jacukowicz, 2016). Numerous psychosocial demands were cited as a contributor to stress, along with public exposure and the risk of being judged, which may result in performance anxiety. Rivalry, mistakes when playing live, the high demands of regular practice, and concentrating for long hours at a time were also identified as contributing factors. Immediate symptoms of stress within classical players were recognized, such as trembling hands, lips, or legs; excessive perspiration; hot flashes; shortness of breath; and impaired concentration and memory.

Looking at 342 orchestral musicians in Denmark, researchers distinguished various psychosocial aspects of musicians’ work and identified those that were seen as stressful (Paarup et al., 2011). The findings showed that the higher work demands, poor work organization and content, and poor relationships and leadership “increased the intensity of all types of stress.”

A total of 163 electronic music artists participated in a recent study examining the mental health of electronic music artists and using a quantitative approach (Kegelaers et al., 2020). Both symptoms of depression/anxiety and well-being were chosen as indicators of mental health issues. Standardized methods were used to assess potential issues around mental health, including sleep disturbance, music performance anxiety, alcohol abuse, drug abuse, occupational stress, resilience, and social support. Overall, 30% of participants experienced symptoms of depression and/or anxiety while still demonstrating moderate levels of functioning and well-being. Resilience and social support were also significant predictors for well-being. The results provide a first glimpse into the mental health challenges experienced by electronic music artists and support the need for increased research as well as applied initiatives directed at safeguarding their mental health.

In research into the lifestyle demands on musicians, Kenny et al. (2004, 2012) have undertaken a number of studies into the music industry, specifically around musicians. They provide an overview of the risks and challenges facing musicians, with the aim of developing awareness and understanding of how to prevent and manage these challenges. Issues were divided into two sections – physical challenges and psychological challenges – and it was found that musicians are at high risk of both physical and psychological strain and injury in their field. Physical and psychological stressors affect musicians on a grand scale. Careful analysis of the characteristics of the performer and the demands on the musician must be made to develop appropriate interventions (Kenny, 2012).

Furthering this research, Kenny explored the mortality rates, causes of death, and changes in patterns of death over time and by music genre membership in popular musicians who died between 1950 and 2014 (Kenny & Asher, 2016). The results showed excess mortality from violent deaths (suicide, homicide, and accidental death, including vehicular deaths and drug overdoses) and liver disease for each age group studied compared with general population mortality patterns. In particular, excess suicides and liver-related disease were identified in country, metal, and rock musicians; excess homicides were observed in 6 of the 14 genres, in particular hip hop and rap musicians. For accidental death, actual deaths significantly exceeded expected deaths for country, folk, jazz, metal, pop, punk, and rock. This shows a link between genres of music and types of death and needs further exploration into interventions around this area.

A Polish music industry study looking at 165 professional musicians ranging in age from 21 to 89 years and interviewed in 1976–80 found that the professional development of musicians seems to be a life-long process (Manturzewska, 1990).

An Australian study investigating the entertainment industry found that workers experience suicide ideation at levels 5–7 times higher than the general population, levels of moderate to severe anxiety symptoms are 10 times higher, and levels of depression symptoms are five times higher. More and in-depth mental health support was cited as needed, as well as awareness of management to around mental health and well-being and even signposting (Zarate et al., 2022).

Exploring coping strategies around the musician's lifestyle, one survey showed that only a minority of musicians sought help to cope with stress (Parker, 2015). Overall, 82% of respondents reported high to very high job autonomy, and 60% reported high to very high social support from co-workers. Parker stated that professional musicians would benefit from a dedicated support organization, apprenticeship and mentoring programs, and more direct funding to artists rather than projects run by charities.

Research in Northern Ireland and The Republic of Ireland offers an overview of the mental health and well-being of those who work in the creative industries (Shorter et al., 2018) Participants explained how creative output arises through working through life experiences, including pain, suffering, and vulnerability. The conditions of the working environment and the lack of recognition of the value of the work can lead to stress and mental health struggles.

Similar outcomes were recorded in a Norwegian study. Results showed higher prevalence of anxiety and depression symptoms (psychological distress) among musicians compared to a sample of the general Norwegian workforce. A total of 4168 members of the Norwegian Musicians’ Union were invited to participate in an online survey about their mental health and psychosocial work environment (Vaag et al., 2015).

