Katie Rose M. Sanfilippo

To what extent do different people find the same moments in a music therapy improvisation session salient, and how similarly or differently do they interpret the same moments? Four half-hour sessions at a music therapy center between different trained music therapists and musically experienced first-time attendees were videorecorded. Immediately after the sessions each participant watched the video of their session individually and commented on the one to five moments that struck them as most noteworthy. For each session, two other participants—one trained music therapist and one other musically experienced observer—also watched the videos and commented on one to five noteworthy moments. An online questionnaire for each session was subsequently created that included all four participants’ comments (anonymized and edited for ratability) and the corresponding video segments. Each participant individually rated the extent to which they agreed with all the anonymized comments about their session. Analyses focused on the extent to which different participants selected the same moments as worthy of commentary, their levels of endorsement of comments originally authored by participants in the different roles, and overall patterns of rating agreement between participants in the different roles. Overall levels of agreement were low, but across the four sessions the trained music therapists’ judgments tended to be more aligned with each other's, with some asymmetries: Session music therapists endorsed statements by the commenting music therapists more, but not the other way around. There was also evidence for greater agreement between session outsiders (commenting music therapists and commenting observers) than between session participants (session music therapists and attendees). In fact, by some measures session attendees’ interpretations of what happened were particularly different from everyone else's. The findings are not consistent with a view that everyone is likely to see the same thing in a video clip of a moment in music therapy.

Common perinatal mental health conditions are especially prevalent in low- and middle-income countries (LMICs) and are associated with numerous adverse effects. While complex interventions have been developed and tested, there has been limited exploration of how these interventions can be implemented and sustained at scale. This scoping review aims to explore the strategies discussed for scaling, spreading and sustaining complex perinatal mental health interventions in LMICs. We conducted a systematic search in APA PsycINFO, Cinahl, Medline (EBSCOhost), Embase, MIDIRS (Ovid Online) and ProQuest for reports published between January 2010 and November 2023, using search terms related to scaling innovations, perinatal mental health and LMICs. We also conducted a grey literature search using the websites of organisations that focus on maternal mental health. We identified 42 information sources. Using thematic synthesis, scale, spread and sustainability strategies regarding workforce diversity, integration of health services, tool and method development, adaptation, training, supervision and support and stakeholder engagement were identified. The study identified persistent gaps in the literature around how interventions move beyond early adaptation and implementation phases. These included the need for more consistency and shared understanding around terminology and increased interdisciplinary collaboration, especially drawing on fields such as implementation science. The findings from this review open new avenues for research and policy on expanding perinatal mental health interventions in LMICs, with an emphasis on long-term sustainability and interdisciplinary perspectives.

Women of Global Majority ethnicities have an increased risk of developing and sustaining perinatal mental health problems in the UK. This is partially explained by the ethnic inequalities experienced at an individual, societal and systemic level. Previous research highlights the benefits of engaging with participatory music-based interventions to alleviate symptoms of postnatal depression, stress and anxiety, but current provision lacks cultural inclusivity. This qualitative study focuses on fourteen women of African, Caribbean and Mixed heritages living in South East London to explore how their perinatal experiences, coping strategies and preferences regarding music-based support could inform a future culturally inclusive perinatal mental health participatory music intervention. Participants took part in either an online focus group or interview, led by a local community leader. An inductive reflexive thematic analysis identified four overarching themes: (1) supportive mechanisms during the perinatal period, (2) the overwhelming pressures and expectations of motherhood, (3) systemic barriers to accessing perinatal mental healthcare and (4) suggestions for future perinatal mental health music-based support groups. This study reveals the individual experiences of the perinatal period for women of African, Caribbean and Mixed heritages, exploring themes of sociocultural pressures, barriers to care and individual activities used to support mental health. The sociocultural, logistical and musical considerations outlined in this study highlight gaps in current community provision and offer practical suggestions for facilitating inclusive music-based interventions for perinatal mental health in South East London.

In South Africa, perinatal depression, stress or anxiety affect an estimated 16% to 50% of women posing serious concerns for both mothers and infants. The vast majority of women receive no perinatal mental healthcare through the public health system, partly due to high levels of stigma and a lack of culturally sensitive mental health care. South African musical traditions such as group singing are culturally significant for supporting social connection and coping with challenges experienced in everyday life. However, there is little research on how group music making could be used to support perinatal mental health in South Africa. This study aimed to explore the potential for developing a culturally embedded, music-based intervention to support women in the perinatal period. Using Community-Based Participatory Research, we held five focus group discussions with: 1) community health workers, 2) music experts, 3) traditional healers, 4) professional healthcare workers, and 5) the management team of a rural health NGO. Through thematic analysis, four themes were identified. Theme 1 encompasses the various challenges that contribute to perinatal mental distress, including social determinants of mental health, unhelpful coping strategies, stigma, and isolation. Theme 2 reflects existing community music practices: the way music is embedded in culture, processes of cultural change, and musical practices associated with perinatal health. Theme 3 encompasses the perceived benefits of music making in supporting social connections and effecting transformation in relation to individual mood and spiritual experiences. Theme 4 includes consideration of factors that are important for the development of a music-making intervention to support perinatal mental health. The findings suggest strong potential for implementing music-based mental health interventions in South Africa, adaptable to various facilitators and community contexts.

