How can music ease the experiences of those with dementia, or those traumatised by war? Simon Mundy reports from the Setúbal Symposium of Music, Health and Wellbeing

The assertion is often made that music is an important catalyst in improving health and wellbeing in a multitude of ways. It is rare, though, to see the theory put into practice so convincingly, and movingly, as it is at the Setúbal Festival. Then to have the theory itself examined from all directions by therapists, scientists and musicians, suitably interrupted by performances, makes the process real and immediately relevant.

This is almost exclusively an Anglo-Portuguese Symposium, now in its second year, a partnership between the Helen Hamlyn Trust and the City of Setúbal which has grown out of the festival itself, reflecting its founding principles of regeneration through the arts.

Setúbal (pronounced Stubal) is a city of significant size 30 miles south of Lisbon at the mouth of the Sado river. From Roman times and probably long before its two reasons for existence were salt and fish processing. For the Romans the result was garum, the fish sauce fermented in stone tanks they used as a burger joint uses ketchup. For much of the 19th and 20th centuries the result was tinned sardines. As with so many industries, by this century the canning factories had closed and the city was left with its pretty old streets cut off from the water by rendundant port buildings and its tower blocks on the outskirts full of people with nothing to do.

A decade ago the mayor, Maria das Dores Meira, was introduced to Helen Hamlyn and they decided to start a festival that used music as community glue. Ian Ritchie, formerly of the City of London Festival and the Scottish Chamber Orchestra, came in to give it shape and has been doing so since 2011.

Although all the performances and discussions take place over a long weekend (23 to 27 May), the preparations in schools, with special needs groups, the immigrants association, the homeless, the local music conservatoire and the elderly, starts months earlier. Importantly the community sections work and perform together, not in isolation. Enough Youth Group members from the first years are now studying in the UK for them to return as the Festival Camerata, providing the professional instrumental backbone, along with the HeadSpace Ensemble from the UK and the astonishing vocal skills and leadership of Merit Stephanos.

‘We’ve involved over 10,000 young people over the years,’ says Ritchie, ‘and the rule is that every professional has to share the platform with someone who is not. The model doesn’t depend on the pros; it depends on the local people plus the pros and the expectation is that at the performances you will not know which is which.’ That determination pays dividends among the parents too when they come to see the events. There were tears of pride as some watched their sometimes profoundly disabled children singing and acting with assurance and expertise. For the mayor there is one simple statistic. Youth and street crime has dropped and new community groups have been formed.

Music helps them self-regulate; to mobilise them to give their best even when they didn’t know they had anything to give

The day and a half of the symposium was packed with speakers, covering everything from therapeutic practice and research to neuroscience. It began with two musicians, the composer Nigel Osborne, who started the Institute for Music in Human and Social Development at Edinburgh University, and the singer/animateur Merit Stephanos from the RCM, a specialist in Arab and contemporary classical, to ‘explore the fluid boundaries between music, theatre, culture and languages’. She examined the festival’s theme, home, and pointed out that while for some it is a peaceful and a shared space for collaboration, for many others it brings a host of contradictions, often pain and loneliness. For many years both Osborne and Stephanos have worked with children traumatised by war and exile.

It was a message taken up by Teresa Leite from Lusiada University. ‘If children have not had the outside of a home, they have not had the inside of it either – or what they experienced inside was not a safe or happy place. This builds into social opposition and resistance. Music helps them self-regulate; to mobilise them to give their best even when they didn’t know they had anything to give.’

Neuroscientist Lee Bartel, from Toronto University, has analysed the effect of music on pain itself and the isolation of dementia. He has found that the cellular and genetic response to music and sound generally is extraordinary. At one level, ‘playing music for two hours changes 70 genetic markers’, and at another, the frequency of 40Hz (basically an E) has been found after a series of sessions to reduce some pain and dementia symptoms in about half of patients by up to 40%.

As well as being programme director of Music for Dementia 2020, Grace Meadows (a bassoonist by trade) heads up music therapy for maternity services at Chelsea and Westminster Hospital so she sees the positive effects at both extremes of human life. ‘Music ripples through the maternity environment,’ she says, seeing maternity as a series of relationships, each of which is helped by the calm and stimulation of music. While it was expected that mothers would benefit she has found one of the most interesting aspects is the way fathers with babies are drawn together by a live player.

On the dementia end of the spectrum she believes ‘music should change the culture of care,’ and should be seen as a proper treatment, whether delivered by musicians or therapists. She illustrates this with the claim that musicians have a five year ‘cognitive reserve’ capable of delaying the onset of age-related brain disease. However, as Amy Mallett of Snape Maltings Creative Campus, says, ‘if practice is to mean something it must go beyond the exercise class.’ It works best when the participants are involved in a project of real artistic quality and invention. It is an aspiration echoed by composer Cevanne Horrocks-Hopayian, ‘we need to think big, start small,’ and trumpeter Thorbjorn Hultmark, ‘the sound world we work in is profoundly contemporary by necessity.’

The festival in Setúbal, with the addition of the symposium, is now evolving into something year-round and settled. Ian Ritchie says, ‘we want to create a structure, a hub’. ‘A nexus,’ interposes Nigel Osborne, ‘that unites all the elements we have brought together – the music and health and, however you want to define it, wellbeing.’ For the British contributors themselves there is something inherently therapeutic in coming together outside their normal context by the Portuguese Atlantic and seeing all the variants of their practice in profoundly satisfying action.