The music comes on – a soft blend of guitar, saxophone, piano – and people sit still at first, then heads start to sway to the sound. Some hum along; mostly they sing, or laugh and dance. At the end, when quiet returns, their mood is assessed – as it was when the session started.
Once or twice a month, Bola Otegbayo brings a team of singers and instrumentalists into this psychiatric unit at University College hospital (UCH) in Ibadan, Nigeria. Otegbayo realised a few years ago that some of her patients were lonely even though their loved ones visited and caregivers provided succour. So she began to share music. Now she is a musicologist alongside her main job as a renal technologist.
Otegbayo’s face lights up as she tells the story of a patient who wasn’t responding, but then started tapping his toes to the beat, finally leaping up and twirling into a dance. She tells another about two women moving, hand in hand, step by step, waltzing to Michael Bolton’s version of Lean on Me. “Music brings bonding,” she says.
There is a treatment gap for those with mental disorders in Africa, especially in sub-Saharan Africa. In Nigeria, an estimated 20% to 30% of the population have some form of mental illness. “When it comes to mental illnesses, it’s a combination of factors,” says Dr Adetoun Faloye, a senior registrar in the department of psychiatry in UCH. “It’s not just medication or psychotherapy or music therapy. We combine a number of therapeutic approaches and tailor them to the individual.”
Music can be stimulative or restorative, but it can also be a source of despair. This is why it needs to be used carefully, says Otegbayo. She would like this form of therapy to be used in other Nigerian hospitals, but admits there are challenges, especially for someone who is not a member of staff.
Besides being a singer or having a passion for helping people, for instance, someone leading a group must be trained and able to work with psychologists and nurses. “It’s not [something] any musician can do. You don’t want to trigger the patients. You don’t just do it and go. You need to observe them as well. Is this working?”
After both world wars, musicians and singers visited hospitals to play for veterans who had physical and emotional trauma. But doctors quickly realised the need for training for those involved in music therapy, especially in mental health.
Music therapy is now a recognised academic course in Canada, New Zealand, the US and South Africa, and it’s a growing topic in academic discourse. In Nigeria, however, it remains a little-known field. One of the challenges Otegbayo experiences is having to suit everyone’s taste. “Some of them prefer Olamide, some Dolly Parton, some Tope Alabi, even Bob Marley.” She often invites singers of different genres so no one feels left out. “Our music is structured. You must know the right music for the right person at the right time. We make sure that the last person is satisfied.”
Music therapy is known to have a positive impact on memory and concentration. “Sometimes you see them crying. And you can tell there’s love springing forth in that particular moment for their loved ones back home.”
Several researchers have also shown that music can strengthen awareness of positive emotions and improve psychiatric symptoms. She tells me most psychotic patients usually find it difficult to sit still, but during the sessions they are absorbed in the music.
All patients, regardless of their wards, diagnosis or social class, have access to therapy. Sessions were temporarily put on hold because of Covid-19. But as things gradually return to normal, or a semblance of it, Otegbayo shares her plans to expand to other departments. She has written a proposal to the hospital management to start sessions at the geriatric centre.
Otegbayo has a degree in physics and another in music. Although organising the sessions is a volunteer service, she keeps training herself. She is a member of the American Music Therapy Association (AMTA) and the World Federation of Music Therapy (WFMT).
The music therapy session is held in a quiet room, with no outside distractions. Before singing begins, Otegbayo and a nurse often go around, talking to each person. “Sometimes they won’t even answer, they are gloomy,” she says, smiling. At the end of the session, when quiet returns, a psychologist who has been standing in the corner, watching, makes an assessment of the effects. Now those who were sullen about an hour ago are saying, “Don’t stop the music. Let’s continue.”
One of the first things a former patient who was readmitted asked was when the music therapy session was. Sometimes nurses from other units stop by to witness the sessions. “Come to us,” they say. “Come to us, too.”
Otegbayo hopes that soon she can expand, to other units, to other patients: “There’s a kind of fulfilment in that.”
