‘How a prescription to grow a sunflower helped me fight anorexia’

For Emily Hough, nature was too often just something “out there,” a world other than hers, the view from a hospital window.

Years spent in specialist mental health units in Birmingham and London, where she was treated for an eating disorder she had had since she was 12, meant she felt little connection to the countryside or interest in the everyday flora and fauna around her.

That was until five years ago, when a hospital occupational therapist gave her an unusual recipe: to grow sunflowers.

“To be honest, I’ve never planted anything in my life,” Ms. Hough said.

“But I planted that sunflower and just watching it grow and watering it and keeping it out of the shade helped me feel connected for the first time and really appreciate what was around me—and how I could change nature and what nature could actually do for me.

“I was in hospital at the time, so my options were very limited. Fast forward five years and here we are today.”

From these early roots, Ms Hough, now 35, accepted what is officially known as the National Health Service (NHS). “green social purpose”where GPs and health practitioners refer patients to organizations that offer outdoor activities, be it walking, bird watching, rock climbing or urban gardening.

It is intended to complement other, more common treatments and therapies, and is a key part of the government's 10-year plan for NHS England.

The scheme may not work for everyone, but for Ms Hough, who has now moved from Solihull and lives in the countryside, the benefits have been huge.

She is now out of hospital and has become what the NHS calls an “experience expert” (EbE) – someone who uses her experience to develop and evaluate new health services.

She helped form the flagship of the Royal Society for the Protection of Birds (RSPB). “nature's recipe” West Midlands scheme launched earlier this year.

On Friday, World Mental Health Day, the program celebrates its 100th health worker with enough resources to support 1,000 patients seeking outdoor activities.

But the future of green social purpose remains uncertain.

Although the four-year national pilot project, which ended in March, was considered a success independent assessment During the first two years of existence, there are concerns that the burden of funding these schemes is being placed on charities.

Organizations including The Wildlife Trusts, RSPB and Ocean Conservation Trust are calling on the government to allocate more funding to nature recipe schemes and roll them out beyond the original seven trial areas.

Dom Higgins, head of health and education at The Wildlife Trusts, said: “It is clear that nature improves mental health.

“I think the time for questioning the evidence has really passed and people in the system, the NHS and decision-makers understand that.

“We just need a mechanism to make it available everywhere. It's time to seriously fund prevention and provide opportunities for people to improve their health in the communities where they live and work.”

In the first two years, the national pilot program prescribed outdoor activities to nearly 8,500 people, with more than half of these patients living in socioeconomically disadvantaged areas.

Chris Dayson, professor of voluntary action, health and wellbeing at Sheffield Hallam University, who was part of the team evaluating the scheme, said it resulted in a “truly statistically significant improvement in well-being” for patients.

The evaluation also found that the scheme delivered an economic and social return – not least by getting people back into work – of £2.42 for every £1 invested.

When contacted by the BBC, the government did not comment on the future of green social prescribing but said an assessment of the second two years of the trial scheme would be published “in due course”.

Although environmental social prescribing is intended to complement rather than replace traditional treatments and therapies, there are concerns that they do not address larger social problems associated with mental health.

Rob Poole, professor of social psychiatry at the Center for Mental Health and Society, said that while he was not against green social prescribing, it was “an inadequate response to the social determinants of health, such as poor housing, poverty and deteriorating social infrastructure.”

“This is not a lifestyle choice. They cannot be solved with time-limited measures, no matter how much better you feel doing green activities in the short term,” he said.

But Shannon Kang, an NHS health and wellbeing trainer at University Medical Practice in Birmingham, who recently completed training in natural prescribing with the RSPB, said she had seen “amazing results” – a reduction in patients' anxiety and stress levels.

For Ms. Hough, exposure to the natural world changed her life: “I was skeptical. For years I walked around without appreciating nature. But I sincerely believe that nature really helped me to save myself. She gave me hope.”

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