Green Prescriptions: Why Scientists Say Nature Belongs in Mental Health Care

When the United Kingdom Government published its 10 Year Health Plan for England, it promised nothing less than the rescue of a health system it described as broken and increasingly unaffordable. The strategy rests on three headline shifts: from sickness to prevention, from hospital to community, and from analogue to digital, with mental health placed alongside physical health as a national priority. Yet according to a review published in PLOS Mental Health, the 171-page document contains not a single reference to nature or biodiversity. For a growing community of researchers, that omission is more than a rhetorical gap. It represents a missed opportunity to embed one of the most accessible, low-cost and broadly beneficial resources for mental health directly into the architecture of national health policy.

The review, authored by Giulia Vivaldi, Emeka Chukwusa, Nick Bridge, Michael Smythe, Ioannis Bakolis, Lisa Page, Rhiannon Thompson, Matthew White and Andrea Mechelli, argues that the benefits of nature and biodiversity to human health are now substantial enough that they should be treated as core infrastructure for prevention and treatment rather than as an environmental afterthought. The authors focus their analysis on mental health, although they note that many of the same benefits extend to physical health. Their central claim is that harnessing nature could play a substantial role in supporting the revised goals of the 10 Year Health Plan, particularly in preventing illness and enhancing treatment at the community level, which is precisely where the plan says it wants the health system to move.

The logic of the argument begins with prevention. Mental ill health places an enormous and rising burden on health services, and the costs of treating conditions once they are established far exceed the costs of reducing the exposures and circumstances that give rise to them. Access to green and blue spaces, from urban parks and community gardens to rivers, coastlines and woodland, is associated in a large body of research with lower levels of psychological distress, reduced symptoms of depression and anxiety, better emotional regulation and improved cognitive function. The mechanisms proposed are multiple and complementary: time in natural environments encourages physical activity, reduces exposure to noise and air pollution, restores attention, lowers physiological stress, and creates settings for social contact that protect against isolation, itself a major risk factor for mental illness.

Biodiversity adds a further dimension that is often lost when green space is discussed purely in terms of quantity. The review emphasises that the richness and variety of living things in an environment, from plant species to birdsong, appears to matter for the psychological benefits people derive from it. Environments degraded by pollution, monoculture planting or poor management may be green on a map yet deliver little of the restorative value that healthier ecosystems provide. This reframes biodiversity loss not only as an ecological crisis but as a public health problem, because the erosion of species and habitats quietly diminishes the therapeutic capacity of the landscapes that millions of people encounter daily, particularly in dense urban areas where access to high-quality nature is already unevenly distributed.

The authors do not confine themselves to describing the problem. They outline concrete examples of effective approaches and techniques that could be incorporated into the 10 Year Health Plan. Among the most prominent are nature-based interventions delivered through or alongside health services, in which clinicians incorporate structured time in natural settings into care pathways. Green social prescribing, a model that has been piloted in England, connects patients with community-based activities such as gardening, conservation work, walking groups and outdoor mindfulness, offering an alternative or complement to conventional treatment for mild to moderate mental health difficulties. Therapeutic horticulture, care farming and wildlife volunteering combine exposure to nature with purposeful activity and social connection, addressing several drivers of poor mental health at once.

Prevention-oriented approaches extend beyond the clinic. The review points to the design and management of the environments in which people live as a form of population-level mental health policy. Greener streets, school grounds and hospital grounds, protected access to parks, and the restoration of urban rivers and wetlands all shape the daily dose of nature that residents receive without any individual needing to seek it out. Because the benefits of nature accrue across the whole population rather than only among those who present to services, environmental interventions operate upstream of the health system in exactly the way the Government’s shift from sickness to prevention demands. The authors argue that this alignment makes nature a natural fit for the plan’s stated priorities, even though the plan itself never names it.

The community pillar of the strategy is equally relevant. The 10 Year Health Plan envisages care moving out of hospitals and into neighbourhoods, and nature-based programmes are inherently community-delivered. Community gardens, park-based walking schemes and local conservation groups depend on and strengthen neighbourhood networks, often run by volunteers and third-sector organisations rather than clinical staff. This makes them comparatively inexpensive to scale, and it simultaneously builds the social fabric that supports mental wellbeing. In the authors’ framing, investment in local green infrastructure does double duty: it creates the settings in which prevention happens, and it supplies the venues in which community-based treatment can take place.

None of this is presented as straightforward. The review is candid about the challenges to implementation and proposes potential solutions. Questions of equity loom large: access to good-quality green space is socially patterned, and without deliberate policy attention, nature-based interventions risk reaching those who already enjoy abundant access to nature while leaving behind the communities with the greatest need. There are questions of evidence and standardisation, since nature-based interventions vary widely in dose, setting and delivery, complicating efforts to evaluate them with the rigour expected of clinical services. There are workforce and funding questions, as green social prescribing requires trained link workers, willing community organisations and sustainable commissioning rather than short-term pilot funding. And there are practical constraints of urban land, competing priorities and the maintenance burden that green spaces carry once created.

The proposed solutions follow from the challenges. The authors suggest that embedding nature within national strategy would allow these interventions to be commissioned, evaluated and scaled in a systematic way, rather than depending on fragmented local enthusiasm. Attention to biodiversity quality, not just green quantity, would ensure that the spaces created deliver genuine benefit. Partnerships between health services, local authorities and environmental organisations could share costs and expertise, while targeted investment in deprived and nature-poor neighbourhoods would address the equity gap. Rigorous evaluation, built in from the start, would strengthen the evidence base and allow commissioners to direct resources toward the models that work best for specific populations and conditions.

The broader significance of the review extends beyond the United Kingdom. Health systems around the world face the same squeeze of rising mental health need and constrained budgets, and many governments are searching for preventive, community-based and cost-effective approaches. The argument advanced by Vivaldi and colleagues is that the evidence has matured to the point where nature and biodiversity deserve a place in that search, not as a romantic add-on but as a measurable component of public health infrastructure. The omission of a single mention of nature from a 171-page plan for a healthier nation, the authors suggest, is therefore not a small oversight but a signal of how far policy still has to travel to catch up with the science. Bringing the natural world into the heart of mental health strategy, they conclude, could help deliver the prevention, community care and sustainability that the 10 Year Health Plan promises, while simultaneously supporting the ecosystems on which that benefit depends.

Subject of Research: Nature-based approaches to mental health care and prevention in UK health policy

Article Title: Nature and the mind: Towards nature-based mental health care and prevention

Article References: Vivaldi, G., Chukwusa, E., Bridge, N., Smythe, M., Bakolis, I., Page, L., Thompson, R., White, M., & Mechelli, A. (2026). Nature and the mind: Towards nature-based mental health care and prevention. PLOS Mental Health, 3(8), e0000647. https://doi.org/10.1371/journal.pmen.0000647

Image Credits: AI Generated

DOI: 10.1371/journal.pmen.0000647

Keywords: nature-based interventions, mental health, biodiversity, green social prescribing, public health policy, prevention, community care, UK 10 Year Health Plan, urban green space, ecosystem health, therapeutic horticulture, health equity