Social Prescribing - Understanding what works in, and supporting provision of, nature - based therapeutic interventions for people with an identifiable mental illness

Summary

We have been awarded funding from DEFRA to identify what works in the use of nature-based therapeutic interventions for people with an identifiable mental illness. The new work is closely aligned with the Medical Research Council funded Nature on Prescription project.

Background

One of the key aims of the Government’s 25 Year Environment Plan is to help identify how we can best use the natural environment as a resource for preventative and therapeutic health programmes. This research will help improve understanding of active elements of therapeutic nature interventions and will clarify how they can be planned, delivered and embedded in wider practice.

Project Aims

For those delivering nature-based interventions, a range of evidence is needed that articulates what works, for whom and in what circumstances in terms of:

• delivery mechanisms
• activities/interventions
• funding models
• outcomes frameworks
• cost-benefits, return on investment models

Project Activity

Work Stream 1: Review and map current provision of nature-based therapeutic interventions, including commissioned and non-commissioned services and schemes, to support people with a mental illness. We aim to understand: which population groups are participating; types of interventions and their nature; funding models; costs; relationship with health and social care organisations.

Work Stream 2: Review the current available evidence base for the effectiveness of therapeutic nature-based interventions. We are using rapid systematic review approaches to assemble and synthesise existing evidence for the therapeutic effects of nature-based interventions. We also aim to identify the mechanisms through which interventions may impact on core mental health symptoms and behaviours; which outcomes are likely to be appropriate measures of impact and the factors that facilitate or hinder intervention implementation and adherence, including medical, governance and financial factors.

Work stream 3: Gather insights from key stakeholders to understand perceptions about what works, and the factors that influence success in commissioning, delivery, and implementation. We will seek to include service commissioners, mental health service professionals, primary health care services, environmental voluntary organisations, community-based providers and other intermediaries in the four key locations.

Work stream 4: Synthesis, We will bring together insights from the mapping, evidence review and qualitative insight work to produce a detailed conceptual framework, descriptive texts and illustrative case cases. We will focus on understanding and explaining the factors that affect successful provision of nature-based therapeutic interventions for people with mental ill-health and how these may be mitigated against. This will include understanding key elements of the social prescribing system where challenges may occur and how these barriers may be overcome, as well as describing successful approaches at each step. We will also identify opportunities to build on existing provision, together with understandings of what works, for whom, in what circumstances. This will provide opportunities to propose how new, larger scale, sustainable and more systematic approaches to offering and delivering nature-based mental health therapies may be developed.

Anticipated Outputs / Implementation in the NHS

Key outputs will be finalised in consultation with DEFRA and Common Parlance but are likely to include:

• An evidence review about what nature-based interventions work, for whom and why, for people with common mental health conditions (academic publication).
• Case studies of good practice for particular participant, commissioner and delivery organisation needs in a range of settings, including funding models.
• A synthesis report which draws on the lessons from all work streams in order to provide recommendations for inform and support future provision and implementation of nature-based therapeutic interventions to support people with their mental health.

Related Projects

Effective Mechanisms for Social Prescribing

Social Prescribing – Nature on Prescription

Social Prescribing – Cornwall & Plymouth Researcher-in-Residence