Green social prescribing
Nature-based or green social prescribing links people with structured and facilitated nature-based activities that have been specifically designed for people with defined health needs. Chief among nature-based interventions are social and therapeutic horticulture (using gardening, food growing and plants to support wellbeing); care farming (involving the therapeutic use of agricultural landscape and farming practices); and environmental conservation (involving activities designed for conservation and management of natural places for health and wellbeing). Green social prescribing is an important component of the government’s Covid-19 mental health recovery plan, which sets out a whole-person strategy to support people living with mental illness.
In 2021 Defra, NHS England and NHS Improvement, Ministry of Housing, Communities and Local Government, Department of Health and Social Care, Natural England and Public Health England have made an investment of over £5.5 million in setting up seven ‘test and learn’ green social prescribing sites in England, focusing especially on communities whose mental health has been disproportionately affected by Covid-19.
The aim of the ‘test and learn’ sites is to embed green social prescribing into communities in order to:
Improve mental health outcomes.
Reduce health inequalities.
Reduce demand on the health and social care system.
Develop best practice in making green social activities more resilient and accessible.
The HNY GSP programme, led by HEY Smile Foundation, was commissioned as one of seven sites across England to develop a ‘test and learn’ site for GSP. A central objective of the HNY GSP programme was to ‘test the ways in which connecting people with nature could improve mental wellbeing’. To this end, a cohort evaluation was conducted (overseen by NIHR ARC Y&H's Mental Health theme at the University of York) to collect before and after outcome data to demonstrate the mental health benefits of engaging in nature-based interventions linked to the GSP initiative across the six places of the Humber and North Yorkshire Health and Care Partnership: East Yorkshire, Hull, North Yorkshire, Vale of York, North Lincolnshire and North East Lincolnshire.
The evaluation project, was co-led by Dr Peter Coventry (Department of Health Sciences) and Prof Piran White (Environment and Geography). Outcome measures were taken at two time points: before participants engaged with the ‘green’ or ‘blue’ activity and on completion of their interaction with the activity (or at 3 months, whichever was sooner). The outcome measures used were the ONS-4 and the Hospital Anxiety and Depression Scale (HADS) and were administered by link workers (or equivalent job title), mental health and occupational therapy teams. Data were captured on demographics, reason for referral, clinical characteristics, and referral route of individuals taking part in the cohort, alongside the activity they took part in and the number of sessions they attended. Data collection began in February 2022 and finished in March 2023.
The findings will feed into and inform the overall national evaluation of the green social prescribing test and learn sites which aims to understand how to scale and embed green social prescribing into primary and community care effectively.
The NIHR YHARC, in partnership with UCLAN and the University of York, also hosted the evaluation of a green social prescribing initiative led by the West Yorkshire Health & Care Partnership.