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Mindfulness can improve mental health and wellbeing in most cases

 

Mindfulness training can help reduce anxiety, depression and stress and increase overall wellbeing, particularly among those at greatest risk, according to NIHR research. However, it may be no better than other practices aimed at improving mental health and wellbeing.

Mindfulness is typically defined as ‘the awareness that emerges through paying attention on purpose, in the present moment, and non judgmentally to the unfolding of experience moment by moment’. It has become increasingly popular in recent years as a way of increasing wellbeing and reducing stress levels.

In the UK, the NHS offers therapies based on mindfulness to help treat mental health issues such as depression and suicidal thoughts. However, most people who practice mindfulness learn their skills in a community setting.

Many randomised controlled trials (RCTs) have been conducted around the world to assess whether mindfulness training can improve mental health and wellbeing, but the results are often varied. 

The researchers, based at the NIHR Applied Research Collaboration of East of England and the NIHR Cambridge Biomedical Research Centre,  identified 136 RCTs on mindfulness training for mental health promotion in community settings. These trials included 11,605 participants aged 18 to 73 years from 29 countries, more than three-quarters (77%) of whom were women.

Their combined analysis of all these trials, published in PLOS Medicine, found that in most community settings, mindfulness reduces anxiety, depression and stress and increases wellbeing compared with doing nothing. However, the data suggested that in more than one in 20 trials settings, mindfulness-based programmes may not improve anxiety and depression and can even lead to higher scores for distress and lower scores for wellbeing.

Dr Julieta Galante from the Department of Psychiatry at the University of Cambridge, the report’s first author and an NIHR Postdoctoral Fellow said: “On the whole, practising mindfulness appears to be better than doing nothing for improving our mental health, particularly when it comes to depression, anxiety and psychological distress.

Mindfulness did not compare as either better or worse against other ‘feel good’ practices such as exercise. The researchers warn that RCTs in this field tended to be of poor quality (for example, being based on small sample sizes), so the combined results may not represent the true effects.

Professor Peter Jones, also from Cambridge’s Department of Psychiatry, and senior author, said: “While mindfulness is often better than taking no action, we found that there may be other, equally effective ways of improving our mental health and wellbeing, such as exercise. In many cases, these may prove to be more suitable alternatives if they are culturally more acceptable or are more feasible or cost effective to implement.”

The researchers say that the reason for the difference in success between different mindfulness-based programmes identified among the RCTs may be as a result of multiple reasons, including how, where and by whom they are implemented as well as who they are targeted at. 

The number of online mindfulness courses has increased rapidly, accelerated further by the COVID-19 pandemic. Studies suggest that these online courses may be as effective as their offline counterparts, despite most lacking interactions with teachers and peers.

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