Introduction: Mental health disorders are among the most common health conditions globally and represent one of the leading causes of disability and reduced quality of life. According to the World Health Organization, more than one billion people worldwide live with a mental health disorder. These conditions often affect an individual's ability to engage in daily occupations and participate in society. Aim: To gain insight into how music activities are used in occupational therapy and how they contribute to the daily functioning of adults and older adults with mental health disorders or cognitive decline. Methods: A literature review was conducted. The literature search was performed in three databases: PubMed, CINAHL and Web of Science, with Google Scholar used as an additional source. The search was limited to articles published in English between 2015 and 2025. The following combination of keywords was used: ("occupational therap*" OR "occupational therapist*") AND ("music-based*" OR "music intervention*" OR "singing*" OR "drumming*" OR "rhythm*"). Results: Eight articles with different methodological designs were included in the final analysis: two randomized controlled trials, two quasi-experimental studies, one experimental study, one qualitative study, one case study, and one scoping review. Based on the thematic synthesis, five main themes were identified: the impact of music activities on emotional well-being, the impact on cognitive functions and functioning, participation in society and recovery, an individualized approach as a key factor in effectiveness, and the role of the occupational therapist. Discussion and conclusion: Music activities proved to be a useful therapeutic medium in occupational therapy practice, one that can support the emotional, cognitive and social functioning of adults with mental health disorders. An individualized approach emerged as an important factor in effectiveness, taking into account the individual's clinical condition and abilities, the form of intervention, and personal preferences. Occupational therapists can take on different roles in music activities, including that of a treatment provider and a member of an interdisciplinary team. In addition, they play an important role in advocating for community-based music activities as meaningful occupations outside the clinical setting.
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