Alone
How nature-based social prescribing may help with addressing loneliness and how nature supports solitude.
Hello, welcome to the latest Compassionate Nature article which considers the role of nature-based social prescribing towards addressing loneliness, alongside how nature can foster solitude.
I wandered lonely as a cloud
That floats on high o'er vales and hills,
The opening lines of Wordsworth’s poem are very well-known. Being alone in nature can be a positive experience that many people welcome, providing a space away from daily life and a connection with the wider natural world.
Being alone is very different to loneliness.
Last week was Loneliness Awareness Week, with the charity Campaign to End Loneliness reporting that in 2022 just over 7% (3.83 million) of adults in the UK reported feeling lonely regularly, an increase from 6% (3.24 million) in 2020. In support of the awareness week the British Psychological Society (BPS) published several articles which included highlighting the public health issue that loneliness presents. In November 2023 the World Health Organisation (WHO) declared loneliness as a global public health issue, with one of the commission leads saying it “transcends borders and is becoming a global public health concern affecting every facet of health, wellbeing and development“. The WHO report also includes a claim that the health risk from loneliness was comparable to smoking 15 cigarettes a day.
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It is worth pausing here to consider that striking comparison and to define what is meant by loneliness. It can be defined differently within psychology, from an affective or emotional response through to a more cognitive based aspect. The Campaign to End Loneliness use a definition which I think works well in covering different aspects, defining it as ‘a subjective, unwelcome feeling of lack or loss of companionship. It happens when there is a mismatch between the quantity and quality of the social relationships that we have, and those that we want’.
The definition highlights a key difference between being alone, loneliness and social isolation - loneliness is a subjective feeling, so you can be alone and feel happy or you can have lots of connections or be with lots of people and feel lonely. Social isolation is more objective, based on lack of social connections rather the feeling. These differences are important when considering the comparison with smoking. The claim originates from the US Surgeon General although it is a misleading statistic, derived from a meta-analysis which included a mixture of studies that focused on loneliness and on social isolation, which was then compared to a meta-analysis on smoking. A recent Radio 4 More or Less programme does a brilliant job of explaining why it is misleading. Despite this, because of the claims source and use within the WHO report, along with frequent usage across media outlets and social media, it is going to be one of those statistical claims which will continue to be used whenever loneliness is mentioned.
This is not to say that loneliness does not present serious health risk nor that steps should not be taken to address it as a public health issue. Some recently published papers have considered how nature can help through social prescribing interventions, along with a study highlighting how nature supports a positive experience of being alone.
Reviewing the evidence
Ashby Sachs and a team of international researchers published a systematic review in 2024 of nature based social prescribing to help with loneliness. Nature-based social prescribing (NBSP) uses non-medical interventions aimed at connecting individuals with community activities to support their health and wellbeing. Social prescribing forms a key part of the NHS Long Term plan in the UK.
The systematic review included quantitative, qualitative and mixed method studies of nature-based group interventions that were linked to social prescribing across all age groups, and which included measures of loneliness, social interaction and social connection. The authors selected 38 studies, which covered three main types of interventions - nature-based physical activity, interventions using an element of nature, and gardening.
The results indicate that when researching loneliness most studies focus on vulnerable groups within society, often with a focus on older age groups. The majority of the studies measured loneliness as a secondary outcome, rather than the main outcome of an intervention. There was limited evidence of age differences within the interventions, while there is some research suggesting loneliness is increasing in younger age groups at a faster rate than in older age groups, although older people are more likely to report loneliness.
Physical activities appeared to support general health and social connection more than other interventions. Gardening was also found to provide positive benefits and had the added benefit of being able to be undertaken both outdoors and indoors, which may be helpful to support a wider range of individuals or to enable interventions to continue irrespective of weather. The results indicated that the benefits to loneliness occur over a long time period and therefore people require ongoing, long term support to address loneliness. Individuals who feel lonely are also less likely to join an intervention without the appropriate support to help them to do so. None of the studies considered which characteristics or aspects of the natural environment were influential upon addressing loneliness.
The review highlights that very few of the studies looked into why participants dropped out of interventions, which means that published results may have a positive bias and there was little cost to benefit analysis undertaken of the NBSP interventions. The reviewed studies also employed various measures to assess outcomes, which makes it difficult to directly compare statistical results on loneliness.
That said the quantitative study results suggest a small to moderate positive effect upon loneliness from NBSP, with the qualitative studies underlining the social connection and the connection with nature that NBSP facilitates, with both appearing helpful in addressing the sense of loneliness. Overall the review found that the NBSP interventions had a positive effect upon loneliness, with increased levels of life satisfaction and can help foster a greater interest in nature.
Developing the future
The systematic review was part of the RECETAS programme, a large long-term research project. RECETAS, which means recipe or prescription in Spanish, stands for Re-imagining Environments for Connection and Engagement: Testing Actions for Social Prescribing in Natural Spaces. The project started in March 2021 and ends in February 2026. Jill Litt and the project team published an overview and update in 2024, which further highlights the global nature of the public health concerns around loneliness and underline that loneliness is different to social isolation. The authors also acknowledge that the Covid pandemic has negatively influenced levels of loneliness.
