In-person mindfulness courses can help improve mental health for at least 6 months, according to a new review. The researchers said the findings should encourage similar teacher-led programmes in workplaces and community settings.
Mindfulness is a technique that involves "noticing what's happening in the present moment, without judgement", according to the mental health charity Mind. The technique has roots in Buddhism and meditation. When practising mindfulness, a person might take notice and be aware of their mind, body, or surroundings.
Mindfulness is widely used to improve mental health. The practice aims to help a person become more self-aware, feel calmer and less stressed, be more able to choose how to respond to thoughts and feelings, and cope with difficult or unhelpful thoughts.
Mindfulness-based programmes (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", explain the authors of the review, published in Nature Mental Health.
Mindfulness practice can be a huge part of people "learning to be well", Dr Audrey Tang told Medscape News UK, and could also "run alongside more conventionally formal intervention". She was not involved in the study.
Dr Tang, a psychologist and the author of 'The Leader's Guide to Mindfulness', highlighted that not only does mindfulness bring "benefits in and of itself — better sleep, improved relationships, higher level of performance, greater creativity — it can simply be a self-care practice to get some time and clarity of headspace for oneself, enabling us to better deal with everyday challenges".
Small to Moderate Reduction in Psychological Distress
Previous research into the effectiveness of MBPs had been "mixed", according to the authors, who pointed out that evidence suggested "beneficial average effects but wide variability".
"In our previous work it was still not clear whether these mindfulness courses could promote mental health across different community settings," noted lead author Dr Julieta Galante from the University of Cambridge.
For the study, the Cambridge team investigated the effect of MBPs on psychological distress. They explained that this encompassed "disturbing or unpleasant mental or emotional experiences including symptoms of anxiety and depression". In addition, they wanted to understand whether and how baseline distress, gender, age, education, and dispositional mindfulness, modified the effect of MBPs on distress among adults in non-clinical settings.
They conducted a systematic review and individual participant data meta-analysis, having searched 13 databases in December 2020 for randomised controlled trials that satisfied a quality threshold, and compared in-person, expert-defined MBPs in non-clinical settings with passive control groups.
They pooled and analysed anonymised data from 13 trials representing eight countries (UK, Australia, Canada, Chile, Taiwan, Thailand, the Netherlands, and the US) for 2371 adults who were moderately distressed, median age 34 years , and 71% women, and who had participated in trials to assess the effectiveness of MBPs. Around 50% of the participants had been randomly allocated places on mindfulness programmes that lasted for 8 weeks, involving a 1- to 2-and-a-half hour session per week.
In comparison with control groups who had received no intervention, the researchers found that group-based teacher-led MBPs resulted in a "small to moderate" reduction in the psychological distress between one- and six-months post-intervention for adults who "volunteer to receive this type of intervention". Specifically, the researchers found that 13% more participants saw a benefit when compared with those who did not attend an MBP.
The researchers also found "no clear indication" that this beneficial effect was modified by baseline psychological distress, gender, age, education level, or dispositional mindfulness.
However, they cautioned that more research was needed to identify sources of variability in outcomes at an individual level.
Give Mindfulness a Try
"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," extolled Dr Galante.
"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," she assured.
However, the authors were keen to point out that they were not saying that it should be done by every single person. "Research shows that it just doesn't work for some people," Dr Galante pointed out. Dr Tang agreed: "If mindfulness doesn't work for you - that's ok," she said.
The authors underlined that they were also not recommending that people should choose a mindfulness class instead of another beneficial activity, emphasising that they had no evidence that mindfulness was 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," remarked Dr Galante.
"If you are offered an in-person 4- or 8-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," Dr Galante recommended.
The authors said that the results should "encourage uptake" of similar teacher-led programmes in workplaces and educational institutions keen to help prevent mental health problems developing in members of their community.
If organisations wondered about offering these types of mindfulness courses to members of their community, Dr Galante proposed "it may be a good investment if their communities express an interest".
The National Institute for Health Research funded the study. In the past 3 years, one co-author has been a consultant to / member of advisory board of / and/or speaker for Medice, Angelini, Janssen, Boehringer-Ingelheim, and Servier. Another co-author is the founder and president of Healthy Minds Innovations, a non-profit organisation. The other authors report no relevant financial relationships.
Nat Mental Health. Published online July 10, 2023. Full text