Sir Stuart Etherington: How volunteering can help with mental problems

In our continuing series of articles on mental health in the workplace, the chief executive of the National Council for Voluntary Organisations says evidence exists that volunteering has a positive role to play

Sir Stuart Etherington
Sir Stuart Etherington

Poor mental health is one of the biggest health issues of our time. Some 300 million people around the world experience depression alone, an illness that can have debilitating side-effects.

So serious is the problem in the UK that at the start of 2017 the Prime Minister, Theresa May, pledged to overcome its stigma.

However, study after study is confirming the benefits of volunteering for people with a range of mental health conditions. The social interaction that volunteering offers is extremely important, with group activities that provide conviviality appearing to offer the most benefit.

Volunteering lifts self-esteem and reduces social isolation. It gives people the chance to get out, mix with others and learn new skills, and might even lead to paid employment, which is also beneficial.

This link between volunteering and improved mental health isn’t just anecdotal. During the past decade a string of studies from around the world, particularly a systematic review of the evidence in 2013 by researchers from the universities of Exeter, Birmingham and Durham, have provided good evidence about the beneficial effects of volunteering, at the same time highlighting the importance of continuing research into the topic.

For example, the 2013 review found that existing longitudinal research (this is where the same group of people is followed over time) "showed volunteering had favourable effects on depression, life satisfaction and wellbeing".

Crucially, these studies have revealed not only that volunteering is associated with improved mental health, but also that it actually causes the improvement.

Only last week, a report from The Wildlife Trusts, the University of Essex and Green Exercise revealed that volunteers working on wildlife projects experienced a significant uplift in their mental wellbeing. Some of them were patients with mental health issues who had been referred by GPs, health centres and NHS trusts. That might open the way for people with poor mental health to be referred to suitable volunteering projects as part of their treatment.

Many charities among the NCVO’s 13,000 members are doing excellent work in this area. Jealott’s Hill Community Landshare, a group working in Berkshire, has volunteers managing the six-acre horticultural garden it runs. They often have a range of conditions, poor mental health being one of them, and benefit from the improved self-esteem and therapeutic qualities of community gardening.

There’s also Oakleaf in Surrey, a social enterprise that offers vocational training to people with mental health issues. The skills Oakleaf offers in horticulture, upholstering, IT and print finishing not only have therapeutic benefit, but also let the volunteers acquire new skills, with the ultimate goal of returning to paid employment.

Admittedly, there are some caveats.

The handful of randomised controlled trials in this area (where individuals are randomly selected to volunteer or not, then compared) have not confirmed this direct causation. It could be that not enough people took part in the trials, the measures of mental wellbeing were not valid or that the positive impact is too small, confined to certain groups or takes too long to show up because trials usually measure only short periods of time. Most studies have so far concentrated on the effects of formal volunteering through organisations. There hasn’t yet been enough work on the effects of informal volunteering. As I said, more research is needed.

The most compelling evidence comes from older volunteers. A British cohort study published in September 2016 found a positive association for the over 40s. These findings are supported by analyses of three other longitudinal studies from the US.

Two of these three showed that volunteering lowered cases of depression for those in old age (Musick and Wilson, Lum and Lightfoot), and Greenfield and Marks found positive psychological benefits for older people who had no partners or jobs.

This is significant because we know that retirement can increase the risk of depression. These pieces of research might also help to explain why the trials, which often involve young participants, don’t show significant positive benefits.

What all this evidence does undoubtedly show is the importance of the social interaction that volunteering offers. It suggests that group activities that offer conviviality are likely to bring the most positive benefits. It also shows the key: that any volunteering to improve mental health must offer a sense of life purpose. This backs up wider research, including a study by the American Psychological Association, showing that volunteers must be altruistically motivated if they are to see improved health.

What we can say with confidence, though, is that  volunteering generally improves mental health, especially among older groups.

We must also ensure that volunteering opportunities are open to those with mental illnesses, because research suggests this group is under-represented.

And we must acknowledge that mental ill health is driven by major life events, such as bereavement and poverty. But we must also explore radical solutions such as social prescribing, where patients are referred to volunteering to help them combat mental illness. Some evidence shows its potential, although it can be controversial, and robust and systematic evidence is limited.

Most of all, we must recognise the importance of providing a good experience to volunteers and, in particular, the substantial emotional support that some volunteer roles require.

The NCVO provides its own staff with up to five days of volunteering leave a year. As we consider how best to counter poor mental health in the community, voluntary leave might be a way to address the issue.

Sir Stuart Etherington is chief executive of the National Council for Voluntary Organisations

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