The project aims to develop, test and evaluate NBSP interventions across six cities (Barcelona, Prague, Helsinki, Marseille, Cuenca and Melbourne). The interventions are developed within their local context and are specific to each city, involving local communities alongside health professionals and academic researchers. The objective to produce a menu of NBSP interventions that can be evaluated for future, wider use. The interventions are informed by an approach called Friends in Nature, with the aim of increasing social support and wellbeing through socially supported nature-based activities. The evaluation of the NBSP interventions will use various study designs and consider participants experience and measures of the environmental factors involved with the intervention. At an individual level the key outcomes measured are loneliness and quality of life, with secondary outcomes such as overall wellbeing, mood and health behaviours. Alongside these wellbeing and social benefits the studies will provide cost-benefit analysis of NBSP.
The project aims to provide policy recommendations, intervention protocols, development of community events and an online platform providing support to those involved with NBSP interventions. A number of case study papers have been published already and it will be very interesting to see how the RECETAS project adds to the existing evidence base for NBSP.
Alone
In contrast to feeling lonely, being alone in nature can be a positive experience, with the natural environment supporting a sense of connection and solitude which Mina Samangooeu, Ralph Saull and Netta Weinstein 2023 paper explored. Their study is based on semi-structured interviews with 60 participants in the UK, aged between 19 and 80- years old. The participants were from different backgrounds and ethnicities, with a mix of people with and without long term health conditions. The authors analysis of their responses provided five themes relating to the experience of solitude in nature.
Firstly the theme of nature enhancing solitude was described, where natural features such as wide open spaces were supportive of wellbeing by providing a sense of perspective and of getting away from daily life. A number of activities supported this, including walking and gardening, with participants noting how they felt greater awareness of the surrounding nature when on their own. The second theme of community may seem counterintuitive to being alone, but several participants noted enjoying the break in solitude through random encounters with others, for example when out walking. Some also enjoyed taking their time alone in a natural space to watch the world go past, which they found relaxing. The third theme reflected a sense of solidarity with nature fostered by a sense of deep connection to nature, which some felt acted as a companion when alone. This was associated for some participants with awareness of environmental issues and the desire to protect nature. The last theme related to elements of nature that participants felt they noticed more when alone, including the passage of time and the seasonal differences to natural environments.
There are a few limitations to note, it is a qualitative study so the themes are interpretations of participant responses and part of the study was undertaken during covid restrictions which may have influenced some responses. The authors highlight that a future study could also explore differences between participants living in rural or urban environments. The overall results though show that nature had supported and enhanced a positive experience of solitude, with benefits to overall wellbeing from time spent alone in nature.
Loneliness has a long-term detrimental impact upon both physical and mental health. It appears to be an increasing public health issue globally and prevalent across age groups, although perhaps with greater prevalence in older people. Nature-based community and social activities offer opportunities to help address loneliness, with NBSP playing a key role in this. Spending time on your own is very different to a sense of loneliness and nature may support positive aspects of solitude, through a greater sense and awareness of the surrounding natural environment.
I was struck by something when selecting images for the article. Using the word “lonely” to search the image library returned a lot of images with a person alone in a natural environment. I found that interesting and when considering the images, found they could be split into two types, perhaps reflective of the studies. Some of the images invoked the sense and negative experience of loneliness, while others suggested the awe and perspective that nature can provide as a positive experience. This suggested to me that perhaps we have a cultural association of both loneliness and solitude with time in nature.
You may never be able to tell when someone is feeling lonely. Perhaps when next out, spending time in a natural environment, just a nod or a quick “hello” to someone you pass may make all the difference to their day. After all, it is the small things in life that matter.
Thanks ever so much for reading this article. All the research reviewed are open access studies, so are freely available to read in detail via the links in the article or from the references below. If you think the article would be helpful to someone else please do share on, it is a freely available public post.
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References
Litt, J. S., Coll-Planas, L., Sachs, A. L., Rochau, U., Jansson, A., Dostálová, V., ... & Pitkälä, K. H. (2024). Nature-based social interventions for people experiencing loneliness: the rationale and overview of the RECETAS project. Cities & Health, 1-14. https://doi.org/10.1080/23748834.2023.2300207
Sachs, A. L., Kolster, A., Wrigley, J., Papon, V., Opacin, N., Hill, N., ... & Litt, J. (2024). Connecting through nature: A systematic review of the effectiveness of nature-based social prescribing practices to combat loneliness. Landscape and Urban Planning, 248, 105071. https://doi.org/10.1016/j.landurbplan.2024.105071
Samangooei, M., Saull, R., & Weinstein, N. (2023). Access to nature fosters well-being in solitude. Sustainability, 15(6), 5482. https://doi.org/10.3390/su15065482
Here is a piece on loneliness among aboriginal peoples:
https://journals.sagepub.com/doi/abs/10.1177/10497323211009475?journalCode=qhra
I really enjoyed this piece, Chris, and it makes total sense that our connection to nature should serve as a balm for loneliness. It certainly has been so for me, as I spend most of my days outside. I probably could have a man here if I really wanted, but nature and farming have filled that void and the loneliness I once felt as a single woman is much diminished through my work. Thank you for such detailed research!🙏