Social Prescribing in Natural Spaces: The RECETAS Project

[Laura Hidalgo is Research Assistant at Barcelona Institute for Global Health (ISGlobal) and researcher of RECETAS project. This text has been published originally on Espai S@alut, a Diputació de Barcelona's newsletter.]

The COVID-19 pandemic and the resulting lockdown and social-distancing measures have brought about loneliness, social isolation and the loss of connections within our communities. Depression and anxiety rates have soared as COVID-19 has increased the pressure on our already overburdened mental health systems. In Europe alone, 30 million adults reported feeling lonely even before the COVID-19 pandemic. Loneliness knows no geographical, economic, cultural or social boundaries. It affects all age groups without exception. However, loneliness is reported more frequently by women, is more prevalent in adolescents and older people, and particularly affects people with limitations in their daily lives and low socio-economic and educational levels. Identifying innovative solutions to promote social connections and reduce the burden on the mental health system is a high-priority task, as reflected in the European Framework for Action on Mental Health and Wellbeing.

Depression and anxiety rates have soared as COVID-19 has increased the pressure on our already overburdened mental health systems. In Europe alone, 30 million adults reported feeling lonely even before the COVID-19 pandemic

The aim of social prescribing is to promote social connectedness and participation in meaningful activities, which in turn are associated with better physical, cognitive and mental health. This approach also allows health determinants to be addressed from outside the health sector and provides doctors, nurses, social workers, and other health and social care professionals with non-medical referral options that dovetail with existing treatments, with the aim of promoting connectedness and, by extension, mental wellbeing and healthy behaviours. These referral options include community-based artistic activities, walking groups, cycling and community gardening.

Collserola Natural Park (Barcelona) / Abel Pau (Flickr)

Social prescribing programmes that specifically include access to nature as a major component are also known as nature-based social prescribing. The evidence suggests that nature-based social prescribing activities can strengthen social structures and improve long-term mental and physical health by activating intrapersonal, interpersonal and environmental processes, although more research is needed to understand the impact of social prescribing as an intervention strategy. Social prescribing can be used to reach a wide range of population groups, including those at high risk, such as minors at risk of exclusion (e.g. due to teen pregnancy), immigrants, older adults, economically and linguistically isolated populations, and people unaccustomed to nature and the outdoors.

Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces (RECETAS) is a project funded by the European Commission’s Horizon 2020 research programme and coordinated by the Barcelona Institute for Global Health (ISGlobal). Six cities in Europe, Latin America and Australia will be involved in the project.

Treating people experiencing loneliness as beneficiaries of nature-based solutions and green infrastructure is a new application of these interventions

The project aims to address loneliness and quality of life through nature-based social prescribing. The necessary social and technological infrastructure will be created and maintained to foster social and community support and cohesion. Nature-based social prescribing will be the nexus between people, spaces and institutions that form social networks and connections with existing investments in nature-based solutions, green infrastructure (e.g. parks, gardens and green roofs) and blue spaces (e.g. lakes and rivers) in order to mitigate the effects of pollution, extreme weather (e.g. heat) and other environmental stressors. Treating people experiencing loneliness as beneficiaries of nature-based solutions and green infrastructure is a new application of these interventions.

Recovered riverfront of the Besòs (Sant Adrià de Besòs, Barcelona) / Yvette Moya-Angeler

In Catalonia, the partners of the RECETAS project are the Catalan Department of Health (Public Health Agency of Catalonia) and the Health and Ageing Foundation at the Autonomous University of Barcelona (UAB). Together with ISGlobal, and in coordination with the other cities, these partners will carry out a clinical trial in the Barcelona metropolitan area within the framework of the project. The trial will include people over 18 years of age living in socioeconomically disadvantaged urban areas of Barcelona province with high rates of immigration, unemployment and older adults at risk of social isolation. The prescribed activities will take place at the recovered riverfronts of the Llobregat and Besòs rivers, the coastal waterfront, urban and wooded parks, and historical and botanical gardens throughout the Barcelona metropolitan area.

The RECETAS project will use participatory research methods, social network analysis, qualitative studies, health economics and randomised controlled clinical trials to test the efficacy and cost-effectiveness of nature-based social prescribing, with the aim of fostering connections between populations experiencing loneliness by providing inclusive, accessible opportunities for socialisation in green and blue outdoor urban spaces. The findings will provide evidence on the effectiveness of nature-based social prescribing in different contexts, as well as methods and tools for replicating this approach in urban areas across the globe.

The project is oriented towards improving policy and real-world practices, with the aim of improving people’s health and reducing loneliness by fostering connections among people who are experiencing loneliness with the help of professionals and significant investments in nature-based solutions and green infrastructure, while also easing pressures on health systems. If successful, this approach will systematically reduce loneliness, promote and sustain active and socially connected communities, and reduce health inequalities by connecting people to nature in a meaningful way.