Canadian Medical Association endorses B.C. Parks plan to prescribe nature

Nature is the ‘fourth pillar of health, just as important as healthy diet, exercise and lifestyle,’ says Dr. Melissa Lem, director of the national nature prescription program called PaRX.

File photo of a forest in the Lower Seymour Conservation area of North Vancouver. More doctors are prescribing spending time in nature for good health. Photo by Arlen Redekop /PNG

From the climate crisis to the COVID-19 pandemic, to inflation woes and the invasion of Ukraine, there’s a lot to be stressed out about these days.

But instead of taking medication for low levels of anxiety, your health care provider may soon prescribe spending more time in nature.

On Saturday, at the COP15 biodiversity summit in Montreal, the Canadian Medical Association officially endorsed a B.C. Parks initiative called PaRx, a national nature prescription program. It’s the first time a national medical organization in the world has endorsed a nature prescription.

Dr. Melissa Lem, a B.C.-based family physician and director of PaRx, says the CMA endorsement will normalize the idea within the medical profession that nature is essential for good health.

What they will typically recommend is at least two hours a week outside, for at least 20 minutes at a time. That could mean going for a hike in the woods, but it could also be something as simple as visiting a local park, gardening, or taking a walk by the sea.

Lem said there is a standardized prescription form that health care providers can fill out, although they may look different in every province.

This screenshot shows what a prescription for nature could look like. Courtesy of Dr. Melissa Lem.

“What the healthcare professional does is they work with the patient to come up with a personalized nature prescription plan. So they figure out their strengths, what their interests are, what nature is in their local environments, and their schedule because a lot of people are busy,” said Lem.

“There’s research that shows that when the information is written down it increases a patient’s motivation to carry out that advice.”

She said this endorsement by the CMA is significant because it is the first of its kind in the world, and aligns with the association’s goal of improving health and increasing environmental stewardship.

Lem added that research shows children and adults who are more connected to nature are not only more likely to work to conserve it, but also to engage in other pro-environmental behaviour.

The program also works with businesses that will wave or reduce fees when someone shows them a nature prescription for a health condition, for example at Van Dusen Gardens in Vancouver.

The B.C. Parks Foundation launched PaRx in November 2020, starting in B.C., then expanding to every province across the country.

Now more than 10,000 prescribers have now registered within Canada, including over five per cent of all practising physicians in the country, according to the foundation.

Lem said while the majority of nature prescriptions are for mental health there are many other conditions that can benefit from taking time out in nature, such as high blood pressure, poor sleep, and cardiovascular disease.

She stressed that a nature prescription is not something that would be given instead of medication, especially for chronic illness, but it could be a starting point for treating low-level anxiety or depression.

“We call nature the fourth pillar of health, just as important as healthy diet, exercise and lifestyle at maintaining your health,” said Lem.

“It’s possible that in mild cases of anxiety or early hypertension a nature prescription might prevent someone from developing a severe case but in chronic cases it is prescribed in conjunction with medication.”

PaRx has already been endorsed by major provincial health partners like B.C. Family Doctors, Alberta Medical Association, Ontario College of Family Physicians and Collège des médecins du Québec.

“Anything that’s going to improve people’s health and reduce the burden of chronic diseases and mental health conditions will also create savings for our healthcare system,” added Lem.

PaRx announced a partnering agreement with Parks Canada in January of this year, so that healthcare professionals registered in the PaRx program can help reduce barriers to accessing nature for their patients by prescribing an Adult Parks Canada Discovery Pass.

They are asked to prioritize those who live close to national parks, national historic sites, or national marine conservation areas, and who could benefit from the pass the most. Each registered prescriber can prescribe up to one Adult Discovery Pass per month.

“Spending time in nature is something that we can all benefit from, physicians and patients alike. The CMA is proud to endorse a nature therapy program that connects us to the land and all of the evidence-based outcomes it provides,” said Dr. Alika Lafontaine, president of the CMA, in a statement Saturday.

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