Nature-Based Interventions for Mental Health Care: Social Network Analysis as a Tool to Map Social Farms and their Response to Social Inclusion and Community Engagement

Uncovering the determinants of brain functioning, behavior and their interplay in the light of context

Notwithstanding the huge progress in molecular and cellular neuroscience, our ability to understand the brain and develop effective treatments promoting mental health is still limited. This can be partially ascribed to the reductionist, deterministic and mechanistic approaches in neuroscience that struggle with the complexity of the central nervous system. Here, I introduce the Context theory of constrained systems proposing a novel role of contextual factors and genetic, molecular and neural substrates in determining brain functioning and behavior. This theory entails key conceptual implications. First, context is the main driver of behavior and mental states. Second, substrates, from genes to brain areas, have no direct causal link to complex behavioral responses as they can be combined in multiple ways to produce the same response and different responses can impinge on the same substrates. Third, context and biological substrates play distinct roles in determining behavior: context drives behavior, substrates constrain the behavioral repertoire that can be implemented. Fourth, since behavior is the interface between the central nervous system and the environment, it is a privileged level of control and orchestration of brain functioning. Such implications are illustrated through the Kitchen metaphor of the brain. This theoretical framework calls for the revision of key concepts in neuroscience and psychiatry, including causality, specificity and individuality. Moreover, at the clinical level, it proposes treatments inducing behavioral changes through contextual interventions as having the highest impact to reorganize the complexity of the human mind and to achieve a long-lasting improvement in mental health.

A mathematical formula of plasticity: Measuring susceptibility to change in mental health and data science

Plasticity is increasingly recognized as a critical concept in psychiatry and mental health because it allows the reorganization of neural circuits and behavior during the transition from psychopathology to wellbeing. Differences in individual plasticity may explain why therapies, such as psychotherapeutic and environmental interventions, are highly effective in some but not in all patients. Here I propose a mathematical formula to assess plasticity - i.e., the susceptibility to change - to identify, at baseline, which individuals or populations are more likely to modify their behavioral outcome according to therapies or contextual factors. The formula is grounded in the network theory of plasticity so that, when representing a system (e.g., a patient's psychopathology) as a weighed network where the nodes are the system features (e.g., symptoms) and the edges are the connections (i.e., correlations) among them, the network connectivity strength is an inverse measure of the plasticity of the system: the weaker the connectivity, the higher the plasticity and the greater the susceptibility to change. The formula is predicted to be generalizable, measuring plasticity at multiple scales, from the single cell to the whole brain, and can be applied to a wide range of research fields, including neuroscience, psychiatry, ecology, sociology, physics, market and finance.

Engaging the agricultural community in the development of mental health interventions: a qualitative research study

BACKGROUND

Farmers and those involved in the wider agricultural industry have a high suicide rate. They are also a 'hard to reach' group who make less than average use of mental health services. There is therefore a need to understand how best to develop interventions that meet their needs. The aims of this study were to develop a deeper understanding of the farming context and target population and to engage farmers in the shaping of two potential mental health interventions that could be incorporated in a pilot RCT.

METHODS

The study was informed throughout by a reference group, who assisted in co-production of the research materials. A snowball approach was used to recruit interested individuals who had an association with farming. Twenty one telephone interviews were undertaken and analysed using the six phases of thematic analysis proposed by Braun and Clarke.

RESULTS

Key themes (and sub-themes shown in brackets) related to the study aims were: everyday life (work-life balance; isolation and loneliness); farm management (technology and social media; production, people management, learning and teaching; external pressures; livestock and farm production; financial aspects); demographics (effects of aging); engagement (appropriate wording when talking about mental health; recognising need for help; religion; normalising mental health issues; approaching the conversation); training (mental health training for supporters of the farming community; health & safety and the inclusion of mental health training); and personal stories and experiences, which was an emerging theme.

CONCLUSIONS

Recruiting farmers into research studies is best done by meeting farmers where they are found, for example, farmers marts. Accessibility of content, tailoring to the farming community, and guided support are key to effective recruitment and retention.

Nurturing mental health and well-being using ordinary farms

Purpose

This practice piece aims to review an occupational therapy led pilot programme – social farming as an intervention option in an adult community mental health setting in Ireland. It will also reflect on the practical implications of delivering the natural surroundings based programme through the COVID-19 pandemic and plans for the future development of such programmes in adult mental health services.

Design/methodology/approach

The Occupational Circumstances Assessment Interview Rating Scale (OCAIRS) was used to measure occupational participation (Forsyth, 2005). This was administered with participants’ pre and post their participation in the 10-week programme. An internal questionnaire was developed to further capture both the participant and farmer experiences of the social farming programme.

