Adopting a greener lens on mental health

In this blog post we discuss the ongoing review into rising demand for mental health services and call for the review's scope to include include planetary health and sustainability.

On 4 December 2025, the UK Government launched an independent review into rising demand for mental health, autism and ADHD services. The interim report published on 31 March 2026 outlines the progress that the independent review has made in understanding complex prevalence patterns and the availability and access to appropriate support. Phase 2 of the review will further explore these patterns and go on to make recommendations.

Whilst the report authors are cautious in emphasising the need to carefully interpret insights and evidence across various sources (data from population surveys, clinical services and lived experience), there is an emerging picture of a significant surge in demand, in the context of clinical systems already under pressure leaving individuals waiting too long for assessment and support. In addition, there are increases in people reporting distress from loneliness and attention difficulties which greatly impact people’s lives, but where there is variable availability of support across localities.

We commend the review’s ambition to forge a “path towards a fairer, more proportionate and more coherent system in which support is better matched to need and available earlier – without unnecessary delay or dependence on diagnosis alone”. We agree that we need to think beyond the current system of waiting lists, prescriptions and services so that people can be supported in a more holistic and timely way.

That’s why we are calling for the scope of phase 2 of the review to include the links between planetary health and sustainability, and mental health and neurodiversity. To include ‘One Health’, in other words.

Our patients, clients and colleagues don’t exist in a hermetically sealed medical bubble, and neither do we. The health of all of us is interconnected with the health of the environment. We are not saying that nature therapy alone cures mental illness, however there is increasing evidence that nature is an important component in supporting the recovery and wellbeing for the majority of people with mental health difficulties and indeed the whole population.

Why nature matters

The international evidence for the benefits of nature for human health is now overwhelming. Study after study reports on what we all intuitively feel – that contact and engagement with nature is good for us, and supports better mental and physical health.

Exposure to green and blue space is associated with lower risk and severity of depression and anxiety, reduced stress, and improved cognitive and emotional functioning. Large population studies also suggest that greener environments may be linked to lower risk of developing psychiatric disorders in adulthood. For children and adolescents, regular contact with nature has been associated with fewer behavioural difficulties, including symptoms linked to ADHD such as inattention and hyperactivity.

Access to nature supports health equity too: greener neighbourhoods are linked to better wellbeing and lower service demand. The UK Government’s own Environment Strategy has set a target for every household to be no more than 15 minute’s walk from a greenspace.

It’s not just about ‘being outside’, however. Recently, researchers have highlighted the importance of nature connectedness — our felt relationship with the natural world. Higher nature connectedness is consistently linked to improved wellbeing, resilience and sense of purpose. And it’s about giving back to nature – many studies show that a deeper sense of connection to nature leads to individual and community behaviours that support climate and nature goals.

Nature-based interventions work

The Government’s green social prescribing (GSP) pilots demonstrated that nature-based support for mental health works. They found real-world improvements: reduced loneliness, fewer GP appointments, better mental-health outcomes and positive return on investment. Other studies show benefits from nature-based activities including walking groups, horticulture, ecotherapy and nature-based coaching, including for people with ADHD, autism and severe mental illness.

Recommendations for the review

In our view, to meet the scale of the challenge, the review should:

1. draw on the Government’s own evidence base, including Natural England and the GSP evaluation
2. link residential greenness with health, education and service-use data
3. include early-life exposure windows, recognising that neurodevelopment is environmentally sensitive
4. commission trials of nature-based interventions, particularly for underserved communities
5. prioritise equitable access to green and blue spaces, and enhancements to greenspace in urban areas
6. incorporate measures of nature connectedness, not only objective greenness.

A greener future for mental health

Green and blue spaces are not an optional extra. The evidence shows they may be integral to mental health and neurodevelopmental resilience. It may also be cost effective and reduce long-term service demand as if we get things right, equitable access to these spaces should be free regardless of where you live.

The 2025 review offers a rare opportunity to recognise the role of our environments in shaping mental health — and to build a healthier, fairer, greener future – view the full response.

And in the meantime you could ask yourself this question: What I am doing to integrate nature to my life at home and at work? We’d like to know the answer!

Authors

• James Farrell, Founding Partner, The Human Nature Partnership and Director, The Natural Coaching Company.
• Dr Daniel Harwood, Chair, RCPsych Planetary Health and Sustainability Committee
• Dr Shuo Zhang, Nature Matters Co-Lead, RCPsych Planetary Health and Sustainability Committee

Selected reading

• Coventry, P.A., Brown, J.V.E., Pervin, J. et al. (2021). Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis, SSM - Population Health, 16.
• Department of Health & Social Care (2025) Independent review into mental health conditions, ADHD and autism: terms of reference, gov.uk.
• Donovan, G.H., Michael, Y., Gatziolis, D. & Mannetje, A. (2019). Association between exposure to the natural environment, rurality, and attention-deficit hyperactivity disorder in children in New Zealand: a linkage study. The Lancet Planetary Health. 3(5).
• Geary, R.S. et al. (2023). Green-blue space exposure changes and impact on individual-level well-being and mental health: a population-wide dynamic longitudinal panel study with linked survey data. Public Health Res (Southampt). Oct;11(10):1-176.
• Haywood, A., Dayson, C. Gartside, R. et al. (2024). National Evaluation of the Preventing and Tackling Mental Ill Health through Green Social Prescribing Project: Final Report. January 2024. Department for Environment, Food and Rural Affairs (London).
• Liu, BP., Huxley, R.R., Schikowski, T. et al. (2024) Exposure to residential green and blue space and the natural environment is associated with a lower incidence of psychiatric disorders in middle-aged and older adults: findings from the UK Biobank. BMC Med 22, 15.
• Sheffield, D.; Butler, C.W.; Richardson, M. (2022). Improving Nature Connectedness in Adults: A Meta-Analysis, Review and Agenda. Sustainability, 14, 12494.
• The Wildlife Trusts (2023), A Natural Health Service: Improving lives and saving money.
• Tran I, Sabol O, Mote J. (2022), The Relationship Between Greenspace Exposure and Psychopathology Symptoms: A Systematic Review. Biol Psychiatry Glob Open Sci. Jan 28;2(3):206-222.
• UK Government (2025). Environmental Improvement Plan 2025. gov.uk
• Zhang R, Zhang CQ, Rhodes RE. (2021). The pathways linking objectively-measured greenspace exposure and mental health: A systematic review of observational studies. Environ Res. 198:111233.