We hear a lot these days about ‘getting back to nature’ and ‘greening’ everything we do, as a reaction to our always-connected (and consequently always-stressed) lives.

There is also a lot said about the benefits of social prescribing, a practice that has the potential to truly revolutionise our approach to health care and wellness. Now though, the two have been combined into what is fast becoming more widely known as Green Social Prescribing.

Green Social Prescribing or GSP is (according to Natural England, the government’s adviser for the natural environment):

“the practice of supporting people in engaging in nature-based interventions and activities to improve their mental health. Social prescribing Link Workers (and other trusted professionals in allied roles) connect people to community groups and agencies for practical and emotional support, based on a ‘what matters to you’ conversation.”

Looking back a year or so, one of the most noticeable things to come out of the recent pandemic is how much nature suddenly began to take on a new importance, and become a crucial way to keep ourselves heathy and sane during the worst of the lockdowns. 90 per cent of adults in England reported they view green and natural spaces as good places for mental health and wellbeing.

Doing activities in these spaces—with others in your community—is what it’s all about. These green activities can be prescribed by a doctor, but they may also be offered by community groups or social care / link workers. The NHS target was that at least 900,000 people will be referred to social prescribing by 2023/24.

Natural England is working with the Department for Environment, Food and Rural Affairs (Defra), NHS England, Department of Health and Social Care (DHSC), the Department for Levelling Up, Housing and Communities (DLUHC), NASP and Sport England, as well as local partners, on a national £5.77m project to prevent and tackle mental ill health through green social prescribing, which runs until March 2023. Seven ‘test and learn’ sites have been established.

Salute the Salutogenic approach

There’s a key bit of the approach that makes it different from ‘normal’ medical treatment. The focus has pivoted away from finding disease and treating the symptoms of it, towards focusing on how to prevent disease in the first place. Known as the “Salutogenic approach”, it’s an approach to wellness focusing on health and wellbeing (rather than looking for “pathogenensis” (disease)). And, as you may have guessed, green environments or green spaces have high salutogenic potential.

A review in the scientific journal SMM Population Health showed clearly that outdoor nature-based interventions improve mental health outcomes in adult populations in the community, including those with common mental health problems, SMI, and long-term conditions.

The largest treatment effects were observed in studies that tested nature-based interventions for between eight and 12 weeks, with between 20 and 90 min of contact time per session. This means delivery can readily fit with existing provider delivery models, and people can gain health benefits from modest amounts of regular engagement with nature.

Natural Health Service

Putting the theory behind this idea into practice is one organisation called the Natural Health Service. This group is active across Merseyside and North Cheshire, and sees the natural environment – our parks, woodlands and other green spaces – as a vitally important health asset; places that can contribute to the prevention and treatment of physical and mental health conditions.

They have created five ‘products’ which they base their delivery on. These are different types of socially prescribed green activities, backed up with evidence to prove their efficacy:

The statistics are stark around mental health:

• 1 in 10 children have a diagnosable mental health problem but only 1 in 4 are accessing treatment.
• Around 40% of primary care appointments are about mental health.
• 1 in 5 older people living in the community and 40% of older people living in care homes are affected by depression.
• Ultimately, people with severe and prolonged mental illness are dying on average 15 to 20 years earlier than other people.

But as well as making us stop and think, these statistics can also spur us on to keep changing and improving the way we help people—and help nature at the same time—so that poor mental health is not inevitable and everyone in our society can live happier, healthier lives.