Qs & As : Prof Wolfgang Mastnak, University of Music and Performing Arts of Munich
In view of its 75th anniversary on 21st September 2020, the United Nations (UN) has invited several stakeholders including educational institutions to encourage youth participation and work out innovative solutions to address the Sustainable Development Goals (SDGs).
For some years now, the University of Mauritius (UoM) has been encouraging teaching using new methods to support the UN objective by sharing knowledge and skills with the youth on specific programmes. In this context, the UoM implemented its first Western Music programme in August 2016 in close collaboration with Prof Wolfgang Mastnak of the University of Music and Performing Arts of Munich (Germany), Director of the Beijing Normal University Research Centre (China) for Arts Therapies, Professor of Shanghai Conservatory (China), and whose specialty is music therapy in several categories of patients and disease conditions.
Prof Wolfgang tells us in this email interview about music therapy and research work being undertaken to help both nurses and patients, and also the environment to help mental health patients.
* We live in an environment that is more and more stressful. How would you define “mental health” in this context?
In my opinion, mental health is a complex state of subjective well-being, which does not hurt others. In addition to that you highlight a very aggressive factor: stress. Internationally, interdisciplinary stress research is highly advanced so that we know a lot about its destructive psychosomatic mechanisms.
* What is your current research work about?
My current research work focuses on music therapy & depression; music therapy & obstetrics, e.g. anxiety disorders in pregnant women and how antenatal music interventions enhance the brain development of the unborn child; psycho-neuro-interfaces, that is the mechanisms that link the central nervous system and our psyche; long-term cardiac rehabilitation; cross-cultural arts therapies; health education and educational public health.
* According to a 2016 WHO report, 28·4 out of every 1,000 Mauritians suffer from severe mental or substance abuse disorders; moreover schizophrenia affects 2·6 out of every 1,000 people and 7·9 out of every 1,000 have severe depressive disorders. How do we compare with other countries, and how serious is the problem in Mauritius?
There is no doubt the problem is serious in Mauritius. WHO reports (Jan 2020) that globally more than 264 million people suffer from depression. That is higher than the ratio in Mauritius.
Nevertheless, we have to take into account that the registration of mental diseases also depends on public health and cultural conditions.
As for schizophrenia, WHO (Oct 2019) speaks of globally 20 million patients which is less than the percentage you refer to.
Finally, 1 person in 30 suffering from a severe mental or drug-related disorder is really alarming.
* Is there work to be done for better identification of mental health problems as well as on the different treatments available so as to bring down the increasing number of people suffering from these problems?
A key factor is health education. Not only according to WHO but also from an inter-disciplinary perspective, health has both medical and social dimensions. For example, the development of health-awareness and self-competence for healthy lifestyles is above all an educational matter that involves, of course, preventive medicine. Early diagnosis and better identification of risk-profiles require interdisciplinary collaboration, both in research and practice.
Given the different causes of mental disorders, appropriate treatment is very important , for example, in depression caused by social isolation and experienced loneliness.
It is most obvious that pharmacological treatment with SSRIs – a standard medication for depression – cannot treat the root cause. But even in the medical fields, new approaches matter. For instance, research from Harvard University suggests that the best means to enhance neuroplasticity is music. This result has important implications for the treatment of stroke-patients, and for speech and motor rehabilitation.
* In what way does music therapy help in the treatment of mental health patients?
Many years ago, often medical doctors who were fond of music encouraged their patients to enjoy their favourite songs to relax and alleviate their symptoms.
Today we use an interdisciplinary approach (medical sciences, neurosciences, psychology, educational sciences, biological anthropology etc), to study the ‘underlying mechanisms’ of music therapy.
- From a psychological perspective, music can be an efficient means to cope with early childhood traumas that result in depression or anxiety disorders.
- We use behavioural music therapy to support the acquisition of language in children with cerebral palsy.
- Based on neuroscientific findings, we apply a combination of music and dance therapy to reduce symptoms of Parkinson’s disease.
- Complex psychiatric theories elucidate how therapeutic singing modulates certain forms of post-traumatic syndromes, etc.
Today, music therapy can be of help in several medical specialities e.g. oncology, cardiology, neurology, psychiatry, sexual medicine, etc.
I have to emphasise that music therapists are specially trained musicians.
* Should music therapy take place only in institutional settings or can it be carried out in the community?
Not only in institutional or clinical settings, because in fact, ‘community music therapy’ has become an important aspect of music therapy. For example, the activities of the NGO ‘Vent d’un Rêve’ in Cité Mangalkhan involve a lot of health-relevant factors that can be called “community music therapy”.
