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Id		842
Author		Williams E., Dingle G.A., Clift S.
Title		A systematic review of mental health and wellbeing outcomes of group singing for adults with a mental health condition
Reference		Williams E., Dingle G.A., Clift S.; A systematic review of mental health and wellbeing outcomes of group singing for adults with a mental health condition ;European Journal of Public Health vol:28.0 issue: 6.0 page:1035.0
Link to article		https://www.scopus.com/inward/record.uri?eid=2-s2.0-85056735213&doi=10.1093%2feurpub%2fcky115&partnerID=40&md5=4bb994db78a9472012ddc2d2d06c0f34
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. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Results:

Candidate transition variables
These members were found to experience a moderate reduction (d = 0.44) in mental distress over that time period. .
These programmes are used to support recovery from health issues through providing access to increased social supports and engagement in meaningful activities. .
Background: A growing body of research has found that participating in choir singing can increase positive emotions, reduce anxiety and enhance social bonding. .
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. .
Recent studies indicate that engaging in singing groups has a wide range of benefits which have the potential to improve mental health and wellbeing. .
Studies have found that while people are engaged in group singing, they experience increased positive emotions and immune functioning, as well as decreased negative emotions including anxiety.5-7 Singing in groups is also reported to enhance social bonding,8 which predicts improvements in anxiety and mental wellbeing.910 .
Therefore, referring clients to arts programmes, such as choir singing, may facilitate therapeutic goals, such as developing social support and confidence. .
This review aimed to assess the viability of choir singing to improve mental health and wellbeing in people with a mental health condition. .
The search strategy included terms related to group singing (choir, singing group, group singing), mental health and wellbeing (mental health, anxiety, depression, wellbeing, wellbeing). .
In particular, enjoyment of singing, experiencing improved emotional states, developing a sense of belonging and self-confidence were reported in all the studies reviewed. .
These studies focused primarily on the positive impacts of participating in group singing. .
Potentially anxiety could be a barrier to some people participating in singing programmes, however, these studies also indicate that overcoming performance anxiety while participating in choir singing could be an empowering experience. .
People participating in these programmes ascribed improvements in their emotional, social and occupational wellbeing to participating in group singing. .
The current review supports that choir singing could promote mental health recovery by providing social connectedness, emotional enhancement and meaning in life. .
Future research directions The studies reviewed provided consistent conclusions that choir singing can help people with mental health conditions improve their mental health and wellbeing, however, there were major limitations in their methodology. .
The current results are promising, indicating that many people with mental health conditions have experienced benefits to their mental health and wellbeing through participating in community singing groups. .
For example, it has been concluded that there is strong evidence that engaging in music and singing activities decreases depression, anxiety and loneliness in older people; and moderate evidence that engaging in music and singing activities enhances wellbeing and decreases depression in young adults, marginalized groups and people with chronic physical health conditions.23 .
However, there were convergent results across the studies indicating that, while people participated in group singing, their mental distress decreased, and quality of life and wellbeing improved with moderate effect sizes (see table 1). .
Moreover, after participating in the choir, participants depression was significantly lower than the control, when controlling for baseline levels of depression. .
' Participants in established choirs report benefits including positive affect, social support and cognitive stimulation.4 .
Despite these methodological limitations, the studies reviewed consistently demonstrate that choir participation can have a positive impact on mental health among people living with a mental health condition. .
There was considerable consensus between the studies on the types of perceived benefits that participants with mental health issues experience in a singing group. .
This research extends on previous findings which have found similar wellbeing benefits of choir participation for older adults, young adults and people with physical health conditions.1-3,22-24 Implications The studies reviewed indicate that choir singing can help people with mental health conditions to overcome problems pertaining anxiety, depression and social disconnection. .
Therefore, choir singing is a viable option for arts-on-referral in mental health. .
Moreover, when people with mental health conditions were engaging in these programmes their mental health and wellbeing significantly improved. .
Recent research on arts-on-referral has shown that while engaging in arts programmes participants mental wellbeing significantly increases.12 .
Existing systematic reviews have found that community music and singing activities can promote mental health in people who are not diagnosed with a mental health condition. .

ARTICLE - CANDIDATE TRANSITION VARIABLES

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