Music as Medicine: Orchestras and the Social Prescribing Movement

Guest blog post by Claire Speed and Ian Ritchie.

“Music and rhythm find their way into the secret places of the soul” Plato

In June 2019, two national conferences took place over the same two days in Ottawa. One focused on Community Health Connections, the other on the Orchestra of the 21st Century. On the surface, neither had much to do with the other. One was about health, the other about the arts. But they shared a common goal: to create healthier, more inclusive communities.

https://www.health.org.uk/infographic/what-makes-us-healthy

We have never been in doubt about the healing powers of the arts but their value has not been fully realized nor embraced. This attitude, however, may be changing. Today, there is a growing movement, in Canada and internationally, to increase awareness among politicians and the medical community about the potential of the arts to cure: “The power of music to integrate and cure…is quite fundamental. It is the profoundest nonchemical medication.” (Oliver Sacks, “Awakenings”) Funding shortages have forced some governments to think differently about how they deliver healthcare, away from hospital-centred care and over-prescribing of medications to more patient-centred self-care. As stated in a 2017 report by the All-Party Parliamentary Group on Arts, Health and Wellbeing in the U.K. “up to a fifth of patients see a G.P. for a problem that requires a social solution.” To address this statistic, some primary care workers are now taking a more proactive approach to healing through social prescribing which is defined as: “a co-creative effort between a health care provider and a patient that recognizes and responds to a patient’s strengths, interests and health needs” (Social Prescribing in Ontario: Progress Report, June 2019). Social prescriptions, therefore, do not presently aim to replace the main ingredients of primary medicine but are seen to be complementary.

While good health care practitioners in Canada have been involved in this work for decades, the Social Prescribing movement has brought the terminology and associated momentum from UK to Canada and in particular Ontario with a project funded by the Ontario Ministry of Health and Long-Term Care and overseen by the Alliance for Healthier Communities, a network of equity-focused community-governed primary health care organizations that include Community Health Centres (CHCs). The Alliance presented sessions on Social Prescribing at the two national conferences in Ottawa in June. In relation to orchestras, we believe it should be a natural progression for them to extend their mandates (and funding sources) to include health and wellbeing just as they have done for many years in education: this would offer new opportunities to deploy the power of music beyond those attending concert venues and places of learning to reach across the whole human spectrum, from newborns to those in palliative care. At first sight there are few obvious ways for orchestras to engage in social prescribing except in a volunteering capacity, as is currently happening, or by providing free tickets and the opportunity to be a part of the audience. If we target and treat audiences in the right way, this can form part of the current social prescription model.

During the particular session at the Orchestras Canada conference on “Social Prescribing and Orchestras”, Sonia Hsiung, who is leading the Ontario initiative at the Alliance for Healthier Communities, posed the following question: “Where do you see the role of orchestras in enhancing wellbeing and creating community belonging?” Some examples of successful partnerships between the Arts community and CHCs were presented at the two June conferences. South Riverdale CHC’s chronic pain management program, in partnership with the Art Gallery of Ontario, provides training for Peer Ambassadors to lead gallery visits and art-making workshops “with the lens of health and well-being to support self-management and healthy living” for people who have similar lived experience. What if orchestras across Canada are able to co-design similar community-specific arrangements with local healthcare providers that create facilitated access for those with health and social barriers and unable to attend otherwise? Or if docent programs run by the orchestra’s volunteer committee could include CHC clients identified for their love of children to help out with pre-concert activities at family concerts? With sufficient desire and adequate support, many more innovative partnerships like this one in Toronto could be piloted.

We believe music’s relationship with health and wellbeing can be viewed as four overlapping circles – ‘music therapy’, ‘music medicine’, ‘music care’ and ‘music in the community’. The different ways in which music and the arts can benefit society, in terms of health, wellbeing, care and community, suggest that our profession should not be totally reliant on cultural streams of income, public or private, but also find financial recognition from those delivering education, healthcare and social welfare. A more integrated and holistic approach to funding would enrich all the interconnected areas of work.

