Before he died aged 56 years of pancreatic cancer in 2011, Steve Jobs, co-founder and CEO of Apple Inc. said, ‘The six best doctors in the world are sunlight, rest, exercise, diet, self-confidence and most of all, friends.’

In spite of having a net worth of $10.2 billion at the time of his passing, money had ceased to be important to him and medicine was not in his list of prescriptions for optimum mental health.  One’s impending death focuses one’s mind and re-prioritises what matters in life and it is no coincidence that there are many doctors worldwide who follow a concept called Social Prescribing, ie; prescribing an engagement with nature, gardening, cookery, sports, volunteering, the arts, healthy eating advice, etc. as a form of preventative medicine in place of prescriptive drugs.

One such proponent of Social Prescribing was Dr Shigeaki Hinohara who died in 2017 aged 105 years. As Chairman Emeritus of St Luke’s International University in Tokyo, he treated patients up to his death and was known to work up to 18 hours a day.  He gave 150 lectures a year which lasted between 60 and 90 minutes and stood throughout all of them to ‘maintain strength.’  He kept his dietary requirements to a minimum and maintained the belief that “To know the illness and help people, we need liberal and visual arts, not just medical ones.”

His philosophy for a long and healthy life was simple:

  • Retire as late as possible in life, if at all
  • Watch your weight and always take the stairs
  • Have a purpose in life which fills your every day
  • Keep all rules and therefore, stress, to a minimum
  • Illness is individual and doctors cannot cure everything
  • Find inspiration, joy and peace in art

Three quarters of mental health difficulties occur before the age of 25 years and half begin before the age of 14.  With this disturbing rise in mental health conditions in children as well as adults in recent years, social prescribing would appear to be a useful tool in the armoury of health practitioners as it would encourage young people to engage more with the world around them rather than taking a pill to mask their ailments.  Mental and physical isolation is a problem worsened by the prevalent use of social media and computer-led activities, so could social prescribing be the perfect antidote to our modern lifestyles?

Certainly, there are many studies currently being undertaken on the subject as well as schools of thought which are advocating the benefits of interacting with nature, such as the Japanese practice of shinrin-yoku, literally translated as ‘forest bath’ which was developed in Japan in the 1980’s.  Dr Qing Li from the Nippon School of Medicine in Tokyo firmly believes in spending as much time as possible connecting with nature through shinrin-yoku and maintains that it has tremendous benefits on mental as well as physical health.  This practice is now fully incorporated into the Japanese government’s health programme and there is growing recognition by British doctors as well as in royal circles.  The Duchess of Cambridge was inspired by the concept of shinrin-yoku when she co-designed her garden for the Chelsea Flower show in 2019.

Studies have shown that the reduction in blood pressure, lower cortisol levels and improved concentration and memory associated with walking in nature may be due to a chemical released by trees and plants called phytoncides which has been found to boost the immune system.

It is thought that 1 in 5 patients consult their GP for what is primarily a social problem.  Where medicine is not likely to be helpful, perhaps the idea of Forest Bathing as a social prescriptive medicine may just help fill this gap.

 “Look deep into nature, and then you will understand everything better.”

Albert Einstein.

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