Social prescribing, green care and exercise

A growing body of research has been showing the benefits of physical activity, access to nature and outdoor activity for mental health with much of this research having used our Understanding Society dataset owing to its representative UK sample and longitudinal household data capture. Our researchers have been driving forward this field generating important findings to inform community approaches to preventing mental ill health and promoting mental wellbeing.

Along with a team of sports scientists and psychologists, Dr Claire Wicks has re-analysed research findings on the psychological benefits of physical activity to show that exercise in natural environments is more beneficial than exercise in outdoor urban environments. Research during COVID-19 lockdown in the UK by Dr Carly Wood found that mental wellbeing was worse for people who did very little physical activity during lockdown and to whom physical activity had become less important than before lockdown.

In spite of the known benefits for mental wellbeing, physical activity and sport is not always accessible to all groups in society and people with experience of mental distress may be particularly vulnerable to exclusion and discrimination which prevent them taking part. Along with a team of occupational therapists and medical sociologists, Dr Anna Pettican’s research uses participatory approaches to explore how marginalised groups experience taking part in a community-based football league and how they face stigma and exclusion in their efforts to engage in physical activity. The research has important implications for how occupational therapists might support people with mental distress to be more active by ensuring they recognise and address any social barriers preventing people taking part in the activities.

While research suggests physical activity is linked to positive mental wellbeing, we also know that some mental health conditions are associated with inactivity or lack of movement. To better understand the role of movement associated with psychological distress, biomechanist Dr Aleksandra Birn-Jeffery, supported by MQ Wellcome funding, will be leading an investigation of the lived experience of people who experience depression and or anxiety in terms of movement and motor functioning. This will inform a biomechanical investigation of the objective differences and changes in movement of those with and without diagnosed anxiety or depression and how this might change over the course of treatment.

We have particular expertise in researching the effectiveness of nature-based interventions including those which aim to improve mental wellbeing. iCARP is an angling-based programme developed in Essex to support military veterans experiencing trauma symptoms, depression and anxiety. Participants are taken on group fishing trips which include opportunities to open up and talk about their experiences alongside therapeutic support.  The research team, led by Dr Nick Cooper, has undertaken pilot research pointing towards short and long-term benefits. The team are now working with funding from the National Institute for Health and Care Research to undertake a more formal evaluation of treatment effects and extending the intervention to other emergency and front line personnel.

Another form of nature-based intervention is “therapeutic gardening” which is a kind of “green social prescription” focused on using garden space and gardening activities to improve mental health, build social skills, and develop confidence alongside qualified therapists providing therapeutic support. Research into this programme by Dr Carly Wood found that people with poor mental health taking part in the programme benefitted and showed improved mental wellbeing even during the pandemic when the mental health of the general population was deteriorating. Their research also helped explain how this kind of intervention can help, showing that the intervention provided hope, facilitated social relationships and engaged people in nature, all of which positively impacted on mental wellbeing.

Social prescribing is a growing component of healthcare systems in the UK and elsewhere. The approach involves prescribing community-based activities rather than medical treatments. Activities might include community groups or services which are selected based on individual preferences and interests and which are most likely to engage the individual in a way which improves their health and wellbeing. Research by political scientist Prof Gina Reinhardt shows that social prescribing can play a key role in addressing the growing problem of loneliness which is known to have strong negative associations with mental wellbeing.

In partnership with English and French local authorities and funded by the European Regional Development Fund, Prof Reinhardt led an international evaluation of a major social prescribing scheme “Connected Communities”, a social prescribing programme for older people. Given that social prescribing is a relatively new field of healthcare practice and research, Prof Reinhardt’s team have also highlighted the need for research programmes to become more precise in defining and measuring outcomes in order to enable comparison of outcomes across different social prescribing programmes.

Drumming is an example of an activity that can have a number of health benefits including improving mental and cognitive wellbeing for people who are neurodiverse. Dr Ruth Lowry has worked with a diverse range of scholars and practitioners establishing an evidence base on outcomes and mechanisms of drumming for health. Dr Lowry’s research was featured at the Royal Society Summer science exhibition 2023 and has shown, for example, that learning to drum can improve behaviour and brain function in autistic teenagers; and can enhance motor and psychological skills in children with emotional and behavioural difficulties.