Might green prescriptions undermine the benefits of spending time in nature? That was the research story that made the news last week with completely misleading headlines like “Green prescriptions don’t work”. The story was based on research published in the journal Scientific Reports. The cross-sectional study investigated whether time in nature has the potential to help people with mental health issues. The press release suggested that giving people with existing mental health conditions a ‘green prescription’, may undermine some of the benefits. However, as we will see below, there’s more to the study and there is good empirical evidence that well-designed green prescriptions do work.
The aim of the research was to understand people’s motivations to spend time in nature, how often they visited green/blue space, and how social pressure influenced the emotional experience of the most recent blue space visit. The study collected data from more than 18,000 people in 18 different countries. The report acknowledges the work was based on a cross-sectional survey of visit frequency and experience of a recent blue space visit, rather than a pre-post evaluation of specific green prescriptions.
Encouragingly, there was evidence from the findings that some people with mental health issues use nature as part of their own symptom self-management. Previous research has found that people seek out nature for emotional regulation when happy and sad – a topic I considered more deeply in a 2019 paper. The findings also suggested that although pressure to spend time in nature can encourage visits, that pressure can also undermine the emotional and wellbeing benefits of time in nature – highlighted in the press release. The more pressure people felt to visit nature, the less motivated they were and levels of anxiety increased.
In our large scale evaluation of a green prescription based on improving nature connectedness (the closeness of our emotional relationship with nature), rather than time in nature and visits, we found that people with mental health issues reported sustained and clinically significant improvements in mental health. People who reported spending less time in nature before the study benefitted more. Using a smartphone app (now available within Go Jauntly), we asked people to notice and write down the good things in nature, rather than prescribing visits to, or time in, nature – although we designed the app to prompt people to notice nature when they were near a green space if possible. A nature connection and the ‘three good things in nature’ approach is now part of a green prescription pilot being run by RSPB Scotland in collaboration with NHS Lothian’s charity partner, the Edinburgh and Lothians Health Foundation.
A nature connectedness, or moments and minutes approach is also supported by very recent work yet to be published. We’ve found that an audio meditation based on the pathways to nature connectedness improved the wellbeing benefits of time spent in nature. Similarly, in another recent study people asked to “tap into their sense of wonder” on a 15 minute walk in nature found greater awe, joy, pro-social and positive emotions than those that just walked in nature. This also made the news, but again many of the headlines focussed on time and the benefits of a 15 minute walk, rather than the benefits of developing an emotional connection with nature during that walk.
There seems to be an assumption that green prescriptions are simply about visiting nature or spending time in nature. After all, a great deal of valuable research that has shown that nature is beneficial for human wellbeing uses time and visits to nature as a variable. However, research has largely overlooked the relevance of person specific factors such as nature connectedness. Time and visit frequency are both straightforward to measure, they provide a reasonable proxy for nature connectedness, but when nature connectedness is added to the model time matters less.
In a study using similar methods to the work described above, we’ve found that nature connectedness was important over and above getting out into nature for eudaemonic wellbeing – living a worthwhile life. Visiting nature was associated with general health – but not directly to eudaemonic wellbeing. However, nature connectedness influences the way in which people respond to visits and time in nature. This suggests that for health and mental wellbeing interventions are needed that increase both time in, and connection to nature.
All of these results suggest that a more nuanced approach to green prescriptions and human-nature interactions is necessary. It should also be remembered that nature doesn’t have a ‘part-time role’ in wellbeing that prescriptions based on ‘doses’ or visit frequency and time might suggest. Nature is a fundamental, and a close connection to it emerging as a basic psychological need. Green prescriptions need to be carefully designed to consider nature connectedness and the experience in nature, rather than a simple instruction to visit and spend time in nature. Otherwise the prescription might not deliver optimal benefits and undermine motivation for nature-based experiences.
Tester-Jones, M., White, M. P., Elliott, L. R., Weinstein, N., Grellier, J., Economou, T., & Nieuwenhuijsen, M. (2020). Results from an 18 country cross-sectional study examining experiences of nature for people with common mental health disorders. Scientific Reports, 10(1), 1-11. 10.1038/s41598-020-75825-9
Sturm, V. E., Datta, S., Roy, A. R., Sible, I. J., Kosik, E. L., Veziris, C. R., & Miller, B. L. (2020). Big smile, small self: Awe walks promote prosocial positive emotions in older adults. Emotion.
Martin, L., White, M. P., Hunt, A., Richardson, M., Pahl, S., & Burt, J. (2020). Nature contact, nature connectedness and associations with health, wellbeing and pro-environmental behaviours. Journal of Environmental Psychology, 101389.
Richardson, M. (2019). Beyond Restoration: Considering Emotion Regulation in Natural Well-Being. Ecopsychology, 11(2), 123-129.
Details of Tester-Jones et al. (2020) adapted from the press release: https://www.exeter.ac.uk/news/research/title_824180_en.html