Prescribing nature can improve happiness and reduce anxiety

Researchers from the University of Exeter -- in partnership with the University of Sheffield, Sheffield Hallam University, and University of Plymouth -- have today (September 4) published a report for the Department for Environment, Food & Rural Affairs (Defra) on their findings into efforts to increase access to Green Social Prescribing, and its effectiveness in tackling and preventing mental ill health.

Green Social Prescribing is the practice of supporting people with mental health needs to engage in nature-based activities. Referrals will typically come from GPs, community mental health teams, or social workers, but people can also self-refer. Social Prescribing Link Workers, and other trusted professionals, then connect people to community groups and agencies for practical and emotional support. There are many different types of nature-based activities and therapies, including conservation, horticulture and gardening, care farming, exercise and sports, or talking therapies in the outdoors.

Professor Ruth Garside of the European Centre for Environment and Human Health at the University of Exeter said: "Our findings are significant because it provides evidence that Green Social Prescribing is an effective way of supporting people with their mental health. But this is just the beginning and further government investment is now supporting the leadership and systems change that we know Green Social Prescribing needs to be successful. However, there must be an ongoing commitment from policymakers to understand the needs of communities and enable more diverse people to connect with nature, alongside investment in those organisations that provide nature-based activities."

In total, 8,339 people with mental health needs took part in nature-based activities at seven Green Social Prescribing Project Test and Learn pilots across England. Compared to many other social prescribing initiatives the project reached a broader range of people, including children and young people aged under 18, ethnic minority populations (21-percent), and people from socio-economically deprived areas (57-percent).

Prior to accessing nature-based activities participants' happiness, anxiety, life satisfaction, and feeling that their life was worthwhile was worse than national averages. After taking part in the project wellbeing had improved, and typically happiness and anxiety was in line with the national average. Levels of life satisfaction and feeling that life was worthwhile had also improved significantly.

Participants in Green Social Prescribing said:

"After the group I feel joyful, happy, calm. I have a sense of achievement and I feel my wellbeing increasing. I look forward to attending."

"It works better than medication for me. It works better than CBT for me. Most of my stuff is related to trauma, so NICE guidelines don't recommend medication for borderline personality disorder. I have my counselling and that is really valuable, but this is on a par with that."

With an average cost of £507 per participant, researchers also found Green Social Prescribing to be a cost-effective method of supporting people across a wide spectrum of mental health needs. That's when compared to other interventions, such as Cognitive Behavioural Therapy (CBT), behavioural activation, and early intervention for psychosis and collaborative care for depression.

Marion Steiner is a GP in Bristol and part of the Bristol, North Somerset and South Gloucestershire Test and Learn Pilot Site project board. She said: "Connecting with nature is a lifelong resource with proven benefits for mental and physical health. It can cut through generations of adverse life events. But many of the patients I treat can't currently access nature in this way due to a range of personal, social, and cultural barriers. That's why Green Social Prescribing is so important. This project has the potential to reduce a range of prescribing and treatment costs for the NHS, as well as addressing many health needs and lowering the risk of several diseases, from diabetes to depression."

Dr Annette Haywood, Head of Public Health Section Sheffield Centre for Health and Related Research (SCHARR) and Principal Investigator of the study said: "I'm thrilled to have led on this national evaluation of Green Social Prescribing. There is already a wealth of evidence to show the positive impact that nature and outdoor activities can have on mental and physical health. The findings of this report add to this evidence-base, demonstrating that nature-based activities are a relatively cost-effective way to support people with a variety of mental health needs."

Funding for the project was provided by HM Treasury's Shared Outcomes Fund and various central government departments and external agencies. Partners included: Department of Health and Social Care, Department for Environment, Food and Rural Affairs, Natural England, NHS England, NHS Improvement, Public Health England, Sport England, Department for Levelling Up, Housing & Communities and the National Academy for Social Prescribing.