A systematic review of mental health and wellbeing outcomes of group singing for adults with a mental health condition

Journal article

Williams, E., Dingle, G. and Clift, S. 2018. A systematic review of mental health and wellbeing outcomes of group singing for adults with a mental health condition. The European Journal of Public Health. https://doi.org/10.1093/eurpub/cky115
AuthorsWilliams, E., Dingle, G. and Clift, S.
Abstract

Background
A growing body of research has found that participating in choir singing can increase positive emotions, reduce anxiety and enhance social bonding. Consequently, group singing has been proposed as a social intervention for people diagnosed with mental health problems. However, it is unclear if group singing is a suitable and effective adjunct to mental health treatment. The current paper systematically reviews the burgeoning empirical research on the efficacy of group singing as a mental health intervention.

Methods
The literature searched uncovered 709 articles that were screened. Thirteen articles representing data from 667 participants were identified which measured mental health and/or wellbeing outcomes of group singing for people living with a mental health condition in a community setting.

Results
The findings of seven longitudinal studies, showed that while people with mental health conditions participated in choir singing, their mental health and wellbeing significantly improved with moderate to large effect sizes. Moreover, six qualitative studies had converging themes, indicating that group singing can provide enjoyment, improve emotional states, develop a sense of belonging and enhance self-confidence in participants.

Conclusion
The current results indicate that group singing could be a promising social intervention for people with mental health conditions. However, these studies had moderate to high risk of bias. Therefore, these findings remain inconclusive and more rigorous research is needed.