Higher rates of anxiety and depression were seen among vocalists, solo/lead performers, keyboard instrument players, and musicians playing within the traditional genre. Musicians were primarily between the ages of 25–66 years: younger and reported higher levels of education compared to the general workforce. Mental health difficulties were reported in 18% of the musicians and in 8% in the workforce sample.

While reviewing literature around gender and mental health in the music industry, not many significant pieces were identified, which suggests a disparity in studies around music and mental health.

Women in particular are cited as being “disadvantaged by the boundary-crossing between home and work, paid work and unpaid work and new pressures around identity-making and self-presentation, as well as continuing difficulties related to sexism and the need to manage parenting responsibilities alongside earning” (Conor et al., 2015).

Female musicians report significantly more trait anxiety (the tendency to feel anxious consistently, even when there is no immediate risk), music performance anxiety, social anxiety, and other forms of anxiety and depression than male musicians. The youngest female musicians were most affected by music performance anxiety (Kenny et al., 2012). Female musicians struggle more with their mental health than males, with more women than men showing symptoms of distress (female musicians: 21% / workforce: 10% and male musicians: 15% / workforce: 7%).

In contrast, there has been extensive research into drug and alcohol use within the music industry.

Five core reasons for musicians to have dependencies on substances have been cited as:

The pressure to be creative and original

The pressure created by performance anxiety

Trying to manage emotional turbulence generated by life experiences, often accompanied by negative media coverage

Combatting social, cultural, and workplace pressures to drink or use drugs

Dealing with identity issues (public persona versus private self, subcultural identity, and issues with fame and celebrity) (Saintilan, 2019)

“Reward drinking” impacts musicians, leading to matching their intoxication to that of their audience and having incentives for their mental health such as reducing anxiety (Forsyth et al., 2016). Participants reported “constant exposure” to alcohol and drinks as a huge factor contributing to excess drinking. Performance-related encouragement around drinking before, during, and after shows were frequently mentioned, and “free-drinks” were perceived as a “perk of the job,” provided by venues, fans, and peers. Participants disclosed that it was an expectation that musicians should drink.

Within “Insecurity, Professional Sociability, and Alcohol: Young Freelance Musicians’ Perspectives on Work and Life in the Music Industry,” drinking patterns associated with networking and socializing within the job were shown as a way of advancing work prospects among 18 young musicians, in which alcohol consumption was prevalent (Dobson, 2011).

Pitfalls in the music industry are cited as drugs and alcohol use, mental health problems, and suicide and suicide ideation. It has been suggested that the music industry have a “duty of care” toward the mental health of its members (Eynde et al., 2014)

A study looking at the dangers of substance abuse in the music industry offers suggestions for changes that need to be made around drugs and alcohol (Shorter et al., 2018). Drug and alcohol use is significant within the music industry, and raising awareness of the effects of substance use amongst those in the creative industry must improve, focusing particularly on the impact on creativity and health.

Exploring “inter-relationships among state and trait anxiety, occupational stress, perfectionism, aspiration, and music performance anxiety in a group of elite operatic chorus artists employed full-time by a national opera company,” researchers found that chorus artists reported higher trait anxiety, higher occupational role concerns, and higher occupational personal strain (Kenny et al., 2004). Psychosocial work aspects, stress, and musculoskeletal pain among musicians were found to be significant among musicians who come across high physical demands at work and face psychosocial demands that can lead to stress. For example, public exposure and the risk of being judged can result in performance anxiety.

A total of 163 electronic music artists were surveyed in a Norwegian study. Performance anxiety was identified as being the main factor that led to poor mental health, alongside sleep disturbances and job insecurity (Kegelaers et al., 2020). The results provide a first glimpse into the mental health challenges experienced by electronic music artists and support the need for increased research as well as applied initiatives directed at safeguarding their mental health.

