Background / Significance of the Problem

According to recent international studies, it is estimated that there are approximately 322 million people suffer from chronic depression. (WHO, 2017) “Mood disorders, including major depression, dysthymic disorder, and bipolar disorder, are the third most common cause of hospitalization in the U.S. for both youth and adults aged 18–44” (Agency for Healthcare Research and Quality, The Department of Health & Human Services. (2009).

Statistics in 2015 demonstrated that overall 6.7%, equivalent to 16.1 million, of all U.S. adults, had at least one major depressive episode. As of sex women, 8.5% had a higher rate of depression than men, 4.7%. The rate of depression decreased by age from 10.3% among youth aged 18-25 to 4.8% among adults aged 50+ (NIMH, 2017).

District of Columbia stands as number one for the state prevalence of youth with the major depressive episode at 8.69%, in numbers 3000 (Mental Health America, 2016). “In DC, 72 percent of adolescents in Medicaid managed care diagnosed with depression had an unmet need for depression care”(Chandra, Blanchard, and Rudder 2013). “In Prince George’s County, two of every five children ages 6 through 19 experienced one or more mental health risks (such as anxiety, difficulty sleeping, or depression)” (Chandra et al. 2009). “Fairfax County students have depression and suicide contemplation rates higher than the national rates, and suicide is the leading cause of death among youth there” (Partnership for a Healthier Fairfax 2011) “In DC, 60 percent of adults enrolled in Medicaid managed care with a diagnosis of depression have an unmet need for depression care” (Chandra, Blanchard, and Rudder 2013).

There are those times when everyone feels low or sad, yet usually, these feeling fade away soon. In contrast to daily life mood swings, depression,  also called “clinical depression” or a “depressive disorder”- is a mood order where how people feel, think and handle daily activities, such as sleeping, eating, or working is affected by distressing symptoms. There are different types of depression. However, overall, to be diagnosed with depression, the symptoms must be observed almost every day for at least 2 weeks (NIMH, 2015).  Depression does not look same in everyone. It affects different people in different ways. The way women, men, older adults, younger children, older children, and teens experience depression varies notably. The examples can be easily found in almost every setting of daily life from schools to universities, workplaces, even at homes. There are different forms of depression. Some forms may not exhibit great differences or some may develop under unique circumstances. Some of the forms of depression are a Persistent depressive disorder, perinatal depression, psychotic depression, seasonal affective disorder, bipolar disorder. It can be treated by numerous means including medication, psychotherapy, and brain stimulation therapies (NIMH, 2016).

“Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship with a credentialed professional who has completed an approved music therapy program.” (AMTA) In therapeutic relations, music is used as a means to address the physical, emotional, cognitive, and social needs of individuals. In evaluating the qualities and requirements of every client, the qualified music therapist gives the particular treatment including making, singing, moving to, or potentially tuning in to music. Through melodic exposures in the therapeutic setting, clients' capacities are fortified and exchanged to different parts of their lives. Music treatment additionally gives alternatives for communication that can be useful to the individuals who think that it is hard to convey what needs be in words. Research in music therapy underpins its viability in numerous areas, for example, general physical rehabilitation and facilitating development, expanding individuals' motivation to noticeably involve with their treatment, giving emotional support to customers and their families, and giving an outlet to the expression of emotions. (AMTA)

After music therapy gained noteworthy support and interest, new associations emerged in the early 1900s. Even though they were short-lived, in 1998 The American Music Therapy Association (AMTA) was formed as a merger between the National Association for Music Therapy (NAMT) and the American Association for Music Therapy (AAMT) whose purposes were similar but their philosophy, education, and approach varied. Since then AMTA is the intellectual home to students, graduate students, member music therapists and other supporters.

Music therapy has proven to be effective in treating depression (Erkkilä et al., 2011), (Maratos A, Crawford MJ and Procter S., 2011). Some of the major health benefits of music therapy are; it reduces anxiety and physical effects of stress (Kemper &Danhauer, 2005), improves healing (Guzzetta, 1989), can help manage Parkinson’s and Alzheimer’s disease (Raglio et al. 2015), (Aldridge, 1994) reduces depression and other symptoms in the elderly stress (Kemper &Danhauer, 2005), helps reduce symptoms of psychological disorders including schizophrenia (Jeon, Gang, & Oh, 2017).and improves self-expression and communication (Scholer, 2010).