Findings

Whilst improvements were noted in a number of OCAIRS domains, it was difficult to identify small changes over a short period of time. The main domains of change were habits, roles, interests and personal causation. The success of the social farming placements was also reflected in the internal questionnaire. The pilot programme has resulted in the further development of the social farming programme and securing of funding for placements for five years.

Originality/value

It would be beneficial to consider other standardised assessments that assess quality of life and occupation for future placements. It is also beneficial to consider practical implications in delivering a social farming programme, particularly to those with barriers to transport. It is hoped this paper will contribute to the growing knowledge of social farming as a meaningful therapeutic intervention in mental health occupational therapy practice.

Plasticity in mental health: A network theory

Plasticity is the ability to modify brain and behavior, ultimately promoting an amplification of the impact of the context on the individual's mental health. Thus, plasticity is not beneficial per se but its value depends on contextual factors, such as the quality of the living environment. High plasticity is beneficial in a favorable environment, but can be detrimental in adverse conditions, while the opposite applies to low plasticity. Resilience and vulnerability are not univocally associated to high or low plasticity. Consequently, individuals should undergo different preventive and therapeutic strategies according to their plasticity levels and living conditions. Here, an operationalization of plasticity relying on network theory is proposed: the strength of the connection among the network elements defining the individual, such as its symptoms, is a measure of plasticity. This theoretical framework represents a promising tool to investigate research questions related to changes in neural structure and activity and in behavior, and to improve therapeutic strategies for psychiatric disorders, such as major depression.

Risk Factors for Brain Health in Agricultural Work: A Systematic Review

Certain exposures related to agricultural work have been associated with neurological disorders. To date, few studies have included brain health measurements to link specific risk factors with possible neural mechanisms. Moreover, a synthesis of agricultural risk factors associated with poorer brain health outcomes is missing. In this systematic review, we identified 106 articles using keywords related to agriculture, occupational exposure, and the brain. We identified seven major risk factors: non-specific factors that are associated with agricultural work itself, toluene, pesticides, heavy metal or dust exposure, work with farm animals, and nicotine exposure from plants. Of these, pesticides are the most highly studied. The majority of qualifying studies were epidemiological studies. Nigral striatal regions were the most well studied brain area impacted. Of the three human neuroimaging studies we found, two focused on functional networks and the third focused on gray matter. We identified two major directions for future studies that will help inform preventative strategies for brain health in vulnerable agricultural workers: (1) the effects of moderators such as type of work, sex, migrant status, race, and age; and (2) more comprehensive brain imaging studies, both observational and experimental, involving several imaging techniques.

Shaping therapeutic trajectories in mental health: Instructive vs. permissive causality

We are currently facing the challenge of improving treatments for psychiatric disorders such as major depression. Notably, antidepressants have an incomplete efficacy, mostly due to our limited knowledge of their action. Here we present a theoretical framework that considers the distinction between instructive and permissive causality, which allows formalizing and disentangling the effects exerted by different therapeutic strategies commonly used in psychiatry. Instructive causality implies that an action determines a specific effect while permissive causality allows an action to take effect or not. We posit that therapeutic strategies able to improve the quality of the living environment or the ability to face it, including changes in lifestyle and psychotherapeutic interventions, rely mainly on instructive causality and thus shape the individual's ability to face the psychopathology and build resilience. By contrast, pharmacological treatments, such as selective serotonin reuptake inhibitors, act primarily through a permissive causality: they boost neural plasticity, i.e. the ability of the brain to change itself, and therefore allow for instructive interventions to produce beneficial effects or not. The combination of an instructive and a permissive action represents the most promising approach since the quality of the living environment can shape the path leading to mental health while drug treatment can increase the likelihood of achieving such a goal.

Social Farming Evolutionary Web: from Public Intervention to Value Co-Production

The organization of multifunctional agriculture for the provision of social/health/educational services is spreading throughout Europe and elsewhere. This concept is not new, and the organization of practices differs according to each country’s welfare model. The aim of this paper is to reflect on the existing practices and trends and to provide a suitable comprehensive framework. Starting from long-term research action on this topic started in 1999 and from participation in European research projects and networks, this paper reflects on the features of existing practices and distinguishes emerging social farming models. Specific attention is given to the potential of social farming for both global change and the re-organization of local societies and welfare organizations. The diverse social farming models and their interactions with emerging constraints and needs during times of challenge and crisis, such as those we are currently experiencing, are considered in order to understand their basic principles (from direct support to co-production models), as well as how they correlate with the ongoing process of welfare reorganization and evolutionary societal demands.