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Prescription for nature, fresh air and green space improves mental health

RHS Garden Bridgewater has been involved in a scheme which shows the prescribing of activities in nature has helped more than 8,000 people across England suffering with mental health problems

NHS England’s Green Social Prescribing Programme’s overall aim is to improve people’s mental health and reduce both health inequalities and the demand on the health and social care system. It is thought to be the largest project in the world so far, to ensure that those most in need, living in disadvantaged areas with poor access to nature, receive vital support for their health and wellbeing.

RHS Garden Bridgewater has been involved in the programme, following a government pledge to transform mental health services and increase social prescribing and personalised care. This is part of the NHS Long Term Plan and also forms part of the government’s 25-year environment plan to support more people, from all backgrounds, to engage with and spend time in green and blue spaces in their everyday lives.

The social benefits of gardening

The Green Social Prescribing project has been largely successful at RHS Bridgewater
The programme started in April 2021 with £5.77 million of government funding to seven schemes at sites in Humberside, South Yorkshire, Derbyshire, Nottinghamshire, Manchester, Surrey and the West Country. It reached a broad range of people, with 21% from ethnic minority populations and 57% from economically deprived areas.

RHS Bridgewater has been involved and the position of an RHS Therapeutic Gardener was appointed. Ozichi Brewster, a mental health professional, was choosen for this role. In 2019, Ozichi worked with a local NHS care team and the University of Salford in a programme which aimed to benefit up to 75 people through supported garden activities as a pilot project. The programme ended but social prescribing has continued successfully at RHS Bridgewater. Ozichi and a team of wellbeing volunteers continue to work with people referred through Salford’s award-winning Wellbeing Matters Social Prescribing team. 

A group of friends at RHS Bridgewater during the celebration event in partnership with Greater Manchester NHS to mark the end of the Social Prescribing pilot
In 2019, before the opening of RHS Bridgewater, participants helped to develop and beautify a small back-of-house woodland area (the ‘Spinney’) and an old scout building by creating planters, making structures out of wood such as bug hotels and bird boxes, planting up different areas and creating pathways. Fast-forward to 2024, and the creation of a purpose-built Wellbeing Garden means that participants enjoy a full range of seasonal gardening activities in a space that can be closed off for them to enjoy in peace and privacy, as well as still taking time to enjoy the Spinney which, with the addition of a polytunnel, means participants can spend time indoors on wet weather days sowing seeds, re-potting, herbal tea tasting and immersing themselves in nature-inspired crafts.

Having dealt with depression and anxiety for a third of my life, I assumed there wasn’t much prospect for me. Gardening has been a way to rebuild and find purpose

A participant in the RHS Bridgewater Green Social Prescribing pilot
Some of the groups that have visited so far include care home residents, parent carer groups, NHS frontline workers and other professionals such as a staff team, mental health charities, asylum seeker and refugee groups, community centre groups, and many others.

A participant in the RHS Bridgewater session said: “Having dealt with depression and anxiety for a third of my life, I assumed there wasn’t much prospect for me. I’d previously worked in demanding, high-stress jobs but over time my deteriorating health meant I was no longer able to cope so well. Then I stumbled onto something that made a real difference – gardening. Following a GP referral, I started attending the RHS Bridgewater sessions every Monday. This turned out to be my safe space, and it further fuelled a real love for gardening that the ‘old me’ didn’t see coming. Looking back, this journey into gardening is more than just digging and planting. It’s been a lifeline, a way to rebuild and find purpose.”

Gardening increases happiness

Results of the 2021-2023 GPS project showed that gardening increases happiness and reduces anxiety
RHS Bridgewater also hold group sessions for health care professionals. Cath Applewhite, Matron for Wellbeing, Manchester Foundation Trust, Critical Care Units said: “The sessions are incredibly helpful to our teams, the feedback has been overwhelmingly positive. From the sessions, staff have gone back to visit Bridgewater, become members of the RHS, and become volunteers at Bridgewater. I really do feel that there is some magic in the Wellbeing Garden and Ozichi does a wonderful job in weaving that magic into individuals’ lives to improve them and their health and wellbeing. Thank you so much for all you are doing for the MFT Critical Care Team. We are very grateful.”

The 2021-23 GSP project was assessed by the Department for Environment, Food and Rural Affairs and extended because of positive results until 2025. Results showed people’s feelings of happiness and ‘of finding life worthwhile’ jumped to near national averages and levels of anxiety fell significantly.

Average happiness scores went from 5.3 out of 10 to 7.5 and feelings that life was worthwhile rose from 4.7 to 6.8. Reported levels of anxiety fell from 4.8 to 3.4.

I’ve felt accepted, heard, safe and secure within these sessions. I’ve moved my body, felt a sense of accomplishment and inspiration

A participant in the RHS Bridgewater session
“Each week I’ve learned something new and felt like I have contributed something to the garden and fellow group members. I’ve really enjoyed being in such beautiful surroundings, amongst the plants and crops, tasting new things, seeing, touching, hearing and smelling new things using all of my senses. It has greatly improved the felt sense of my complex PTSD, supported my ADHD and pain levels. The depth of support and care of Ozichi and her wonderful team of volunteers has been such a blessing to experience. I’ve felt accepted, heard, safe and secure within these sessions which have been fun, interesting and varied. I’ve moved my body, felt a sense of accomplishment and inspiration,” said a participant in the RHS Bridgewater session.

Connecting with nature is a lifelong resource

Gardening can be accessible to everybody, regardless of mobility levels
The GP’s surgery is often a place people go to when they don’t know where else to turn. Approximately 20% of people visit their GPs for what is primarily a social rather than a health problem. This is where social prescribing link workers, and other trusted professionals, can make a difference, connecting people to community groups and agencies for practical and emotional support.
 
They can help people who may become isolated, providing time and relationships that are critical to building confidence and reconnecting. There are many different types of nature-based activities and therapies, including conservation, horticulture and gardening, care farming, exercise and sports, or talking therapies in the outdoors.
 
Dr Marion Steiner, a GP in Bristol and part of the pilot project in the west country, said: “Connecting with nature is a lifelong resource with proven benefits for mental and physical health. It can cut through generations of adverse life events. However, many of the patients I treat can’t currently access nature in this way due to a range of personal, social, and cultural barriers. That’s why green social prescribing is so important. This project has the potential to reduce a range of prescribing and treatment costs for the NHS, as well as addressing many health needs and lowering the risk of several diseases, from diabetes to depression.”
 
Ozichi Brewster, Therapautic Gardener at RHS Bridgewater said: “For millennia, we have been aware of the deep restorative power of being in nature and way back much of our livelihood was connected to the outdoors. The disconnection with nature coupled with our sedentary and immersion in a technology-led lifestyle is a result of many of the chronic health problems that we are experiencing. Increasing our regular interaction in the green physical world as part of our lifestyle can be deeply restorative whether it is gardening, walking and sitting in green spaces, the result is always healing, and this is because we are part of the cycle of nature and have an innate need to be connected, without it we get ill.”

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