Looking Within: An Investigation of Music Education Majors and Mental Health

Abstract

The primary purpose of this article was to establish the current state of mental health among music education majors. Music education majors across the United States (N = 1137) self-reported indicators of depression, anxiety, and stress. According to the results, music education majors are highly busy, enrolling in an average of 16.5 credit hours (not including zero-credit courses) and rehearsing 9.75 hours a week; a majority of them also work for an average of 13 to 15 hours a week. Participants reported elevated levels of stress, with 57% exhibiting moderate to severe depression and over 70% exhibiting moderate to severe anxiety. We discuss the findings, provide implications for music teacher education, and share suggestions for future research.

Keywords

anxiety depression mental health music education music teacher education

Mental health, specifically depression and anxiety, remains an ongoing concern among college-aged students and is an emerging focal point within the research literature (American College Health Association [ACHA], 2017; Buchanan, 2012, 2013; Castillo & Schwartz, 2013; Eisenberg et al., 2007; Eisenberg et al., 2009; Hunt & Eisenberg, 2010a; Whitton et al., 2013; Wristen, 2013; Zivin et al., 2009). Across a variety of disciplines, researchers frame their studies of mental health by (a) identifying ways to help people minimize the impact of mental health issues before they arise and (b) developing effective coping strategies to manage symptoms within their daily lives. Because college students experience rapidly evolving environments, life changes, and stressors due to newfound independence, their reporting of mental health concerns remains the focus of researchers. According to the National College Health Assessment (ACHA, 2017), college students reported struggling with both depression and overwhelming anxiety (anxiety affected twice as many students as depression), with over half listing at least one mental health problem in their responses (Zivin et al., 2009). In a 2017 Health Minds Survey, 14% of college students reported major depression while 31% described some level of depression and anxiety overall, corroborating the ACHA findings.

It is important, at this point, to operationalize three terms through both definitions and common symptoms: (a) stress, (b) anxiety, and (c) depression. The American Psychological Association (n.d.) defines stress as “the physiological or psychological response to internal or external stressors.” Stress is a human reaction to pressures encountered on a daily basis (American Psychological Association, 2020c) and is not inherently dangerous. Stress can be healthy and lead to growth if managed correctly; however, if these pressures begin to interfere with typical routines or interactions, it can negatively affect one’s health. Nearly three in four people report that headaches, fatigue, or loss of sleep comprise their reactions to stress at any given point (American Psychological Association, 2020c).

Anxiety is “an emotion characterized by apprehension and somatic symptoms of tension in which an individual anticipates impending danger, catastrophe, or misfortune” (American Psychological Association, 2020a). Those who experience anxiety actively try to avoid situations that intensify their physical reactions such as sweating, dizziness, increased heart rates, or panic (American Psychological Association, 2020a). Depression is a disorder defined as “a negative affective state, ranging from unhappiness and discontent to an extreme feeling of sadness, pessimism, and despondency, that interferes with daily life” (American Psychological Association, 2020b). Depression is often realized through physical changes such as sudden weight loss, insomnia, withdrawal from regular activity, or fatigue and is considered the most common mental disorder (American Psychological Association, 2020b). Furthermore, depression and anxiety are frequently diagnosed simultaneously, and the medical profession considers them comorbid (Moscati et al., 2016). Comorbidity adds a layer of difficulty when identifying, analyzing, and interpreting results of these types of studies.

College students’ propensity for failing to seek help for these issues seems to be another consistent theme throughout the literature (Buchanan, 2012, 2013; Eisenberg et al., 2007; Eisenberg et al., 2009; Hunt & Eisenberg, 2010a, ACHA, 2017; Whitton et al., 2013; Wristen, 2013; Zivin et al., 2009). According to the AHCA (2017), fewer than 20% of students reported being diagnosed or treated for depression or anxiety, with a majority often citing residual issues up to 2 years after the initial inquiries (Zivin et al., 2009). Access to free counseling or medical services did not seem to alter students’ willingness to seek help; they often cited an absence of perceived need, lack of awareness of services, insurance issues, skepticism, socioeconomic status, and ethnicity as common reasons for not seeking help (Eisenberg et al., 2007). While very few college students have reported thinking less of someone for seeking help (Eisenberg & Lipson, 2017), the stigma of being diagnosed with a mental health disorder (Eisenberg et al., 2009; Zivin et al., 2009) could be a barrier to timely and effective mental health treatment.

