Does volunteering improve mental health?

Today is World Health Day, and the health issue everyone is talking about is depression – earlier in the year, the prime minister pledged to tackle its stigma.

Globally, 300 million people have depression making it the world’s largest cause of disability and around the same number have anxiety disorders. Volunteering is often heralded as boosting mental health, with the ‘do good, feel good’ mantra all over recruitment literature. But what does the evidence show?

Yes, volunteering improves mental health – with some caveats

There is now good evidence showing that volunteering improves mental health, including reviews in 2007, 2008 and, perhaps most reliably, a systematic review of the evidence in 2013. Crucially, these reviews present evidence that volunteering causes improved mental health – not just that it is associated with it. For example, the 2013 review found that existing longitudinal research (where the same group of people are followed overtime) ‘showed volunteering had favourable effects on depression, life satisfaction and wellbeing’.

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— NCVO (@NCVO) April 7, 2017

However, the handful of randomised controlled trials in this area (where individuals are randomly selected to volunteer or not, and then compared afterwards) have not confirmed this direct causation. It could be that the trials are underpowered (ie not enough participants took part), the measures of mental wellbeing were invalid or that the positive impact is too small, confined to certain groups or takes too long to show up (trials typically only measure short periods of time). We don’t know – more research is needed.

Evidence is strongest for older groups

The most compelling evidence is around older volunteers with a recent British cohort study only finding a positive association for over 40s. These findings are supported by analyses of three other longitudinal studies from the US showing that volunteering lowers depression for those in old age (Musick and Wilson, Lum and Lightfoot (PDF, 120KB)) and Greenfield and Marks finding positive psychological benefits for older groups who had ‘role-identity absences’ (eg no partner or job). This is significant because we know that retirement can increase the risk of depression. These pieces of research may also help to explain why the trials – which often involve young participants – don’t show significant positive benefits.

The evidence cited in this blog highlights the importance of the social interaction that volunteering offers, suggesting that group activities that offer conviviality are likely to see the most positive benefits. It also shows that the activity being meaningful is key to offering a sense of life purpose, backing up wider research, such as a study by the American Psychological Association, showing that to see improved health – volunteers must be altruistically motivated.

Volunteering can also negatively affect mental health

A review in the Journal of Nervous and Mental Disease looked at evidence from disaster relief finding that volunteers had higher complaint levels than staff partly due to the lack of post-disaster support they received. Recent research by Kamerade and Bennett shows that the specific life circumstances of the volunteer may also lead to negative impacts, finding that regular volunteering amongst unemployed groups can actually be detrimental for mental health in countries with low levels of unemployment benefit.

What we don’t know

As is so often the case, unfortunately, the evidence discussed here primarily relates to regular formal volunteering (through an organisation), with little systematic research into informal volunteering (undertaken as an individual). It is also unclear exactly what effect the type of activity has with a review in BMC Public Health finding ‘insufficient evidence to demonstrate a consistent influence of volunteering type’. Again – more research is needed.

What volunteer-involving organisations should do

Given the evidence discussed above we should:

• say with confidence (and certain caveats) that volunteering generally improves mental health – especially amongst older groups. For some this will seem obvious but for the more sceptical – hopefully this blog has convinced you
• ensure that volunteering opportunities are open to those with a mental illness as research suggests this group is underrepresented
• acknowledge that mental ill-health is driven by major life factors such as bereavement and poverty while also exploring radical solutions like social prescribing – where patients are referred to volunteering to combat mental illness. Some evidence shows its potential although it can be controversial and ‘robust and systematic evidence‘ is limited
• and finally, recognise the importance of providing a good experience to volunteers and, in particular, the substantial emotional support that some volunteer roles require

What do you think?

Are you convinced or have you seen evidence to contradict this blog? What can organisations do to make sure they are open to those with mental ill-health? Let us know in the comments.