 

References

Agency for Healthcare Research and Quality, The Department of Health & Human Services. (2009). HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2009. Retrieved January 16, 2015, from http://www.hcup-us.ahrq.gov/reports/factsandfigures/2009/pdfs/FF_

The agency for the healthcare research and quality (AHRQ) has the mission of improving the safety, quality, effectiveness, and efficiency of the healthcare for the Americans. In order to fulfill the goal, AHRQ sponsors the healthcare costs and utilization project (HCUP), a healthcare family database and the related software, statistical information, and products to provide information for the policy makers, researchers, public and the system leaders. With the partnership with the state, industry and federal organizations, the agency has developed from the single database to an inpatient hospital care and into the six states, the national level which covers the ambulatory surgery, pediatric encounters, inpatients and the emergency department. Due to this reason, the HCUP has been recognized as the biggest all-player source of the hospital history data in the United States.

The database of HCUP continues to grow since 1988 due to the new information regarding the patient information and other services offered in the hospitals. The inpatient database currently includes 95 percent of the whole of hospitals in the United States. The agency is built in order to understand and provide more help to the challenges which occur in the health care centers in the United States.

 

 

American Music Therapy Association.(n.d.). Retrieved from https://www.musictherapy.org/about/history/

The article establishes the idea that music could be the answer to healing the behavior and health have been there since time in history. During the past century, musicians from all communities took their skills both the professional and amateur to the hospital to play music to the fallen soldiers during the First and Second World War. The war heroes were suffering physically, emotionally and mentally and the music was used to heal some wounds which were developed after the war. The change in the people was notable both emotionally and physically and this led to the doctors to order the involvement of the musicians in their hospitals. Soon the hospital's musicians were required to undergo some sort of training before the entry and this led to the growth of demand for the musicians in hospitals.  

Aldridge, D. (1994). Alzheimer's disease: rhythm, timing, and music as therapy. Biomed Pharmacother, 48(7), 275-281.

In this article, the active music-making is regarded as the one method that reduces the activities of failure in a patient suffering from Alzheimer’s. Evidence indicates that the life quality of Alzheimer’s affected people improves significantly with music therapy which is accompanied by the social benefits of the sense of belonging that is obtained through having a communication with other people. The therapy of music when it is based on treatments which are clear in terms of the objectives will reduce the patient’s prescriptions of the tranquilizing medications; the use of the hypnotics is reduced, and the goal of rehabilitation is reduced. Self-expression, mood improvement, the organization of mental status and the speech development are highly influenced by the music. Alzheimer’s disease has seriously reduced and this can be accounted for the music therapy.     

Chandra, Anita, Janice C. Blanchard, and Teague Rudder. 2013."District of Columbia Community Health Needs Assessment." Washington, DC: Rand Corporation

In the article, the District of Columbia healthy communities collaborative (DCHCC) signifies a collaboration that exists among the District of Columbia hospitals and the health centers of qualified federals. In response to the community commitment and the affordable care acts, the DCHCC tasks itself with conducting a community health needs assessment which will guide the decisions about how and where to have resources allocated and implement the most necessary health care systems for populations. The assessment described in this sense is the analysis of the existing demographic, hospital data, health status, emergency discharge data and the hospital. The analysis of the data is run hand by hand with the analysis of the current stakeholder with regards to the health needs and the health policy including the investment priorities. The assessment provides a demonstration of the many issues which were identified previously such as mental health, obesity, sexual health, and asthma. Despite the high rate of insurance, the health care services are never evenly distributed within the ward which creates a high significant challenge in accessing. The services need to be expanded to have improved health care’s systems and effective coordination between the social and health care services to assist in system navigation.  

Chandra, Anita, Carole Roan Gresenz, Janice C. Blanchard, Alison Evans Cuellar, Teague Ruder, Alex Y. Chen, and Emily M. Gillen. 2009. "Health and Health Care Among District of Columbia Youth." Washington, DC: Rand Corporation.

The report indicates the findings obtained from analysis of health care and the health of children within the District of Columbia and has identified the areas which need improvements. This study was practically funded by the medical center for children for improvement of better services offered. The report makes clear objectives to the policy makers within the district and the surrounding local areas including the organizations and individuals who care about the issues related to the health of the youth.

Erkkilä J, Punkanen M, Fachner J, Ala-Ruona E, Pöntiö I, Tervaniemi M, Vanhala M and Gold C. (2011). Individual music therapy for depression: Randomised controlled trial (PDF). British Journal of Psychiatry; 199: 132-139.

In this article, music therapy has been established to be highly effective in the treatment of stress and depression and the involved studies have indicated success in the use of music to treat health issues. The major concern is the determination of the essence of music therapy compared to just care in the treatment of stress and depression in the working class people. The participants were randomized to get the music therapy at a minimum of three months. The clinical measures included anxiety, depression, alexithymia, quality of life and general functions. Results indicate that getting the music therapy and the care indicated success compared to the ones who were receiving the care only. The conclusion is that the level of stress and depression reduced to significant levels after the music therapy making it evident that music does work.    

