Alfredo de Oliveira Neto is a Professor at the Department of Primary Health Care, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Arnab Bishnu Chowdhury is a Senior Researcher at the Sri Aurobindo Ashram Trust, Pondicherry, India; and founder of Know Your Rhythm.
Christopher Dowrick is Emeritus Professor of Primary Medical Care at the Department of Mental Health and Primary Care, University of Liverpool, Liverpool, UK.
Since the second half of the 20th century, there has been a considerable growth of interest in the benefits of cultural participation for health and wellbeing, and, particularly, involvement with the creative arts. Evaluation studies have documented these benefits in a systematic way, contributing to the growth of evidence-based practice. We focus here on music.
Music is beneficial to our mental health. Engaging with music, whether in the form of passive listening or active music making, has positive impacts on our quality of life and wellbeing, prosocial behaviour, social connectedness, and emotional competence. It enhances the lives of people with experience of anxiety and depression, substance use disorders, and psychosis.1
“Music, like yoga, offers us the possibility of a radical change of consciousness …”
The constant chatter and distractibility of the mind, the perpetual hankering for different objects of desire, and the recurrent pull of inertia are states of psychological disturbance that mar our inner wellbeing. At the psychological level, music acts as a powerful tool for mood regulation, enabling us to cope with negative experiences by alleviating negative moods and feelings. Physiologically, music modulates arousal levels including heart rate and cortisol, and impacts neurochemical pathways involved in reward processing. Music is a balm to the spirit, bringing people and communities together. Socially, it is a fundamental resource for connecting our own lives to our communities and environment, with the ability to fuel social and political movements.2
From an existential perspective, through reflection and illustration of the serious problems we face in our lives, music offers catharsis, relief from strong or repressed emotions. It is simultaneously expressive and transformative of despair. The contemporary philosopher Charles Taylor understands music, along with other creative art forms, as an interspace, the locus of a ‘strong sense of cosmic order, and of our connection to it.’ 3 When we listen to sublime music, our experience is not simply of pleasure but of an overwhelming feeling of encountering and exploring some truth. Music, like yoga, offers us the possibility of a radical change of consciousness through enhancing a sense of peace, inner security, and confidence.4
The Music and Mental Health Project
The World Organization of Family Doctors (WONCA) is a global not-for-profit professional organisation representing family physicians and GPs from all regions of the world. WONCA has an active working party focusing on mental health. The Music and Mental Health Project (MMHP) emerged from conversations within the WONCA Working Party on Mental Health about the challenges posed by the COVID-19 pandemic.
Our objective is to expand the visibility of musical projects across family medicine and primary care. We wish to sensitise family physicians, other health professionals and managers, as well as patients and their families, to the transformative power of music as a tool for care in psychosocial suffering.
“Music is a balm to the spirit, bringing people and communities together.”
MMHP started during the pandemic in 2020 with a worldwide outreach to register similar musical experiences for therapy and healing on Google Forms. We found 30 musical experiences across 14 different countries. We produced a teaser with MMHP members singing verses from The Beatles’ Here Comes the Sun;5 and composed Tone of Mind, a hopeful song recorded in Brazil and India.6
Gradually, MMHP has focused its attention on musical expressions led by people with twin expertise in music and healthcare practice. Each of the four selected members represent a continent and culture: Brazil, India, Australia, and South Africa. Across the years, they have shared their challenges, solutions, and experiences in this growing field, and we share details of their work below:
Harmony Gets Crazy (Brazil). This band, comprised of psychiatric patients and health professionals, originated from music therapy workshops at the Rio de Janeiro Psychiatric Centre that started 23 years ago, and which challenges stigmatising notions of insanity.7,8 Currently in the process of recording their fifth album featuring original songs, the band serves as a potent symbol of Brazilian psychiatric reform. They show how psychiatric reform processes have produced not only new possibilities for life, expression, and social inclusion for the subjects of mental suffering, but also the construction of a new social place for madness. Alfredo de Oliveira Neto, family physician, is an active member of this musical band based in Rio de Janeiro.
Know Your Rhythm (India). A training programme created by Arnab Bishnu Chowdhury. It blends music therapy with yoga therapy, helping participants discover their own sense of rhythm while raising wellbeing, wellness, empathy, teamwork, and leadership. Based in Pondicherry, south India, Arnab is third generation from a family of Indian classical musicians and traces his musical lineage to Baba Allaudin Khan, the master teacher of Ravi Shankar, the sitar maestro, and Rabin Ghosh, the violin maestro, who was Arnab’s grand uncle. He collaborates with doctors, therapists, and international musicians to compose therapeutic music for different conditions. Over the past 10 years, Know Your Rhythm has engaged over 20 000 global caregivers from health care including COVID-19, wellness, special education, management, and education spaces.
Project Susthiti (which means ‘stability’ in Sanskrit) composed original Raga-based music tapping into the framework of Raga Chikitsa based on the requirements of COVID-19 warriors working in COVID wards, and applied our music to induce deep relaxation, rest, and sleep. This music helped about 300 healthcare workers across India lower stress and anxiety, and raise levels of empathy and bravery during the COVID-19 pandemic. For example, in a specific pilot study with 19 participants in Shree Krishna Hospital in Anand, Gujarat, listening to the composition daily for 1 week after completing 12 hours of duty led 68% of participants to record significant change in alertness, followed by calmness and control over anger.9
“Our objective is to expand the visibility of musical projects across family medicine and primary care.”
