BRIGHT YOUNG MINDS

Good mental health is crucial to a young musician’s development. Rita Fernandes hears from administrators, counsellors and teachers from leading music schools about what defines a successful conservatoire mental health support system

Royal College of Music students rehearsing at London’s Wigmore Hall

HIL ROWLEY

While undertaking research for this article I was hit with a caveat at every turn. ‘You can’t talk about mental health without talking about general health’; ‘It’s impossible to separate a young musician’s mental health from their musical performances’; ‘To understand a conservatoire’s mental health service, you must understand the educational structure in which it exists.’ What came from this endless zooming out was the realisation that when talking about mental health services in conservatoires, we are in fact talking about what responsibility institutions have in forming the best, and by extension healthiest, musicians possible.

From the bright-eyed fresher to the gigged-out fifth year, young musicians are at a vulnerable point in their lives when attending conservatoire. Establishing networks can be difficult and navigating new structures and cultures can trigger anxiety. These musicians can experience debilitating perfectionism and will have their mental resilience tested constantly. The latter is especially true since, owing to the rapidly changing music profession, students will most likely become freelance performers and be forced to handle uncertainty.

On top of that, the institutions at which these young people study are structured in a way that does not always make it easy to concentrate on self-care: friendships intersect with professional relationships, hierarchical structures can make it difficult to question authority, and heavy performance schedules can obscure the need for rest and recuperation. It is vital, therefore, that the institutions guiding these people through their developmental years are equipped with the resources to deal with the mental health struggles that may come with being not only a musician but also a human.

Although this article focuses mainly on mental health services within conservatoires, these are only one part of what makes an institution effective in supporting its students’ well-being. I therefore use phrases such as ‘mental health support’ when referring to institutional support (whether through teachers or curricula), whereas mental health ‘service(s)’ refers specifically to the institution’s counselling services.

According to administrators, counsellors and teachers from several leading music conservatoires, there is a general sense of optimism about the state of mental health support in their institutions. Services may not be perfect, but they are run and surrounded by people who genuinely care about offering effective help and are continually working to improve their services in a holistic way.

Within three years, the counselling service at London’s Royal Academy of Music (RAM) has grown from a three- to an eleven-strong team. ‘We have six part-time counsellors, three trainees and we took on some more staff to lift some of the administrative burden from the counsellors’ shoulders so they could really focus on the students,’ says Elizabeth Kenny, dean of students and a lutenist, teacher and Academy alumna. ‘The service is almost unrecognisable from what we had when I was a student.’

The free on-site service is based on short-term, solutionbased therapy. After an initial assessment with the student, the team gets together to discuss who might be available to help them. Up to twelve sessions can be booked, and these are followed by a review. ‘If they need longer-term help we’ll either refer them externally or let them take a pause after which they’re welcome to re-register,’ says Kenny. ‘The short-term aspect is an equity issue; it means we can give help to more students.’ Demographic data and student feedback are used continually to improve the service.

Anita Gould

KENNY PHOTO RICHARD HAUGHTON. ACADEMY PHOTO ADAM SCOTT. COLLEGE PHOTO FRANCES MARSHALL

Outside the Academy’s service, work is done to demystify the topic of mental health. ‘The head of the psychological support services, Anita Gould, talks to first and second years about it, so that they can see that there’s a person on the other end,’ says Kenny. Mental health-related materials have also been added to the Academy’s website and intranet, and news on the topic is shared in newsletters. Staff members who are trained externally as Mental Health First Aiders also work closely with the counselling service. ‘In a busy institution with a lot of hourly paid teachers, communication is really important. It’s a constant piece of work making sure that people are aware of the services available to students,’ says Kenny. ‘Then we can work on how to use this awareness in our educational model to harness effectively the amazing capacities of these young people.’

Elizabeth Kenny

Venture west, and you arrive at another of London’s esteemed conservatoires: the Royal College of Music (RCM). Its counselling team has been steadily growing since 2005, and they currently have three part-time therapists, alongside administrative staff. ‘The mental health communications of our student services have increased immeasurably since 2005 to meet the needs of our students and the rise of social media,’ says Nicola Smith, who manages the counselling service.

Nicola Smith

‘Students can self-refer themselves to the service by completing an online form. They are invited for an initial assessment and then offered six counselling sessions, either online or in person at the college,’ says Smith. Students can apply more than once, and the counsellors will signpost students to other services when appropriate. The service is free and on campus.

Since 2018, the RCM service has partnered with Togetherall, a 24/7 clinically managed online service where people can share their mental health struggles. Some staff are trained as Mental Health First Aiders and Smith has recently updated the RCM mental health policy to strengthen the service’s ability to respond to and communicate about students of concern.

The RCM also has a unique connection to the Centre for Performance Science (CPS). Established in 2000 at the RCM, it concentrates on scientific research into performance generally.

