Saturday, 6 April 2019

Social prescribing > gardening rather than drugs

"Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being."
Social prescribing: less rhetoric and more reality. A systematic review of the evidence | BMJ Open
NHS England » Social prescribing
Home | The Social Prescribing Network

Health, in other words, is a social issue.

It can involve getting us to move a bit more:
Futures Forum: Active by Design Summit: Sustrans "discuss the massive gains that can come from increasing physical activity levels in cities."

It can be about better design of our environment:
Futures Forum: Landscaping for Health

It can mean getting some fresh air in nature:
Futures Forum: Hug a tree > it's good for you
Futures Forum: "Green care"  >>> nature-based interventions for mental health care
Futures Forum: Take a walk: it's good for you!

It can be about learning to cope:
Futures Forum: Resilience and Salutogenesis: "Environment, health and resilient cities: what constitutes salutogenic environments?"

It should be all about community:
Futures Forum: 'Down to Earth': using sustainability to improve people’s mental health

It could be about a spot of gardening: 

‘My doctor prescribed me gardening rather than drugs. It has made a big difference to my mental health’

Karen Litton had been suffering with depression for eight years when she was introduced to garden allotments next to Vale Community Hospital

Friday March 29th 2019

Karen Litton had been suffering with depression for the last eight years when a friend introduced her to the garden allotments next to Vale Community Hospital in Dursley, Gloucestershire.

The area was a wasteland until Down to Earth, a local not-for-profit organisation that supports people in growing and harvesting their own fruit and vegetables, teamed up with local doctors to introduce a social prescribing scheme that allows patients to tend their own allotment – instead of receiving medication.

“My friend was prescribed an allotment herself and told me how good it was for her,” says Karen. “I then saw my GP and asked for a referral. It’s very good for me because I suffer with depression, which can be quite isolative, whereas here I feel part of a group, I meet lots of new people.”

The allotment is also somewhere Karen, 53, can bring Hope, her seven-year old Yorkshire Terrier poking her head out from Karen’s jacket where she enjoys sheltering to stave off the rather cold and windy weather on the day i visits the gardens.

“I’ve put in broad beans, leeks and garlic – and also have rhubarb that came with the allotment. Being here also helps build my knowledge of weeds and plants and flowers, not that I remember them all the time! There’s so much to learn. I’ve been doing it for a couple of months so I’m beginning to get to know people’s names and building a group of friendship really.”

Non-medical treatments

Social prescribing – non-medical treatments which have health benefits – forms a key part of the NHS long term plan, launched in January by Theresa May and NHS England chief executive Simon Stevens. Within five years over 2.5 million more people will benefit from social prescribing according to the plan, which promises over 1,000 trained social prescribing link workers will be in place by the end of 2020/21. Health Secretary Matt Hancock has said he wants the “balance shifted” from drugs to social activities to improve the nation’s health.

Down to Earth founder Amanda Godber spent three years leading the £25,000 Dursley project – from the design to the funding, which is almost entirely charitable rather than from NHS budgets – through to its recent launch. Of the 51 raised beds, each measuring 16 feet by 4 feet, five are currently used by patients with plans to increase that figure to 15. The only thing that is banned are potatoes – and trees. Amanda has already spotted on this morning. “That’ll have to come out,” she says.

“One of the reasons shy it works so well is that it’s become an extension of someone’s garden, which is really good. When people think about it as a garden – that’s a lovely place to be.”Dr Simon Opher, of the Walnut Tree Practice in

Dr Simon Opher, from The May Lane Surgery, in Dursley, has worked on the project in conjunction with Down to Earth since the outset and is delighted with the results. As well as growing cabbages, cauliflowers, leaks, or almost anything they fancy, patients can make a cup of tea, chat and bond with other people. Most patients using them are over 50 with some around the age of 30. They tend to visit up to three times a week.

“It’s not actually a therapy, it’s getting people to do different things,” Dr Opher says. “It’s trying to demedicalise what we’re doing. I think it’s generally true that we’ve all got a bit too medicalised, so if you’re a bit isolated you tend to go to your doctor rather than talk to your neighbour – then the doctor medicalises you by potentially giving you tablets. This was a different response to that. It’s not saying that medicine doesn’t have a place, it’s saying that sometimes you can look to do different things to make people better as well.”

There are several factors behind the increasing number of people who say they are socially isolated, he says, including a reliance on cars, the “slight breakdown” of local communities, and the way organised religion has stopped attracting quite so many people to weekly gatherings.

“This is a way of getting people back together and doing something positive. One thing about the allotments is that they don’t do any harm – you can’t get any side effects! Well, apart from getting a bit chilly,” Dr Opher laughs.

Changes to diet

An evaluation of the Dursley project found that not only did patients enjoy being prescribed an allotment to care for, but that it also made them think more about their diet. “That was an interesting outcome, because if you start growing your own food you start saying ‘this is really fresh and it tastes better’, it promotes a more healthy eating,” Dr Opher says.

The only downside seems to be the finite number of people who can prescribed an allotment. “If it gets really popular we might be in trouble,” he adds.

Social prescribing is for anyone with a physical or mental health diagnosis. A patient is prescribed an allotment for up to a year. If they want to keep it on longer there’s a nominal charge of £11 per year to keep going – or hand it back for someone else to enjoy.

I think it’s about people missing that link with nature as well,” says Amanda. “About being outside in the fresh air with a group of people who have similar interests. It’s a really good move from the government by encouraging it, otherwise we go and get medication which doesn’t need medicalising. It’s good to have a reason to get up and go out the door.”

Karen says she has noticed the benefits to her mental health already. “When I’m down here, I forget about my worries. I can be part of a group, talking to people. People who just accept you for what you are rather than what diagnosis you have. That’s really important.

“If I didn’t do this I might not be doing anything on a Thursday, maybe not even leave the house.”

'My doctor prescribed me gardening rather than drugs. It has made a big difference to my mental health' - inews.co.uk

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