Guzetta, C. E. (1989). Effects of relaxation and music therapy on patients in a coronary care unit with presumptive acute myocardial infarction. Heart &Lung: the Journal of Critical Care, 18(6), 609-616.

In this article, the essence of music and relaxation is examined on how well they combine in reducing stress in the patients. In this study, at least 80 patients were assigned randomly to relaxation, the control group, or the music therapy. The music therapy and the relaxation groups participated in at least 3 sessions over the 2 days. Stress and depression are evaluated by the heart rates, cardiac complications, peripheral temperatures and the qualitative evaluative data of the patients. According to the data analysis, lowering the apical heart rates and having the peripheral temperature raised, there is more success in terms of relaxation and the music therapy patients compared to the controlled group.      

Jeon, G. S., Gang, M., & Oh, K. (2017). The Effectiveness of the Nanta-Program on psychiatric symptoms, interpersonal relationships, and quality of life in forensic inpatients with Schizophrenia.ArchPsychiatrNurs, 31(1), 93-98.

In this article, the purpose is to have an examination of how effective the Nanta-program is on the psychiatric symptoms, quality of life and interpersonal relationships in the forensics of the inpatients affected with schizophrenia. The method applied is the quasi-experimental method which employs a nonequivalent control group and the pre-posttest design is conducted. The patients were 38 inpatients from South Korea where 18 were the experimental group and the 20 were the controlled group. The experiment was conducted over 12 weeks in just 12 sessions which took 90 min per session. Data analyzed through the t-test. The results indicate that the experimental group had improved in the psychiatric symptoms and some improvements on the interpersonal relationships after the 12 weeks of music therapy. There is no significant change in the quality of life in both experimental groups. This indicates that the program is effective for the improvement of the symptoms and the interpersonal relationships of the schizophrenia victims.      

Kemper, K. J, &Danhauer, S.C. (2005) Music as therapy.South Med J, 98(3), 282-288.

The article is aimed at explaining and describing the expectations which are related to the use of music from the viewpoints of nurses, parents and the physicians. The questionnaires used were given to 836 people who were retrieved from the university hospital. More than half of the people preferred having the recorded music compared to the live music in the research. They all expected that personal preference of the music could be of benefit to the staff, parents, and infants. The parents indicated that the live music is more preferred for the infants while the staff indicated that music of choice is more preferable. This shows a difference in the expectations of the parents and the staff in music choice.  

Maratos A, Crawford MJ and Procter S. (2011). Music therapy for depression: it seems to work, but how? (PDF) British Journal of Psychiatry; 199: 92-93.

In the article, evidence with regards to music therapy is obtained on how it can be used in improving the health of people who suffer from depression. According to a research done in 2004, BBC listeners indicated that the only way to have the reduction of depression is by listening to the song by The Smiths. It is, therefore, appropriate to continue listening to music and reading some articles as a way of relieving some stress. There are challenges involved in having the evaluation of music and this can be evaluated using the complex intervention of music therapy which is associated with the treatment. The attention should be granted on fidelity since it is borne out of the results which do not compare between the therapists. This indicates that the agent of change is not in any case likely to be the personality of the therapist, nature of the patient but the music.   

Mental Health America.(2016). Retrieved from http://www.mentalhealthamerica.net/issues/mental-health-america-prevalence-data

The article highlights the ways in which the government of America promotes the mental health of its citizens. The government advocates for early identification of mental health issues. According to a study carried out across the country, one in five citizens has a mental health illness. Due to rising levels of drug abuse, the mental health of the youth is deteriorating at a faster rate. The government has put up more psychiatric hospitals and centers where people suffering from mental illnesses can get help. However, there is need to increase the mental health care providers in these centers.

National Institute of Mental Health.Major Depression Among Adults. (n.d.).Retrieved  from https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml

The article states that most of the adults in the United States who have mental disorders suffer from major depression. A major depressive incidence is a period of two or more weeks in which an individual expresses the loss of interest and a depressed mood that causes problems such as lack of sleep and changes in their normal functioning. It is estimated d that 16. 1 million adults in the USA experienced an episode of major depression in 2015. The national health mental institute carried out a survey regarding major depression across the country. The survey covered household residents who were 18 years and above. However, 30% of the sample population failed to complete the survey. Many of the people who failed to respond to the surveys suffered from major depression.