The RAM has an eleven-strong counselling service

Three part-time therapists are on hand at the RCM

George Waddell, performance research and innovation fellow, is responsible for integrating the CPS’s research into RCM undergraduate teaching. One example is the compulsory Healthy Musician module for first year BMus students, now taught by Anna Détári, a lecturer in performance science. Both Waddell and Détári have performance backgrounds – in piano and flute, respectively. The Healthy Musician module looks at why a student’s health should be, as Waddell states, ‘as core in their daily thoughts as learning repertoire’. Week three of the eight-week module is focused on mental health, using the PERMA model (see figure 1). ‘We look at what day-to-day things you can do to boost your mental health and feel that sense of empowerment,’ explains Waddell. Sessions on resilience are also included. ‘We talk about coping strategies for when things get tough, when you didn’t get that audition or gig, and how to maintain networks around you.’

Some of CPS’s experiments also involve musicians’ mental health, such as the use of a performance simulator to recreate concert conditions and help manage performance anxiety. But Waddell and Détári stress the importance of treating mental health as part of health more generally. Waddell describes it like this:

Anna Détári

‘We tend to speak about physical and mental health separately, but they’re linked; they’re going to pull themselves down and lift each other up.’

Across the pond, we come to the Berklee College of Music in Boston, MA. Its counselling service is part of the school’s Health and Wellness department – it’s free and on campus. Director of counselling Allison Lara oversees a team of nine full-time, salaried therapists, including two multicultural specialists. Four of these have been added over the past two years. Lara and associate director Kathleen Irving also provide therapy sessions from time to time. ‘The large team supports not only the students but also the staff. Counsellors don’t burn out, are more resilient and are still excited about staying. When staff retention is good, students will continue to come,’ says Lara.

FIGURE 1 The PERMA model used to understand mental health

STUD TS PHOTO PHIL ROWLEY. WADDELL PHOTO COURTESY ROYAL COLLEG

Students at the RCM café

STUDENTS PHOTO PHIL ROWLEY. WADDELL PHOTO COURTESY ROYAL COLLEGE OF MUSIC

Since January 2019, the service has worked on a ‘flexible care model’, based on an urgent care system. Before that, it functioned in a similar way to an outpatient therapy clinic: ‘People who were coming at the beginning of the semester were more likely to get care, and by October there was a waiting list of two months,’ says Lara. ‘We had to rethink how we deliver care.’ The current model offers either same-day appointments or those scheduled in seven days. ‘It considers a student’s lifestyle. If they have a change in their schedule and can come in, we want to give that support immediately. The model prioritises access.’ Data from the end of every semester is used to help move the service forward. Recently this has seen the creation of several support groups. Outreach work includes setting up presentations in faculty meetings, often at the request of the faculty.

The school also recently started a collaboration with the Jed Foundation. ‘The Foundation does an assessment to see the status of mental health education and prevention at your institution and helps you establish plans to fill in any gaps,’ says Lara. ‘On a college campus, the counselling centre can be a very siloed place because we engage with students in a confidential way, so it’s hard to be spokespeople. The partnership allows us to bring our knowledge to the students.’

George Waddell in the CPS’s Performance Simulator

Offering mental health support within an institution is not limited to providing a counselling service. ‘You can have all the counsellors you want, but if you’re getting a contradictory message from the most influential voices, it can undo a lot of the good,’ says Waddell. ‘Conservatoires have a unique structure where the teacher is basically your musical parent, a first aider – and so much more,’ says Détári. ‘Research has proven that the first person a student goes to in order to discuss their problems is their primary teacher.’ Teachers are therefore central to whether an institution successfully supports its students’ mental well-being.

David Wallace, head of strings at Berklee, says of his experience as a teacher and head of department: ‘I’m approached by students who need help, as well as by faculty advocating on behalf of their students. Faculty sometimes accompany students to the Health and Wellness office to assist them with making an appointment.’ With teachers most likely not trained clinically, a clear referral system is vital to ensure students are directed to the right place. ‘Because Berklee has developed strong resources, a solid team and accessible information, referring students to mental health services is now a simple, friendly process.

Making this support system a reality has taken time, effort and a strategic investment from our school, but it has paid off.’

David Wallace

The Berklee College of Music’s Boston campus

Hsin-Yun Huang, who teaches the viola at the Juilliard School, New York, and at Philadelphia’s Curtis Institute of Music, talks about the teacher’s supportive role from a pedagogical standpoint: ‘I see myself as working for the young musicians. How can I help that particular human being, with what I know about them, to survive in this particular structure? Students have come specifically seeking you out to be their teacher, so we’re given that incredible privilege to be part of the student’s life.’ Huang likens the teacher role to that of a GP. ‘You can’t always say, “Go to the specialist.” As teachers, we have to pool many different senses and say, “OK, that person could be in trouble.” But if students feel like they can’t talk to me, then they can seek help – because, after all, I’m not trained in that.’

