GREEN GYMS AND MENTAL HEALTH

Presented by

Calum Macintosh – Green Gym Development Manager and Bill Upham – Deputy Director

Mission & Vision

Mission:

“To create a more sustainable future by inspiring people & improving places ”

Vision:

“A better environment where people are valued, included & involved” 2

Three Key Themes

• Connecting people with places • Building healthy and sustainable communities • Increasing peoples lifeskills

• • • • WHO claims that depression Mental illness affects 1 in 6 of the adult population 1 in 5 under 16yr olds have a mental disorder By 2020 this will be the second most prevalent cause of ill health The total cost to the economy is £75 billion Mental Illness 4

The scale of the problem

Estimates relating to the prevalence of mental distress in Britain vary from 1 in 4 to 1 in 6 people. • • • • • around 300 people out of 1,000 will experience mental health problem every year in Britain 230 of these will visit a GP 102 of these will be diagnosed as having a mental health problem 24 of these will be referred to a specialist psychiatric service 6 of these 1000 will become inpatients in psychiatric hospitals Figures from 15 years ago !

Depression

• • • Depression occurs in 1 in 10 adults in Britain at any one time 1 in 20 people at any one time will suffer major or ‘clinical’ depression Women are more prone to mixed anxiety and depressive disorder than men

Prevalence of mental health problems - by gender (people aged between 16 to 64 years - all figures are percentages)

Diagnosis and rate (past week)

Mixed anxiety and depression Generalised anxiety disorder Depressive episode Phobias Obsessive compulsive disorder Panic disorder Any neurotic disorder

Female 1993 2000

10.1

11.2

5.3

2.8

2.6

2.1

1.0

19.9

4.8

3.0

2.4

1.5

0.7

20.2

Male 1993 2000

5.5

7.2

4.0

1.9

1.3

1.2

0.9

12.6

4.6

2.6

1.5

1.0

0.8

14.4

1993 All 2000 7.8

9.2

4.6

2.3

1.9

1.7

1.0

16.3

4.7

2.8

1.9

1.2

0.7

17.3

Health Prevention UK

• • • 70% of UK population deemed inactive Inactivity doubles the chances of a heart attack Regular exercise reduces anxiety/depression and increases stamina, confidence and well

being

Every adult should accumulate 30 minutes of moderate intensity physical activity most and preferably every day of the week (European and US recommendations)

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Ecotherapy

• regular physical activity helps prevent/manage some mental health problems • • particularly effective with mild or moderate depression Includes all forms of “green exercise” • and environmental art

Calories used in different activities

Sitting Raking Cycling Weeding Walking Aerobics Tree Planting Digging Felling Trees Running 0 2 4 6 8 10 Kcal/min McArdle,Katch and Katch, 1996

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The Green Gym

Promoting health, fitness and the environment 11

What is a Green Gym?

• • • • • Practical activity - 3 hours once a week benefits both participant and environment Partnership between BTCV, health agency (e.g. ARC) and others NHS , e.g. GPs, NHS Trusts, LHBs, endorse the Green Gym Health and Safety Guidelines are followed Sustainable exit – the activity continues 12

Green Gyms

• • • • • • • • Improve mental and physical well being Create opportunities for social contact Reduce stress and anxiety Gets people out into the fresh air – “biophilia” Help people to know more about their community and environment “topophilia” Teach new skills Provide training opportunities Improve confidence

“It’s a great way to get fit, meet new people and gain confidence whilst making a positive contribution to the local environment.”

National Evaluation of Green Gym 2003-2007

Prof. Paul Yerrell School of Health and Social Care, Oxford Brookes University, March 2008.

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• 99% said that the Green Gym benefited their health and self confidence • 94% led to new skills and training • 92% enabled to make contribution to the environment 15

“I am retired…I had cancer and the radiotherapy really knocked me out….although I joined for the physical health side…I have found that it has helped the mental health side…I got pretty depressed and it helps a lot.”

Mental Health Benefits

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“Exercise is secondary for me…it is more the social side: meeting different people.” “It’s good to come out and meet people a really friendly crowd..very welcoming”

Social Benefits

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INDIVIDUAL COMMUNITY

HEALTH

ENVIRONMENT

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Who could be involved?

• • • People with mild to moderate mental health problems, such as depression or anxiety, who are using primary health care services e.g. their GP or GP referred counselling.

– People with a diagnosis of severe or enduring mental health illness, such as bi-polar disorder or schizophrenia, who have used secondary care services, such as hospitals. We should aim to involve this group at the point where they are relatively ‘well’ and living in the community, but could use our activities to help rebuild their self-confidence and social connections.

OBESITY

People with experience of mental distress who may not be using health or social care services.

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Aims:

To improve the health and wellbeing of people with experience of mental distress To enable people with experience of mental distress to increase their skills and self-confidence To lessen stigma and discrimination towards mental health service users

Results

Improved mental health of volunteers Improved physical health of volunteers Increased social interaction of volunteers Increased skills Increased self-confidence Volunteers take on new challenges and responsibilities Mental health service users integrated into local community groups 20

Participant’s journey

Referral, Initial meeting and induction 1 st month review Participant able to demonstrate a technique to a volunteer joining the group Participant given responsibility for 1 week for refreshments, or maintaining tools

Our intervention to make it possible for people with mental distress to succeed

Staff training – an introduction to mental distress and the conditions it includes. Include how to ID issues or problems Coaching of the individual above and beyond that of another volunteer Informal training in these simple tasks to ensure their confidence is not knocked by failing to do them well Participant to give a site safety or tool safety talk at the beginning of one session Participant to accept long term responsibility for one or more of the following: tools talk, site safety talk, preparing refreshments, preparing the practical tasks programme leaflet / website entries, any other useful role thought up by the participant Participant to accept Key Volunteer status Coaching the participant Informal training in these simple tasks to ensure their confidence is not knocked by failing to do them well Celebration of volunteer’s achievement in accepting responsibility Ensure it is on their CV, and rewarded with merchandise such as fleece etc 21

Families and Inequality

Mental ill-health is: • • • • Greater among children in lone parent families (16 %) than among those in two parent families (8%) And in families with neither parent working (20%) compared with those in which both parents worked (8%) 17% of children whose parent had no educational qualifications had a mental disorder Only 4% of children where the parent had a degree level qualification 22

The Family Employment Initiative

• Designed to engage families in targeted areas using local green space as a catalyst to economic activity • Provides skills building, training, motivation and mentoring, volunteer career paths • A cross-sector approach to addressing skills and labour market gaps, e.g. collaborative work between employment opportunities and health sectors • Includes work with GPs and primary care providers 23

Creating Sustainable Health and Wellbeing The Family Employment Initiative

GREEN EXERCISE – “THE NATURAL HEALTH SERVICE”

Green Exercise activities include Green Gyms, walking, cycling, collective use of allotments Tackles ill-health as a barrier to economic activity Increases family and community cohesion through: • recreational activities • • • sports socialisation relaxation

“The family that plays together, stays together”

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The Green Gym

Promoting health, fitness and the environment 25