National Institute of Mental Health.Depression. Retrieved October 2016, from https://www.nimh.nih.gov/health/topics/depression/index.shtml

The article defines depression as a disorder that causes extreme sadness in a person. Depression affects how people carry out their daily activities like eating, sleeping and working. Depression occurs in different forms. Perinatal depression is a form of depression that affects a mother during pregnancy and after giving birth. Perinatal depression is characterized by anxiety and exhaustion that hinders the mother from functioning normally. Dysthymia is a form of depression that lasts for two years or more. People who suffer from dysthymia may extreme episodes of major depression. Seasonal affective disorder affects individuals during the months of winter. The symptoms of depression disappear during summer and spring. Psychotic depression is characterized by delusions and hallucinations. Individuals who have this form of depressions are consumed by poverty, guilt or illness. People who suffer from bipolar disorder sometimes experience low moods and other times they experience irritable moods. Generally, depression is characterized by a feeling of hopelessness, loss of interest in activities, decreased energy, weight changes, suicidal thoughts, low self-esteem, body pains, persistent digestive problems and feeling restless. Depression is mainly caused by physical illnesses, family history of depression, trauma and stress. Depression is treated with therapy and medications. People suffering from extreme depression are given anti-depressants.

 Partnership for a Healthier Fairfax. 2011. Community Health Status Assessment: Community Report. Fairfax, VA

This report focuses on quality of life, risk factors, and the health status of the FairFax community. A subcommittee was formed to collect and compile the data. As one of the most populated counties in the country, FairFax community has many assets and community resources. Generally, the county has a high per capita income and has ethnically diverse residents. However, a section of the population has high unemployment levels, poor health, and low socio-economic status. This difference in the quality of life presents a challenge during provision of services. The ethnic and racial minorities within the FairFax community are at risk of contracting diseases and dying early. The community members, business owners, community-based organizations and the authorities came together to improve the overall health of the county members through various projects such as housing projects.

Raglio, A., Attardo, L., Gontero, G., Rollino, S., Groppo, E., &Granieri, E. (2015).Effects of music and music therapy on mood in neurological patients.World J Psychiatry, 5(1), 68-78.

The article states that depressive disorders have severe effects on people who suffer from epilepsy, stroke and Parkinson’s disease. In clinical practice, these disorders are rarely treated and thus they put the patients at risk of dying due to further cerebral damage. Music therapy has great effects in patients who suffer from neurological disorders. In addition to having an emotional impact on the patients, music encourages socialization. The music listening therapy does not require the presence of a trained therapist. This form of therapy further promotes recovery in neurological patients.

Scholer, M. (2010).Receptive music therapy with persons suffering from a physical handicap.BullSocSci Med Grand DucheLuxemb, 1(1), 193-203.

The article states that music is a therapeutical tool that improves, maintains and restores the emotional, physical, and mental health of individuals. Listening to music intimately to gain pleasure and wellbeing are referred to as receptive music therapy. A study was done on music listening behaviors of physically challenged persons. The statistical results proved that a musical experience yielded positive outcomes in their lives. Personal interviews with the participants showed that receptive music therapy should be adapted in all psychiatric hospitals and centers.

U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. (2015). Depression (NIH Publication No. 15-3561). Bethesda, MD: U.S. Government Printing Office.

This booklet focuses on depression, its symptoms, and ways of prevention. Sadness is experienced by everyone. However, extreme sadness causes a depressive disorder. Signs of depression are persistent sadness, increased fatigue, pessimism, difficulty in concentrating and making decisions, oversleeping, insomnia and restlessness. Depression is caused by factors such as brain chemistry, genetics, trauma, a difficult relationship, and other disturbing life events. Diseases such as cancer and diabetes can also lead to depression. There are different types of depression. Persistent depression disorder refers to an extreme sadness that lasts for two or more years. Postpartum depression affects new mother after they give birth. Psychotic depression is characterized by hallucinations and delusions. Major depression severely affects a person’s ability to carry out normal activities. According to research, depression occurs more in women than in men. Teenagers are more likely to suffer from depression compared to children. Older people suffer from depression due to various old age illnesses such as diabetes. Depression is treated with therapy and use of anti-depressants.

 World Health Organization (WHO). (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization

The article indicates the reliable up-to-date approximation of the proportion of the general population who are affected by the different health conditions or diseases which is a critical inclusion in the planning and evaluation of the health policy. Studies indicate that the psychiatric disorders are now being undertaken through a wide range of the low, middle and high-income parts of the world which have had a contribution to the understanding of how common these kinds of disorders are in the world. The proportions of depressions in the year 2015 are approximated to be around 4.5 percent. Depression is identified to be more prevalent to females with 5 percent and males 3.5 percent.

Varying by the age, the older adulthood is approximated to be at 7.5 percent amongst the females who are aged 55 years to 74 years and at 5.5 percent for the males. Depressions can also occur among the adolescents and children who are below 15 years but who have a lower level than the older age groups. More than 320 people are affected by depression in the world today. More than half of the number thrives in south-east Asia and the western Pacific which reflects a high number of the regions. The number has drastically improved with at least 18 percent from 2005 to 2015.