KeywordsEmotions; adult; mental health; community; qualitative research; singing
Year2018
JournalThe European Journal of Public Health
PublisherOxford University Press
ISSN1101-1262
Digital Object Identifier (DOI)https://doi.org/10.1093/eurpub/cky115
Publication dates
Print02 Jul 2018
Publication process dates
Deposited20 Jun 2018
Accepted01 Jun 2018
Accepted author manuscript
Output statusPublished
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Sexual feelings and relationships: a booklet for young people
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Merton, Sutton and Wandsworth female sex workers outreach project report
Clift, S. 1995. Merton, Sutton and Wandsworth female sex workers outreach project report. Merton, Sutton and Wandsworth Health.
Europe against AIDS summer campaign 1995 schools resource pack
Clift, S. and Thomas, L. 1995. Europe against AIDS summer campaign 1995 schools resource pack. Canterbury Christ Church University.
Sexual behaviour abroad: a study of genito-urinary clinic attenders
Black, P., Clift, S. and Wijesurendna, C. 1995. Sexual behaviour abroad: a study of genito-urinary clinic attenders. Travel Medicine International. 13 (6), pp. 66-69.
Part V: Psychology - Coach and players' assessment of coach effectiveness in an elite men's hockey team
Balsdon, A., Clift, S., Underwood, G. and Stephenson, G. 2001. Part V: Psychology - Coach and players' assessment of coach effectiveness in an elite men's hockey team. Journal of Sports Sciences. 16 (1), pp. 71-72. https://doi.org/10.1080/026404198366966
Gay tourist space and sexual risk behaviour
Forrest, S. and Clift, S. 1998. Gay tourist space and sexual risk behaviour. in: Aitchison, C. and Jordan, F. (ed.) Gender, Space and Identity Eastbourne Leisure Studies Association. pp. 163-176
An exploration of players' and coach's assessment of player performance in an elite men’s hockey team
Balsdon, A., Clift, S., Bird, S. and Stephenson, G. 2001. An exploration of players' and coach's assessment of player performance in an elite men’s hockey team. Journal of Sports Sciences. 19 (1), p. 16. https://doi.org/10.1080/026404101750070166
The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older people: protocol for a randomised controlled trial
Skingley, A., Clift, S., Coulton, S. and Rodriguez, J. 2011. The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older people: protocol for a randomised controlled trial. BMC Public Health. 11 (1), p. 142. https://doi.org/10.1186/1471-2458-11-142
Romance and sex on holidays abroad: a study of magazine representations
Clift, S. 1994. Romance and sex on holidays abroad: a study of magazine representations. Canterbury Canterbury Christ Church College.
The use of singing-in-a-group as a response to adverse life events
Von Lob, G., Camic, P. and Clift, S. 2010. The use of singing-in-a-group as a response to adverse life events. International Journal of Mental Health Promotion. 12 (3), pp. 45-53. https://doi.org/10.1080/14623730.2010.9721818
The significance of choral singing for sustaining psychological wellbeing: findings from a survey of choristers in England, Australia and Germany
Clift, S. and Hancox, G. 2010. The significance of choral singing for sustaining psychological wellbeing: findings from a survey of choristers in England, Australia and Germany. Music Performance Research. 3 (1), pp. 79-96.
Singing for health: a musical remedy
Clift, S. 2010. Singing for health: a musical remedy. British Journal of Wellbeing. 1 (6), pp. 19-21.
Let the music play
Clift, S. 2010. Let the music play. British Journal of Wellbeing. 1 (1), pp. 15-17.
The Silver Song Club Project: A sense of well-being through participatory singing
Bungay, H., Clift, S. and Skingley, A. 2010. The Silver Song Club Project: A sense of well-being through participatory singing. Journal of Applied Arts and Health. 1 (2), pp. 165-178. https://doi.org/10.1386/jaah.1.2.165_1
Arts on prescription: A review of practice in the UK
Bungay, H. and Clift, S. 2010. Arts on prescription: A review of practice in the UK. Perspectives in Public Health. 130 (6), pp. 277-281. https://doi.org/10.1177/1757913910384050
Supported further education provision for people with long-term mental health needs: Findings from a survey of further education colleges and primary care trusts across the south east of England
Morrison, I., Clift, S. and Stosz, L. 2010. Supported further education provision for people with long-term mental health needs: Findings from a survey of further education colleges and primary care trusts across the south east of England. Perspectives in Public Health. 130 (2), pp. 78-85. https://doi.org/10.1177/1757913909360454
Australian data from the "cross-national research on the effects of choral singing" project
Stewart, D., Sun, J., Clift, S., Hancox, G., Morrison, I., Hess, B. and Kreutz, G. 2008. Australian data from the "cross-national research on the effects of choral singing" project.
Stress and Antonovsky's Resistance Resources: A practical example
Morrison, I. and Clift, S. 2007. Stress and Antonovsky's Resistance Resources: A practical example. Stress News. 19 (2), pp. 4-5.
