Green prescribing and Natural Happiness

I see green prescribing as one of the more hopeful innovations by the NHS in recent years. This blog explains briefly what it is, and shows how my Natural Happiness methods can contribute to it.

NHS England’s website has a whole section about green social prescribing, see here. It includes details of their pilot projects and the positive results, plus a link to the Green Prescribing Toolkit, and a lot of other useful links.

They define green social prescribing as “the practice of supporting people to engage in nature-based interventions and activities to improve their mental and physical health”. Their seven ‘test and learn’ pilots in 2021-23 involved 8500 people, and a remarkable 85% uptake of green prescriptions by patients. The evaluation showed “positive improvements in mental health and wellbeing and strong engagement in communities”…

Green prescribing group in action (image courtesy of NHS England)

In essence, what Natural Happiness offers is helping people to see the parallels between their own human nature and the ecosystem they’re working with, and to use organic cultivation methods to grow their own wellbeing and resilience.

Here’s an example: in organic systems, composted waste is the main source of fertility for future growth. I’ve found that people readily see the parallel for human nature: many of us spend a lot of energy pushing down difficult feelings and anxious thoughts. I recognise that major issues may need professional help such as counselling, but there are simple methods like circular breathing, stomping, and ranting, which can harness the positive energy out of everyday minor issues.

Alan with a Natural Happiness group at Hazel Hill Wood

I developed the Natural Happiness methods through working with a range of people, including some typical green prescribing groups: clients suffering from depression, bereavement, and physical health issues such as Alzheimer’s and cancer. Typically we’d weave a couple of processes into a 3-hour conservation session.

Another analogy which works well is roots and fruits. At Hazel Hill, I often invite people to do a short, guided meditation, sitting with a tree: imagining that they too have a root network, a trunk, and spreading branches. These represent the resources and stability they depend on (roots), the ways they process resources and handle stress (trunk), and their fruits or outputs (branches). I invite them to feel into whether these three elements are in balance, or if they may need to nourish their roots or prune back some branches.

Nourish your Roots and Compost your Troubles are Seeds 1 and 3 in my recent book, Natural Happiness: Use Organic Gardening Skills to Cultivate Yourself. The early chapters explore how we can use a range of gardening methods, including crop rotation (to avoid burnout), mulching, and soil structure improvements. Later chapters are probably less relevant to green prescribing, on cultivating community and growing through climate change.

It’s written as a self-help book, with processes explained to apply these analogies. If you facilitate green prescribing groups, you should be able to lead these processes from the book. Clearly in this context one has to be careful about clients’ learning capacity and emotional resilience: one benefit of the Natural Happiness model is that it is literally grounded in down-to-earth methods, and it can enrich and inform anyone’s experience of Nature contact.

Research shows that GP practices who were set up for green prescribing were enthusiastic: a key element was a ‘link worker’ who was part of the practice team. Their role is literally pivotal: GPs could refer patients to them, the link worker would interview patients and give them an informed green prescription. The link worker’s other key role is to liaise with local host organisations to ensure a good fit between their needs/capacity and the patients’.

Done well, green prescribing benefits everyone involved. GPs told me about ‘nuisance’ patients who constantly badgered them for pills and were now healthier and happier. The organisations hosting prescribees may have a new source of volunteers, although volunteers are rarely a free resource: it takes plenty of staff time to welcome, deploy and support them.

The 2019 Monitor of Engagement with the Natural Environment (UK) found that there are deeply entrenched disparities in the ways in which nature is used and accessed by people from different socioeconomic groups and ethnic backgrounds. Barriers to nature contact are complex and systemic, and awareness of this is important if GSP is to avoid the pitfalls of operating along the lines of existing societal inequalities, potentially excluding those most at risk of poor mental health from participation.

However, a major strength of GSP is the diversity of settings and activities that can be utilised, meaning this moment can also be viewed as an opportunity to develop a highly inclusive sector, and to tailor activities with appropriate materials and accessibility to specific groups of people or specific needs.

Another potential barrier to the creation of an effective GSP system is that- as yet –  there is no real clarity on how money flows around the system. The current system assumes that supervised and guided nature contact is an infinite and free resource which is a fallacy that will need to be addressed. A valuable guide to green prescribing in general is The Handbook for Nature on Prescription 2021, Exeter University), which you can download via this link.

The top three activities the NHS lists for green prescriptions are:

• Local walking schemes.
• Community garden projects.
• Conservation volunteering.

I’ve had positive experience of sharing Natural Happiness methods in all three of these situations, so let’s explore how it could help.

Conservation volunteers at Hazel Hill Wood

• Deeper Nature connection: green prescribees are often stressed and preoccupied with their condition. I invite them to slow down and connect more fully with Nature: for example, by mindful walking, using all five senses, sitting with a tree, or maybe using my Tree Talk
• Natural energy sources: to explore this, I’d briefly describe how large-scale farms depend on artificial fertiliser to push growth, and on chemicals to suppress problems, and invite people to see the parallels for people. Then I’d invite them, during the activities of the session, to harness natural, clean energy sources such as appreciation and inspiration.
• Composting: in organic cultivation, waste is transformed into energy for growth, and people can do the same with negative feelings or anxious thoughts. I always explain that bigger issues may need professional help, but then demonstrate a short breathing exercise to compost minor issues.

With green prescription groups, I’d expect attention spans for this material to be limited, so I’d keep interventions brief, and intersperse them with physical activities. There are full write-ups of these and other possible processes in my book, Natural Happiness: Use Organic Gardening Skills to Cultivate Yourself, and at www.naturalhappiness.net.