‘Lifts your spirits, lifts your mind’: A co‐produced mixed‐methods exploration of the benefits of green and blue spaces for mental wellbeing

• Published in: Health expectations : an international journal of public participation in health care and health policy 2023-08, Vol.26 (4), p.1679-1691
• Main Authors: McCartan, Claire, Davidson, Gavin, Bradley, Liam, Greer, Katherine, Knifton, Lee, Mulholland, Aodán, Webb, Paul, White, Chris
• Format: Article
• Language: English
• Subjects: Access; Anxiety; Barriers; Benefits; Construction; COVID-19; Data collection; Design; Dissemination; Efficacy; Exercise; green and blue spaces; Health care expenditures; health inequalities; Health problems; Health services; Health status; Humans; Intervention; Landscape architecture; Lifts; Mental disorders; Mental Health; Mental health care; Mental health professionals; Mental health services; mixed methods; Mixed methods research; Motivation; nature connectedness; Original; Outdoors; Patients; Personal safety; physical health; Polls & surveys; Population; Public Health; Relaxation; Research applications; Research design; Safety; Scholarship; Self esteem; Self report; Selfimage; Social anxiety; Social contact; Social networks; Statistical analysis; Surveys; Teams; Time; Well being; wellbeing
• ISSN: 1369-6513; 1369-7625; 1369-7625
• DOI: 10.1111/hex.13773

Introduction Mental health problems are a considerable public health issue and spending time in nature has been promoted as a way to access a range of psychological benefits leading to the development of nature‐based interventions for people with severe and enduring mental health problems. Less, however, is understood about the potential benefits and efficacy of day‐to‐day routine access to outdoor green and blue spaces for mental health service users. Methods Using a mixed‐methods design between April and October 2021, we explored the benefits and barriers to spending time outdoors with a purposive sample of mental health service users (N = 11) using qualitative interviews and an online general population survey (N = 1791). Qualitative evidence highlighted the restorative benefits of nature and identified a number of barriers associated with fears around personal safety, social anxiety, fatigue and lack of motivation. COVID‐19 had also restricted access to green and blue spaces. Having social contact and support encouraged people to spend time outdoors. In the quantitative survey, self‐report and standardised measures (the Patient Health Questionnaire and the Warwick–Edinburgh Wellbeing Scale) were used to assess past and current mental wellbeing. Findings Statistically significant differences were found between wellbeing and the use of green and blue spaces. Those with mental health problems spent time outdoors because they: felt guilty; wanted to reduce their anxiety; or rely on someone for encouragement. Those without mental health problems endorsed more positively framed reasons including relaxation, improving physical health or getting exercise. Barriers for people with mental health problems involved safety concerns, feeling anxious and having a poor self‐image. These findings give insight into motivations for an outdoor activity to help inform the design of public mental health interventions. Conclusion Further work is required to improve access and safety to promote the benefits of green and blue spaces for everyone. Patient or Public Contribution The research team included expert experienced researchers with a mental health service provider (Praxis Care) and they were involved in the development of the research idea, funding application, design, data collection, analysis, writing up and dissemination activities.