Mental health needs in the workplace
Morrison, I. and Clift, S. 2005. Mental health needs in the workplace. The Institution of Electrical Enginners Engineering Management. 15 (2), pp. 36-37.
The Open Door programme: student journeys to employment and university
Morrison, I. and Clift, S. 2005. The Open Door programme: student journeys to employment and university. A Life in the Day. 9 (2), pp. 23-26. https://doi.org/10.1108/13666282200500016
A survey of supported education for people with long-term mental health needs in Further Education colleges in the South East of England
Morrison, I. and Clift, S. 2006. A survey of supported education for people with long-term mental health needs in Further Education colleges in the South East of England. Canterbury Canterbury Christ Church University.
Arts and healthy communities in the South East
Clift, S. and Vella-Burrows, T. 2003. Arts and healthy communities in the South East. Canterbury Canterbury Christ Church University.
The MusicStart Project: evaluation of an early years music initiative
Clift, S., MacKenzie, K. and Bushell, F. 2006. The MusicStart Project: evaluation of an early years music initiative. Canterbury Canterbury Christ Church University.
Choral singing, wellbeing and health: findings from a cross-national survey
Clift, S., Hancox, G., Morrison, I., Hess, B., Stewart, D. and Kreutz, G. 2008. Choral singing, wellbeing and health: findings from a cross-national survey. Canterbury Canterbury Christ Church University.
Choral singing and psychological wellbeing: quantitative and qualitative findings from English choirs in a cross-national survey
Clift, S., Hancox, G., Morrison, I., Hess, B., Kreutz, G. and Stewart, D. 2010. Choral singing and psychological wellbeing: quantitative and qualitative findings from English choirs in a cross-national survey. Journal of Applied Arts and Health. 1 (1), pp. 19-34. https://doi.org/10.1386/jaah.1.1.19/1
Singing and health: a systematic mapping and review of non-clinical research
Clift, S., Hancox, G., Staricoff, R. and Whitmore, C. 2008. Singing and health: a systematic mapping and review of non-clinical research. Canterbury Canterbury Christ Church University.
Evaluation of the 'Sound Start' project - singing to babies before and after birth
Clift, S. 2002. Evaluation of the 'Sound Start' project - singing to babies before and after birth. Canterbury Canterbury Christ Church University College.
Southampton Silver Song Club: reflections on music making with elderly people facilitated by student volunteers
Bamford, A. and Clift, S. 2007. Southampton Silver Song Club: reflections on music making with elderly people facilitated by student volunteers. Canterbury Canterbury Christ Church University.
Music into Upton: reflections on an initiative to bring live music into a hospital setting
Bamford, A. and Clift, S. 2007. Music into Upton: reflections on an initiative to bring live music into a hospital setting. Canterbury Canterbury Christ Church University.
Making singing for health happen: reflections on a 'Singing for the Brain' training course
Bamford, A. and Clift, S. 2007. Making singing for health happen: reflections on a 'Singing for the Brain' training course. Canterbury Canterbury Christ Church University.
An evidence base for mental health promotion through supported education: a practical application of Antonovsky's salutogenic model of health
Morrison, I., Stosz, L. and Clift, S. 2008. An evidence base for mental health promotion through supported education: a practical application of Antonovsky's salutogenic model of health. International Journal of Health Promotion and Education. 46 (1), pp. 11-20.
The MusicStart Project: an evaluation of the impact of a training programme to enhance the role of music and singing in educational settings for children aged three to five years
MacKenzie, K. and Clift, S. 2008. The MusicStart Project: an evaluation of the impact of a training programme to enhance the role of music and singing in educational settings for children aged three to five years. International Journal of Music Education. 26 (3), pp. 229-242. https://doi.org/10.1177/0255761408092524
Choral singing and psychological wellbeing: findings from English choirs in a cross-national survey using the WHOQOL-BREF
Clift, S., Hancox, G., Morrison, I., Hess, B., Kreutz, G. and Stewart, D. 2007. Choral singing and psychological wellbeing: findings from English choirs in a cross-national survey using the WHOQOL-BREF. in: Williamon, A. and Coimbra, D. (ed.) Proceedings of the International Symposium on Performance Science Association Européenne des Conservatoires, Académies de Musique et Musikhochschulen. pp. 201-207
Tourism and the sexual ecology of gay men
Clift, S. and Forrest, S. 2000. Tourism and the sexual ecology of gay men. in: Clift, S. and Carter, S. (ed.) Tourism and Sex: Culture, Commerce and Coercion Leicester Pinter.
Gay tourism, sex and sexual health promotion
Clift, S. and Forrest, S. 2000. Gay tourism, sex and sexual health promotion. in: Horne, J. and Fleming, S. (ed.) Masculinities: Leisure Culture, Identities and Consumption Eastbourne Leisure Studies Association.
