Healthcare systems in several countries are exploring whether structured time in natural environments can complement conventional care amid rising rates of stress, anxiety and chronic disease. Green prescriptions, blue prescriptions and other forms of nature-based social prescribing involve healthcare professionals recommending activities in parks, gardens or near waterbodies alongside standard treatment.
The premise is not that nature replaces medicine, but that spending time in natural settings may support mental well-being, encourage physical activity and promote social interaction. While research suggests mental health benefits, evidence for long-term physical health outcomes remains limited. Experts also stress that the effectiveness of these interventions depends on urban planning, environmental protection and equitable access to safe public spaces.
What are green and blue prescriptions?
Green and blue prescriptions are forms of nature-based social prescribing. Green prescriptions encourage activities in parks, gardens or other green spaces, while blue prescriptions involve spending time near rivers, lakes, wetlands or the coast.
Forest bathing, or shinrin-yoku, originated in Japan in the 1980s. Unlike exercise-focused activities, it involves spending quiet time in a forest while engaging with the surrounding environment. “Forest bathing is less about physical activity and more about being fully present in a natural environment,” says Vinod Prem Anand, senior consultant in internal medicine at MGM Healthcare, Chennai. “Green and blue prescriptions, meanwhile, are recommendations made by healthcare professionals as part of nature-based social prescribing.”
Other approaches include horticultural therapy and care farming, typically delivered in more structured settings.
What does the evidence say?
Research suggests nature-based interventions may reduce stress, anxiety and depressive symptoms while improving mood and psychological well-being. Some studies have also reported modest improvements in blood pressure, sleep quality and stress-related physiological markers.
“There is reasonably good evidence for reduced anxiety, lower depressive symptoms and improved mood, particularly among people experiencing stress-related conditions,” says Nithya M., consultant psychiatrist, Apollo Speciality Hospitals, Vanagaram. Evidence also points to improved attention and reduced cognitive fatigue, although it remains unclear how much exposure is needed or how long benefits persist.
Dr. Vinod cites a systematic review in the International Journal of Environmental Research and Public Health that found associations between nature-based social prescribing and improved mental and physical health outcomes. The United Kingdom’s National Health Service has incorporated green and blue prescribing into parts of its social prescribing programme.
However, experts caution against overstating the evidence. “Many available studies involve relatively small numbers of participants,” says R. Sundararaman, senior consultant in internal medicine at SIMS Hospital, Chennai. “The findings are encouraging, but larger, well-designed studies are still needed.”
How might they work?
Researchers believe several factors contribute to the observed benefits. Nature-based activities often combine physical activity, social interaction and a break from stressful environments. Morning daylight may also support healthy sleep-wake cycles.
Dr. Nithya says exercise releases endorphins and increases brain-derived neurotrophic factor (BDNF), which supports learning and neuroplasticity, while natural settings may reduce stress. Dr. Vinod adds that group outdoor activities can reduce loneliness and strengthen social connections.
Beyond individual choice
Doctors stress these interventions complement rather than replace evidence-based care.
“The biggest misconception is that these approaches can replace conventional therapy. They cannot,” says Dr. Nithya. They are valuable additions, not substitutes, for modern healthcare.
Experts say wider adoption in India will also depend on multiple factors as rapid urbanisation, air pollution, traffic, safety concerns and unequal access to green spaces already limit opportunities. Older adults, people with disabilities, and those living in hostels or densely populated neighbourhoods often face additional barriers due to inaccessible infrastructure and limited access to safe public spaces.
Published – July 24, 2026 06:30 am IST