In previous studies, social context and social support have been found to be important in nature-based services. However, no studies have previously focused on the meaning of different dimensions of social support in these contexts. The aim of this study is therefore to uncover dimensions of social support in relation to mental health among young adults with mental health problems participating in nature-based services in Norway. This study applies data from a survey of 93 young adults participating in nature-based services; in addition, qualitative interview data from 20 interviews are also used. The data are analysed using qualitative content analysis, descriptive statistics, and correlation analysis. The results indicate that participants in nature-based services experience emotional, esteem, informational, and instrumental support in addition to social integration and opportunities for nurturance in these services. The service leader, other participants, and the animals are important contributors to these dimensions of social support. Nature-based services may be a helpful intervention for young adults with mental health problems. The unique context of these services, including nature and animals, adds special qualities to mental health and social work practices.

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.

There is increasing interest in the potential for using nature and animals in services and interventions for people with mental health problems. However, the knowledge about nature-based services and participants is limited. The overall aim of this thesis is to examine nature-based services for young adults with mental health problems in Norway, focusing on the meaning of different dimensions of social support.

The results indicate that social aspects are important in nature-based services. The young adults participating in the services exhibit more symptoms of mental health problems than a sample of young adults from the general population, but fewer than a sample of clinical mental health care in-patients. Furthermore, the results show that a variety of dimensions of social support is found in the services and that nature-based services add specific qualities to these dimensions, for instance, through support from animals. For participants struggling with mental health problems and social insecurity, emotional and esteem support, and the opportunity to provide care and support to others may be of particular importance in strengthening their self-esteem and social confidence.

Purpose:This article analyses the psychometric properties of the Social Provisions Scale 10-items version.Methods:The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied todata on 93 young adults (16–30 years) out of school or work, participating in different nature-based serv-ices, due to mental or drug-related problems.Results:The psychometric analysis concludes that the original scale has difficulties related to targetingand construct validity. In order to improve the psychometric properties, the scale was modified to includeeight items measuring functional support. The modification was based on theoretical and statisticalconsiderations.Conclusion:After modifications the scale showed not only satisfying psychometric properties, but it alsoclarified uncertainties regarding construct validity of the measure. However, further analysis on larger sam-ples are required

Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.

This article reviews Nordic literature on Green Care for people out of work orschool, or with mental health- and/or drug-related problems, published from1995 to April 2014. Green Care is a well-established international concept thatuses animals, plants and nature in an active process to offer health-promotingactivities for people. Reports, evaluations and scientific articles are included. Themainfinding was that the Green Care services described in the literatureprovided positive activities for our target group. Seven main categories emergedduring the analysis: mastery and coping, positive effects on mental health,physical activity, structure and meaningfulness, the feeling of dignity producedby performing a decent ordinary job, social gains, animals and natureexperienced as being supportive. Essential intervention factors identified can bedescribed as: (i) contact with animals, (ii) supportive natural environments,(iii) the service leader as a significant important other, (iv) social acceptance andfellowship with other participants and (v) meaningful and individually adaptedactivities in which mastery can be experienced. Thesefive components interact ina holistic way; the synergetic effects extend the sum of the single factors.