Gardening, painting and fishing aren’t just fun, they can contribute to good mental health. Or so some health professionals in the United Kingdom think – they’re even prescribing recreational activities to help people with mild depression and anxiety.
The movement, called “social prescribing,” is growing in popularity in the U.K., says Richard Kimberlee, a senior research fellow in the Faculty of Health and Life Sciences at the University of the West of England, and a member of the Social Prescribing Network.
People might go to their doctors and get a referral to someone who can help link them with a community group or activity that they’re interested in – often with the cost partly covered by the public health system.
In Devon, for example, a gardening program has taken off, he said. “The prescriber would work with them, would take them there, would introduce them to a gardening project, and then would check over time to see how they’re getting on.”
More than a diagnosis
A gardener that Kimberlee spoke to said that the program helped him a lot. “For him, he said, what helped about the gardening group was that he was treated as normal. He wasn’t treated as a person with mental health challenges. For him, working with other people, he felt a sense of ambition, of enjoyment and he felt like he was another person.”
Those sentiments are familiar to Craig Currah, a recreationist and case worker at the Centre for Addiction and Mental Health in Toronto. Currah, who helps to develop recreational activities as part of a day program at CAMH, thinks that they’re an important part of life.
“Recreation can really help people to create meaning, whether it’s journaling, art, joining a sport or a team, because that provides you an opportunity to have a role that’s not bound by your diagnosis,” he said.
“In time it can help people to recognize that they’re not a diagnosis. They’re a full person and just as deserving of all the great things in life as anyone else.”
Although the social prescribing movement is being championed by people like London mayor Sadiq Khan, evidence on its effectiveness is mixed so far. A review published in BMJ Open in 2016 found that many studies were small-scale or had issues with bias, and concluded that “current evidence fails to provide sufficient detail to judge either success or value for money.” Other qualitative studies have found some success.
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However, the general idea of social activities helping people deal with depression is solid, said Dr. Marnin Heisel, a clinical psychologist and associate professor at Western University’s Schulich School of Medicine and Dentistry.
“Helping people to focus on their communication style, on the way of getting their emotional needs met and getting more involved in social activities actually has a strong evidence base, both in the treatment of depression and other mood disorders,” he said.
Encouraging people to socialize instead of withdrawing into themselves, “Can be a wonderful thing for people,” he said. “I’ve seen people really sort of blossom in that sort of context and it makes a huge difference in their lives.”
He notes that it’s not for everyone. People with severe social anxieties or who have a lot of trouble with interpersonal relationships might have a bad experience if they were asked to join a social group. Some people would also benefit from this approach in conjunction with other kinds of therapy or medication, he said.
“There isn’t a one-size-fits-all intervention that fits everybody.”
Currah would agree – he thinks that in order for a social intervention to be successful, the patient needs to buy into the idea. “If we tell people what to do, we’re not instilling skills around independence or individual coping,” he said.
Social activities have another benefit too, said Heisel – they can help a person forget about their problems, at least for a while. “Being involved with sports, it can be fun, it’s game-like, it involves social interaction. And it also can help people focus on something outside of themselves.
“The more we focus especially on what’s going wrong, the more we focus on our physical symptoms, our emotional symptoms, we can actually exacerbate them,” he said. Focusing on your teammates or your art project instead can be helpful.
In general, he’s supportive of any idea that helps physicians think holistically about a person’s health and their social life, he said.
Currah believes that it’s important to have leisure activities, not just because it helps you live a full life.
“Recreation and leisure helps promote connection: connection to communities, connection to their neighbourhood, connection to other support. Knowing that you’re not alone. Feeling that other people understand you and accept you for who you are.”
“That can be a very transformative moment in people’s health.”