A patient placed a blanket over his head to keep everyone away. He rocked in his seat while a string quartet from the Lima Symphony Orchestra set up in a room at Mercy Health–Saint Rita’s Medical Center in Lima, Ohio. As the musicians played, the man listened intently, removed the blanket, and began to let go of his fears and panic. The quartet is part of the orchestra’s Healing Through Music program, designed for people struggling with mental illnesses and opioid addiction. It’s one of an increasing number of programs run by orchestras in the United States that bring music to people with mental illnesses. Many of these programs educate the public about mental health issues—and they also can help some musicians destigmatize their own mental health diagnoses.
“Orchestras are more than just about performing in concert halls,” says Elizabeth Brown-Ellis, executive director of the Lima Symphony Orchestra. “In addition to performing at Mercy Health, we perform at a mental health clinic, a drop-in center for at-risk youth, and a low-income housing complex. In the near future, we hope to bring our music to prisons. We’re offering our music to our community and presenting music in a way that affirms others.”
“Orchestras are more than just about performing in concert halls,” says Elizabeth Brown-Ellis, executive director of the Lima Symphony Orchestra, which performs at a medical center, mental health clinic, drop-in center for at-risk youth, and low-income housing complex.
Ohio has one of the highest rates of opioid overdose deaths in the country. Brown-Ellis credits the concerts with getting people to talk about their mental health. “These conversations will hopefully benefit people on their journey to building a healthier life, away from their illness and addiction,” Brown-Ellis says. The two violinists, violist, and cellist that make up the Lima Symphony Orchestra’s quartet find the small rooms they perform in far more intimate than a concert stage. It’s not just the intimate space: “After the concerts,” Brown-Ellis said, “the audiences and performers talk about music, mental health, and other topics. It’s a safe space. They audience trusts us.”
Teri Brister, a professional counselor who serves as director of information and support for the National Alliance on Mental Illness (NAMI), sees a need for such programs. “Research shows that listening to, performing, or creating music can improve mental health and well-being,” Brister says. “Music can also act as a medium for processing emotions, trauma, and grief. Specifically, music provides benefits for various mental health conditions by creating an opportunity for expression. There is also joy and comfort in playing music, and listening to music can create a healing environment.” According to NAMI, approximately one in five adults in the U.S. (that’s 46.6 million Americans) experiences mental illness in a given year. For children ages 13 to 18, the percentage who will go on to have a severe mental disorder at some point during their life is also one in five.
Despite the number of Americans affected by mental illness, the topic was taboo in many communities not long ago. But today, in tandem with gradually more open public conversations about mental illness, orchestras are stepping in by creating programs for people experiencing mental illness. And a host of scientific studies support NAMI’s findings that music can positively impact people with mental illness. The National Institutes of Health and the John F. Kennedy Center for the Performing Arts are studying music’s effect on brain circuitry, and ways that music can be used to improve health and well-being, through a program called Sound Health: Music and the Mind. Ohio’s Toledo Symphony Orchestra is working with local university researchers to learn how classical music can help people with post-traumatic stress disorder. In Colorado, the Fort Collins Symphony Orchestra’s B Sharp program with Colorado State University, underway for five years now, has studied people with Alzheimer’s and dementia. B Sharp participants were invited to live performances and post-concert receptions; the study’s initial findings showed a reversal of cognitive decline from listening to classical music. In the U.K., a neuropsychology researcher at University College London has formed a choir for people with dementia as a way to study the effectiveness of music in reducing symptoms such as depression and agitation.
Among orchestras with ongoing programs or individual initiatives aimed at people with mental illness are the Williamsburg Symphony Orchestra in Virginia, which recently reached out to Liz Popovich—an 82-year-old violinist with Alzheimer’s who was experiencing confusion, agitation, and disorientation—and invited her to attend rehearsals, which improved her ability to hold conversations and talk about music. Musicians from Ohio’s Akron Symphony Orchestra have performed at inpatient behavioral health settings at Summa Health, an Akron-based hospital system, as part of the orchestra’s Music and Mental Health initiative. In 2011, former Los Angeles Philharmonic violinist Vijay Gupta co-founded Street Symphony, a nonprofit that presents live music in prisons and with the city’s homeless community, many of whom have mental illness. In Virginia, the Winston-Salem Symphony’s principal percussionist, John Beck, uses drum circles to help behavioral health and cancer patients.
Below is a look at some of the orchestras that are addressing mental health issues through music.
