The concept of a ‘nature prescription’ is gaining momentum in a number of states across America, with many doctors now sending their patients to parks for a variety of physical and mental health issues, including diabetes, obesity, depression, anxiety and asthma. Dr Daphne Miller, a physician and associate clinical professor at the University of California, San Francisco, is one of a growing number of doctors who are no longer simply advising their patients to spend more time in nature, but are now writing formal prescriptions such as the following:
Drug: Exercise in Glen Canyon Park
Dose: 45 minutes of walking
Directions: Monday, Wednesday, Friday, and Saturday at 7:00 am
Refill: Unlimited
Dr Miller has been a champion of nature prescriptions for over a decade, and believes there is ‘no other health-promoting activity that’s more worthy of our time’. She looks forward to a time, in the not-too-distant future, when ‘nature exposure’ will become a critical piece of data collected at the start of every medical encounter, joining blood pressure, temperature, and pulse as the newest ‘vital sign’.
In 2017, Park Rx America (PRA) was established in Washington, D.C., by paediatrician Dr Robert Zarr, with a mission to ‘decrease the burden of chronic disease, increase health and happiness, and foster environmental stewardship, by virtue of prescribing Nature during the routine delivery of healthcare’. The organisation has expanded rapidly in its first year, and there are currently doctors in 13 states, delivering nature prescriptions and receiving individual analysis from PRA of their patients’ park visits. Enthusiasm for Park Rx America is evident with over 8000 parks in 27 states now signed up to the database and ready to participate in the project.
Throughout America there are numerous medicine-nature collaborations, some funded by private hospitals, some by insurance companies, and some by government agencies, including the National Park Service and the Centres for Disease Control and Prevention. Nature-based interventions to treat specific mental health problems are becoming increasingly popular, as both mental health professionals and policy makers become aware of their efficacy and cost-effectiveness. For example, the Green Road Project, which opened in 2016, treats veterans for PTSD and traumatic brain injury, and there are a number of schools such as SOAR Academy in North Carolina, which offer specific nature-based adventures and experiences to treat young people with diagnoses of ADHD and autism.
Nature initiatives promoting mental wellbeing and serving non-clinical populations are also thriving in America. In 2012, the Association of Nature and Forest Therapy Guides and Programs (ANFT) was founded by M. Amos Clifford. ANFT’s mission is to ‘develop and disseminate the practice of forest therapy, leading to its widespread acceptance and integration into health and wellness practices and programs and eco-activism’. Drawing on ‘the latest medical research, new developments in the field of nature connection, and ancient traditions of mindfulness and wellness promotion’, it now considers itself ‘the global leader for forest therapy’, and to date has trained over 600 guides, who are currently conducting forest therapy walks and workshops in 46 countries across six continents.
Nature Sacred is a network of community projects across the States that has been creating small green spaces of ‘refuge, respite and renewal’ for over 25 years. Each ‘sacred place’ is intended to reconnect people with nature, restoring minds and enabling its visitors to regain perspective and find balance.
Kids in Parks is another nature-health partnership, which began in North Carolina but is expanding nationwide. The programme uses paediatricians’ offices as ‘trailheads’ with the goal of getting kids and parents off the couch and into the woods, and there are currently 55 trails in five states.