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Overview of research on singing for mental health and well-being of children and young people

Within the context of the arts and health movement and the initiatives outlined above which advocate for the promotion of arts for health and well-being, this overview will highlight some of the ways in which singing may support the health and well-being of children and young people.

“Singing is not only the exercise of the body function but also a way of self-expression, which brings about a positive personal and social impact” (Kang et al, 2018, p. 394)

This overview is presented in 3 broad areas linked to mental health and well-being. The focus is on research related to children and young people and draws on some wider research in order to provide further information. It is acknowledged that these headings will have some degree of cross-over.

  1. Personal – identity, sense of well-being, purpose, agency, mood/emotions, spiritual

  2. Neurobiological – immune function, heart rate, arousal, relaxation, cognitive & executive functions

  3. Social – entrainment, connection, emotions, cognition, executive functions (in relation to connecting with others)

​1. Personal

In a rapid review of children and young people’s arts programmes, findings consistently highlight the positive impacts on resilience and mental well-being.

Group singing has been shown to improve children’s psychological well-being, with more subtle results for those with existing high levels of psychological well-being, suggesting that more improvement may be evidenced in those with poorer mental health. These findings mirror studies with adult populations which indicate that group singing develops mental well-being.

A study which explored the notion of well-being using the PERMA model and reflecting on this in with the context of ‘flow’ theory concluded that subjective well-being can be positively impacted through immersive and enjoyable singing.

Singing can improve self-esteem and reduce depression in children and young people.

Children and young people who engage in high quality singing opportunities leads to a positive singer identity, which in turn contributes to higher levels of self-esteem and positive evaluations of singing ability.

Self-efficacy can be nurtured and developed through singing, which is highlighted in this study where measures were much higher for children engaging in music than those who were not.

Children with Asthma took part in a study to explore the potential of singing for support with their condition. Results found that children were better able to manage their Asthma and noted improvements in self-esteem as well as feeling positive benefits of a family focussed approach. It is well documented that singing can promote improved respiratory health and general well-being for those living with COPD (chronic obstructive pulmonary disease).

2. Neurobiological

A study in Austria compared measures of psychological and biological impacts on children of in-person choir singing with virtual singing. Although there were positive findings overall, the in-person singing seemed to have a stronger psychobiological effect. Cortisol levels (salivary) saw a marked decrease for the in-person participants, along with observed reduction in stress and higher levels of calmness.

Cortisol is the ‘stress’ hormone produced when the nervous system senses a threat and prepares the body for a fight or flight response. Build up of cortisol is detrimental to both mental and physical health.

Group singing can regulate breathing and heart rate, having a direct impact on the autonomic nervous system potentially improving heart health (circulatory system). This describes a process of entrainment, whereby independent rhythmical systems interact with each other.

Research suggests that singing with others releases endorphins, the neurotransmitter which produces a natural high (euphoria) and can help with pain management.

Oxytocin is coined the ‘love hormone’ which supports bonding and connection and some studies with adults have found that singing and social vocalisation produces oxytocin, particularly when improvisation is involved (perhaps lending itself to enhanced social connection).

In a study examining the impacts of group singing for adults affected by cancer, biomarkers indicated that singing improved immune function, which correlated with reduction in stress (cortisol).

Singing encourages the lengthening of the exhalation. This, alongside deeper diaphragmatic breathing triggers the Parasympathetic Nervous System (therefore instigating the relaxation response), measured by blood pressure, heart rate and heart rate variability (HRV).

Executive Functions are grouped under the headings of working memory, inhibitory control and cognitive flexibility. These functions can be impaired by early trauma and chronic stress, impacting on abilities to focus, learn, concentrate and manage emotions.

A study of nearly 4,000 children involved in the Sing Up programme found that singing improved confidence and self-esteem (both elements of Executive Functioning).

A classroom based mentoring and singing programme for Year 1 classes and their teachers found positive changes in reading ability and aspects of Executive Functioning related to inhibition and phonological working memory.

3. Social

Social connections make a difference to our mental health. Singing has been labelled ‘the ice breaking effect’ resulting in efficient group bonding.

Research suggests that social capital can be fostered through singing, encouraging the making of new friends and building confidence. However, this is not always a straightforward and linear route and social connectedness needs to be considered in relation to other factors, such as economic and cultural capital.

A study in a UK hospital Singing Medicine programme found a strong link between singing and the development of a ‘hospital family’, helping to form connections and support social development.

Taking part in music and singing can provide a safe space in which to express and explore emotions. Songs can both enrich identify and foster a sense of group solidarity.

In a study of children and young people’s mental health and well-being it was concluded that rap can structure emotional expression and help regulate aggression and singing can support expression of deeper emotional involvement in young people.

A study into children and young people’s singing habits before and during the Covid-19 pandemic found that the importance of physical togetherness was something that was missed during lock down and online singing opportunities. Although children and young people reported feeling ‘calm’ during the pandemic they missed the social connections enjoyed through singing. Other research suggests that singing was a creative outlet for coping with the Covid-19 pandemic.

The young people that are attending music sessions at the moment, I know are benefiting massively from it.

Lizzy Watkiss, Occupational Therapist

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