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Author: Dr Dimity Williams
Date: April 2015

By Dr Dimity Williams, Doctors for the Environment Australia

Instinctively, we want contact with nature- we’d all like the office with a view of the park instead of a view of the carpark. Yet few doctors are aware of the health benefits associated with regular contact with nature and this is despite an ever expanding evidence base. I hope this article will inspire you to bring nature into your practice and the prescription of a ‘green hour’ into your management plan for the wellbeing of not only your patients and your staff but for you too.

I like to think of contact with nature as analogous to a swimming pool, having a natural view up the shallow end and a wilderness experience like bushwalking in an old-growth forest up the deep end. In the middle is being in the presence of nature whilst riding or walking to work through a green space, gardening or chatting to friends in a park.

Studies have shown that patients in a hospital whose views are of nature rather than buildings recover more quickly, need fewer medications and are discharged home earlier. The new Royal Children’s Hospital in Melbourne has taken this research on board and in its new building the majority of patient’s rooms have views of the surrounding Royal Park- it is a hospital within a park! Inside there is a meerkat enclosure taking up an entire wall of the outpatients department- sure beats looking at outdated magazines or a tv screen when you’re waiting!

We can apply this knowledge to general practice by bringing some nature into our practices with pictures of nature when views are not possible and living things like potted plants or aquariums.

Professor Mardie Townsend from Deakin University has long studied the importance of contact with nature on health- particularly on mental health. She talks about us suffering from environmental deprivation when our lifestyle has led to us being cut off from regular contact with nature. This nature deprivation increases our risk of suffering from anxiety and depression.

Conversely, regular contact with nature is beneficial to our emotional wellbeing – it elevates mood, reduces stress and enhances concentration. The evidence base for this is outlined in beyondblue’s literature review ‘Beyond Blue to Green’. So as well as referring our depressed patients to a psychologist I propose we should be advising them to spend a ‘green hour’ each day in a park either when walking or cycling to work or in a lunch break. This is something we should be doing ourselves too, especially on those stressful days when we need to refocus for the afternoon session. I like to think of this lunchtime nature break as a preventative mental health measure.

Dr Robert Grenfell from The Heart Foundation is in the process of evaluating a recent health intervention in the Geelong area in which over 1000 participants were engaged in nature based activities for health. Patients were referred from community programs like Headspace and Maternal and Child Health Nurses as well as GP’s who were able to identify and refer their patients with complex medical problems like diabetes, cardiovascular disease and osteoporosis either to a website or to a supervised group walk depending on the level of support needed. The results so far are promising and hopefully this type of program will come to other regions. In the meantime, perhaps larger clinics could run their own ‘green exercise’ walking program for suitable patients.

Up the deep end of nature experience is ‘wilderness therapy’ where time in the wild provides solace, escape and adventure. This has been shown to improve outcomes for youth with psychosocial health problems and anecdotally to this particular GP!

I hope you can now see how this spectrum of ‘nature therapy’ can benefit us all and you can start today to bring nature into your clinical practice.