In-person mindfulness courses may help prevent mental health problems

Adults who voluntarily take part in mindfulness courses are less likely to experience symptoms of anxiety and depression for at least six months after completing the programs, compared to adults who do not take part, a new analysis pooling data from 13 studies has confirmed.

University of Cambridge researchers looked at participants of group-based and teacher-led mindfulness courses, conducted in person and offered in community settings.

They say the results, published in the journal Nature Mental Health, should encourage uptake of similar teacher-led programs in workplaces and educational institutions keen to help prevent mental health problems developing in members of their community.

In our previous work it was still not clear whether these mindfulness courses could promote mental health across different community settings. This study is the highest quality confirmation so far that the in-person mindfulness courses typically offered in the community do actually work for the average person."

Dr Julieta Galante, lead researcher, who conducted the research while at the University of Cambridge

Mindfulness in these courses is typically defined as "the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment".

These courses, formally known as mindfulness-based programs (MBPs), often combine elements of meditation, body awareness and modern psychology, and are designed to help reduce stress, improve wellbeing, and enhance mental and emotional "resilience". They consist of groups of participants led by mindfulness teachers, who promote reflection and sharing over several one-to-two hour sessions.

The body of research into the effectiveness of MBPs to date has been mixed. Cambridge researchers sought to confirm the effect of MBPs on psychological distress ‒ which encompasses disturbing or unpleasant mental or emotional experiences including symptoms of anxiety and depression.

They pooled and analysed data from 2,371 adults who had taken part in trials to assess the effectiveness of MBPs. Roughly half the participants had been randomly allocated places on mindfulness programmes that lasted for eight weeks, with a one- to two-and-a-half hour session per week and compared them to those that were not through self-reported questionnaires.

The study found that MBPs generated a small to moderate reduction in adults' psychological distress, with 13% more participants seeing a benefit than those who did not attend an MBP.

The researchers found that existing psychological distress, age, gender, educational level and a disposition towards mindfulness did not change the effectiveness of MBPs.

Galante said: "We've confirmed that if adults choose to do a mindfulness course in person, with a teacher and offered in a group setting, this will, on average, be beneficial in terms of helping to reduce their psychological distress which will improve their mental health. However, we are not saying that it should be done by every single person; research shows that it just doesn't work for some people.

"We're also not saying you should absolutely choose a mindfulness class instead of something else you might benefit from, for example a football club – we have no evidence that mindfulness is better than other feel-good practices but if you're not doing anything, these types of mindfulness courses are certainly among the options that can be helpful."

The researchers conducted a systematic review to select previous studies for inclusion in their large-scale analysis. They obtained complete but anonymized data from 13 trials representing eight countries. The median age was 34 years-old, while 71% of participants were women.

While mindfulness apps are on the rise, researchers remain unsure whether it is the practice of mindfulness that reduces psychological distress, or the fact that courses involve in-person group-work with a teacher present.

"Apps may be cheaper, but there is nowhere near the same evidence base for their effectiveness," said Galante. "Some apps may say they are evidenced-based, but they are often referring to trials that are in-person with a teacher and a group."

The effectiveness of smartphone apps, as well as what happens when people continue to practice mindfulness meditation by themselves, will be investigated by Galante, who has recently taken up a new position as Deputy Director of the Contemplative Studies Centre, at the University of Melbourne.

"If you are offered an in-person four- or eight-week mindfulness course in a group setting with a teacher, and you are curious about it, I'd say based on this study, just go ahead and try it," said Galante. "And for organizations wondering about offering these types of mindfulness courses to members of their community – this research suggests it may be a good investment if their communities express an interest."

This research was funded by the National Institute for Health Research.