Nature, Prescribed? Fostering Mental Health Through the Outdoors

Scenic view of beautiful sunset above the river at summer evening.

As pharmaceutical solutions for mental health care have dominated in the United States in recent decades, we tend to overlook an important component of both our physical and emotional wellbeing: Nature.

Although anecdotal evidence of nature’s benefits has existed forever, the medical community is just starting to evaluate and consider the nature-health relationship with the scientific seriousness it deserves. Our partners at the REI Coop offer a recent example, funding an initiative with the University of Washington’s Earth Lab and the UCSF Benioff Children’s Hospital’s Center for Nature and Health to study the connection between nature and human health.

For the last several years, Dr. Nooshin Razani, the Center’s director, has prescribed nature to her pediatric patients and their families. That’s right – instead of a bottle of pills, she writes a real, medical prescription for spending time outside. “Access to nature is a health equity issue,” says Razani. “This is about opportunities to heal and to connect with each other and with ourselves. This is about meaningful connections with nature and with family.”

The Life-Changing Mental Health Effects of Nature

Student Conservation Association (SCA) has received many firsthand accounts of the life-changing mental health powers of nature. One example is park ranger Brandi Heasley, a former SCA intern. “My SCA experience was the perfect timing for me – it truly saved my life.” she says. “I’d finished college and was going through a really dark, depressive stage. I was struggling to find work in my field and was stuck in an abusive relationship. I was even considering suicide.” When Heasley received an email advertising the SCA’s Adirondack AmeriCorps Program, she jumped at the chance to make a change and immerse herself in nature. “I had the most amazing crew,” she recalls. “Having them there, in my moments of thinking about the past, really helped. Nobody knew how dark of a hole I was in, but they were so welcoming and supportive. It was probably the most fun I’ve ever had.”

That twin effect of nature and community can even help to heal the wounds of war. After serving three tours in Iraq and winning the Silver Star Medal as well as two Bronze Stars with Valor, Josh Brandon returned to his home state of Washington and founded the non-profit Hound Summit Team. The organization’s goal is to provide mountaineering and other outdoor recreation opportunities to help the 11 – 20 percent of veterans suffering from post-traumatic stress disorder (PTSD) to build confidence, physical stamina, and leadership skills. In subsequent years, Brandon noticed that participants in the program began to trust one another and build social relationships that extended to their personal lives. Other improvements included increased self-confidence, reduced incidences of anxiety and depression, and a diminished reliance on medication and alcohol.

Backing Stories With Science

Determined to back what he had seen with scientific proof, Brandon received $100,000 in seed money from REI, allowing him to team up with the University of Washington College of the Environment to conduct a pilot study – followed in 2019 and 2020 with full clinical trials – to test the effects of group-based expeditions on war veterans grappling with PTSD. “I can tell feel-good stories or give high-fives for the rest of my life, but mental health care is a huge crisis in our country right now,” says Brandon, recognizing the need for hard evidence to convince the nation’s medical community and policymakers of the need for a change in paradigm in which nature plays a key role in both the prevention of, and recovery from, physical and mental illness.

Back at the UCSF Children’s Hospital, Dr. Razani’s goal is very much the same. She is collecting data as part of a randomized clinical trial to determine how to go beyond individual prescriptions in order to set up a park-wide nature prescription program – and, crucially, to do so in a low-income setting.

“From an equity perspective, sometimes there is an assumption that low-income people or people of color are not as interested in nature,” says Dr. Razani, “but that’s not what our findings show.” This is extremely important not only in the Bay Area, with the large disparities of wealth between Oakland and San Francisco, but across the country where lower-income communities often have reduced access to natural areas, or are less aware of the opportunities that do exist close by. Lower-income communities are also at higher risks of conditions such as Type 2 diabetes, depression, and anxiety, with highly uneven access to medical care. Could nature play a part in healing?

Participants in Dr. Razani’s study were given nature counseling and maps of public transit and local parks before being divided into two groups. The “independents” were asked to spend an hour in nature three times a week, while the “supported” group were invited on weekly outings to local parks with transportation, lunch, and guided activities such as walks, fishing, and boating. The results? Participants in both groups saw a reduction in stress of some four percent. While more research is needed, this is an encouraging first step that echoes the results of other studies finding a similar connection between time outdoors and stress reduction.     

Nature: a Trail to Happiness

Following her experience in the Adirondacks and a subsequent stint on an SCA leader crew in the Southern Sierras, Brandi Heasley has gone on to a career in the parks, currently serving as the interim superintendent at the Big Bend State Park in Texas. “I’m in a lot better state of mind today,” she says. “But when I do start getting a little low or feeling rundown from work, I just step out the door and go for a hike.” It’s a lesson our medical community, thankfully, is starting to take heed of.


SCA has been helping young people connect to nature since 1957. To find out more about our programs, check out our list of available programs here