Mental Health and Music

Researchers rarely consider within-discipline or program-level factors that may affect the mental health of college students (Hunt & Eisenberg, 2010a). Anxiety and depression are very salient to the lives of music majors (Wristen, 2013). Wristen has suggested that music students (a) become more aware of and carefully monitor the warning signs of depression and anxiety, (b) develop healthy coping strategies, and (c) create an environment of acceptability when it comes to seeking diagnosis and treatment.

Many music education majors perceive themselves as "different" from other music students (Conway et al., 2010). This may be because music education majors, in addition to navigating degree requirements common to all professional degree students in music, regularly incur responsibilities specific to practicum experiences in schools. These experiences may result in feelings of isolation, a lack of time for music practice, and an overall sense of being overwhelmed by competing demands. Conway et al. (2010), for example, quote an instrumental music education major who observed, “Sometimes we just need to sit down and have a Coke. We need to relax and be a person. We need to sleep!” (p. 266). Such statements, considered within the larger context of music school culture, could reflect the reality of mental health struggles being experienced by many music education students.

The primary purpose of this study was to establish the current state of mental health among collegiate music education students. Specifically, we focused on stress, anxiety, and depression as major mental health indicators. We also aimed to (a) develop a profile of students’ lives with regard to personal, professional, and academic activities; (b) determine whether their self-reports of mental health are consistent with those of the general collegiate population; and (c) identify any substantive relationships among mental health indicators and other major survey variables.

Method

Instrument

We piloted a questionnaire with music education students (N = 65) to obtain feedback that would enhance item clarity. Based on participants’ responses, we adjusted item wording, added items to address additional mental health factors, and reordered items to improve flow. Subsequently, we sent a revised questionnaire to music education faculty at the same institution to establish face validity and clarify survey intent. The final version of the questionnaire, which was distributed to study participants as part of an online survey, included basic demographic items, items specific to various stressors (e.g., employment, course load, rehearsal and practice time obligations, hobbies, GPA), and mental health items adapted from the American Psychiatric Association’s (2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).

Procedures

Throughout the design process, we developed two methods of ensuring a robust participation. The first method involved distributing the survey through an email listserv maintained by the National Association for Music Education (NAfME). NAfME staff administered the survey to approximately 5,000 collegiate members during the initial mailing including two follow-up reminders within the ensuing 2 weeks. All collegiate members who opted to receive email solicitations by NAfME were included in this process. Understanding that not all music education majors were members of NAfME, we selected three or four schools from each state to broaden the sample. Once the institutions were selected, we identified music education heads and included them on the initial contact list of 155 institutions. Music education heads received a form email inviting them to recruit potential participants. Heads who did not respond received one follow-up email, upon which a nonresponse would remove them from the list. If an affirmative response was obtained, we sent a form invitation email to the music education faculty to forward to their respective students. To align with NAfME survey procedures, faculty also provided nonresponding students with two follow-up reminders. In total, we distributed the survey instrument to approximately 6,000 music education students nationwide. Our total response rate was just under 19%, with a margin of error of ±2.4% (95% confidence interval).

We designed and administered the survey using Qualtrics Survey Software. To ensure anonymity, all IP addresses were masked to the researchers, and survey data were de-identified prior to analysis. As an additional security measure, we employed a software filter to prevent multiple entries from the same person, regardless of the form of recruitment. We employed self-reporting for two reasons: (a) anonymous self-reporting provides more honest responses than other data collection methods (Aday & Cornelius, 2006) and (b) we needed to align the survey instrument with the American Psychiatric Association’s (2013) DSM-5, which screens for mental health through a self-report method. Given the sensitive nature of mental health, we stressed the assurance of anonymity through our invitation, in the questionnaire cover page, and in a debriefing message after responses were submitted.

Participants provided demographic and environmental data, and also responded to a variety of (Level 1) screening statements representing key indicators of mental health (depression, anxiety, and sleep disorder) as validated and designed by the American Psychological Association. Data yielded included responses to each statement in the Level 1 screening. A response of two (2 = mild) or above on any of the statements prompted additional questions (Level 2) to determine the extent of the reported indicator. In all, students responded to 19 Level 1 statements with the possibility of 23 additional Level 2 questions depending on their specific responses. We subsequently downloaded all data from the password-protected survey site into SPSS, which we used to conduct descriptive and correlational analyses.

Results

Participants

Participants (N = 1,137) represented undergraduate music education majors currently attending mostly public (77.8%) universities and colleges with an average enrollment of over 10,000 students (61.6%). In total, respondents (average age: 20.2 years old) comprised all 50 states and six regions as defined by NAfME (Eastern, 13.1%; North Central, 27.9%; Southern, 17.3%; Southwestern, 25.9%; Northwest, 9.2%; Western, 6.3%). Most reported their ethnicity as white (84.3%), with smaller distributions representing African American (2.3%), Pacific Islander (0.9%), Asian (3.1%), Native American (1.1%), Hispanic (6.4%), or Other (1.8%), while a majority (63.1%) identified as female. Freshmen represented a plurality (29.3%) of respondents followed by seniors (22.5%). The latter could indicate the extension of a degree program past 4 years, as both fourth- and fifth-year seniors identified as seniors for the purpose of the current survey.