This leads naturally to the idea that social prescribing – currently valued as a beneficial social and community complement to clinical practice but largely reliant upon informal artistic and other social opportunities that are voluntary or receive one-time funding envelopes – may possibly one day be equally valued alongside pharmaceutical prescription for its health impacts and built in to the formal healthcare system. The UK government’s announcement in October 2019 of funding for a new Academy of Social Prescribing, with the purpose of regulating provision and making this available for every patient in the country, is an important step in the right direction. Also encouraging is the 2019 report by the World Health Organization “on the role of the arts in improving health and well-being”. Maybe Ontario, along with other provinces in Canada, will be next to embrace social prescribing for all patients? Until then, we can seek opportunities to partner, experiment, demonstrate and advocate for the healing power of music and the arts.

Health and well-being are simultaneously local and global issues. In traditional cultures, effective medical remedies have always been locally grown and sourced. As far as the arts are concerned, international success in creation or curation is normally dependent on the strength of the local roots and identity of the works and their makers. So the activities and networks for social prescribing – and for the nexus of arts, health and wellbeing in general – will continue to develop locally and be shared abroad: the world is our home and vice versa.

Ian Ritchie lives in London, UK and is Artistic Advisor, Setubal Music Festival as well as Artistic Director, The Musical Brain and Joint Chair, Music Action International. Claire Speed lives in Ottawa, Canada and is an Independent Consultant & Facilitator for the Arts/Health/Community. Musico-Nexus is being established as an international entity by Ian and Claire to create projects, curate events and develop networks which support music’s powerful and beneficial contribution to people’s health and wellbeing, social inclusion and interdisciplinary practice. For more information or to make contact: musiconexus@gmail.com

Member Spotlight: Music4Life String Orchestra

Orchestras Canada’s member orchestras range in size from fully professional ensembles, to smaller regional orchestras, to community groups working with enthusiastic amateur musicians. The Music4Life String Orchestra is one such community group.  Based in Ajax, Ontario. Music4Life’s orchestra currently has over 30 string musicians, including four professional section leads who act as mentors and teachers to the rest of the ensemble. The orchestra members range in age from 8 to 78 years old, making for an unusual but beneficial social and musical experience for all involved.

Many community orchestras have professional musicians among their ranks. The extent of their participation varies, from having only a professional concertmaster, to having five professional principal strings, to engaging professional principal musicians in all sections to work alongside community musicians. While Music4Life’s employing a professional conductor and musicians in itself is not unusual, the way in which it is framed is. The orchestra uses the side-by-side professional/amateur experience and in-rehearsal teaching as a particular point of interest to current and prospective community musicians.

The community musicians benefit from having a professional conductor and section leaders present throughout the rehearsal and performance process. Although some of these musicians have private teachers, for many, orchestra rehearsal is the only chance they have for further instruction on their instrument. Seating is rotated at each rehearsal so that each musician gets a chance to sit next to their section leader, and break times are viewed as opportunities for further informal and social exchanges between professional and amateur musicians. The Music4Life arrangement provides an excellent collaborative and supportive environment for all and is a complement to traditional private lessons.

For the professional musicians, this is an opportunity to share their musical knowledge and to reach a wider number of musicians in the community. The group’s professional and advanced musicians are given opportunities to play paid gigs in string quartet/quintet arrangements for public and private events. Proceeds raised from these performances are directed back into the operation of the non-profit orchestra. The side-by-side nature of the Music4Life String Orchestra is one that supports exchange between professional and amateur, and young and old, in a way that benefits the musical experience of all involved.

Music4Life’s next concert is on December 7th at Forest Brook Community Church. Under the musical direction of Kathryn Knowles, a Toronto-based Cellist, Composer and General Manager of the Canadian League of Composers, the event will feature a collaboration with a string quartet of award-winning jazz/classical crossover musicians who will perform seasonal, classical and jazz repertoire with the orchestra. Learn more about the Music4Life String Orchestra on their website.

Music As Community Medicine at the Windsor Symphony Orchestra

Musicians from the Windsor Symphony Orchestra visited community and health venues between October 1st and 10th as part of their Music for Health outreach program. Last year this program included 21 performances to more than 1200 seniors in and around Windsor.

