Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness

Int. J. Environ. Res. Public Health 2015, 12(2), 1928-1951; doi:10.3390/ijerph120201928

Author

Eva Sahlin ^1,* , Gunnar Ahlborg, Jr. ²

, Artur Tenenbaum ³

 and Patrik Grahn ¹

¹

Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, P.O. Box 88, Alnarp S-230 53, Sweden

²

Institute of Stress Medicine, Sweden and Sahlgrenska Academy, University of Gothenburg, Region Västra Götaland, Carl Skottbergs Gata 22B, Göteborg SE-413 19, Sweden

³

Arbetslivet, Region Västra Götaland, Skaraborgs Sjukhus Skövde, Skövde SE- 541 85, Sweden

^*

Author to whom correspondence should be addressed. 

Academic Editor: Paul B. Tchounwou

Received: 4 November 2014 / Accepted: 30 January 2015 / Published: 9 February 2015

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Abstract 

After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process. View Full-Text

Keywords: Nature-Based Rehabilitation;  burnout;  depression;  anxiety;  health care utilization;  sick leave

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