Mental health clinicians’ perceptions of nature-based interventions within community mental health services: evidence from Australia

Abstract

Background Mental health conditions are one of the largest burdens of disease in Australia and globally. There is a need to seek innovative and alternative interventions that can prevent and alleviate mental health symptoms. Nature-based interventions (NBIs), namely programs and activities where individuals engage with natural environments with the aim of improving their health and wellbeing (e.g., nature walking groups), may be such an alternative. This study aimed to explore the perceptions of mental health clinicians on the potential benefits of, and barriers to, implementing NBIs within a community mental health setting. Methods This study used a qualitative, exploratory research design. Fifteen mental health clinicians were recruited from the Illawarra Shoalhaven Local Health District, Australia, and interviewed (September–October 2021) about their perceptions of NBIs within mental health settings. The semi-structured interviews were analysed using an inductive thematic approach and managed with NVivo. Results Mental health clinicians viewed spending time in nature as relaxing, refreshing, and therapeutic. Many described it as part of their lifestyle and encouraged consumers to engage in nature-based activities on their own time. If NBIs were to be introduced as part of mental health services, clinicians expressed willingness to promote them to their consumers. Clinicians listed many potential benefits of NBIs for mental health consumers including improved mood, calmness and relaxation, a sense of empowerment, and social connections. Despite these benefits, clinicians were concerned about a variety of barriers to NBIs including consumers’ mental health symptoms such as anxiety or lack of motivation, scepticism, and geographic accessibility, as well as organisational barriers such as policies around safety risk. Conclusion Responding to the individual and organisational factors that could hinder the implementation of NBIs while building on the existing evidence of the positive impact of nature on health and wellbeing and, as demonstrated in this study, mental health clinicians’ interest and supportiveness of NBIs, mental health services should consider the implementation of NBIs as part of routine practice.

“I can get to a happy place by visiting nature”: The benefits of implementing nature walking groups within mental health services

“…Consumers are usually granted a weekly or fortnightly session with a mental health professional to address their symptoms and concerns. Recent research (Tambyah et al, 2022) has shown that numerous mental health clinicians have advocated for NBIs as an adjunct to medical and talking therapies that would entice consumers who struggled with regular sit-down therapy, taking medications, and leaving the house. As this study's ndings demonstrate, the presence of clinicians, however, ensured the mental health recovery orientation of NBIs and support in the consumers' recovery journey.…”

“…Despite reasonably clear evidence of mental health bene t and now demonstrably strong interest in NBIs among people experiencing high psychological distress, loneliness, burnout and poor sleep (Astell-Burt et al, 2023), few studies have been conducted with people who have diagnosed mental illnesses (Adevi et al, 2018;Picton et al, 2018). A recent study in Australia demonstrated that mental health clinicians were supportive of and willing to recommend NBIs as they believed that it would enhance the consumers' mental wellbeing, social connections, mindfulness, and relaxation (Tambyah et al, 2022). Consequently, this project partnered with the Illawarra Community Mental Health Rehabilitation Service [hereafter 'the Service'] to implement a Nature Walking Group [hereafter NWG] and learn about the experiences of the mental health consumers who participated in the group.…”

The Evolution and Future of Research on Nature-based Solutions to Address Societal Challenges

“…In a highly urbanised world with a disrupted relation to nature, this kind of evidence could be groundbreaking and motivate broad implementation of NbS across regions. Proof of a cause-effect relationship could also serve to reduce scepticism within the medical establishment and support the use of NbS in health care 36,57 . This would likely result in increased awareness in policy and decision-making, leading to better acceptance of NbS for several health challenges.…”

Green spaces for mental disorders

“…Furthermore, while evidence suggests that green social prescriptions are likely to be cost-effective for individuals with mild to moderate mental illness [46]; further research is required to demonstrate the magnitude of these benefits and the potential social and wider returns on investment. It is also reported that while mental health clinicians perceive nature-based interventions to provide a range of health benefits for individuals with mental illness including improved mood, wellbeing, and social connections; there are concerns over barriers to use of services, such as individuals’ mental health symptoms, lack of motivation and geographical accessibility [47,48]. These barriers need to be overcome in order to increase accessibility and uptake of green social prescriptions for the prevention and treatment of mental illness.…”