The Music for Health program is an important part of the Windsor Symphony Orchestra’s commitment to the Windsor-Essex community.  This year’s edition included visits to Hospice Windsor, the Windsor Public Library, Downtown Mission, and senior’s retirement and care centres across Windsor-Essex, delivering beautiful music to those who would otherwise be unable to attend a mainstage performance.

The program is based upon the growing body of evidence that shows the positive impact music has on mental, emotional, and even physical health.  Developed by two WSO musicians who have worked very closely with local music therapists in hospital settings, this program features performances by WSO string quartets and quintets at rest homes, retirement homes and social service agencies across Essex County. Clients are encouraged to participate in the performances using small hand percussion (provided by the WSO), selecting works that the ensemble will perform, as well as sharing memories and recollections evoked by the performance. Learn more on the Windsor Symphony Orchestra’s website.

From Development to Engagement

Donna Walker-KuhneAs part of OC’s National Conference, in Ottawa this June 11-14, we will be welcoming Donna Walker-Kuhne as one of our keynote speakers. Donna is currently Senior Advisor of Community Engagement at the New Jersey Performing Arts Centre (NJPAC). Started four years ago by Donna, the NJPAC community engagement department is small (with a staff of three), but is seeing some stunning results. With over 200 events, and some 30,000 people through their doors each year, the NJPAC is actively working to bring the arts to a more diverse audience, and engaging them in many different ways.

Successfully engaging community

Early in their community engagement work, Donna and her department decided to more extensively activate the advisory council of community members already in place at NJPAC to help guide their work. “We have an amazing advisory council that creates events that they find are of interest to their community, that introduce the arts, engage people in the arts, and educate people about the arts,” she says. The joint work of the community engagement department and the advisory council has changed the way that the NJPAC operates. “It’s had significant impact, not just in the audiences, but also in the opportunities we can present to our corporate funders. Because we are able to give them a footprint in the community, they are allocating additional dollars, and in certain instances exclusively funding our department.”

Measuring success

It can be challenging to measure the impact of this work on communities. Donna spoke about measuring success at NJPAC through the actions of their partner community organizations and associations. “Buying a ticket is not one of our measurements. We are not a sales entity,” she says. Rather, they look at how deeply they are engaging with the organizations they serve, on something of a ‘ladder of engagement’ that shows different kinds of interactions with NJPAC events:

  1. Attending free events
  2. Promoting NJPAC events (taking fliers, sending e-blasts, helping NJPAC reach people that they might not otherwise be able to)
  3. Bringing groups to events
  4. Volunteering at events

Once organizations are doing three of these four things, they are described as engaged partners, and tracking these is a key measure of success. NJPAC currently has 122 engaged partners.

Audience Development and Community Engagement

Photo of NJPAC with a packed crowd outsideHow has this work changed over time? “It’s an evolution. I’ve been involved in this work since 1982,” Donna says. “At that time we didn’t have any terminology for the lack of diversity in audiences, but there was a conversation.” It took a while for organizations to move on what they heard. In the 1990s, people started using the term audience development, and some foundations started putting funds towards this. Over time, audience development became to be seen as a term more concerned with sales, i.e. developing an audience to purchase tickets. The term community engagement represented the next step. “First we have to cultivate the community to be interested in what we’re doing,” Donna says.

While the terminology has changed, the desire to become more deeply engaged with our communities is still strongly felt in orchestras and arts organizations. However, building this work into long-term plans is challenging. We need to allocate time and money from within our organization to make it happen. “It has to be a priority,” Donna says. “It has to be something that the board and senior leadership have embraced.” It’s important to have ways to measure success, and to be cultivating connections that last longer than one particular project or staff member. It’s not easy work, but it opens up our orchestras to all kinds of interesting, rewarding and long-lasting relationships with our communities.

At our National Conference, Donna will be giving a keynote address and leading a workshop that will explore best practices in the field of community engagement, present success metrics for these programs, and look at how to build and expand multicultural arts audiences. Visit the Conference area of our website for more information.