The Desert Stars (Australia). Hailing from the Tjuntjuntjara Community in the remote Great Victoria Desert region of Western Australia, The Desert Stars claim the title of ‘the world’s most remote rock band.’ 10 Jay Minning is lead singer and songwriter. The journey of this unique rock band is documented in Gravel Road, a 2022 film directed by Tristan Pemberton.
Delisile Kubheka (South Africa). A healthcare professional and classical opera singer. She currently serves as a qualified Health Promotion Officer in the Health Research Fraternity with Wits Health HUBB, a research division of Wits Health Consortium. In 2020, Kubheka won the Sarah Walker prize in the Voices of South Africa International Singing Competition.
Our current project is producing a documentary about the daily life of these people, their stories, and their songs, filmed by the participants themselves. We ask them all the following questions:
- Can music serve to engage and reduce stress and other mental health challenges of the individual and community?
- What about the care-receiver and caregiver?
- How do musical collaborations, whether in person or online, lead to positive change in mental health?
- And what are our musical experiences teaching us from various perspectives – emotional, social, and spiritual?
We explore how music fits into and helps their lives, and show how music leads to positive mental health outcomes. Case studies include Project Empathy, offering therapy and care for children and their caregivers, and Project Gratitude, in which receptive music therapy led to significant reduction in peri-operative anxiety for women during caesarean section and hysterectomy, and reduced stress in their caregiving team.11 Both Project Empathy and Project Gratitude are initiatives from Know Your Rhythm.
“We propose that access to music deserves to be a basic human right too.”
We show how music can enable family doctors, working in teams with other health professionals and local communities, to create a unique ecosystem to provide the right care in a sustainable and appropriate way. We confirm that music serves as a balm for the spirit of both performers and listeners, a glue that binds a community of caregivers and care-receivers.
The World Health Organization recognises mental health as a basic human right.12 We propose that access to music deserves to be a basic human right too. Our mental health, like our physical health, is complex in nature. It needs healing, deep rest, and positive activity that fosters bonding and empathy for itself, and builds resonance with other members of the community.
There is an urgent need to consider the way forward for music and mental health studies, strategies, and practices that help us raise the quality of our lives, at the level of personal, social, spiritual, and community development. Music and mental health evidence-based studies need to happen in close collaboration with mental health and medical professionals, building protocols, programmes, and sets of best practices, while bearing in mind the needs of the specific culture and local community.
References
1. Gustavson DE, Coleman PL, Iversen JR, et al. Mental health and music engagement: review, framework, and guidelines for future studies. Transl Psychiatry 2021; 11(1): 370.
2. Turino T. Music as social life: the politics of participation. Chicago, IL: University of Chicago Press, 2008.
3. Taylor C. Cosmic connections: poetry in the age of disenchantment. Harvard, MA: Harvard University Press, 2024.
4. Dalal AS. Living within: the yoga approach to psychological health and growth. Selections from the works of Sri Aurobindo and The Mother. Pondicherry: Sri Aurobindo Ashram Trust, 1987.
5. World Organization of Family Doctors – WONCA. Music and Mental Health Project – WONCA WWPMH (Here Comes the Sun Cover). YouTube 2021; 15 Jun: https://www.youtube.com/watch?v=qg1n4WMfbHo (accessed 11 Mar 2025).
6. WONCA. Music and Mental Health: Tone of Mind. 2021. https://www.globalfamilydoctor.com/News/MusicandMentalHealthProject.aspx (accessed 11 Mar 2025).
7. Siqueira-Silva R, Moraes M, Nunes JA. Music groups and mental health: actors working within the scenario of psychiatric reform in Rio de Janeiro, Brazil. Revista Crítica de Ciências Sociais 2011; 94: 87–107.
8. Amarante P, Torre EHG. Madness and cultural diversity: innovation and rupture in experiences of art and culture from Psychiatric Reform and the field of Mental Health in Brazil. Interface (Botucatu) 2017; 21(63): 763–774.
9. Yajnik K, Chowdhury AB, Varma J, et al. The effect of music and yoga on healthcare professionals working in COVID-19 isolation wards – a pilot study. Vellore: Christian Medical College, 2020.
10. Fletcher J. The long and winding Gravel Road. https://www.filmink.com.au/the-long-and-winding-gravel-road (accessed 11 Mar 2025).
11. Vaishnav S, Chowdhury AB, Raithatha N, et al. Receptive music therapy: an effective means to enhance well-being in patients undergoing caesarean section and hysterectomy and their operating team. International Journal of Yoga – Philosophy, Psychology and Parapsychology 2021; 9(2): 73–79.
12. World Health Organization. Mental health: promoting and protecting human rights. 2023. https://www.who.int/news-room/questions-and-answers/item/mental-health-promoting-and-protecting-human-rights (accessed 11 Mar 2025).
Great initiative in search of truth.We otherwise believed the power of music in our culture.