Safe Spaces for Musicians
One high-profile initiative is an orchestra created by Vermont-based conductor Ronald Braunstein, who has a diagnosis of bipolar disorder. In 2011, he founded Me2/Orchestra specifically for musicians with mental illness. It got its name because “Whenever we told people we have a mental illness, they responded by saying, ‘me too,’” Braunstein says. Me2/Orchestra has expanded beyond its original Burlington, Vermont location to Boston and elsewhere in the U.S. The Me2/Orchestra predates the #MeToo movement founded to help survivors of sexual assault and is not related to it.
Being part of the Me2/Orchestra in Boston allows Nancy-Lee Mauger, a French horn player, to take risks. “I know I won’t be judged,” she explains. “Even the sign on the rehearsal door reads, ‘This is a stigma-free zone;’ it puts everyone at ease.” Mauger, who was diagnosed with dissociative identity disorder, post-traumatic stress disorder, and depression, says, “There’s always someone to lean on here. I’m looking forward to sharing my story at one of our upcoming concerts because the more we talk, the less we are stigmatized.” At each performance, two or three musicians briefly talk about their mental illness and take questions from the audience. “Instead of thinking people with mental illnesses are lazy or dangerous, they see what we’re capable of,” says Braunstein. “It has a positive effect on all of us.”
Braunstein, an accomplished conductor, won the Karajan International Conducting Competition in Berlin decades ago after graduating from Juilliard. He was 23 years old. Following his win, his career took off. He worked with orchestras in Europe, Israel, Australia, and Tokyo. At the time, he didn’t have a diagnosis. “My bipolar disorder was just under the line of being under control,” he says. “It wasn’t easily detected. Most people thought I was weird.”
As his career progressed, things started to unravel. He was diagnosed with bipolar disorder at age 35. When Braunstein told his manager, he was dropped as a client. Then he was fired from a conducting job in Vermont. It was there that he met Caroline Whiddon, a French horn player, who had been diagnosed with depression and anxiety disorder. Together, they formed the Me2/Orchestra in Burlington, Vermont. Me2/Boston and Me2/Manchester (New Hampshire) followed, then affiliate groups in Atlanta and Portland, Oregon; there are plans to expand to 20 more groups throughout the U.S. Whiddon serves as Me2’s executive director, and Braunstein and Whiddon are married. The musicians in each of the orchestras range in age from 13 to more than 80. Some have a mental-health diagnosis and others have family and friends who do. Me/2’s Boston affiliate recently launched a percussion ensemble; a documentary about Braunstein and the Me2/Orchestra called Orchestrating Change opened in select theaters in October 2019.
“We’re bringing neuroscientists together with musicians
to speak each other’s language,” says National Institutes of Health Director Francis Collins, at right.
Drumming Out Depression
A 2016 study by the Royal College of Music in London found that drumming reduces depression by as much as 38 percent and anxiety by 20 percent. John R. Beck—principal percussion with the Winston-Salem Symphony and professor of percussion at University of North Carolina School of the Arts and Wake Forest University—has seen the positive effects drumming has on the participants in his drum circles. Beck works with behavioral health and cancer patients and has been active in a program called Comfort Sound Drumming, a research study developed by scientists at Wake Forest Baptist Medical Center. At the Center, stem cell transplant recipients participate in small drum circles led by Beck. Initial data from the study showed that more than 80 percent of patients reacted positively to the drumming and showed improvement in energy, mood, and relaxation and decreases in distress and anxiety, with over 60 percent reporting decreased anxiety and distress, and a majority with less pain. Results will be published in Percussive Arts Society journal in 2020.
“I like making connections with each person in the drum circle,” Beck says. “This isn’t about getting them to talk and share their feelings. It’s about having fun, letting one’s guard down.” He starts with a traditional song from Guinea, West Africa. “We drum and call out our names,” he says. “It’s a way to make eye contact, for them to tell me their names, and to get a smile.” He doesn’t know anyone’s diagnosis. Instead, the doctors and nurses tell him on his return visits how much more open the patients were with sharing their feelings. “Drumming isn’t a cure-all,” Beck says. “It can certainly help counteract depression by offering some relief from negative thoughts. It’s a lot of fun. I can see it from the smiles on the faces of those in the drumming circles.”
Violinist and social-justice advocate Vijay Gupta is co-founder of the nonprofit Street Symphony, where he spends much of his day among the people on Skid Row in Los Angeles County. Gupta attended Juilliard and Yale and was hired in 2007 as one of the youngest members of the Los Angeles Philharmonic, a position he gave up in 2018 to focus on Street Symphony. “Street Symphony was organized for the presence of those that are often ignored,” Gupta says. “Here in L.A., we’re home to the largest homeless community living on the street in the U.S. We also have the largest incarcerated population of anywhere in the country. Our jails are effectively the nation’s largest psychiatric institutions. That’s why we have to take our role as artists seriously. That role is to heal, inspire, and to disrupt and provoke. I ask, why should great art only happen on a concert stage?”
