A £5.77m cross-government funded project has shown that widening access to green social prescribing can promote wellbeing and improve mental health.
Researchers from the University of Exeter, in collaboration with the University of Sheffield, Sheffield Hallam University and the University of Plymouth, have today (4 September) published a report for the Department for Environment, Food and Rural Affairs (Defra) on their findings on efforts to increase access to green social prescribing and its effectiveness in tackling and preventing mental illness.
Green social prescribing is the practice of supporting people with mental health needs to take part in activities in nature. Referrals are usually from GPs, community mental health teams or social workers, but people can also refer themselves. Social prescribing link workers and other trusted professionals connect people with community groups and agencies to provide practical and emotional support. There are many different types of nature-based activities and therapies, such as conservation, horticulture and gardening, care farming, exercise and sport or outdoor talking therapies.
Professor Ruth Garside, from the European Centre for Environment and Human Health at the University of Exeter, said: “Our findings are important because they demonstrate that green social prescribing is an effective way of helping people with their mental health. But this is just the start and there is now more government investment supporting the leadership and systems change that we know green social prescribing needs to succeed. However, there needs to be continued commitment from policy makers to understand the needs of communities and enable more diverse people to connect with nature, alongside investment in those organisations that deliver nature-based activities.”
In total, 8,339 people with mental health needs took part in nature-based activities in seven Green Social Prescribing Project trial-and-learn pilots across England. Compared to many other social prescribing initiatives, the project reached a wider range of people, including children and young people under 18, ethnic minority populations (21 per cent) and people from socio-economically deprived areas (57 per cent).
Before participating in nature activities, happiness, anxiety, life satisfaction and a sense of life being worthwhile were worse than national averages. After participating in the project, well-being had improved and overall happiness and anxiety were in line with the national average. Levels of life satisfaction and a sense of life being worthwhile had also improved significantly.
Participants in the Green Social Prescription said:
“After the group I feel joyful, happy, calm. I have a sense of accomplishment and I feel that my well-being increases. I really want to attend.”
“It works better for me than medication. It works better for me than cognitive behavioural therapy. Most of my problems are trauma-related, so NICE guidelines don’t recommend medication for borderline personality disorder. I have my own therapy and that’s really valuable, but this is on a par with that.”
At an average cost of £507 per participant, researchers also found that green social prescribing is a cost-effective method of supporting people with a broad spectrum of mental health needs, 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 sits on the committee for the Bristol, North Somerset and South Gloucestershire Test and Learn Pilot Site. She says: “Connecting with nature is a lifelong resource with proven benefits for mental and physical health. It can prevent generations of adverse life events. However, many of the patients I treat are currently unable to access nature in this way due to a range of personal, social and cultural barriers. This is 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 reducing the risk of a range of diseases from diabetes to depression.”
Dr Annette Haywood, Head of Public Health Section at the Sheffield Centre for Health and Allied Research (SCHARR) and Principal Investigator of the study, said: “I am delighted to have led this national evaluation of green social prescribing. There is already a wealth of evidence demonstrating 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, showing that nature activities are a relatively cost-effective way of supporting people with a range of mental health needs.”
The project was funded by Her Majesty’s Treasury Shared Outcomes Fund and a number of central government departments and external agencies. Partners included: the Department of Health and Social Care, the Department for Environment, Food and Rural Affairs, Natural England, NHS England, NHS Improvement, Public Health England, Sport England, the Department for Levelling Up, Housing and Communities and the National Academy for Social Prescribing.