A total of 155 of 650 professional musicians playing in symphonic orchestras in The Netherlands completed a self-report questionnaire concerning performance anxiety (Van Kemenade et al., 1995). Of the 155 respondents, 91 disclosed experiencing performance anxiety intensely enough to affect their professional or personal lives. There appeared to be no difference in impact between men and women. Significant percentages of anxious musicians reported “considerable anticipation anxiety” days (36%), weeks (10%), or even months (5%) prior to a performance. The results indicate that performance anxiety is a significant professional problem, and the researchers recommended that “teaching explicit coping strategies should be incorporated in the curricula of schools of music.”

Existing Interventions

As per the literature on mental health and musicians, we can categorize the existing service provision landscape into a number of clearly defined areas:

- Talking therapies

- Triage/telephone services

- Medical interventions

- Music therapy

- Technology and apps

The rapid review unearthed several pieces of literature on the subject of interventions. However, the lack of literature also highlights a need for more research into mental health interventions and “what works” for the contemporary music scene and its members.

Talking Therapies

Help Musicians set up their Music Minds Matter service as a response to their survey in 2016. They state on their website the new service will offer advice, signposting, emotional support, clinical pathways, professional therapeutic services, counselling, and cognitive behavioral therapy (CBT) to musicians and people within the music industry suffering with mental health issues.

Offering a clinical perspective is the Music Industry Therapist Collective, a community of psychotherapists and counsellors with a background in the industry. The collective, based in London and Los Angeles, works in person and online with individuals and bands, as well as offering workshops and group therapy. The collective is also working on a best practice guide, the Touring and Mental Health Manual, to tackle issues including performance anxiety, relationship difficulties, addiction, stress and burn-out, trauma, and post-tour depression (Hussey, 2023).

Triage/Telephone Services

The charity Music Support have set up a 24-hr helpline dedicated to the music industry and employs trained and music industry-experienced staff to make referrals to rehabilitation facilities and other appropriate services. They also have a directory of counsellors that they refer their members to when necessary.

Eric Mtungwazi, managing director of Music Support, stated that over 1000 people had used their services and mental health support apps over the previous six months during the pandemic. Here, he talks of the issues that musicians have faced:

“Around 50 percent of people are coming to us with anxiety issues and 35 percent are dealing with depression at a moderate to severe level. There have been a number of people who have talked about suicide in recent months too, that's at the most severe and acute end of the scale. We’re also getting increasing calls relating to alcohol and/or substance abuse” (Trendell, 2020).

Medical Interventions

While there is no specific therapy for musicians, most available therapies seem to be effective with music industry professionals. In an interview in 2020, Years and Years singer Olly Alexander stated that he had therapy once a week and did mediation and exercise to counter anxiety (Kaplan, 2020). Other musicians have been candid about their use of medication and of speaking with psychiatrists about their mental health, leading to alternative treatments (Bakare, 2020).

During a study in Austin, Texas, it was found that out of 260 musicians, 84% taking psychiatric medication felt strongly that their mental health had improved as a result of the treatment (Berg et al., 2018). Medical approaches that consider the physical, emotional, and social aspects of a musician's life may be effective. This could involve collaboration between mental health professionals and medical practitioners leading to the prescribing of appropriate medication (Van Fenema et al., 2013).

Substance Use Disorder (SUD) is recognized as a chronic, relapsing disorder, often requiring ongoing, sustained attention and care. The acute care model, which typically focuses on clinical stabilization and discharge, may not adequately address the longer-term needs of individuals in recovery from addiction (Stanojlović & Davidson, 2021). Addiction often involves complex factors, including biological, psychological, and social elements. Adopting a long-term recovery-oriented systems of care (ROSC) model involves creating a network of services and support that emphasize sustained recovery. This may involve collaboration between treatment providers and community organizations to create a supportive environment. Charities such as Music Support refer their service users within the music industry to rehabilitation centers to aid recovery, but a long-term recovery can be difficult within the music industry lifestyle (Saintilan, 2019).

Technology and Apps

In April 2021, Music Support teamed up with “Thrive,” a mental health app approved by the NHS, focusing on improving overall wellbeing for users inside and outside of work by building personal awareness and allowing them to nurture their own mental health. The app claims to tackle common stressors, such as sleep, bereavement, and work issues, via the use of evidence-based therapies, such as CBT, meditation, deep muscle relaxation, breathing exercises, and distraction games. The app also uses official GAD7 and PHQ9 questionnaires to assess users for anxiety and depression, prescribing the relevant support.

