The Humber and North Yorkshire Green Social Prescribing Programme was one of seven ‘test and learn’ sites established across England as part of a cross-government initiative on green social prescribing, coordinated by the Department for Environment, Food and Rural Affairs (DEFRA). The programme aimed to connect individuals experiencing mild to moderate mental health difficulties with local, nature-based activities such as gardening, food growing, care farming, and creative outdoor experiences.
Delivered in collaboration with the HEY Smile Foundation and the NHS Humber and North Yorkshire Integrated Care Board, this initiative included one of the first quantitative, pre- and post-intervention evaluations of green social prescribing in England. The cohort evaluation for the Green Social Prescribing paper was part-funded by the NIHR Applied Research Collaboration Yorkshire and Humber (YHARC) and focused specifically on mental health outcomes, providing evidence that green social prescribing has potential as an innovative, community-based approach to supporting mental health and wellbeing.
More than 200 participants engaged in a diverse range of nature-based activities, which were categorised into three primary typologies: (1) horticulture and care farming, (2) sport and physical activity, and (3) creative and alternative outdoor-based activities. The majority of participants attended activities on a weekly basis, with the duration of engagement ranging from one to four weeks, five to eight weeks, and nine to twelve weeks or more. Participants reported mild to moderate mental health issues, high levels of poor physical health, and many lived in areas characterised by high levels of socioeconomic deprivation.
Mental health and wellbeing outcomes were assessed before and after engagement in green social prescribing activities using the Office for National Statistics’ (ONS-4) measures of personal wellbeing and the Hospital Anxiety and Depression Scale (HADS). The evaluation found statistically significant improvements in wellbeing—specifically life satisfaction, happiness, and a sense of life being worthwhile—as well as significant reductions in symptoms of depression and anxiety. The most pronounced mental health and wellbeing benefits were associated with longer durations of engagement (5–8 weeks and 9–12 weeks), and with participation in horticulture and care farming activities.
The findings of this evaluation indicate that green social prescribing represents a valuable community-based asset with the potential to alleviate pressure on mental health services in the context of growing unmet need. This is particularly pertinent given the rising prevalence of mental ill-health, the increasing burden of long-term conditions, an ageing population, and a healthcare system where demand persistently exceeds capacity. The results demonstrate that green social prescribing not only supports positive health outcomes at the individual level—with treatment effects for anxiety and depression comparable to, and in some cases exceeding, those associated with conventional primary care interventions such as cognitive behavioural therapy (CBT)—but also aligns with wider system goals. Specifically, it contributes to a strategic shift towards prevention, the delivery of care closer to home, and the strengthening of community-based support services.
