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Whilst there are few empirical studies of the positive impact on health and social care services of engagement in STH, STH has been shown to deliver both mental and physical health benefits that are complementary to the wider health and care system, with restorative and preventative effects seen across a wide range of client groups.

STH, even in a very simple form, such as placing a plant next to a patient, has been shown to lower feelings of pain, stress, anger, fear, and anxiety (Ulrich 2002, Yamane 2004) which could have clear implications for analgesic costs; supporting mental and physical health whilst waiting for treatment and faster rehabilitation and recovery after an accident, illness or life event can all reduce demand on health and care services.

Engagement in STH in community settings can improve the quality of life for people with long-term health conditions and the adoption of healthier lifestyles can lead to reduced health risks and therefore reliance on health and care services.

Visits to green spaces in urban environments have been associated with a reduced need for psychotropic, antihypertensive and asthma medication (Turunen 2023).Where a person engages with a nature-based group, the participation can reduce loneliness and help bolster the individual in adhering to an addiction program (see Bloomfield, Allen 2014, Bonham-Corcoran 2022, Mughal 2022).Incorporation of green features can lead to a quicker recovery (where the patient has a ‘green view’ Ulrich 1984), stress reduction (where patients have access to a garden Ulrich 1991), reduced agitation (for those with dementia Murroni 2021), and the availability of a green space at a healthcare facility can help with communication with patients (Space to Breathe).

The Chief Medical Officer’s report 2023 – Health in an aging society - makes recommendations about prevention and maintaining health as adults to reduce illness/disability risk in later life.

In the Forward Dr Whitty states: “One of the most satisfying things that doctors experience is caring for women and men of a grand old age facing the end with great serenity and saying ‘I’ve had a good innings’ or equivalent. Some of this is due to good luck, but the chances of delaying disease and disability are substantially increased by straightforward measures individuals can take to prevent or significantly delay disease and maintain physical, mental and social activity.”

He goes on to highlight “the significant gap in effective biological age experienced by those living in poverty and deprivation who experience multiple risk factors across the life course such as exposure to smoking, air pollution and [lack of] access to green space, compared to those living in the least deprived areas” which means that “on average, females in the most deprived areas spend 51.9 years in good health and 26.4 years in poorer health, whereas females in the least deprived areas spend 70.7 years in good health and 15.6 years in poorer health, and live around 8 years longer overall.”

He concludes that “Renewed focus on mental health improvement interventions and services for older adults is key to improving overall quality of life in people’s later years.”

In his recommendations, Dr Witty states: “Making it easy and attractive for people to exercise throughout their lives is one of the most effective ways of maintaining independence into older age.” and “The longer people live with risk factors such as hypertension or high cholesterol, the earlier the start of their disabilities will be.”

As a holistic and person-centred intervention, STH programmes for older adults and for younger adults who are ‘at risk’ will address the many of the factors seen as necessary for maintaining better health in later life.

MHA is the largest charity care provider for older people in the UK. They support more than 19,200 older people each year through their 62 MHA Communities schemes, 67 retirement living settings or 86 care homes. At its core, MHA’s mission as a charity is to enable people to live later life well.

MHA’s Green Care Strategy is one of 5 specialist strategies that support their overall strategy. It sets out commitments on how access to nature enables residents and members to live later life well, as well as how it plays a key role for family members and colleagues. The aim of the Green Care strategy seeks to enhance wellbeing of everyone they support through both structured and informal access to the natural world.

“Our Green Care commitments:

  • We will ensure that all residents and members, together with their friends and loved ones, volunteers, and colleagues have the opportunity, and are supported, to spend meaningful time in, or interact with nature.
  • We will train, support and resource colleagues and volunteers to ensure they are equipped to deliver meaningful interaction with nature.
  • We will develop structured programmes of Social Therapeutic Horticulture (Green Care) that seek to address the individual needs of our residents and members.”

Launching the Green Care Strategy in May 2023, Sam Monaghan, CEO of MHA said: “MHA is delighted to be working with Thrive, the leading gardening for health charity, to bring to life our new Green Care strategy throughout our homes and schemes.

“Today celebrates the immense benefits upon both our physical and mental wellbeing of engaging with nature.

“At MHA we have recognised these benefits for quite some time.

“The implementation of this new specialist strategy and our partnership with Thrive will bring these benefits to our residents, community groups, and colleagues, enabling us all to grow together.”

MHA has identified 5 care settings to form a vanguard project, setting up therapeutic gardens and training staff in the principles of STH.

“MHA Communities are seeking local community STH groups to partner with, to bring STH to the older people we support, and to welcome people of all ages into inter-generational Green Care activities in the gardens of many of our care homes.”