What we don’t yet know

The causal question:

We have good evidence that singing is associated with improved wellbeing, social connection, and self-esteem, and we have practitioner accounts of profound change in individual young people. What we lack is robust causal evidence that singing alone produces sustained, clinically meaningful improvements in mental health.

Most studies show correlation, not causation; immediate benefits, not long-term outcomes. This doesn’t mean singing doesn’t work – it means the research hasn’t yet caught up with practice. Longitudinal studies tracking young people over months and years are needed, but are expensive and complex to deliver.

The dose-response question:

How much singing is enough? How often? For how long? We don’t have clear answers – and the answer likely varies by individual, context, and severity of need. A weekly session for a term? Daily singing embedded in school life? Intensive work over a short period? Practitioners make judgments based on experience, but the evidence base for dosage is thin. This matters for programme design, funding decisions, and managing expectations.

The specificity question:

Does singing work better for some mental health challenges than others? We don’t know – most studies treat ‘mental health’ or ‘wellbeing’ as a single outcome. More nuanced research exploring which young people benefit most, and from what kinds of singing, would strengthen practice.

The mechanism question:

Connection Theory proposes that singing works by generating connection across multiple dimensions. But this hasn’t been rigorously tested – we don’t yet know which connections matter most, or whether simultaneity is the key. Comparative studies – singing versus interventions targeting single domains (just breathing, just social skills) – would help, and while neuroscience offers promising directions, youth-specific biomarker research is limited; much is extrapolated from adult studies.

The durability question:

Even where benefits are demonstrated, how long do they last? Does wellbeing gained through a singing programme persist after it ends? Under what conditions? If a young person stops singing, do the connections fade? Long-term follow-up is rare in this field – we need it.

What we’re taking forward

The Sing Up Foundation is committed to building the evidence base, not just advocating from what we wish were true! Our priorities include:

Research and evidence

• We believe practitioner-led action research is badly needed in this field, and we will continue to advocate for it and seek partnerships to make it happen

• In the current funding environment, we are also focusing on approaches that generate learning through practice: narrative capture, case documentation, and investing in the workforce itself as a source of knowledge

• More nuanced exploration of which young people benefit and how

• Exploring how to measure connection itself, not just musical outcomes or generic wellbeing scores

• Honest reporting: publishing what we find, including null results and complications

Practice development

• DO-KNOW-BE is a living framework, not a finished toolkit. Once published, we want to keep developing it, through dialogue and shared learning, so that it remains dynamic, creative and responsive to the realities of practice

• We’re exploring models of knowledge exchange, including mentoring, practice-based learning and peer observation, that could strengthen the workforce while surfacing and sharing the pedagogical knowledge that skilled practitioners already carry

• Commissioning and signposting to training that addresses relational capacity, not just musical skill or mental health knowledge

• Exploring the relationship between singing-as-participation and Music Therapy more deeply, in dialogue with the Music Therapy profession, to understand where the boundaries, overlaps and collaborative opportunities lie

• Growing our base of resources that help practitioners create the conditions for connection: safe spaces, agency, cultural responsiveness, etc.

• Supporting communities of practice where practitioners can learn from each other, reducing isolation

Advocacy and policy

• Harnessing the opportunities presented by current policy changes and commitments

• Advocating for singing to be recognised in multiple contexts: as curriculum entitlement (Tier 1) and as legitimate targeted intervention (Tiers 2 and above)

• Building connections with CAMHS and wider clinical services, so that singing based approaches can be understood as a complement to clinical provision, not a competitor, and so that referral pathways can work in both directions

• Making the case for workforce development that spans education and health

• Continuing to position singing for mental health as serious, evidence-informed work – not a soft option or a nice-to-have