HUANG PHOTO RAYMOND HUANG. WALLACE PHOTO DAVE GREEN. BERKLEE PHOTO KELLY DAVIDSON

The institutions themselves also have a critical role in the promotion of mental well-being, whether that’s integrating the services’ findings into their teaching, or making sure there is clear communication between every part of the organisation. Hsin-Yun Huang Michael Durrant is the coordinator of the Healthy Conservatoires Network, which brings together a group of mainly UK-based conservatoires (including the RCM and RAM) to discuss health in the performing arts. The network runs two to three meetings a year focusing on different themes, including mental health. ‘One of our challenges is how to understand change on an organisational level,’ says Durrant. ‘Some sectors understand this well, but for the large part of conservatoire history, the “master– apprentice model” hasn’t been called into question.’ In order to offer effective mental health support on an institutional level, it must be ‘a central part of the cultural identity of the institution’.

‘There’s been a lot of conversation around how curricula need to change because they’re so demanding,’ says Berklee’s Lara. ‘And with the new generation of students getting more and more comfortable with talking about mental health, counselling services need to develop the necessary skills quickly.’ For Kenny at the RAM, ‘The gold standard is that the principles we learn from the mental health service then influence our teaching. It shows that the institution values it and is committed to encouraging good mental health. We’re also looking at how we run our educational offering to make sure this aligns with promoting good mental health in an intensive performing environment. After Covid, all the conservatoires have been more eager to share if someone’s doing something good, so we’ve also received good advice on building up our service, especially from the drama schools.’

‘THE GOLD STANDARD IS THAT THE PRINCIPLES WE LEARN FROM THE MENTAL HEALTH SERVICE THEN INFLUENCE OUR TEACHING’ – ELIZABETH KENNY,

PHIL ROWLEY

THE KEY TO OFFERING EFFECTIVE MENTAL HEALTH SUPPORT IS BY MAKING SURE IT IS ENMESHED IN BROADER STRUCTURES

The key to offering effective mental health support in conservatoires is making sure it is enmeshed in broader structures. Communication between people, departments and institutions, as well as visibility of and access to the service, are the main pillars that the above conservatoires have concentrated on to achieve this integration. Institutionally, that means reinforcing a unified message on every level of the organisation. Scientifically, it means seeing mental health as part of health more generally. And artistically, it’s about understanding that mental well-being is intimately linked to being a good musician. ‘Learning how to maintain and pursue health is as important as learning to develop instrumental technique,’ says Wallace. In Huang’s words: ‘Music doesn’t lie. When someone is healthy inside, it sounds that way.’

Pragmatically speaking, having services on campus and free to all students has huge benefits in terms of accessibility. ‘Most external services are overwhelmed by high demand. We can provide immediate support to our students,’ says Anita Gould, head of psychological support services at the Academy. ‘We can support students more holistically,’ says Smith from the RCM. ‘If any issues relating to students are flagged up, counsellors are better placed to advise them on processes within our institution.’ Lara sees the internal services as a ‘good place to test the waters’ before committing to outpatient therapy.

Ultimately, one could ask whether conservatoires should have a responsibility to provide mental health services. The answer is not necessarily. It may be preferable, but it’s not what dictates whether an institution values the mental health of their students. ‘You don’t need to have a “centre for performance science” in your department. Making everyone have a shared vision is our goal. It’s not just to play at our best possible level; it’s to thrive in our health,’ says Waddell.

If a school can achieve comprehensive support without the need for a counselling service, that’s wonderful. It is unnecessary to make direct comparisons between different conservatoires’ mental health services or be critical of schools if they don’t have a service. Some schools may be in countries with effective-enough healthcare systems that referring students externally would result in better support. Unfortunately, this is not the case in the countries discussed here. And maybe a counselling service would be irrelevant in a country where seeking therapy is a cultural taboo, but where outreach projects are more effective. That is not to say that every conservatoire in the world provides adequate mental health support – from personal experience, I know this is not the case. But that is a subject for another article.

A better question would be: do conservatoires have a responsibility to offer the necessary education for a student to become the best musician they can be? In my opinion, the answer is a resounding yes. And caring about your students’ mental well-being, in whatever way works best for your school, is a necessary part of this. It can come down to the smallest things: a teacher being aware that services exist, or an administrator putting a struggling student’s needs before administrative inconvenience.

‘Our goal is not to “fix” students. Instead, we hope to provide the resources and empowerment students need to improve their ability to manage their own mental health,’ says Wallace. ‘It’s not so different from helping our students to become independent professional musicians. In fact, it’s an integral part of that process.’