Changing the conversation about health

Beyond Pills Campaign: Dr William Bird on the impact Green Social Prescribing can have

Reading GP Dr William Bird, the College of Medicine’s Nature Lead and a pioneer of Green Social Prescribing, talks to Sarah Stacey about the healing power of nature for every age group…

Think of the shapes, colours and sounds of nature: softness, curves, greens, blues, golds, dancing gleams of light on water, froths of pale blossom, bird song and burbling streams or splashing crashing waves – often long views to woods, lakes, hills under a big sky.

Now think of modern built-up landscapes: mostly shades of grey, with implacable lines, hard surfaces and high walls. It’s no wonder which environment our millennia-old brains respond to best.

“Being outdoors in nature is comforting and restorative,” says Dr William Bird MBE, a pioneer of what’s now called Green Social Prescribing and a supporter of our Beyond Pills Campaign.

Green Social Prescribing: Dr William Bird was an early passionate advocate of the power of nature to benefit health, a concept now recognised by the Government (Image: Pixabay/StockSnap)

“It goes straight to the autonomic nervous system (ANS). While hard unyielding shapes and surfaces cause a stress response – ‘there’s something wrong here’ – when we go back into natural surroundings, everything shifts round and the brain de-stresses and feels safe again.’

Green Social Prescribing is recognised by the Government, which says ‘The COVID-19 pandemic has highlighted the importance of being outdoors to people’s mental and physical health’. Seven sites were chosen and funded as pilot studies to research how nature can be used to improve mental health and wellbeing. Reviews are due this summer. 

Dr William Bird pictured speaking at a College of Medicine event; the Reading-based GP says being in nature can help reduce negative thoughts

“When you feel negative or low,” Dr Bird continues, “and you go out for a walk in a green and/or blue space – whether to your local park or somewhere wilder, even wandering round your garden deadheading flowers – a lot of your problems fall away.

This reduction in negative rumination is because nature provides positive distraction away from ‘self’, which is a traditional method used to reduce negative thoughts. You could see it as a form of mindfulness.”

He points out also ‘the absence of visual cues of advertising and urban social hierarchy, which can trigger feelings of inadequacy’. (1) 

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As a family GP in the 1990s, Dr Bird set up the first Health Walk scheme, followed by giving his patients prescriptions for Green Gyms. The combination of contact with nature and companionship are, he discovered, major drivers of keeping people active. The benefits of exercise are recognised by NHS England as ‘the miracle cure we’ve all been waiting for’. (2)

“Our evolutionary survival instincts are intrinsically connected to finding shelter, water and food – so most of us subconsciously feel safe when we’re near those natural resources,” he says. Even the high pitched notes of birdsong are proven to be inherently relaxing and reassuring, compared to low sounds like the roar and rumble of traffic, which your evolutionary brain perceives as signaling predators on the prowl. (3)

For some adults, however, being in nature is far from a benign experience. According to Dr Bird, this is usually because they have not grown up with a relationship to nature.

“Sometimes creating this for an adult is as simple as having a picnic and a few beers in a local park,” he suggests. “But ideally we need to give children the chance to have that immersion from the earliest years up to the critical age of 12, according to research. They need to pull on welly boots and make mud pies in puddles and dig for wriggly worms with sticks. To build dams and collect tadpoles in a jar. To climb trees and splosh through streams. As they get older, they can join in groups walking, running or hiking, ore get involved in bird watching or forest bathing.” (4)

The nation’s schoolchildren have been encouraged to walk to school – tapping in at certain points with a card as they go – in the Beat the Street scheme, which Dr Bird helped devise

Converting a tarmacked schoolyard into a green space, perhaps with a garden or vegetable patch, has been shown to help stop bullying. In the former, bullies dominate, often forming gangs, whereas putting children into a natural environment stimulates the creative children to come out on top and bullying drops. There is a clear correlation between children being outside and greater resilience to disease and depression, as well as improvements in behavior for ADHD and autism. (5)

Interestingly, research shows that teenagers find nature important as a refuge. “There’s a lot of evidence that teens will go to a river or hillside, often on their own, to sit and contemplate away from miserable parents and horrible school. They feel comforted, almost safe and that there’s something bigger and separate from a situation in which they may feel judged, bullied or found wanting.” (6)

For older people with dementia, there’s evidence that helping them go into a garden helps to reduce agitation and become calm. (7) 

I also know from a local prison governor in Dorset, he says, that having access to a garden with rescue animals soothes elderly inmates with mental health problems. Young offenders who have grown up in urban environments with little or no access to green or blue space derive significant benefit from the Parachute Regiment’s Airborne Initiative, which provides a five day residential course on Dartmoor aimed at reducing reoffending.

Two things Dr Bird is adamant about: firstly, ‘not being preachy – we mustn’t be the “We Know Best Brigade”. People need to find their own way – we can just signpost opportunities’. And secondly, these opportunities should be routed in the community and accessible via non-medical routes. “Of course it’s great if a social prescribing link worker suggests options but we also need people to be able to go straight to community groups to connect with nature.”

From his starting point in the 1990s with ‘more traditional’ health walks and green gyms – not, incidentally, recommended by his GP colleagues at that point – Dr Bird came up with the concept of empowering people by creating a free fun game for all ages and stages.

Taking place in a particular location over a period of weeks, Beat the Street turns towns into ‘giant games’ where people can get out of restricted environments and walk, run, cycle or even scoot to discover more options in their own neighbourhood.

In towns where Beat the Street takes place, 98 per cent of schools participate and, during the past six years, over 800,000 children have been encouraged to be outside in nature through the game. Teachers and parents are encouraged to take up the challenge and lead children to local parks and green spaces.

Over his 30 years as a ‘very happy GP’, Dr Bird has concluded that ‘for many chronic conditions, modern healthcare at best just delays the progress of disease – at worst it has no impact other than causing side effects and a lifelong dependency on healthcare. Connection to nature, however, can reduce chronic stress, increase social connections and increase physical activity. All of these can prevent and/or limit the progress of many diseases, outside the healthcare system.’

Footnotes:

  1. Rethinking Rumination https://pubmed.ncbi.nlm.nih.gov/26158958/
  2. Benefits of exercise https://www.nhs.uk/live-well/exercise/exercise-health-benefits/
  3. Natural sound facilitates mood recovery https://pennstate.pure.elsevier.com/en/publications/natural-sound-facilitates-mood-recovery
  4. Emotional Affinity toward nature as a motivational Basis to Protect Nature https://psycnet.apa.org/record/1999-10622-002
  5. Physical Activity and Social Behaviors of Urban Children in Green Playgrounds https://pubmed.ncbi.nlm.nih.gov/30772148/
  6. Mental health benefits of interactions with nature in children and teenagers: a systematic review;  https://pubmed.ncbi.nlm.nih.gov/29950520/
  7. Effectiveness of Therapeutic Gardens for People with Dementia: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469939/