Factors associated with the sexual behaviour and risk of gay men on holiday
Clift, S. and Forrest, S. 1999. Factors associated with the sexual behaviour and risk of gay men on holiday. AIDS Care. 11 (3), pp. 281-295.
Sex and international travel: behaviour, health and human rights
Clift, S. 2003. Sex and international travel: behaviour, health and human rights. in: Bor, R. (ed.) Passenger Behaviour London Ashgate.
Tourism and health: present issues and future concerns
Clift, S. 2000. Tourism and health: present issues and future concerns. Tourism Recreation Research. 25 (3), pp. 55-61.
The health promoting school: a resource for developing indicators
Barnekov, V., Buijs, G., Clift, S., Jensen, B., Paulus, P., Rivett, D. and Young, I. 2006. The health promoting school: a resource for developing indicators. Copenhagen International Planning Committee of the European Network of Health Promoting Schools Task Force.
Cognitive predictors of adherence to malaria prophylaxis regimens on return from a malarious region: a prospective study
Abraham, C., Clift, S. and Grabowski, P. 1999. Cognitive predictors of adherence to malaria prophylaxis regimens on return from a malarious region: a prospective study. Social Science and Medicine. 48, pp. 1641-1654.
Incidence and location of diabetic foot ulcer recurrence
Galea, A., Springett, K., Clift, S., Bungay, H., Fava, S. and Cachia, M. 2009. Incidence and location of diabetic foot ulcer recurrence. The Diabetic Foot Journal. 12 (4), pp. 181-186.
Antonovsky revisited: implications for mental health promotion practice
Morrison, I. and Clift, S. 2007. Antonovsky revisited: implications for mental health promotion practice. International Journal of Mental Health Promotion. 9 (2), pp. 36-46. https://doi.org/10.1080/14623730.2007.9721837
Mental health promotion through supported further education: The value of Antonovsky's salutogenic model of health
Morrison, I. and Clift, S. 2006. Mental health promotion through supported further education: The value of Antonovsky's salutogenic model of health. Health Education. 106 (5), pp. 365-380. https://doi.org/10.1108/09654280610685956
Music and well-being
Clift, S. and Hancox, G. 2006. Music and well-being. in: Greenstreet, W. (ed.) Integrating Spirituality in Health and Social Care: Perspectives and Practical Approaches Oxford Radcliffe Publishing. pp. 151-165
Arts and health
Clift, S. 2011. Arts and health. Perspectives in Public Health. 131 (1), p. 8. https://doi.org/10.1177/17579139111310010401
The perceived benefits of singing: findings from preliminary surveys of a university college choral society
Clift, S. and Hancox, G. 2001. The perceived benefits of singing: findings from preliminary surveys of a university college choral society. The Journal of the Royal Society for the Promotion of Health. 121 (4), pp. 248-256. https://doi.org/10.1177/146642400112100409
Malaria prophylaxis and the media
Clift, S. and Grabowski, P. 1996. Malaria prophylaxis and the media. The Lancet. 348 (9023), pp. 344-344. https://doi.org/10.1016/S0140-6736(05)64522-9
Factors associated with gay men's sexual behaviours and risk on holiday
Clift, S. and Forrest, S. 1999. Factors associated with gay men's sexual behaviours and risk on holiday. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV. 11 (3), pp. 281-295. https://doi.org/10.1080/09540129947929
Shall we dance? An exploration of the perceived benefits of dancing on well-being
Quiroga Murcia, C., Kreutz, G., Clift, S. and Bongard, S. 2010. Shall we dance? An exploration of the perceived benefits of dancing on well-being. Arts & Health: An International Journal for Research, Policy and Practice. 2 (2), pp. 149-163. https://doi.org/10.1080/17533010903488582
The arts and global health inequities
Clift, S., Camic, P. and Daykin, N. 2010. The arts and global health inequities. Arts & Health: An International Journal for Research, Policy and Practice. 2 (1), pp. 3-7. https://doi.org/10.1080/17533010903421476
Coming of age for arts and health: what we hope to achieve
Camic, P., Clift, S. and Daykin, N. 2009. Coming of age for arts and health: what we hope to achieve. Arts & Health: An International Journal for Research, Policy and Practice. 1 (1), pp. 3-5. https://doi.org/10.1080/17533010802614627
The state of arts and health in England
Clift, S., Camic, P., Chapman, B., Clayton, G., Daykin, N., Eades, G., Parkinson, C., Secker, J., Stickley, T. and White, M. 2009. The state of arts and health in England. Arts & Health: An International Journal for Research, Policy and Practice. 1 (1), pp. 6-35. https://doi.org/10.1080/17533010802528017
Guest Editorial
Clift, S. 2005. Guest Editorial. Health Education. 105 (5), pp. 328-331. https://doi.org/10.1108/09654280510617150
Dimensions of holiday experience and their implications for health: a study of British tourists in Malta
Clift, S. and Clark, N. 1995. Dimensions of holiday experience and their implications for health: a study of British tourists in Malta. Canterbury Christ Church University.