Health experts may suggest that people spend more time in nature to improve their physical fitness through activities in forests, parks or gardens. However, research has shown that nature-based programs are also particularly effective in improving poor mental health.
Our previous work has shown that important aspects of why these programs work are a stronger connection to nature, a break from the pressures of daily life, a greater sense of purpose, learning new skills, physical activity and more opportunities for social interactions.
There is growing evidence that being in a natural environment can also improve the health and well-being of people with drug and alcohol problems.
Activities offered through these programs may include hiking, camping, gardening, conservation activities, and adventure activities such as rock climbing, among others.
Although there has been a growing awareness that time in nature can benefit people with drug and alcohol problems, there has been limited research, particularly in the UK, on how best to develop effective nature-based programs for this group.
During our study, we spoke to staff who work in nature-based programs for people with poor mental health and substance use problems, as well as researchers interested in nature’s role in health, among others.
They told us that the reasons these programs are effective for people with drug and alcohol problems are similar to why they improve mental health.
The participants benefit, for example, from escaping the stress of everyday life and having space to think. Increasing physical activity also improves overall health.
The confidence that people gain through new activities can help them regain their purpose. This can lead to positive change as they no longer feel defined solely by their substance use.
The relationships with employees and others who use the programs also allow them to feel less alone.
This is important because many people with alcohol and drug problems report high levels of loneliness and isolation.
Finally, building relationships with other program participants who have not had drug and alcohol problems can reduce stigma.
We know that stigmatizing people with drug and alcohol problems can make them more likely to be harmed by substances and less willing to seek help.
Although such contact with nature could lead to a reduction in substance use, it is important to note that this is not the express goal of these programs.
Nature-based programs typically do not require a commitment to reduce or eliminate the use of drugs and alcohol, which is common in other treatment settings.
Instead, the focus is on broader components of health, meaning that nature-based programs can benefit people whether or not they are trying to reduce their substance use.
With the insights from this research, we have created a new framework that shows how positive outcomes of nature-based programs are being achieved for people with poor mental health and drug and alcohol problems.
The framework shows how it is the interaction between time spent in nature, changes within a person (e.g. increased self-confidence) and changes in social relationships that lead to positive, holistic outcomes.
We hope that, based on our findings, programs for this group of people can be designed and implemented more effectively.
High number of drug-related deaths
In 2021 there were 4,859 drug-related deaths recorded in England and Wales and 1,330 in Scotland. In the same year, 9,641 alcohol-related deaths were recorded in the UK.
In particular, drug- and alcohol-related harm is not the same across social groups. For example, drug and alcohol-related deaths are significantly higher in deprived areas of Scotland.
Politicians, researchers and drug treatment experts have described the extent of drug-related harm in the UK as a public health emergency.
However, people with drug and alcohol problems may find both addiction and mental health services difficult because of stigma, past negative experiences, and unrealistic expectations about stopping substance use.
The addition of nature-based programs as a treatment approach has the potential to implement several policy recommendations in drug and alcohol policy in Scotland and across the UK.
For example, tackling stigma, providing a holistic approach, a greater focus on engaging those who currently do not have access to services, and more support for community-based projects have been highlighted as ways to improve access to support and treatment.
Nature-based programs for people with drug and alcohol problems aim to achieve all of these goals.
In addition, programs can provide support for people who have both substance use and mental health problems.
This is important because 70% of people who use drug services and 86% of people who use alcohol services also have mental health problems.
When used as part of a substance treatment plan that prioritizes the preferences and needs of the service user.
Nature-based programs could be a viable solution to support people with drug and alcohol problems at a time when the harms associated with them are increasing.
The increasing pressure on drug and alcohol services to support people with many different, complex needs means exploring new initiatives such as nature-based programs is now essential – particularly for those already facing health and social inequalities.
Written by Wendy Masterton, Hannah Carver, Tessa Parkes. The conversation.
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