At the end of the first Street Symphony concert in 2011, a young man in the audience got up and told the musicians he could feel their hearts, Gupta says. The man later told them his mother used to beat him. He was homeless and suffered from mental illness; the people in the crowd got up to hug him. “When we play, the audience hangs on every single note,” Gupta says. “There’s no us and them. We’re all broken in different ways. That’s how we understand who we are.”
This past summer, Street Symphony held a block party on Skid Row. They worked with the Midnight Mission, a human services organization in downtown Los Angeles’ Skid Row, to feed more than 2,000 people. People came for the food and for the music, which included the West African drumming circle Ashe Drummers from the Heart, the all-female Mariachi band Las Colibri, Street Symphony’s jazz ensemble, and DJ Sir Oliver with a string ensemble.
Since its inception, Street Symphony has presented nearly 300 free performances for communities affected by homelessness and incarceration in Los Angeles County. According to the Substance Abuse and Mental Health Services Administration (branch of the U.S. Department of Health and Human Services), between 20 and 25 percent of the homeless population in America suffer from some form of severe mental illness. “We need to be human beings of the highest quality,” Gupta says. “Performing amongst the people allows us to do that. We can reclaim our mental health when we claim our wholeness as people.”
Musicians from the Toledo Symphony Orchestra and researchers from the University of Toledo’s Department of Psychology will examine ways that classical music can help those with post-traumatic stress disorder (PTSD) better manage and direct their emotions, leading to improvements in mood, functioning, and quality of life. Merwin Siu, principal second violinist and artistic administrator of the Toledo Symphony Orchestra, said the two-year study will have two parts: the first centers on recorded excerpts and the second will incorporate live performances from symphony musicians. (The Toledo Symphony Orchestra is one of nineteen U.S. orchestras to receive a 2019 grant from the League of American Orchestras to support innovation and organizational learning. The two-year American Orchestras’ Futures Fund grants, in the amount of $80,000–$150,000 each, are made possible by the generous support of the Ann and Gordon Getty Foundation.)
“PTSD is a serious mental health disorder,” says Matthew Tull, professor of psychology at the University of Toledo. “Although there are a number of effective psychological treatments available for PTSD, some clients may find it difficult to connect with and process their emotions during these treatments. This collaborative project between the Toledo Symphony Orchestra and the Department of Psychology at the University of Toledo is exciting in that it may identify a novel way to facilitate and improve PTSD treatment.”
The National Institutes of Health (NIH) has teamed up with the John F. Kennedy Center for the Performing Arts to explore how listening to, performing, and creating music involves brain circuitry that can be harnessed to improve health and well-being. The initiative, Sound Health: Music and the Mind, grew out of a 2013 year-round community engagement initiative by the National Symphony Orchestra. The program sends musicians into local hospitals, pediatric units, and military health centers in the Washington D.C. area to bring music and personal interaction to patients, their families, and medical providers.
“We’re bringing neuroscientists together with musicians to speak each other’s language,” Francis Collins, M.D., Ph.D., and NIH Director, says. “Mental health conditions are among those areas we’d like to see studied. We’ve seen when you sing or play an instrument, it doesn’t just activate one part of your brain. A whole constellation of brain areas becomes active. Our response to music is separate from other interventions such as asking people to recall memories or listen to another language.” Soprano Renée Fleming, who is an artistic advisor at the Kennedy Center, is working with Collins on SoundHealth. “The first goal is to move music therapy forward as a discipline,” she says. “The second is to educate the public and enlighten people about the power of music to heal.”
The NIH/Kennedy Center initiative is new. So far, scientists are investigating how music could help patients with Parkinson’s disease walk with a steady gait, help stroke survivors regain the ability to speak, and give cancer patients relief from chronic pain. The goal is to improve mental health. “We know music shares brain areas with movement, memory, motivation, and reward,” Collins says. Research from Columbia University’s College of Physicians and Surgeons in New York found people with mental illness seem to have an increased risk of stroke. Music has played a significant role in helping stroke survivors speak.
As Collins says, “These things are hugely important to mental health, and researchers are trying to use this same concept of an alternate pathway to address new categories of mental disorders.”
This article originally appeared in the Winter 2020 issue of Symphony magazine.