On average, students reported a current registration of 16 credit hours, including three ensembles. Students also were enrolled in an average of two additional courses for which they received no credit, implying that their total course load was in excess of 18 credit hours. They reported an average GPA of 3.6, despite typically logging almost 10 hours of ensemble rehearsal and 8 hours of individual practice per week. A majority (57%) had a part-time job and worked an average of 3.5 days for up to 15 hours per week. Most students lived off-campus (51.7%) and were not currently in a relationship or married (52.5%). A full report of all demographics is included in the online supplemental material.

Mental Health of Music Education Majors

For almost three fourths (73.2%) of participants, responses to Level 1 screening statements initiated a series of Level 2 questions regarding depression. Of those who answered the Level 2 questions, 82.7% indicated symptoms of mild (25.5%), moderate (44.5%), or severe depression (12.7%). Similar to depression, a majority (79%) of music education majors exhibited indicators of anxiety and required follow–up prompts from the Level 2 questionnaire. Of those who answered the Level 2 questions regarding anxiety, 87.8% reported symptoms of mild (17.2%), moderate (48.4%), or severe anxiety (22.2%). In a clinical setting, further testing and analyses would be initiated to determine the depth and impact of these indicators and lead medical professionals to a definitive diagnosis for both depression and anxiety.

Overall Stress

On a scale from 1 to 10, where 1 indicates no stress and 10 indicates overstressed, music education majors reported an average stress level of 7.12 (SD = 1.97), with 60% rating their stress level as 7 or higher. Furthermore, when ranking common stressors, students emphasized (in order) lack of time, homework, practicing, and overcommitment. A perceived lack of time (which is a corollary of overcommitment) was clearly the most pronounced stressor, with just over three fourths of respondents ranking it as one of their top three stressors and almost one in two ranking it as their top stressor. See Table 1 for a complete listing of stressors and rankings.

Table 1.

Complete List of Stressors and Rankings.

Stressor	Rankings, %
Stressor	1	2	3	4	5	6	7	8	9	10
Lack of time	41.4	21.8	12.3	9.6	5.3	3.9	3.1	1.2	0.8	0.7
Homework	12.6	18.2	17.5	15.1	13.9	8.9	5.2	4.2	3.2	1.2
Practicing	14.3	15.9	17.1	15.0	11.4	8.9	6.4	6.6	3.4	0.8
Overcommitment	13.9	10.5	10.8	10.9	8.7	10.0	9.5	12.4	8.9	4.3
Maintaining a schedule	6.9	10.7	11.5	10.9	10.9	14.1	14.4	10.1	6.9	3.4
Finding time to sleep	3.4	8.3	9.4	9.3	15.9	13.3	13.8	15.3	8.9	2.4
Ensemble preparation	2.5	6.8	7.5	9.9	11.1	13.9	11.9	12.8	13.9	9.7
Finding time to eat	2.0	3.5	7.6	10.7	10.8	13.5	14.2	15.5	14.1	8.2
Work	2.3	2.5	4.3	4.1	5.7	6.8	8.9	6.7	11.9	46.8
Extracurricular activities	0.6	1.7	2.1	4.4	6.3	6.5	12.8	15.1	27.9	22.6

Emerging Relationships

We subsequently looked at potential relationships between music education majors’ reporting of stress and their total scores for depression and anxiety. Reported stress levels were significantly correlated with DSM-5 total scores for depression (r = .34, p < .01) and anxiety (r = .52, p <.01). Among other noteworthy relationships (see Table 2 for exact correlation and probability values), total credit hours (computed by adding current course registration to the number of zero-credit hours as reported by participants) was positively correlated with depression and anxiety, and number of hours worked was positively correlated with stress level. Conversely, GPA was negatively correlated with depression and anxiety, just as hours of sleep was negatively correlated with depression and anxiety.

Table 2.

Correlation Matrix for Mental Health and Music Education Majors.

