Stepped-Wedge Cluster Randomised Trial of Social Prescribing of Forest Therapy for Quality of Life and Biopsychosocial Wellbeing in Community-Living Australian Adults with Mental Illness: Protocol.

Tamsin Thomas,Daniel D’Appio,James Baker,Debbie Massey,Christina Aggar

doi:10.3390/ijerph17239076

Abstract

Social Prescribing (SP) involves linking individuals with mental illness to local health and welfare services to improve quality of life (QoL) and biopsychosocial wellbeing. SP programs address psychosocial wellbeing by linking individuals to group activities. Forest Therapy (FT) is a group nature walk with prescribed activities that promote mindfulness, relaxation, and shared experience. Improvements in psychological and physical wellbeing have been demonstrated in FT, but psychosocial impacts have not been widely investigated. This study will implement an SP FT intervention and assess the impacts on QoL and biopsychosocial wellbeing. Participants will include 140 community-living adults with mental illness at Sydney/Gold Coast, Australia. A stepped-wedge cluster randomised design will be used; each participant will complete a 10-week control period followed by a 10-week FT intervention. Weekly 90-min FT sessions will be conducted in groups of 6–10 in local nature reserves. Validated tools will measure self-report QoL and biopsychosocial wellbeing pre- and post-control and intervention periods, and 5-week follow-up. Blood pressure and heart rate will be measured pre- and post-FT sessions. Hypothesised outcomes include improvements in QoL and biopsychosocial wellbeing. This study is the first to assess SP FT, and may provide evidence for a novel, scalable mental illness intervention.

Highlights

The global prevalence of mental illness and substance use disorders is 15–20%, or over one billion people [1]
In Australia, Mental illness is the most common issue managed in General Practice (GP), being discussed in 62% of visits in 2018 [3] and placing increasing pressure on GP resources [4]
This study aims to assess the impact of a Social Prescribing (SP) Forest Therapy (FT) intervention on the quality of life (QoL) and biopsychosocial wellbeing of community-living adults with mental illness, 1.2

Summary

Introduction

The global prevalence of mental illness and substance use disorders is 15–20%, or over one billion people [1]. In Australia, Mental illness is the most common issue managed in General Practice (GP), being discussed in 62% of visits in 2018 [3] and placing increasing pressure on GP resources [4]. The most common course of treatment for mental illness is medication [4], this approach only targets disease-specific neurological systems [5]. Is not as effective as targeting the broad range of biological, psychological, and social factors implicated in mental illness [6]. An emerging approach to providing holistic care (treating this broad range of biopsychosocial factors) for individuals with mental illness is Social Prescribing (SP). Assessments 1–5 will be conducted by participants’ Link Workers at PCCS offices. Additional assessments pre- and post-FT sessions will be conducted by PCCS staff at FT sites.

Methods

Discussion

Conclusion