Nature, Mental Health and Coping with Cancer

Recent research shines light on the positive influence of time spent in nature on our mental health. These findings are highly significant in the UK as health services are so strained, and are relevant for young people with cancer and the support we offer at Flynne’s Barn.

Despite growing awareness and destigmatisation, difficulties with mental health continually affect many in the UK. The latest APMS Survey of Mental Health and Wellbeing found that almost half of adults believe they have at some point experienced a diagnosable mental health problem. Researchers suggest that everyday aspects of modern life adversely affect our mental health, particularly in highly urbanised environments. Recent social conditions have made it even harder to promote wellbeing; COVID-19 has resulted in long periods of isolation and greater precarity in the workplace, and now the cost-of-living crisis adds further pressure.

For those with a cancer diagnosis these effects will likely be heightened. Treatment centres are located in major cities, requiring patients to inhabit an enclosed, clinical space, usually in the midst of a busy ward. Access to familiar coping mechanisms, including contact with peers or physical exercise, are often restricted. Cancer can also bring about or worsen financial insecurity; growing numbers of patients are forced to choose between food and water or travel to hospital appointments due to the cost-of-living crisis. Along with the more salient traumas that come with facing cancer, these additional constraints further contribute to psychological distress.

As mental health services are increasingly overstretched in the UK, implementing cost-effective measures to take pressure off the NHS is critical. Social prescribing, the practice of recommending non-clinical services and activities, is becoming more commonplace. The Advice Services Alliance estimate that one in five GP consultations relate to primarily social problems. Acknowledgment of the varying factors that affect our health, including employment, debt and housing, allows us to look beyond sole reliance on traditional medical interventions. Although many issues clearly relate to systemic realities predominantly out of our own control, social prescribing has the potential to alleviate some of the harm: one University of Westminster study suggests that it reduces the number of GP appointments by 28% and helps lower A&E attendances and outpatient referrals. Further research however is still needed to confirm its concrete impact.

Spending time in nature has emerged as an important area of focus for mental health services, as seen by an initial £4 million investment towards ‘green social prescribing’ in 2020. Although the association between nature and health has been long recognised, more recently researchers have extensively explored this connection, established statistical significance and are influencing policy. This attention has largely been a result of COVID-19; with prolonged restrictions on normal activities and travel, looking to nature was one of the few sources of relief and entertainment for many.

Mathew White has led numerous studies in this field. Notably, his team found that a minimum of two hours a week in nature is enough to provide the associated health benefits. It’s suggested that this recommendation will join official health guidance with 150 minutes of exercise a week and the famous 5-a-day. They also conducted analyses across 18 countries, detecting significant correlation between access to blue/green spaces and reduced anxiety and depression. Another piece of their research centres on the specific influence of aquatic environments, highlighting a tendency for self-reported general heath to increase with proximity to a safe water body.

Shinrin-yoku – translated as ‘forest bathing’ – is a form of Japanese therapy popularised in the 1980s. The practice involves mindful immersion in nature through use of all the five senses, inspiring researchers and therapeutic services internationally. Multiple studies have found that shinrin-yoku effectively reduces unwanted mental health symptoms, anxiety in particular. Data on the benefits of woodland usage here in the UK aligns with the Japanese approach, estimating that in annual mental health costs they save £185 million.

So why does spending time among trees or by the sea positively affect us in such a meaningful way? With 99.99% of human history occurring in natural rather than urban environments it makes sense that we feel better in nature; but how exactly this positive effect on our mental health comes about is complicated and not yet fully understood. Initial research implies that combined elements of natural spaces – including coloration, shapes and scents – comprehensively stimulate our senses and result in various psychophysiological benefits. A multisensory experiment published in Nature found that when comparing environments, participants’ physiological responses were more affected by olfactory cues compared to visual or auditory ones. Physiology was also studied in experiments investigating the benefits of shinrin-yoku: exposure to forest environments led to “lower concentrations of cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nerve activity, and lower sympathetic nerve activity”.

Other associated aspects of time spent in nature bring about more easily identifiable health advantages – for example, physical exercise, connecting with others, air quality, eating healthily or pursuing a hobby. It’s likely that this blend of recognised stress reducers comes together when accessing green/blue spaces.

Clearly the advantages of harmonising with nature are not just speculation – they are grounded in quantitative research, with considerable social potential. It is also clear that these health benefits are highly relevant for those with cancer, despite the illness limiting access to natural spaces. Making time for excursions is more difficult with an ongoing routine of inner-city check-ups and treatment, and low energy levels associated with illness and medication are also an obstacle. To address this inequality Flynne’s Barn services have been developed in line with this growing body of research, providing a space for young people with cancer to gain prolonged access to nature.

Residentials take place at Thorneythwaite Farm in the Borrowdale valley. The site is enclosed in nature and supports a range of wildlife. Visitors can enjoy the local environment in their own time or engage in outdoor activities in collaboration with other nearby organisations. Flynne’s Barn offers a natural setting, bringing together recognised modes of psychosocial support: community; education; creative arts; and physical activity. Travel, stays and activities are fully funded. Correspondingly, we aim to promote biodiversity in the local area through our engagement with the environment. A tree planting programme began in Autumn 2018 in partnership with the Woodland Trust and Pete Leeson, and we work collaboratively with Green Up Borrowdale, a recently formed environmental group.

On its own, spending time in nature is not enough to deal with complex mental health problems or cope with cancer. We instead advocate that the benefits of nature should be more widely acknowledged within broader support systems. Our collective understanding of mental health and ways to promote wellbeing continue to grow, while the public provision of necessary resources in this field continue to lag. A public programme to develop more green urban spaces would not only be beneficial for mental health but also boost employment and productivity. In the UK, the world’s fifth largest economy, it should be possible to improve support for those coping with serious illness and prevent widespread mental health problems with social roots.