Background: Women of Global Majority ethnicities have an increased risk of developing and sustaining perinatal mental health problems in the UK. This is partially explained by the ethnic inequalities experienced at an individual, societal and systemic level, which necessitate an increased reliance on self-coping strategies to support mental health. Previous research highlights the benefits of engaging with participatory music-based interventions to alleviate symptoms of postnatal depression, stress and anxiety, but current provision lacks cultural inclusivity. Objectives: The current study focuses on women from African, Caribbean and Mixed heritages living in South East London to explore how their perinatal experiences, coping strategies and preferences regarding music-based support could inform a future culturally inclusive perinatal participatory music intervention. Design: This study took a qualitative approach using reflexive thematic analysis of semi-structured focus groups and interviews. Methods: Fourteen women from African, Caribbean and Mixed heritages took part in online focus groups and interviews, led by a local community leader. Questions considered the participants’ lived experiences of the perinatal period, any coping mechanisms employed and suggestions for future participatory music groups. Results: An inductive reflexive thematic analysis identified four overarching themes: (1) supportive mechanisms during the perinatal period, (2) the overwhelming pressures and expectations of motherhood, (3) systemic barriers to accessing perinatal mental healthcare and (4) suggestions for future perinatal creative support groups. Conclusions: This study reveals the individual experiences of the perinatal period for women from African, Caribbean and Mixed heritages, exploring themes of sociocultural pressures, barriers to care and individual activities used to support mental health. The sociocultural, logistical and musical considerations outlined in this study highlight gaps in current community provision and offer practical suggestions for facilitating inclusive music-based interventions for perinatal mental health in South East London.

In South Africa, perinatal depression, stress or anxiety affect an estimated 16% to 50% of women posing serious concerns for both mothers and infants. The vast majority of women receive no perinatal mental healthcare through the public health system, partly due to high levels of stigma and a lack of culturally sensitive mental health care. South African musical traditions such as group singing are culturally significant for supporting social connection and coping with challenges experienced in everyday life. However, there is little research on how group music making could be used to support perinatal mental health in South Africa. This study aimed to explore the potential for developing a culturally embedded, music-based intervention to support women in the perinatal period. Using Community-Based Participatory Research, we held five focus group discussions with: 1) community health workers, 2) music experts, 3) traditional healers, 4) professional healthcare workers, and 5) the management team of a rural health NGO. Through thematic analysis, four themes were identified. Theme 1 encompasses the various challenges that contribute to perinatal mental distress, including social determinants of mental health, unhelpful coping strategies, stigma, and isolation. Theme 2 reflects existing community music practices: the way music is embedded in culture, processes of cultural change, and musical practices associated with perinatal health. Theme 3 encompasses the perceived benefits of music making in supporting social connections and effecting transformation in relation to individual mood and spiritual experiences. Theme 4 includes consideration of factors that are important for the development of a music-making intervention to support perinatal mental health. The findings suggest strong potential for implementing music-based mental health interventions in South Africa, adaptable to various facilitators and community contexts.

This article sets out a collective vision for a new Music and Parental Wellbeing Alliance. It starts from the premise that challenges to parental wellbeing represent a persistent, global concern. When unchecked, these challenges can lead to negative consequences for the whole family. Music is common in the lives of many parents around the world; yet despite emerging evidence, it is not yet considered as an option in most parental care pathways. To address this requires a collaborative approach, leading to the founding of the Music and Parental Wellbeing Research Network in 2023. As a network comprising of parents, musicians, music therapists, healthcare practitioners, researchers, arts leaders, and policy experts, we set ourselves the task of proposing and setting out a direction for the field of music and parental wellbeing. We embarked on agreeing the key steps needed to advance the field, and the driving principles underpinning such endeavor, arriving at a vision for our ongoing work: To enable, sustain, and expand an international and interdisciplinary community that works towards ensuring that all parents have the opportunity – and are empowered and equipped – to engage with music that can support their wellbeing. In this short article, we articulate a mission for a new Music and Parental Wellbeing Alliance that is focused on achieving our vision through SHAPING evidence and practice, SUPPORTING professionals working in the field, and SHARING the potential of music in supporting parental wellbeing. We invite readers to join us in progressing this mission.