The most comprehensive study into green prescriptions by far provides compelling evidence for prescribing doses of nature on the NHS as a matter of routine
Gardening, walking in the woods, or some other dose of nature, could soon be commonly prescribed as a treatment on the NHS after a major study found that “green prescriptions” can work wonders for our mental and physical health.
Green prescriptions can take many different forms, depending on the individual, but typically involve bringing people together outdoors so that patients can benefit from social interaction as well as exposure to the sea, park or other kind of green or watery environment.
As little as 15 minutes of outdoor nature-based activities a week has been found to really help – although green prescriptions more typically involve a hour or two of exposure a week.
The study findings will put further pressure on the Government to expand the green prescription pilot programme it has been running in seven areas across England over the past two years, when it decides whether to roll it out more widely, early next year.
Although there have been many small studies into the benefits of nature on our wellbeing, this is by far the most comprehensive report into the issue, which has looked at the evidence of hundreds of previous studies.
The new study found that being out in nature increased wellbeing, happiness, resilience, and reduced social isolation.
It can also lead to a decrease in symptoms associated with PTSD and ADHD, when offered alongside therapeutic and mindfulness activities, the research found.
There are thought to be many reasons why being in nature – and with other people – can help our health, although they are not fully understood. Among other things, it can help by lowering blood pressure and stress hormone levels, calming the nervous system and enhancing the immune system, experts say.
The research, led by the National Academy for Social Prescribing, provides a compelling case for rolling out green prescriptions much more widely, suggested NHS England, which commissioned the report with Natural England.
“This report provides the health and care system with the foundation to encourage a wider rollout – reaching into areas who may experience health inequalities and support people and what matters to them,” said James Sanderson, director of community health and personalised care at NHS England. “We have been promoting the wide range of physical and mental ill-health benefits of nature based activities, particularly with examples across the country through our Green Social Prescribing Test and Learn sites to tackle and prevent mental ill-health,” he said. Jim Burt, joint chief executive at the National Academy for Social Prescriptions, added: “We have heard the calls for more evidence for social prescribing. The extensive, high-quality research outlined in these reports shows that nature can be of real benefit to both our mental and physical health.” “The studies demonstrate that there is now a large body of research evidence reporting the benefits of the natural environment on mental health,” he says. “There will be a full evaluation of the pilots published next year, but we hope the new evidence reviews help demonstrate the huge potential of nature-based activities, and will encourage health leaders across the country to recognise the benefits for people who are struggling with their mental health.” Mr Burt says that the report draws on evidence from hundreds of high-quality studies, examining the experiences of thousands of people to understand how nature has affected them. The result is a large body of evidence, detailing the many ways in which spending time in nature, and connecting with it, is beneficial for our health and wellbeing. Meanwhile, where there have been studies that have estimated the economic value associated with “green” interventions for mental health, they have typically shown them to be cost effective and to result in savings to society, the report found. This suggests green prescriptions could be a good way to help the NHS save money. A 2019 study by Leeds Beckett University found that every £1 spent by Wildlife Trusts’ nature conservation projects – which offer outdoor volunteering opportunities and programmes that support people experiencing problems such as anxiety, stress or mild depression – saved society £8.50, in part because they needed fewer visits to GPs or felt more able to get back into work. Green Social Prescribing is described in the report as “connecting and supporting people to engage in nature-based activities to improve their mental health”. “These reviews draw on a wide range of evidence to show that spending time in nature is good for our mental and physical health, and that green social prescribing supports social connections and reduces isolation and loneliness. Gardening has been shown to be particularly beneficial to both physical and mental health,” said Helen Chatterjee, professor of human and environmental health, at University College London, who worked on the report. The Government has set up seven “test and learn” sites and will publish a full evaluation of the project in 2023. They are in Humber Coast, South Yorkshire, Nottinghamshire, Derbyshire, Greater Manchester, Surrey and Bristol. A Government spokesperson said: “These evidence notes demonstrate the crucial links between nature and people’s health and wellbeing and form part of a suite of evidence being developed through the green social prescribing programme. We are currently considering next steps for the programme.” Marian Spain, chief executive of Natural England, said: “Spending time outdoors in our incredible nature rich places – no matter how big or small or whether in town or country – has been shown to improve people’s lives. That’s why it’s vital that we continue to invest in nature recovery and make places for everybody to enjoy and reap the benefits for their physical and mental health.”
What the report found
The main message from the expert team of authors was that social prescribing can have an impact on a very wide range of outcomes, including decreases in loneliness, and improvements in mental health and wellbeing, in social connections and in overall wellbeing:
Increases in self-esteem and confidence, sense of control and empowerment
Improvements in psychological or mental wellbeing, and positive mood
Reduction in symptoms of anxiety and/or depression, and negative mood
Improvements in physical health and a healthier lifestyle
Increases in sociability, communication skills and making social connections
Reduction in social isolation and loneliness, support for hard-to-reach people
Improvements in motivation and meaning in life, providing hope and optimism about the future
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