	GPA	EP	HP	HS	EX	PHR	MHR	AHR	SR	TD	TA	SQ
GPA	1	.14	.09	.19	−.04	.10	.12	.33	−.05	−.09	−.07	.14
EP		1	.09	−.01	−.04	.06	.03	−.01	.02	.32	.36	.04
HP			1	−.19	.08	.00	−.01	.12	.03	−.01	−.03	−.03
HS				1	−.01	.19	.31	.17	−.26	−.21	−.16	.40
EX					1	.08	−.05	−.02	.00	.02	−.03	−.01
PHR						1	.38	.19	−.22	−.23	−.26	.24
MHR							1	.39	−.54	−.65	−.56	.43
AHR								1	−.27	−.33	−.27	.19
SR									1	.47	.52	−.33
TD										1	.75	−.38
TA											1	−.32
SQ												1

Note. This table provides correlations for all study variables. GPA = Grade Point Average; EP = Total enrollment including 0 hour courses; HP = Hours practiced; HS = Hours of sleep per night; EX = Hours of exercise per week; PHR = Physical health rating; MHR = Mental health rating; AHR = Academic health rating; SR = Stress rating; TD = Total depression score; TA = Total anxiety score; SQ = Sleep quality. Because of the large sample size (N = 1,137), all correlations greater than .075 were statistically significant (p < .01). Boldface font highlights correlations of modest magnitude (r = .20) or larger. Larger magnitude correlations associated with stress, anxiety, and depression are enclosed by borders.

Discussion

Two primary purposes of this study were to establish baseline data for collegiate music education students with respect to their daily lives, academic practices, and mental health indicators, and to compare the mental health of music education students with that of college students in general. Both depression and anxiety emerged as significant mental health concerns, perhaps reflecting the comorbid nature of these indicators, as well as the complex and busy lives that music education students lead. The percentage of music education students reporting issues with depression was nearly double the previously reported incidence level for college students overall (AHCA, 2017), while the percentage of music students reporting issues with anxiety was almost 20% greater. Furthermore, music education majors exhibited elevated levels of depression and anxiety across all demographics, which is consistent with the literature (ACHA, 2017; Buchanan, 2012, 2013; Hunt & Eisenberg, 2010a; Whitton et al., 2013; Wristen, 2013; Zivin et al., 2009). While we did not develop items to assess music students’ help-seeking behaviors, it is likely that most students reporting moderate or high levels of depression and anxiety are receiving counseling, medication, or some other treatment. Coping behaviors and formal treatment represent two areas of inquiry that should be examined in greater detail.

Despite the cautions about outside work commonly advanced by advisors and program heads, work was ranked lowest among a group of 10 stressors. This may reflect the fact that most students reported working only a few days a week for 15 or fewer hours, such that potentially negative impacts on mental health may be constrained. For students in part-time positions, work also may provide an escape from or counterbalance to the intensely focused music activity that often stresses music education majors. In other words, work may serve as a respite from the grind of studying music, practicing, or rehearsing with ensembles.

While music education students do not appear to see work as highly stressful, the need to work may reflect stressors operating through other channels, such as the financial pressures that come with escalating tuition and increased levels of student loan debt. Moreover, as music education students elect to increase the amount of work in which they engage outside of school, the quality of their engagement within school (e.g., practice time, devotion to developing their craft as musicians and educators), and their ability to disconnect from school to allow for the enjoyment of hobbies or other wellness activities, may be compromised. Because hours of work were associated with elevated levels of stress, the indirect effects of work on student stress should be studied further.

Many significant relationships emerged through our analysis. Stress, anxiety, and depression seem to be interwoven, or even inseparable, facets of the music education major experience. Considering that most students reported moderate or high levels of stress, it would seem important to identify key contributors to stress (beyond work), determine which stressors are reasonable for students to manage or control (i.e., some students may overreport stress or equate elevated stress with being productive or dedicated), and assess various coping strategies or policy mechanisms that may be employed to reduce the incidence and impact of specific stressors. A greater number of credit hours (including required zero-credit courses), for example, was associated with higher levels of anxiety and depression. The traditional approach to calculating and reporting credit hours, and documenting course requirements, remains a problematic area for music schools. In many instances, one-credit ensembles meet 5 to 6 hours a week, and other one-credit courses with laboratory designations may meet 2 or more hours a week. These undercredited degree requirements, in turn, can increase the total number of obligations and responsibilities that music education students are required to manage within a given semester. Under such circumstances, few students are likely to muster the coping skills needed to reduce commitments, increase available time, and lessen the likelihood of anxiety or depression. More systematic policy changes implemented by music teacher educators may be needed to balance professional standards with student capacity to learn. In lieu of such changes, students may be able to gain some ground against distress by making sure they engage in proper wellness behaviors (including getting adequate sleep, as more sleep was negative correlated with anxiety and depression) and academic success behaviors (GPA was negatively correlated with anxiety and depression).

