The joint selections of the RCPsych Article of the Month for April are ‘Investigating the impact of music therapy on two in-patient psychiatric wards for people living with dementia: retrospective observational study’ and ‘BJPsych Open: A summary of growth and vision for my second innings as editor-in-chief‘. The first article addresses music therapy and the second is a summary editorial of the first 5-year term of this Editor-in-Chief with reference to publishing under-represented topics including arts and mental health. Both are published in BJPsych Open and the blog has been written by the author of the first article, Naomi Thompson.

This research with a vulnerable clinical population, who are experiencing significant distress, gives us an important insight into whether music therapy may be helpful for patients and staff on NHS inpatient psychiatric dementia wards by reducing distress and improving wellbeing.

The benefits of using music, including clinical interventions delivered by qualified music therapists, to improve wellbeing for people living with dementia and their carers is increasingly recognised. This innovative project sought to evaluate whether group music therapy, delivered as part of standard care on two NHS inpatient psychiatric wards, was beneficial to patients, staff and the ward environment. Mixed methods were used.

We looked at routinely collected data relating to staff reported incidents of a distress behaviours (termed ‘disruptive and aggressive behaviour’). There was a significant reduction in the frequency of staff reported incidents, with an incident reported every 3 days on a day without music therapy reduced to an incident reported every 14 days on a day with music therapy. This was supported in findings from a reflexive thematic analysis of 8 interviews with ward-based staff and 3 interviews with music therapists. Music therapy was reported to lift mood and calm agitation for patients in the moment, as well as supporting staff wellbeing and staff relationship with patients, and changing the atmosphere on the ward beyond the group. Staff were unanimously positive and excited to share their experiences of music therapy, from observing patients calm and happy, to joining in singing and dancing together. One staff member summed this up, saying “music is the key”.

Although the evaluation was conducted on two wards over one year, the positive findings are really encouraging. These results provide us with a platform to continue exploring ways to better meet patient need on inpatient mental health dementia wards. The team, alongside experts-by-experience, are exploring how and why music therapy may help to reduce distress for this clinical population through reviewing the literature and gathering insight from stakeholders as part of a realist review. This information will be used to co-develop a novel music therapy manual which will provide additional music therapy time on the ward, as well as supporting staff and family members to incorporate music interventions in everyday care.

Though having significant impact on our patients, different forms of therapeutic interventions are often overlooked.  Music therapy is one such intervention with limited publication in BJPsych Open. 

As article of the month, BJPsych Open is highlighting two articles: one addresses music therapy and the second is a summary editorial of the first 5-year term of this editor-in-chief with reference to publishing under-represented topics including arts and mental Health.

The first highlighted article – “Investigating the impact of music therapy on two in-patient psychiatric wards for people living with dementia: Retrospective observational study” is a small mixed methods study.  Retrospective quantitative data noted a significant reduction in the frequency of reported disruptive and aggressive behaviors on days with in-person music therapy (every 14 days) than on the same weekday with no or online music therapy (every 3.3 or 3.1 days, respectively). Qualitative findings, using semi-structured interviews with reflexive thematic analysis, supported the quantitative findings while noting that music therapy was accessible to persons with dementia, improved mood, and reduced agitation.

The second highlighted article – “BJPsych Open: A summary of growth and vision for my second innings as editor-in-chief” – reviews the growth of BJPsych Open during the past five years in several key areas: editorial board, productivity, quality, impact factor, and thematic series.  This editorial considers the creation of the Journal with original remit, vision for the second term, and updated remit – “a general psychiatric journal with high-quality, methodologically rigorous and relevant publications, with relevance to the advancement of clinical care, patient outcomes, the scientific literature, research and policy.”  Vision for the second term includes, but is not limited to, emphasizing under-represented topics such as human rights, ethics and arts and mental health. As Editor-in-Chief, I am very pleased that BJPsych Open published the highlighted music therapy article and look forward to future submissions on arts and mental health.

Kenneth R. Kaufman

Editor-in-Chief, BJPsych Open