The report reviews the benefits and outcomes of approaches to green care for mental ill-health. With mental ill-health on the rise, and estimates showing in England at least one in four people will experience a "significant" mental health problem every year, the report holds up green care interventions as a cost-effective way of supporting mental health services.
Titled "A review of nature-based interventions for mental health care", the research was commissioned by Natural England from the University of Essex and mental health charity Mind.
A literature review was carried out as part of the study. It found a large number of mental health and other benefits arising from the green care offerings, including "psychological restoration" and increased general mental wellbeing, reduction in depression, anxiety and stress related symptoms, improvement in dementia-related symptoms, better self-esteem, confidence and mood, better cognitive capacity and attention span, improved happiness, feelings of safety, more social contact, and an increase in work skills.
Part of the research involved a survey of those in the "green care" sector, including care farming groups, environmental conservation and social and therapeutic horticulture. There was general consensus among the groups that they should work together to provide a larger offer to commissioners such as Clinical Commissioning Groups, with around 25 green care groups set to form a Green Care Coalition moving forward.
The report presents evidence that shows that projects in each of these areas are already making a difference. People involved in these types of green care activities have a greatly increased level of social contact and inclusion, as well as a sense of belonging and personal achievement, the report says.
Environment minister Rory Stewart said with mental health one of the most serious and complex issues Britain faces today, "it is great that we now have clearer scientific evidence that nature is so beneficial for our minds and our sense of self". He said the Government is supporting projects like care farms through its £900m Countryside Stewardship scheme.
Alan Law, Natural England's chief strategy and reform officer, said: "This report highlights how nature makes a real difference to the quality of people's daily lives. It shows what we can do to improve people's wellbeing, working through new partnerships and offering new services.
"There is now compelling evidence to show that contact with nature and the outdoors improves physical health and mental wellbeing. Natural England is committed to find ways to help more people access the benefits that come through practical experiences in the outdoors."
The report recommends a range of actions that would help increase awareness and access to nature-based support for mental health care in England. They include:
Collaboration within the green care sector - There is a need for the green care sector umbrella organisations to work together in partnership to promote the sector more widely to policymakers, commissioners and potential service users
Streamlining communications with health and social care commissioners - To ensure clarity, the term "Green Care" should be used to describe the range of activities that fall within the scope of nature-based interventions for individuals with a defined or diagnosed need, with key national organisations using the term to drive its adoption
Distinguish between commissioned interventions for individuals with a defined need (green care) and public health programmes for the general population - The report says there has been some confusion about the difference between a general public health intervention and one that is specifically aimed at treating those with mental ill-health. Distinguishing the two will ensure nature-based service providers use the right language and talk to the right commissioners; i.e. green care providers will target health and social care commissioners (Clinical Commissioning Groups and local authority social services) and more general nature-based programmes will target commissioners of public health (Public Health England and local authority public health departments)
Publish an annual status report - this would provide a comprehensive picture of the scale and nature of green care for mental healthcare in the UK
Register online as care providers - Green care services should register with local online directories of services (or consortia of service providers) and have representation on their local hubs to advertise their services to potential service users
Offer guidance on how to collect evidence - Green care providers should have access to guidance on how to scientifically measure the effectiveness of their service on people's mental health, including cost-benefit measures where possible
Carry out large-scale demonstration trials - this would help test new approaches to scale up delivery
Access large-scale health and social care contracts - the Green Care partnership group can work with members to help facilitate access to these contracts
Natural England has already commissioned Care Farming UK to identify practical models and case studies to increase the scale of green care services. Natural England and the University of Exeter are preparing a series of Health and Environment fact sheets to summarise the most compelling evidence on the impact of the natural environment on a range of health and wellbeing outcomes.
The report identifies the need for greater collaboration and leadership to help enhance the provision of green care services. Plans to launch a Green Care Coalition, involving around 25 organisations from the care farming sector to social and therapeutic horticulture organisations, will help tackle this issue.
Natural England will be working with professionals from across the health and natural environment sectors to address the issues raised in this report at a conference later this year.
Natural England is working with the Centre for Sustainable Healthcare to deliver a number of mental health fellowships so clinical leaders can help to encourage practical changes within the healthcare system.