“WowThat hat you got there from the sun on your face is a massive serotonin boost! Alison Greenwood, founder of Nature’s Food, says the charity has successfully offered time outdoors as a treatment for mental health.
Greenwood surrounds Pensford Field, a small patch of woodland tucked behind houses in south-west London. A clear day highlights the early blooms of the black sedges, shining from the pond where a heron watches the little frogs and the shadows of the birch trees on the wooded path. “All these trees and plants give off phytoncides, and they’re also good for your immune system,” says the former NHS psychologist.
Nature’s Dose has already delivered 1,500 one-to-one courses and outperforms NHS standard talking therapy, with a recovery rate of 64% compared to 50% for health services, and a reliable improvement rate of 86% compared to 69%. Unlike most green social prescribing schemes, customers are referred directly by their GPs. “Our nature prescriptions are a real alternative to drugs and other traditional psychotherapies,” says Greenwood.
The key, he says, is rediscovering something very old: “The idea that nature is good for our mental health and well-being has been around for thousands of years. We’re outside, under the sky, [and so] We are animals who spend most of our time locked in schools or cars or offices or homes. As soon as we get out, we are free.
“It’s only relatively recently that we’ve forgotten about it – I’d say it’s an unfortunate piece of our history,” he says.
There are two key components to Nature Prescription Dose: helping people get outside and, once there, begin to notice nature to relax their mind and body. Greenwood insists it doesn’t have to be a hike through beautiful countryside. Sitting on a local park bench is fine.
For some people, the impact is profound. “It’s changed my life,” says Tom Cromans, a soft-spoken man who became a customer three years ago and now works as vice president of operations for Nature Foods.
“I felt very vulnerable and hopeless,” he says. He was diagnosed with bipolar disorder in his early 20s and endured a rough patch of highs and lows, including several stints in hospital. “But every time I would meet with my guide, I would feel better.”
“We will walk by the river,” he says. “The focus was slow, so we’d sit on a bench and we’d look at the river, really appreciate all the little details, try to appreciate all the shapes, the way the light hits the river, the rhythm and the flow.”
Cromans says bipolar can feel like a “life sentence” and severely limit your opportunities: “I’ve never experienced any sort of stable stability, but I haven’t had a mania episode in three years. I’ve never felt more active and more optimistic about the future.”
Explaining the science that covers the benefits of time in nature is a core part of the Nature Scale. The basic theory is that as we have evolved in nature, it has become comfortable as a natural and relaxing focus for our attention, away from the pressures of the artificial world in which we spend most of our time.
There are many special benefits. In addition to serotonin-boosting sunlight and phytoncides that can reduce stress hormones, studies have shown that natural sounds such as water, wind and bird calls improve mood. Nature’s fractal patterns have been shown to aid in recovery from stress and boost alpha waves in the brain, which bring a wonderfully relaxing awakening, while exposure to soil microorganisms also improves mood.
Sal, a Dose of Nature customer, says: “It was a real resource to help you understand the science behind why nature is so good for you – it’s not flimsy and it’s not all chip off the tree.” She was diagnosed with a life-limiting illness last year and was laid off from her banking job.
She says that nature’s diet has changed for her well-being, and she now has a daily routine of going out. “You’re so out in nature, time seems to slow down,” he says. “But even if you don’t feel like going outside, you can still benefit by just looking at pictures of nature or opening the window and getting some sunlight on your face.”
The Nature Dose course is recommended by GPs and starts with a 90-minute assessment and discussion with a psychologist. Clients are then joined by a trained volunteer guide and attend eight weekly outdoor sessions, one-on-one and usually local to them, or at Pensford Field.
The goal is to find the best way for the customer to connect with nature. The course ends with another psychologist’s assessment, but the client can join nature groups as long as they want. It ranges from running and tennis to art, singing and yoga – all outdoors. Everything is free for clients and GP practices.
Emily May Alford became a volunteer guide five years ago, while training as a psychotherapist. “I expected people to be skeptical, but people naturally know that they feel better in nature, although they may not know why. It’s not like you end up in therapy, where you never see a therapist again. We leave them with nature and, of course, groups.”
Another volunteer guide, Kevin Beck, says: “We’ve evolved over millions of years around trees, grasses, birds and frogs, it’s something we’ve been able to de-stress without trying – it just happens, which I think is magic.”
As a plane headed for Heathrow, the pilot Beck joked: “I’m making all this noise, so this is my way of giving something back, sorry for hurting everyone’s mental health.”
Having a volunteer mentor is an advantage, says psychologist Georgina Gould, clinical lead for Nature’s Food, who previously worked in the NHS Child and Adolescent Mental Health Services team.
“Some people have negative experiences with mental health services for a variety of reasons,” she says. “Here they are sitting outside listening to the birds and talking to somebody, it just feels very human and very real, and it automatically creates a different experience for that person.”
The program works and costs according to an independent evaluation by researchers at the London School of Economics. They conducted a randomized controlled trial, following 375 people over two and a half years. They found “clinically meaningful benefits” and concluded that Nature’s Prescription Diet treats mental illness. Both nature and increased social connection were found to be important factors, and researchers estimated that the social welfare benefits were worth eight times the cost of the prescription.
Dr Faisal Islam, a GP at Cross-Deep Surgery at Twickenham, is one of the doctors now referring patients to Nature’s Diet. He has seen it make a real difference in their symptoms and how often they need to contact the exercise. “Many of these patients have moved out of psychiatric services and are either trying counselling, or trying to self-fund [other treatments]. Some of our complex patients, who were kind of “written off,” felt they were getting a new chance.
Islam says medication is an important treatment option but doesn’t work for everyone, while there are long waiting lists for NHS talking therapies such as cognitive behavioral therapy (CBT): “Now we’ve got an alternative – it’s immediately on my mind when I’m assessing a patient with medication and CBT. I honestly think it will save lives and improve patients’ mental health.”
Nature’s Food launched in 2019 and now has 11 staff funded by the NHS, local authorities and charities. “In terms of our demographics, while we are in an affluent area [Richmond]”We have more people who are low-income and from different communities than other services,” says Gould.
There is now also a nature center in North Guildford, and plans for projects in Hounslow, London’s least leafy borough, and possibly Lincolnshire. Greenwood says the goal is to prove the method’s effectiveness in different settings and help other groups develop natural versions.
“We want to get it to as many people as possible,” he says. “It’s for everybody. It’s not just for one section of society. What we’re trying to show is that it will not only work better for you, if you do it in a certain way, but it will work for you for the rest of your life. You don’t have to meet nature.”
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