Greenspace programmes supporting people with problem substance use are increasing in popularity within the UK, however there is still little understanding of the mechanisms by which these programmes are successful, particularly for people who use drugs. On the 22nd June 2021, DRNS collaborated with Wendy Masterton, PhD student and Research Assistant at the University of Stirling, to host an event discussing greenspace programmes and problem substance use. The two-hour event was designed to share ongoing learning from a number of organisations across Scotland currently providing a range of greenspace activities.
The event was attended by 40 individuals including academics researchers, third sector providers, NHS colleagues and individuals with an interest in green prescribing. This event included four presentations from Wendy, Dave Barrie (We are With You Dundee), Robin Jeffery (Venture Scotland) and Dr Viola Marx (Dundee Green Health Partnership). An interactive Q&A followed the presentations, providing an opportunity for attendees to ask questions and contribute to the discussion. This report provides a summary of the presentations, and access to slides, as well as some key points highlighted in the group discussion.
Presentations
The event presentations were recorded and can be accessed here:
Unfortunately, due to some technical difficulties on the day, Dave Barrie’s presentation was cut short, however all of his slides are available below, and he is open to further questions. Any questions or comments you have for the speakers, please send to admin@drns.ac.uk and we can forward on.
Welcome & introduction: Dr Hannah Carver, Deputy Director, Salvation Army Centre for Addiction Services and Research
How might greenspace programmes be used to support reductions in problem substance use? Wendy Masterton, PhD Student & Research Assistant, Salvation Army Centre for Addiction Services and Research
Wendy discussed her ongoing research and her recently published framework that may aid in future implementation of greenspace programmes for people with problem substance use. She also discussed some of the challenges of implementing programmes and potential barriers to acceptability and buy-in. Access her slides here to find out more on her study:
Dundee Recovery Service: Dave Barrie, Service Manager, We are With You Dundee
Dave provided an overview of the different outdoor recovery programmes for people who use drugs, currently offered through the Dundee Recovery Service, a We Are With You funded project. These programmes include hillwalking and cycling groups, an allotment project, fitness groups, such as Street Soccer, and a woman’s walking group. He explained how these programmes have helped to build social confidence among those taking part as well as creating group connections, support and influence, all of which help to support those in their treatment. Access his slides here:
Referrers Programme Venture Scotland: Robin Jeffery, Delivery Manager, Venture Scotland
Robin presented information on the Journey Programme, offered by Venture Scotland to anyone aged 16-30 who is seeking support to make changes to their mental, physical or emotional health, including their own problem substance use. The programme offers a range of outdoor activities to help build trust, grow communication skills, understand emotions and maintain positive relationships. His presentation is available here:
Dundee Green Health Partnership – Green Health for Everything: Dr Viola Marx, Co-ordinator, Dundee Green Health Partnership
Viola introduced the Dundee Green Health Partnership, explaining the health benefits to spending time outdoors and provided details on green health prescribing. She explained the need for cross-partnership working to ensure all areas of health are covered. This can include partnerships between councils, NHS boards, academics and local communities to increase access to greenspaces to all, including those in treatment for problem substance use. She discussed how time in nature can be used as a preventative tool to reduce substance use as well as helping support the recovery process. Find out more about the partnership and greenspace prescribing in her slides:
Q&A and Group Discussion
During the event, attendees were given access to a Padlet board, a virtual collaboration tool whereby anyone with the link can post comments, ideas and questions. The board included prompts to help stimulate discussion within the group. Below provides a summary of points raised and related comments from the event attendees during the group discussion/Q&A.
Greenspace programmes which work well with people who use drugs
- Programmes which are part of a holistic care approach where positive relationships can be developed without the expectation/requirement of abstinence from substance use.
- Programmes such as Care Farming, Community and River Gardens, Group Walks and Wilderness and Adventure Programmes.
- Opportunities to take part in physical activity, share experiences and meet peers.
Funding opportunities/issues
- Current rising costs associated with treatment services.
- Greenspace programmes often have issues accessing long-term funding. This can lead to issues with maintaining staff engagement due to the short term nature of work.
- Past issues have related to formal accreditation for greenspace programmes.
- Integration is needed into already existing NHS services.
Greenspace access – opportunities/barriers
- The physical environment can be a barrier, often individuals have never been exposed to these spaces before and may feel uncomfortable/apprehensive about taking part e.g. remote locations, being outdoors in poor weather.
- There is collateral benefits for staff delivering these programmes – time spent outdoors can reduce feelings of staff burnout.
- Weather – programmes may need to be seasonal to keep people engaged. Poorer weather may stop some activities.
- Many programmes will provide all the necessary outdoor gear so participants do not need to worry about bringing their own. This minimises personal costs.
- Issues around perceptions of safety.
- Quality of greenspace can be lower in more deprived areas – people may have to travel to participate, leading to issues with travel costs.
- The physical capabilities of participants may cause barriers, they may not be aware that programmes can be tailored to suit the needs of those attending.
Impact of COVID-19
- The cessation of many public transport services and implementation of social distancing during the pandemic made it difficult for groups to access the greenspaces, especially those in more remote locations.
- The number of people accessing greenspaces during lockdown periods reduced due to notions of fear of catching the virus by leaving home and interacting with other people.
- Many programmes were put on hold or stopped all together.
- One result of the pandemic has been the rise in poorer mental health, with past evidence showing that this often leads to increased drug and alcohol use. There is a need to push greenspace programmes to support those struggling with mental health as research has shown that access to greenspace can improve mental wellbeing which in turn can help to reduce substance use.
What are the risks of participating in greenspace programmes? Or not participating?
- Is there risks of prescribing greenspace programmes managed by third sector organisations who may have limited funding for staff and training opportunities?
- GPs and secondary care providers complete assessments of individual patients and recommend programmes suitable for each case. It is unlikely that a programme will be unsuitable given the necessary checks are made. Presenters explained they had never come across a programme which lacked the necessary training for staff but this is certainly something that needs awareness to ensure this does not happen, and clients’ needs are met.
Working outside
- Recovery and support groups should consider holding some sessions outdoors.
- Linking up with community gardens or walking groups could be beneficial.
How best to engage people who use drugs in programmes
- Peer volunteers.
- Support worker attendance at sessions to help with lessening anxieties.
How might greenspace programmes best fit into existing services
- Utilise third sector partners as pathways between services.
Additional information
Masterton et al. (2020). Greenspace interventions for mental health in clinical and non-clinical populations: What works, for whom, and in what circumstances?