There are already very convincing Mauritian activities that satisfy the criteria of “community music therapy”.
- Jean-Clair Seevraz has initiated various projects using music to support children with special needs and in specific mental risks in special educational and paediatric domains.
- Mégane Duvergé has performed choral activities to improve social inclusion and mental well-being in parts of the Mauritian older generation.
It is very important to identify key domains of music therapy, a field which is very complex and depends on given socio-cultural conditions. It comprises such different topics as community-based drug prevention, anaesthesiology in surgery, home care for individuals with Alzheimer’s disorder, specific developmental support of children with autism spectrum disorder, etc.
Settings can be very different and to design the most efficient interventions is challenging.
* Given that nurses are the largest group of professionals providing mental health care, do you think it’s important to include music therapy in their psychiatric education curricula training for the treatment of patients? Or should “music therapists” be another category of professionals altogether?
From an international perspective, opinions about this issue differ and are even contradictory. There are very rigid positions stipulating that only fully trained music therapists should be allowed to perform music therapy.
I do not share this opinion but suggest distinguishing three different fields.
- Music therapists who have accomplished an education comparable to medicine or psychology by, as for example, in Austria, following courses leading to BA (3 years) and MA (2 years).
- Medical, psychological and educational professionals who have successfully accomplished additional music therapeutic trainings, who use specific modes of music therapy in selected diagnostic fields, for example.
- nurses in geriatrics (e.g. dementia),
- midwives (e.g. singing techniques to strengthen the deep pelvic floor muscles),
- psychiatrists (e.g. schizophrenia),
- educators (e.g. autism), etc.
Nevertheless, they will not be called ‘music therapists’. They have their main professional qualification and additional competencies.
- Specialists who use music-based treatment according to cultural traditions such as Siberian Shamans or healers in the Philippines.
I suggest that particularly in academic programmes of nursery and midwifery music therapy – e.g. singing techniques for different stages of labour – should be taken into consideration, eventually complemented by specific in-service-trainings and specified courses, but only for those who reach certain musical standards.
* You have initiated the first music programme at the University of Mauritius, which allows for further specialisation in music therapy after completion of undergraduate studies. Does this reflect the needs of the country?
I had the great pleasure and honour that the Chancellor of the University of Mauritius, Dr Jean-Claude Autrey, invited me to design and promote the first academic music programme in Mauritius.
Your first question: Why a music therapy module in the Bachelor Studies of music?
- For one, I feel that music therapy could be helpful for the public health system in Mauritius.
- Secondly, I am convinced that music therapy can greatly promote professional health tourism in Mauritius, for example, in the field of stress therapy and burnout prevention or in the multifaceted domain of couples therapy.
Further, Mauritius could also significantly contribute to cross-cultural music therapy. In this context, particularly the sega contains a high therapeutic potential and I hope we will have the possibility to conduct research on its health-related factors.
I am also convinced that future trainings in music therapy in Mauritius must be based on the complex culture of Mauritius and be benchmarked to international research standards.
* Would you say that we have the competencies and resources to conduct such training locally?
At the moment, I do not think that Mauritius has enough resources to run an academic programme in music therapy, which would need about three years of intensive collaboration to educate competent lecturers for the different fields of music therapy.
With its wonderful, vivid, and multifaceted culture Mauritius has the potential to develop a school of music therapy that would explore the still undiscovered therapeutic wealth and values of Mauritian music.
And we must not forget that the core of music therapy is music and not another discipline. Educators and health staff all can use music in a professional way, but they are not music therapists, because music therapy is a highly developed discipline today.
* Is it necessary to work out a mental health policy as well as a model for action based on agreed values, principles and objectives before starting music therapy in Mauritius?
- Yes, definitely. This is because: Music therapy concerns several ministries; for example, Ministry of Health and Wellness, the Ministry of Education, the Ministry of Arts and Cultural Heritage and others.
- Genuine Mauritian music therapy needs research. Just to import music therapy from other countries would not at all meet the requirements of Mauritian music therapy. The best place for conducting and coordinating such research would be the University of Mauritius, in collaboration with the whole relevant network, particularly clinical domains,
- Music therapy needs competent music therapists who are able to teach and to promote music therapy in theory and practice.
I think that Mauritius faces an important phase of music therapy development. This cannot be done overnight or by a single person. It needs an efficient interdisciplinary team and some years to establish high level music therapy.
* Published in print edition on 26 May 2020