“It sounds dramatic, but this place saved my life,” says Wendy Turner, looking out over the Steart salt marshes in Somerset. “I am really loving the colours of all the marsh grasses at the moment, and the flocks of dunlin and plover. The light is just so beautiful.” Turner was once a high-flying international project manager. “But the Covid pandemic resulted in me losing everything – my business and my home – and I had years of abuse in a marriage.” In July 2020, she attempted suicide and woke up in A&E. But then she discovered the Steart nature reserve: “If you can just be quiet, you can find your balance again. I feel like everything is possible here.” Turner is one of the fast-growing number of people using nature to improve their health and wellbeing and she is now helping to boost the rise of “green social prescribing,” where health and community services refer people to nature projects. She has helped co-create a mental health and nature course with the Wildfowl & Wetlands Trust (WWT), which manages the Steart reserve, and The Mental Health Foundation. There is already good evidence of nature’s efficacy, such as a 2019 study showing that a two-hour “dose” of nature a week significantly improved health and wellbeing. The missing link has been connecting health services and nature activities. “These activities have being going for years, it’s just that they often have not had that connection into the health systems to enable them to receive the people who need the benefits the most, and to deliver precisely what they need,” says Dave Solly, at the National Academy for Social Prescribing (NASP), which was launched in 2019 with funding from the Department of Health. But things are changing. Seven NHS care groups from the Humber to Surrey received a combined £5m in government funding in December for projects harnessing nature to improve mental health, including tree planting and growing food. There are also now more than 1,000 social prescribing link workers working in GP surgeries and health clinics, helping doctors link patients to nature activities, as well as arts, heritage and exercise groups. A million people could be referred to social prescribing in the next few years. Among the projects championed by NASP are Wild Being in Reading, an open-water swimming group in Portsmouth, Dorset Nature Buddies, the Green Happy cafe in Northampton, and a Moving in Nature project in Chingford, Essex. Back in Steart marshes, NHS rehabilitation physiotherapist Ralph Hammond is setting off on the weekly 30-minute health walk he leads. He started the walk as a volunteer in 2017, having found there was no suitable walking group for recovering patients. The flat landscape and good paths on the reserve, which hosts otters and samphire beds, are important, he says: “We are trying to break down barriers – the people I am after are not walking at all.” The group have been following the fortunes of a pair of white swans and their cygnets. They find the swans, nestled in the tall grass at the water’s edge with seven large cygnets, which are starting to lose their juvenile brown plumage and stretch their wings. Suzanne Duffus tackles the walk enthusiastically with a sturdy wheeled walking frame. She started coming to Steart after her husband died and is now a volunteer, giving support and encouragement to newcomers. Asked how it was going 10 minutes into her first walk, one woman told Duffus: “I hate this.” But gentle support and reassurance from Duffus led to the woman becoming a regular. Hammond said: “The challenge for the NHS is that it is full of patients who need to move beyond NHS care. The potential is massive, but it is early days.” Increasing access to such activities requires staff dedicated to connecting nature groups to the health service. The WWT’s Will Freeman is doing this at Steart and says: “For a lot of people, it is very exciting, but it can also be difficult as the cultures of organisations may not match.” “A lot of nature reserves have not been that well connected with their communities,” he says, and need to become accessible and socially safe spaces for people who may feel anxious about attending. The social side is key too, he says: “We sometimes miss the simple human side – just having a chat and asking how you are. Nature is an asset that adds to all that.” A new course in October at Steart is being offered to people via a local mental health organisation and a community group. The participants will shape the activities, which could include walking, pond dipping to discover fish, beetles and newts, as well exercises like tai chi on the beach. Helen Stokes-Lampard, chair of NASP and of the Academy of Medical Royal Colleges, says: “[During the pandemic] we have all become increasingly reliant on our local outdoor space as other activity was restricted. From allotments and parks to walks in the country, being outdoors has been a lifeline for many of us.” “However, all too often those who would benefit more from time ‘closer to nature’ simply cannot access it,” she says. “Social inequalities mean that those in the most deprived areas spend less time outdoors. As a practising GP myself, it is so heartening to see so many projects flourish right across the country, making the most of this approach to health provision.” Solly, who is on secondment to NASP from Natural England, hopes that green social prescribing will become routinely offered to those who would benefit: “Instead of a prescription for further medicine, your prescription is to go to an activity, with a suggestion of a few options that work for you.”