Discussions about musicians’ mental health often focus on the individual—stress levels, personality traits, self-care routines. The truth is far more complex.
A music student’s well-being is shaped not just by personal habits, but by family dynamics, teacher-student relationships, peer culture, career uncertainty, and the institutions that train them. Sometimes, deeper systemic issues—such as discrimination, abuse of power, and outdated hierarchies—lurk beneath the surface of music education.
Performing arts and health researchers Giulia Ripani and Raluca Matei urge a major move away from focusing on “fixing” musicians and toward addressing the structures failing them. “Instead of telling musicians to be ‘more resilient,’ our work explores the broader conditions that impact mental health in the performing arts,” Matei says. “We’re asking big questions about how musicians are trained, evaluated, and valued—and how those norms might need to change.”
Their project, funded by the Johns Hopkins Bloomberg School of Public Health, brings together expertise from musicians, educators, and scholars across the performing arts, health, and the social sciences. Thus far, they have conducted three in-depth literature reviews and interviewed more than 125 students, freelancers, orchestral players, educators, and experts.
Among the most eye-opening interviews they conducted were with 11 musicologists from the US, UK, Europe, and Singapore. Their insights highlight the hidden pressures and cultural assumptions that can make learning music emotionally and mentally challenging—and these observations will be familiar to anybody trained in classical music:
The Myth of the Suffering Artist: Many musicians feel they can’t speak openly about mental health without being seen as weak. In the industry, the persistent belief that “great art comes from suffering” still looms large, discouraging people from seeking help. Students are often told that harsh criticism builds strength, even though it can leave lasting scars.
Perfectionism at Any Cost: In classical music, perfection is everything. A single mistake can feel like a personal failure. This fear fuels performance anxiety and discourages risk-taking or creativity.
Authoritarian Teaching Styles: Some educators still cling to rigid, top-down approaches where students are expected to copy, not create. Teachers are sometimes also asked to promote health but often without the training or resources to do so.
“Passion” That Masks Exploitation: Musicians are told they should work for the love of it—regardless of pay, job security, or health. Talking about money or wellbeing is seen by some as compromising artistic purity.
What If Excellence Meant More Than Just Virtuosity?: Excellence isn’t only about playing flawlessly. It can also mean being a great communicator, collaborator, or educator, but the current culture often prizes competition over connection.
Losing Touch with the Human Side of Music: Some students struggle with listening or improvising because they’re trained to prioritize control and precision. Yet improvisation—once central to classical music—could be a key to unlocking creativity and easing anxiety.
Institutions Can—and Should—Do Better: Music schools hold tremendous influence. They could promote more inclusive, imaginative definitions of success but, too often, they focus solely on producing technically perfect professionals for a hyper-competitive market.
Ignoring the Body: Physical health is frequently sidelined. Performers may push through pain or illness in pursuit of some ideal of artistic transcendence. And adequate support for those with disability and chronic conditions is still rare.
Learning from Other Cultures: In many parts of the world, music is woven into daily life and community—not locked in elite institutions. These traditions may offer healthier, more sustainable ways to make and experience music.
Pressure Doesn’t Nurture Growth: As one expert put it: “If you yell at a flower, it won’t grow faster.” Musicians thrive in environments that are nurturing, not punishing.
These responses point to a need for deeper cultural change—not simply wellness workshops or stress tips. Mental health isn’t only a personal project. It’s shaped by the assumptions, traditions, and structures around us, some of which may be outdated or harmful.
The challenge becomes navigating how we teach mental health in a way that truly reflects its complexity. Ripani and Matei explore this issue in a chapter for the Oxford Handbook of Musician Health Advocacy, forthcoming later this year. Peabody Professor and Chair of Musicology Remi Chiu’s course Topics in Music and the History of Medicine offers a striking example. Instead of framing performance anxiety as a personal flaw or medical issue to “fix,” the course dives into health’s cultural and historical roots. Students explore how ideas about health and illness are shaped not just by biology but by values, power structures, and beliefs. Crucially, the course shines a light on long-standing assumptions about the need to “discipline” the body—assumptions that often go unquestioned in classical music training.
By tracing where these ideas come from, students learn to place them in context, challenge their authority, and imagine other ways of thinking and being: Just because something was, doesn’t mean it should be. And according to students, they leave the course with a deeper sense of agency—seeing their health, their artistry, and their future not as fixed paths, but as spaces they have the power to reshape.
To find other such models, Matei launched a global project and conducted interviews with instructors who are actively challenging long-standing conventions in music education. She and Chiu are now analyzing the transcripts to develop a framework for understanding how these assumptions are being questioned and reimagined. So far, they have interviewed 15 course leaders across Europe and the UK who are pushing boundaries and redefining what it means to teach music.
Those courses are flipping the script in the following ways:
Rethinking the Score: Students are taught to see the musical score not as a sacred text but as a flexible guide. Improvisation and multiple interpretations are welcomed, encouraging creative freedom over rigid perfection.
Redefining “Correctness”: Instead of chasing a single “right” interpretation, students explore diverse stylistic options. Success is judged by artistic insight and emotional impact—not technical conformity.
Putting Improvisation Back at the Center: From Baroque ornamentation to modern free-form jams, improvisation is reclaimed as a vital tool for creativity and confidence.
Questioning the Power of Recordings: By studying early recordings and how technology shaped musical expectations, students reflect on how today’s obsession with flawlessness came to be—and what we might reclaim from the past.
Blurring the Line Between Performer and Composer: Students are invited to tweak scores, create new compositions, and embrace authorship—deepening their connection to the music they play or sing.
Challenging Cultural Hierarchies: Courses introduce non-Western traditions and historically excluded voices, asking tough questions about Eurocentrism, elitism, and whose music gets valued.
Reimagining Performance as a Shared Act: Through collaborative projects and audience engagement, students learn to make music not just for others, but with them—restoring the relational roots of performance.
Understanding how these radical approaches work and how students experience them can help shape the future of music education. “If we want to support musicians’ mental health in a meaningful way,” Matei says, “we need to challenge the very assumptions that define the art form.”
Ultimately, a healthier future for musicians means rethinking how we define success, how we teach, and how we care for one another. That’s the work that performing arts and health researchers and their collaborators are doing: addressing mental health through reimagining the world that musicians are asked to inhabit.