Left unchecked, excessive levels of stress, anxiety, and depression can negatively affect student learning/performance and jeopardize degree completion. Debilitative patterns of decision making and behavior also can carry forward into one’s professional career, resulting in teacher burnout or attrition (Allen, 2014; Bernhard, 2005, 2007; Teasley & Buchanan, 2016). To intersect the problems of mental health among undergraduates majoring in music education, researchers must explore the circumstances leading to the onset of anxiety and depression; some students may bring mental health issues with them to college, while others may develop mental illness due to changes that accompany the transition from high school to college. Clearly, low to moderate levels of stress can provide motivational benefits for students. However, a nexus of personal, organizational, and situational factors may elevate stress to a level at which anxiety and depression are triggered as major mental health concerns. Researchers should use more sophisticated designs (time series, longitudinal), more advanced statistical methods (e.g., logistic regression, structural equation modeling), and qualitative approaches (e.g., case studies) to ascertain when, how, and why certain stressors become salient to the mental health of collegiate music education students.

Implications for Music Teacher Education

One way to ensure success in addressing mental health of our music education majors is to train and inform both faculty and students of their options on a regular basis, and establish a partnership or network with local mental health professionals who can serve as resources throughout the entire process. There are two sides to this suggestion and those are (a) a faculty’s awareness of the fundamental nature of the issue and (b) a students’ knowledge of their resources and how to utilize them. In the former, institutions should consider two initial steps: (a) training faculty in how to identify and seek help for individuals who are exhibiting indicators of depression or anxiety and (b) establishing a protocol by which students are screened at initial enrollment and checked periodically through advising to support the general welfare of the student following matriculation.

This, however, cannot fall solely on the music faculty. While most music departments will have a small student-to-teacher ratio and in many cases teach one-on-one with students, faculty are not trained as counselors or mental health professionals, so ensuring a strong protocol is in place to address these issues is paramount. Advisors should also be made aware of the protocols and programs available to the students and how to help students access those programs (Teasley & Buchanan, 2016). With regard to communications, students should be provided with information about mental health services (including notions of help-seeking and self-care) through a variety of platforms, including departmental websites, email lists, special wellness seminars, and individual advising sessions. Students should be aware of how to focus on themselves and be informed of the most effective strategies for coping with these feelings and symptoms as well as the best ways to seek help. Focusing on self-care could mitigate many issues before they become critical (Kuebel, 2019). This is especially important given that Bland et al. (2012) found students to be less tolerant of stress when they employ ineffective coping strategies. While working within the bounds of their expertise, faculty should move beyond transmitting information about mental health to actively assisting students in identifying and implementing effective coping strategies, destigmatizing the act of seeking help, and referring students to mental health professionals on campus as appropriate (Bland et al., 2012; Eisenberg & Lipson, 2017; Zivin et al., 2009).

Mental health is an invisible component of an individual’s wellness and contains indicators that are varied, wide, and indiscriminate. Depression, anxiety, and stress are critical issues for future music educators and the music education profession. Revealing and implementing a process that can be effective in identifying the onset or emergence of these indicators and implementing effective coping strategies should remain at the forefront of current research efforts and are critical to the longevity of our students and profession. Such analysis and development could be advantageous at both the micro and macro levels. Doing so will ensure the success of our preservice music teachers both in school and throughout their careers while maintaining a healthy and vibrant work force. Students and faculty alike should continue to strive for a balance in work, music, and life to maintain the forward momentum of ourselves, our universities, and our profession.

Supplemental Material

Online_Supplemental – Supplemental material for Looking Within: An Investigation of Music Education Majors and Mental Health

Supplemental material, Online_Supplemental for Looking Within: An Investigation of Music Education Majors and Mental Health by Phillip D. Payne, Wesley Lewis and Frank McCaskill in Journal of Music Teacher Education

Supplemental Material

The_Relationship_between_Music_Education_and_Mental_Health_(1) – Supplemental material for Looking Within: An Investigation of Music Education Majors and Mental Health

Supplemental material, The_Relationship_between_Music_Education_and_Mental_Health_(1) for Looking Within: An Investigation of Music Education Majors and Mental Health by Phillip D. Payne, Wesley Lewis and Frank McCaskill in Journal of Music Teacher Education

Footnotes

Authors’ Note

The research protocol for the present study was reviewed by the researchers’ institutional review board, who found that the protocol was in line with institutional and federal regulations in the treatment of study participants. As a part of this process, researchers underwent applicable training created by the Collaborative Institutional Training Initiative to ensure that they were aware of federal regulations.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Phillip D. Payne

Supplemental Material

Supplemental material for this article is available online.

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