In recent years, the concept of green prescribing has been gaining momentum as a complementary approach to conventional medical treatments. This method involves recommending nature-based activities to support physical and mental health, and it's being adopted globally with promising results. Let's explore what green/nature prescribing is, trace its origins, and see how it's being implemented around the world.
Understanding Green Prescribing
Green prescribing, also known as nature prescribing, is a health service where medical professionals direct patients to engage in outdoor activities such as walking in nature, joining conservation projects, or participating in gardening. The aim is to use the therapeutic benefits of nature to help treat various conditions, particularly those related to mental health like depression and anxiety, but also physical ailments such as heart disease and diabetes.
The Origins of Green Prescribing
The roots of green prescribing can be traced back to ancient civilisations, but its formal introduction is often attributed to initiatives in New Zealand and the United Kingdom. In New Zealand, the term "green prescription" was coined in the 1990s as part of public health programs encouraging physical activity. Meanwhile, the UK saw formal programs being developed in the early 2000s, with a focus on using nature to support mental health.
Global Implementation
Different countries have adapted green prescribing to suit their healthcare systems and environmental contexts:
United Kingdom: The UK has been a pioneer in integrating green prescribing into its National Health Service (NHS). Programs like "Social Prescribing" and "Shetland’s Nature Prescriptions" encourage patients to engage in local, nature-based activities. These programs are supported by evidence from organisations such as Natural England, which highlights the effectiveness of nature engagement in reducing depression, anxiety, and stress.
United States: While not as formalised as in the UK, the US has seen an increase in nature-based interventions. Organisations like Park Rx America advocate for "park prescriptions," promoting parks as a health resource and encouraging healthcare providers to prescribe nature activities.
Australia: Similar initiatives are seen in Australia, where programs focus on reducing lifestyle-related illnesses. The "Green Prescription" initiative in Western Australia, for instance, aims to tackle obesity and mental health issues through community gardening and nature walks.
Japan: Japan offers a unique example with its practice of "Shinrin-yoku" or forest bathing, a cornerstone of preventive healthcare. This practice involves immersive experiences in forests, aimed at enhancing well-being and reducing stress levels.
Benefits and Evidence
The benefits of green prescribing are supported by a growing body of research. Studies suggest that exposure to green spaces can reduce blood pressure, enhance mental well-being, and improve overall quality of life. For instance, a systematic review and meta-analysis published in "Environmental Research" compiled evidence from over 140 studies (1) to assess the impact of exposure to green spaces on various health outcomes. The research found significant associations between increased exposure to green spaces and reductions in salivary cortisol (a stress marker), heart rate, diastolic blood pressure, and incidence of type II diabetes. Importantly, the study also reported that greater green space exposure is linked to reduced symptoms of depression and anxiety, alongside increased physical activity and improved self-reported health.
The findings of this study suggest that green spaces are a critical health resource that can provide multiple physical and mental health benefits. It supports policies aimed at maintaining and increasing public access to green spaces as a public health strategy.
Twohig-Bennett, C., & Jones, A. (2018). The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes. Environmental Research, 166, 628-637.
Furthermore, the "Nature Connectedness Research Group" at the University of Derby has conducted various studies showing that a deeper connection to nature is associated with lower levels of mental health problems and greater well-being.
Challenges and Future Directions
Despite its benefits, green prescribing faces challenges such as funding, resource allocation, and ensuring access to green spaces. Future directions may focus on expanding accessibility, increasing public and professional awareness, and integrating technology to track and enhance the benefits of nature
Frome’s Nature Prescribing Partnership
The Frome Nature Prescribing Partnership represents a pioneering and collaborative effort in the realm of green and blue prescribing, bringing together a diverse array of organisations committed to harnessing the healing power of nature. Referrals come through Frome Medical Centres health connectors.
This coalition currently includes 14 organisation and is connecting with a large number of freelance providers:
• Shared Earth Learning: Known for its dedication to environmental education particularly in support of mental health and NEETS;
• Field 2 Fork: Providing a connection between agriculture, wellness and food sustainability, including green gym activities;
• Froglife: A champion for amphibian and reptile conservation providing programs for people with dementia;
• Withywood: Providing therapeutic experiences in an old walled garden for young people with learning needs;
• Broadway Community Gardens: Fostering community spirit through shared gardening and rewilding in urban settings;
• Seed Library: Promoting biodiversity and plant conservation through communal seed sharing and growing workshops for children;
• Root Connections: Improving the health and wellbeing of vulnerable adults with complex needs, primarily those who are homeless and rural rough sleeping.
• Giants Garden: Providing gardening and support for young people and NEETS
• Heal: contributing uniquely to ecological restoration and environmental health; and lastly,
• Cultivating Community: Combating loneliness and isolation for all ages through nature based connection and works skills training for individuals who find access to work challenging
• Super Roots: Creating opportunities for children to use tools, swing high, cook on a fire & fuel their imagination in nature
• Better Nature Eco Therapy: Providing guided session includes nature based mindfulness, a theme for contemplation and simple nature connection practices
• River Vision Project: Making the river more accessible through engaging events and activities, to promote physical and mental well-being
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