Liesbeth Tip – Research Assistant and PhD student in Clinical Psychology, University of Edinburgh

Liesbeth Tip
Research Assistant and PhD student in Clinical Psychology, University of Edinburgh

I’ve  had the idea for this project for about two years, as I knew singing in  choir was great and I came across some therapeutic choirs for my work. I thought, why not combine those two?

There were several ways I thought his could be helpful for people.

First, the little research that has been done proves that singing, and singing in a choir, are good for some medical problems and for mental health and that it is even better for you than team sports!

Second, I wanted to target mental health stigma. From my work as a therapist and research assistant I know first hand how much people can struggle with the feelings that there is something wrong with them when they have mental health symptoms. They can feel ashamed and inferior, and this can influence the social interactions they have.

In addition, there are stereotypes in the general population, which can influence behaviour towards those with mental health problems. These don’t  just go away when people don’t know or don’t talk about mental illness. There is a taboo on talking about mental health and people don’t know about each other’s struggles. It is hard to look past labels when you don’t have the correct information or any information at all besides the media.

So for this choir, I wanted to bring people with different mental health backgrounds in touch with each other. In the choir, there is a good reflection of the ratio of mental health symptoms in the general population. My hope is, that singing together will prove to make a difference in mental health but also, in the internalised stigma that can make people feel inferior to others, or an outsider, At the same time, the aim is to change some of the stereotypes that people can have, that don’t have any experience with mental health issues in themselves or in their social circle.

This choir is just a choir though, not a therapeutic choir or with a structuring of any kind of conversations during rehearsals.

What I saw most over the past two months is people working really hard to learn the songs and having fun together!

I can’t believe what they made out of this project! Keep in mind, we had only 9 rehearsals and tonight is the result of that.

The reason we are putting up a show, is that this is another great opportunity to raise awareness of mental health stigma, and target it. We have an amazing line-up of choirs, performers and speakers that will hopefully make you think about mental health while at the same time you can enjoy the musical programme of the night!

Can I just say thinks to our brilliant volunteers and collaborators Sara, Simona, Katie, Lindsay, Emma and soon Leyla for their help with this project. And of course Ben Jones, our musical director, who  arranged all our music and guided us through this process. And a huge thanks to the Edinburgh Fund, an organisation that is supported by alumni and friends of the University of Edinburgh. They funded this project. Sometimes it just takes one person or in this case, organisation to believe in something and by believing in it, make things happen and make a difference.

Prof. Stephen Lawrie – Head of the Division of Psychiatry, University of Edinburgh

Prof. Stephen Lawrie
Head of the Division of Psychiatry, University of Edinburgh

Of course, those of you enjoy singing aren’t gonna be persuaded to do it or not by what I say, but actually there is a bit more evidence for the mental health benefits of singing, and especially choral singing, than you might expect – and certainly more than I expected.

So, the first thing I did was to Google it – mental health and singing – and the first hit hit that caught my eye was an article in the Telegraph of all places (in 2013) about a survey of almost 200 people in the Uk showing that people who did choral singing got more benefits than those who sang alone (not just in the bath I think) and even than team sports.

There are also surveys showing reductions in distress in adolescents by about 60% over a year, an article in TIME magazine and even an NHS choices web-site with a woman describing how choral singing helped her driving phobia.

Encouraged, I did a formal check in the main academic database called PubMed. A grand total of 57 articles ever written is very few, going back to an article in Spanish about the psychoanalytical meaning of singing during a consultation, but – remarkably – there was a systematic review published in 2008 about self help treatments for depression and singing cropped up as something of interest that might work very quickly.

There is even a Randomized Controlled Trial! Of 258 older adults (>60) in Kent who had better quality of life at 3 months – compared to just doing usual activities.

As to how it might work, this is a very speculative area, but choral singing may increases CBF, oxytocin, endorphins, and reduce stress. Psychologically, the effects might be mediated through group shared activity (see synchronised heart beats study).

Now, clinical scientists like me will always caution against uncritical acceptance of the results of one or two studies – but the rest can carry on singing with gusto; and some of you might even be persuaded to do choral singing – or to do it more – by the evidence base!

Dr. Leyla de Amicis – Research Assistant in Clinical Psychology, University of Edinburgh

Dr. Leyla de Amicis
Research Assistant in Clinical Psychology, University of Edinburgh

I am a volunteer befriender with Health in Mind. I am also a researcher and I have studied a lot about prejudice and stigma.

We know that as human beings is natural for us to divide people into groups but our stereotypes can be very harmful and misleading. One of the best ways to overcome this is contact, like creating bonds with stigmatized people, acknowledge that we can have similar interests and we are all unique vulnerable human beings. This really helps create a positive inclusive society.

For me befriending means spending some enjoyable time with a nice person that went through some hard experiences in her life.It helps me challenge any preconceptions of what having schizophrenia looks like, and understand how tough/resilient someone labelled as schizophrenic can be. It allows me to support someone great that would tend to be left out from our community.

So befriending is worth it for all of us, to build a really open-minded and diverse society. If you can spare two hours a week, do befriend!

Prof. Matthias Schwannauer – Head of Clinical & Health Psychology, University of Edinburgh

Prof. Matthias Schwannauer
Head of Clinical & Health Psychology, University of Edinburgh

One of the key problems for people with mental ill health difficulties are the often negative perceptions we all hold about mental health – and yet one on 4 of us will experience significant mental ill health in their lifetime.

The societal and perceived stigma associated with so called mental health problems is often more detrimental to the individuals wellbeing, outlook and recovery that the impact of mental ill health itself.  stigma and discrimination are closely linked  and affect relationships, education and work, leading to loss of income, opportunity and community.

This level of discrimination is evident on an institutional and societal as well as on a personal and interpersonal level – leading to internalised stigma, shame and entrapment.  as such stigma and its consequences are more closely associated with negative outcomes of depression and suicide than the experience of symptoms associated with mental ill health. in turn social identification and community buffer well being against the consequences of discrimination.

Current societal and the historical discourse of mental health and mental health care has always been as much about its place in communities and its societal purpose as it has been about  the actual provision of care – how we locate and understand all of our mental health and well being mirrors very much our individual and societal values and ethics.

Even though we moved a long way from the asylum and autocratic authoritative  care – truly collaborative care and service models of mental health that are shaped by the needs of those who access them remains as true a challenge now as it has been in past centuries and decades.

There is a general paucity of evidence to improve stigma or lessen its negative consequences, increasing knowledge and awareness appear to make little difference to what people think about mental health, but the most robust catalyst for change of perceived stigma and negative attitudes and beliefs towards mental ill health is social contact and community.

So, relationships and interaction with each other is what matters most and that is especially pertinent in the context of mental health and well being. and yet, social interactions, community and relationships are not on the list of treatments and recovery journeys as mapped out by most services.

Gaetano Benedetti, a social psychiatrist instrumental in the Italian movement to close asylum based care, in his formulations of psychological therapy for individuals with major mental health difficulties maintained that social isolation became the main problem for individuals in their recovery and that the community of expression of their creative and intellectual lives one of the key mechanisms to reduce the sense of isolation and create community.

Projects like the one we witnessed tonight truly challenge the us and them of mental health and demonstrate that the interaction and shared purpose is key in breaking down perceptions and barriers.