"Music Has Always Been My Safety Plan": A Qualitative Investigation of Music, Self-Management, and Recovery Among Young Adults Diagnosed with Serious Mental Illnesses

Background and Purpose: Nearly 4 million young adults with serious mental illnesses (YA-SMI) (e.g., schizophrenia, bipolar disorders) are at higher risk for negative outcomes. A key aspect of recovery is the development of self-management strategies to reduce symptoms and enhance quality of life. Since young people spend nearly 40 hours a week listening to music, its potential as a self-management strategy cannot be overlooked. This study explored how music may influence recovery among YA-SMI.

Methods: Semi-structured interviews were conducted with YA-SMI receiving community-based services (N=25). Interviews explored participants’ experiences with music and their perceptions of its role related to their mental health and recovery. Transcripts were analyzed using grounded theory coding techniques and constant comparison. Analysts met to discuss initial codes, refine categories, develop memos, and identify themes, and reflexivity discussions occurred to reduce bias.

Results: The sample was predominately male (65.9%) and Black (46.3%), Latino/a (19.5%), or Multiracial (22.1%) with a mean age of 25.4 (SD=4.8). Five themes emerged. First, music as a coping strategy, captured how music helped manage mental health (e.g., I feel like music has helped me multiple times not self-harm... sometimes music will snap me out of it”). Second, music and regulation, suggested its ability to help manage emotions and symptoms (e.g., It keeps me grounded...music makes me snap out of my depression...keeps me stable). Third, dual and context-dependent functions of music, suggest that the potential benefits and risks of music may vary depending on psychological states including intensifying psychosis (e.g., When I was having my mental illness, anything somebody said to me, I would believe, or I would believe that it has a meaning to me... and music just makes it a bit worse... If I was listening to music, I would think that came directly to me... it was a scary time...”). Fourth, music and identity: empowerment, motivation, and self-confidence, captured the relationship between music and aspects of identity through lyrics (e.g., Music boosted my self-confidence and how I thought about myself... [it] helped me figure out that I can do these things. I can go out there and find love...I really learned from music that you can be who you want to be and love yourself...”). Finally, music and social (dis)connection captured how music may facilitate and hinder interpersonal connections (e.g., My mom passed away...I’ll play something that reminds me of her...makes me feel she’s here”).

Conclusions and Implications: Findings suggest the role of music as a self-management resource, potentially influencing emotional, cognitive, social, and identity-related domains. Music appears to engage regulatory, relational, and cognitive processes, which may be relevant in the context of trauma (Perry, 2009). Results align with literature on intentional and empowering uses of music for esteem, resilience, and growth (Travis et al., 2023). Findings caution against the assumption that all music use is helpful, as data suggest it may intensify psychosis and distress. To align social work science with practice, recovery-oriented interventions may benefit from strategies promoting intentional and empowering music use while minimizing its potential risks.