A new prescription to assist mental ill health

The statistics are worrying.

One in two of us will experience some kind of mental illness at some point in our lives.
Anxiety, depression, psychosis, take your pick, because mental illness does not discriminate.

At any given time, one in five people is struggling with their mental health, and that struggle covers the full spectrum from mild to severe.

One in seven adults in Australia is taking a prescribed anti-depressant and I wonder how many of those include people who have found it difficult to come off their meds, so keep taking them unnecessarily.

The management of mental health in our society remains problematic.

There are insufficient resources or mental health practitioners and staff available to meet the need, meaning patients have to wait an unreasonable amount of time to get the help they require, or get turned away from emergency departments.

The burden of care falls onto family and friends and general practitioners.

According to a productivity commission report, mental illness and suicide is costing Australia $600 million a DAY, or $220 bn a YEAR.

The population I worry about the most are our kids and young adults.

40% of year 12 students report having symptoms of anxiety and depression.

Suicide is the leading cause of death in those aged 5-17 years old.

75% of common mental health problems occur BEFORE age 25.

Revising our approach to mental ill health can include:

1. Developing greater awareness of the contributing factors to our psychological distress.
2. Taking action to lower the risk of mental illness developing.
3. Looking beyond medication to include psychosocial support.
4. Creating strategies to reduce the associated stigma.
5. Greater community support at the grassroots level with projects, programs and simple lifestyle interventions.

None of this is rocket science, but for too long we’ve been locked into a reactive mode where the Government’s response is to chuck money at the problem in the hope it will go away, so they can then take the credit for it.

A new prescription uses a lifestyle approach.

While genes do play a role, it is our environment that contributes greatly to our overall mental wellbeing.

The greatest resistance to changing how we manage poor mental health has been insufficient data. Health practitioners rightly ask, where’s the proof that lifestyle interventions work and how can I convince my mentally unwell patient to consider them?

Until now, the research while compelling hasn’t been able to answer the first part of the question.

The GSP project is a UK-based two-year cross-governmental initiative seeking to evaluate the prevention and management of mental ill health using nature-based settings and activities i.e. green social prescriptions.

Here, 8339 people with mental health needs were supported to access nature-based activities. Of this group, 57% were from the most socio-economically deprived areas and 21% were from ethnic minority populations.

This is important because it is often the poorest and most vulnerable communities that have the least access to nature.

The results speak for themselves.

• Significantly improved wellbeing.
  Increased happiness
  Increased life satisfaction
  Increased feeling that life is worthwhile
  Reduced anxiety
• Reduced symptoms of depression and anxiety.
• Increased levels of physical activity.
• The social return on investment: 2.42 pounds sterling for every 1 pound invested.

Nature-based activities are cost effective but to be taken more mainstream there needs to be many more green social prescribing projects with adequate long-term funding.

Sir Michael Marmot, Professor of Epidemiology and Public Health at the University College of London and Director of the UCL Institute for Health Equity said it best,

“If Wildlife Trusts programmes like those described in this research were made available to more people in more places, they could help prevent unnecessary ill health and reduce the number of people requiring NHS services.”

We can and must adopt a more proactive stance to safeguard our mental health and wellbeing.

This is where lifestyle medicine practitioners as specialist primary care providers, can do so much to reduce the burden of mental ill health. There will always be a place for medication along with inpatient care for those dealing with severe mental illness but let’s look at what can help lower the risk of it from developing in the first place, starting by choosing to spend 15-20 minutes outside every day in a green or blue space.

How do you envisage seeing more green social prescribing become the norm?