Social support in nature-based services for young adults with mental health problems

Sammanfattning: Aim: The overall aim of this thesis is to examine nature-based services for young adults with mental health problems, focusing on the meaning of different dimensions of social support.Methods: The thesis includes four studies that use a variety of data sources and methods: an integrative literature review of nature-based services in the Nordic countries; a quantitative cross-sectional survey of 93 young adults participating in nature-based services in Norway; and qualitative data comprising 20 interviews with nine participants in nature-based services. In addition, a sample of clinical mental health care in-patients and a sample of young adults from the general population are used for comparative analysis related to mental health problems. Data are analysed using a variety of statistical analyses and qualitative content analysis. Rasch analysis is employed to analyse the psychometric properties of the Social Provisions Scale (SPS-10).Results: The majority of young adults in nature-based services struggles with mental health problems. The results indicate that they show more symptoms of mental health problems than the sample from the general population, but fewer than the sample of clinical mental health care in-patients. Previous research papers highlight the importance of social support in nature-based services. However, knowledge about social support in these services is limited. Rasch analysis of the SPS-10 supports the division of social support into functional and structural support and the SPS-10 is revised for use in the nature-based sample. Participants receive emotional, esteem, informational and instrumental support in the services, and experience social integration and opportunities for nurturance. The results also indicate that nature-based services add specific qualities to the dimensions of social support, for instance, through support from animals.Conclusions: Social support is important in nature-based services, and various dimensions of social support are provided in the services. Emotional and esteem support, along with opportunities for nurturance, may be of particular importance for participants with mental health problems.