Music Therapy

There has been considerable research undertaken on the positive effects of music therapy on the general public; however, research excludes members of the music industry community being beneficiaries of music therapy. Music-making itself could be considered an intervention in mental health and the music industry though no research has been undertaken around music-making as a prescribed mediation for the music industry and mental health.

Aalbers et al. (2017) found that music therapy plus medicinal treatment is more effective than treatment alone and that it can considerably reduce depressive symptoms and anxiety and helps to improve functioning such as involvement in jobs, activities, and relationships.

A systematic review of music therapy in cancer patients indicated that music interventions may be beneficial to symptoms of anxiety, pain, and fatigue. Music may have a small effect on heart rate, respiratory rate, and blood pressure (Bradt et al., 2016).

The effects of music therapy on preoperative anxiety in surgical patients was also investigated by Bradt et al. The findings indicate that music listening may have a beneficial effect on preoperative anxiety. These findings are consistent with the findings of three other Cochrane systematic reviews on the use of music interventions for anxiety reduction in medical patients:

“Therefore, we conclude that music interventions may provide a viable alternative to sedatives and anti-anxiety drugs for reducing preoperative anxiety.”

The effects of music-listening interventions are primarily attributed to the general influence of music on the stress response (de Witte et al., 2020). The effects of music therapy, in contrast, may be explained not only by the influence of music on stress but also by the therapeutic relationship established between the patient and therapist. Music therapy involves an interactive process, and the therapeutic relationship is facilitated through patient–therapist attunement, utilizing music as a medium. Dileo (2006) suggests that music therapy is more effective than music medicine interventions (focusing on the clinical benefits of music on patients), emphasizing that music therapists individualize their interventions to meet the specific needs of each patient. The individualized nature of music therapy contributes to its effectiveness compared to more generalized music medicine interventions.

Strengths and Limitations

Interest in both academic and non-academic literature regarding mental health in the music industry is increasing globally. There are numerous studies available, especially in Australia, where it has been recognized that since COVID-19, the conditions of working music industry members have been difficult and mental health is suffering. This rapid review focused on identifying the impact of mental health issues in the contemporary music industry and interventions that may be useful in helping the music industry and its members deal with such issues. Strengths to this are that there is literature available supporting the negative impact that working in the music industry can have upon its members. Members of the contemporary music industry regularly offer their experiences in public forums, meaning that we can learn about the growing pitfalls of the music industry lifestyle regarding mental health. The subject is of interest to people involved in the music industry and to members of the general public who have a curiosity for the music industry, and therefore research is being funded on a more frequent basis than heretofore.

The limitations of researching the literature for this rapid review have largely centered around the lack of research around interventions that have helped music industry members with their mental health. The plethora of academic and non-academic literature focusing on participants’ mental health has not necessarily led to solutions or interventions that may be of help. Music therapy is often confused with therapy in the music industry. Literature has been included on the efficacy of music therapy on people struggling with their mental and physical health, although these studies are not directly linked to those involved and working within the music industry. Conclusions could be drawn on the health benefits of music-making, but not enough evidence is available to make a definitive resolution that this is the case, especially with so much evidence detailing the difficulties of the music industry on mental health.

Recommendations for Future Research

With the lack of research regarding mental health interventions within the music industry and their efficacy, I would recommend further research being undertaken to establish “what works.” The research I am attempting to embark on for my PhD will provide facts on what participants in the music industry feel has worked for them around their mental health and/or what they feel they need to support their own mental health while working in the music industry. The literature available lacks clarification on job roles, age, and pre-existing conditions, factors that would benefit from definition to best inform research on how the music industry affects mental health. Further research in this field would be beneficial.

Footnotes

Action Editor

Jörg Fachner, Anglia Ruskin University, Cambridge Institute for Music Therapy Research.

Peer Review

Rosie Axon, Chiltern Music Therapy. Lutz Neugebauer, Deutsche Musiktherapeutische Gesellschaft.

Data Availability Statement

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical Approval

Not Applicable.

ORCID iDs

Rachel Jepson

Michael Sims

Jermaine Ravalier

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