There is an ever-growing list of the benefits of natural prescriptions – now researchers say nature could offer a cure for loneliness too.

LONDON

 Kye Aziz didn't consider himself a big nature lover. As an asylum-seeker originally from Indonesia, now based in Melbourne, he'd spent stints of time in the outback and high country. But it wasn't until a socially-prescribed picnic and gardening excursion that he began to see nature in a new way.

"You feel like you're transported somewhere else," says Aziz. "Living in Australia and in Western culture can be very lonely and individualistic – but when we're sitting outside and having a laugh and feeling that togetherness, it just feels like home."

There's a science to that feeling. In the 1980s, in a public health bid to help stressed urban workers heal through nature, the Japanese government invested in a campaign for "shinrinyoku", or forest bathing. 

At first, "it was a feeling, not a science" says Qing Li, a medical doctor and clinical professor at Nippon University in Tokyo. But in recent decades, Li and other researchers have linked forest bathing to lower blood pressure, a stabilised nervous system, fewer stress hormones, boosted immune function, and reduced anxiety, depression, anger and fatigue.

According to the late naturalist, Edward Wilson, these health benefits are a product of "biophilia" – an innate love of nature that underpins our near-universal tendency to interact with plants, animals, and other humans.

By making us feel more calm and present, spending time in nature has the potential to help us overcome the self-destructive thinking patterns that can inadvertently increase loneliness – a subjective experience, not an objective state. One study found time in nature reduces neural activity in the subgenual prefrontal cortex, an area of the brain linked to negative thinking patterns, or rumination, and associated with loneliness.  

Now, in a first-of-its-kind global nature-based social prescribing experiment – spanning from Ecuador to Australia – early findings suggest time spent with others in nature could dramatically change conversations on health, healthcare, and loneliness.

"When people are outside, they talk about being relaxed, being away from it all, how it just makes them feel good," says Jill Litt, a environmental studies and public health researcher at the University of Colorado Boulder, US. "Nature happens to be very good at making people ready for change, vulnerable – and open to new experiences."

In 2019, just before the Covid-19 pandemic would make loneliness a globally-felt public health problem, Litt had a hunch about a solution. While observing the health benefits of community gardening, Litt noticed how "getting your hands dirty and being with others seemed to be really important".

Litt then wondered about other nature-based group activities, like bird-watching and trail-walking, and after reading a paper co-authored by Laura Coll-Planas, a medical doctor and public health researcher at the University of Vic – Central University of Catalonia in Barcelona, she became curious about their potential to tackle loneliness. "What would happen if we mixed these three ingredients: aesthetic engagement with nature, participation in an outdoor activity, and social connection with a group?"

Enlisting Coll-Planas in Barcelona and other researchers in Prague, Marseille, Helsinki, Melbourne and Cuenca (in Ecuador), Litt's team put together a research proposal for a study they called Recetas – a five-year, six-country-spanning investigation into nature-based social prescribing as a means to alleviate loneliness, boost health, and reduce pressure on healthcare.

Now in its fourth year, Recetas is currently running trials, and has already seen support from local health systems, Litt says. "If Recetas is successful, this can really change the model of care to be more person-centred, to rely less on pharmaceutical interventions, and to utilise our communities as part of the way health is managed."

Co-led by Coll-Planas and Litt, who also works at the Barcelona Institute for Global Health, Recetas rests on two growing buckets of evidence. Studies find all kinds of social prescriptions, from cooking classes to art workshops, can reduce feelings of loneliness, while researchers have long documented the many health benefits of spending time in nature. 

In one recent study from the University of Exeter, UK, for instance, researchers found nature prescriptions not only significantly improved the participants' happiness, anxiety, and life satisfaction, but also reduced healthcare costs. Analysis from researchers in Australia shows nature prescriptions also contribute to a reduction in blood pressure.

But Recetas demonstrates one of the largest efforts to study the effects of nature-based social prescriptions onloneliness, specifically. "In our accelerated world, having two hours to be face-to-face [with other people] is very revolutionary and powerful for our health," Coll-Planas says. "But it's the first time we're doing this kind of research in an outdoor setting, and we're already seeing the way nature brings a different type of social connection."

Some of these gains seem to be by design. One study found people living with more green space near their home reported fewer incidences of loneliness. Conversely, people living in  "lonelygenic" environments – marked by factors like car dependency and loss of tree canopy – may contribute to weakened social connection.

Another perspective suggests nature uniquely restores our attention. In this way, natural settings may prime us to have more positive social interactions in the present, instead of dwelling on previous negative interactions from our past. "Some people tell us they feel very good when they're here, outside. Then when they go back home, they're back to the same [negative] state," Coll Planas says.

Still, the researchers agree, nature's tendency to remind us of our past can be powerful, too. "We've seen people talk a lot about nature in a reminiscent kind of way – it reminds them of their childhood, or time with their grandmother, or other positive memories," Litt says.

That's the goal for Nerkez Opacin, a social studies research fellow at the Royal Melbourne Institute of Technology, Australia, who works with local Recetas community partner, Many Coloured Sky, a non-profit agency serving queer asylum seekers like Aziz. "Nature often evokes nostalgia and beautiful memories of home – and even though many of [our participants] fled their homes, nature seems to remind them of a time they felt safe there," he says. "It's always a positive feeling."

Especially since settlement services in Australia can be "really challenging for LGBTIQA+ asylum seekers and refugees", Opacin says his goal is simply to plan "fun things in nature" and help people feel a sense of belonging "not just to each other, but in their new home".

Over the eight week period, those fun things have included bat-watching, beach explorations, and something called "sniff-fari" – a nature walk "where we go out and smell the different plants", Opacin explains.

To arrive at these activities, Opacin and the other five site facilitators focus on "co-creation" – designing the group activities based on participants' interests, as well as what's locally available. Sometimes, that means "nature is more passive" in the activity, he says, like when they simply share a meal together outdoors, for instance.

"It wasn't part of the initial intervention, but sharing a meal proved to be not just attractive for our members to fill their stomachs before we start exploring nature, but also as a way to open up conversations, talk about our different cultures, and understand each other better," Opacin says.

Though the goal of Recetas is to help reduce loneliness, Opacin says talking about it can be challenging.  "We try not to be too pushy since people get very emotional if you talk about loneliness all the time, so instead we would talk about connection, finding friends, and what it means to feel belonging," he says. 

That's been helpful for Aziz. More than any individual friendships, he says he became attached to the group as a whole, and the comfort and familiarity he felt there. "When the group was ending, I realised how much I was going to miss that routine of seeing the same people each week, just spending some time in nature, and feeling that sense of belonging," he says. "It kind of killed my loneliness."