Green space and health benefits: a QALY and CEA of a mental health programme

Green spaces are promoted as a means of improving the health-related quality of life (HRQoL) for people with health problems. This paper evaluates the Branching Out programme in Scotland, which provides patients with mental health problems, social, physical and recreational activities in an outdoor ‘community’ setting. Patients carry out group-based woodland activities over a 12-week period. Health agencies in the Strathclyde region of Scotland offer patients the opportunity to participate if they consider that the patient will benefit from Branching Out activities. The evaluation uses the SF-12 questionnaire to assess HRQoL of participants in the programme. From the SF-12 scores, quality adjusted life year (QALY) change is calculated. Cost per QALY is estimated in relation to economic costs of the program (staffing cost, facilities and other costs e.g. travel). Cost effectiveness analysis reveals Branching Out is comparable to other programmes oriented to social recovery. Its cost-effectiveness in terms of National Institute for Health & Care Excellence guidelines for medical treatments depends on the duration of the health improvement.