Effectiveness of a School‐Based Music Intervention Program on the Mental Health of Middle School Adolescent: A Cluster Randomized Controlled Trial

ABSTRACT

Adolescent mental health problems are becoming increasingly prevalent and concerning. This study aimed to evaluate the effectiveness of a school‐based music intervention program in improving the mental health of middle school students. From September 2023 to January 2024, a class‐based stratified randomized controlled trial was conducted at a rural middle school in Nanping City, Fujian Province, China. Seventh‐ and tenth‐grade students were recruited and randomly assigned to either an intervention group or a control group. The intervention group participated in a 17‐week structured music program, while the control group continued with regular school activities without additional intervention. Mental health status was assessed using the Depression Anxiety Stress Scale for Youth (DASS‐Y). A total of 414 students (mean age: 14.57 ± 1.53 years) were included. Baseline sociodemographic characteristics were similar between groups, although students in the control group were slightly more likely to report enjoying school (p = 0.029). Post‐intervention, the intervention group showed significant reductions in the detection rates of depression (13.14% to 1.71%), anxiety (14.29% to 5.14%), stress (5.17% to 0.00%), and overall mental health problems (18.29% to 5.71%) (all p < 0.001), while no significant changes were observed in the control group (all p > 0.05). Between‐group comparisons at post‐intervention further revealed significantly lower rates of depression (1.71% vs. 7.53%), anxiety (5.14% vs. 12.13%), stress (0.00% vs. 4.06%), and overall mental health problems (5.71% vs. 14.64%) in the intervention group. These findings suggest that school‐based music intervention programs may be an effective and scalable approach to promoting adolescent mental health. Further research is needed to explore their long‐term impact and broader applicability.