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Season 2, Episode 9:
Psychiatry, Our Climate Crisis and Mental Health

Guest: Alan Kellas 
Psychiatrist (Retired)


Marina Robb

Hosted by: Marina Robb

Dr. Alan Kellas, MBBS BA MRCPsych 

Alan Kellas trained in medicine and qualified in 1981, worked in General Practice in the NHS, lectured at Bristol University Department of Psychiatry, and was a community NHS Consultant Psychiatrist from 1998 – 2013.  

He has been a member of the sustainability committee of the Royal College of Psychiatrists, nationally, from its origins in 2014, as Green care and Nature Matters rep, until 2022. 

He helped set up the Eco-CAMHS faculty group and Nature Matters networks in RCPsych and was an active part of the core advisory team developing the College response to the Climate and Nature crisis, whose position statement was released in May 2021 (https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/position-statements/position-statement-ps03-21-climate-and-ecological-emergencies-2021.pdf)

The key message of this statement include:

Climate change, pollution and biodiversity loss:

• Have created a health crisis and it is imperative that psychiatrists are informed about it and actively engaged in these issues.

• Are interconnected factors which individually and collectively have a profoundly destructive impact on human and planetary health. Our actions and their impacts will be inherited by the generations to come.

• Have particular implications for mental health and disproportionately affect vulnerable groups, including persons with pre-existing mental illness and children.

In this episode Marina and Alan talk about:

  • What is Psychiatry?
  • How Nature supports our Psychology
  • The link between the Climate Crisis and Mental Health
  • How the natural world plays an essential part in our development

Music by Geoff Robb: www.geoffrobb.com 


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(transcribed by AI so there maybe some small errors!)

Marina Robb: Hello, and welcome to The Wild Minds Podcast for people interested in health, nature based therapy and learning. We explore cutting edge approaches that help us improve our relationship with ourselves, others and the natural world.

My name is Marina Robb, I'm an author entrepreneur for a school outdoor learning and nature based trainer and consultant and pioneer in developing green programmes for the health service in the UK.

It's good to be back after six weeks, it's going to be an exciting season of episodes with some great guests. Remember to subscribe to the podcast so you get notified every week.

You're listening to Episode Nine psychiatry, our climate crisis, and mental health. My guest today on the wild minds podcast is Dr. Alan Kellas. Among many other accolades. Alan has been a lecturer in psychiatry, a community NHS consultant psychiatrist, he's helped set up the green cams faculty group within the Royal College of psychiatry, and was an active part of the core advisory team developing the college's response to the climate and nature crisis, whose position statement was released in May 2021. And I'm going to provide you with a link in the show notes.

What's really stayed with me since this interview, which took place in spring was the Alan described our climate crisis as humans self harming on such a great scale. And that has given me hours of food for thought, which I will talk about next week. In this episode, though, we're also going to be talking about what is psychiatry, and how nature supports our psychology.

Hi, Alan, and welcome to wild minds. I'm very, very excited to have you on this show. And as you know, we start with a little bit of gratitude. Would you like to start today with a little bit of gratitude?

Alan Kellas: Yes, well, Marina, big thanks for inviting me on, I feel honoured to be part of this project of yours. And I'm very grateful for your inspiration, your teaching over the years. I'm grateful to be able to share gratitude. It's always a good, good thing to do, isn't it? We were talking earlier about the delights of spring where wrench we've sort of come through winter, and the multitude of buds and growth and new springtime feelings are all around us. So I'm grateful for you and I'm grateful to spring.

Marina Robb:
Thank you so much. Well, I feel because I've got you here on the podcast, I actually feel immense gratitude to psychotherapists, psychologists, psychiatrists and all the different people actually that have a role within our free mostly NHS system. Because I know how much how much help they give to so many people, including myself over my life, whether that's GPS or not. So yeah,

I'm really grateful that we have a system however flawed it might be, and maybe we'll get to that later on. But but I'm still immensely grateful for the fact that I can ring up a doctor and get an appointment or I can, you know, actually say look, I'm really troubled and I need some help. And I know people like yourself will will do their best. And so yeah, so thank you.

So Thank you so much for that. And for the people out there that are that are doing their best for others. Yeah. So Alan, we've known each other for gosh, I don't know how many years now. But I've, I was always taken by the fact that you were willing to talk to me actually, as somebody who was practising kind of green programmes and taking groups out, I felt that you were always willing to show up and I, and particularly as this idea of being a psychiatrist, because I was sort of brought up with this notion that, in a way, psychiatry was quite exclusive in some ways.

And I just wondered, I know that you're, well, you're a psychiatrist, but I'd love you to, and many more things, by the way, but I'd love you to just share with listeners, what what is being a psychiatrist, and what is psychiatry? Would you mind starting with that?

Alan Kellas: Yeah. I should say, Marina, that I'm sort of retired and pretty much finished being a psychiatrist. So you're getting the party with a benefited sort of hindsight. It's not. But you're right, that I? Well, that's a big question, isn't it? Well, psychiatry, I mean, I suppose within the context to of what you were talking about before of how it is in this country, because I think it's, it's different in other countries.

There's something amazing I think about the creation of the National Health Service and the role of the Mental Health campuses was a big part of the debate around, you know, bringing together general practice hospital trusts and mental health care as it as it was then. And as it's a devolved, partly with the influence of institutional care, I guess that's, you know, certainly one of the origins of psychiatry, but how it, how it's struck me if I can talk a little bit about my own experience, I guess, I, I was interested in medicine, I found that the Soviet psychiatry sits within medicine, which is one of the things that distinguishes it a bit from therapies, psychology, which don't necessarily have such a strong grounding in, in the body.

I mean, people like me, who've trained a psychiatrist, have trained as doctors first. So we've often had experiences of, you know, anatomy, physiology, dissection, biochemistry, all of the those natural sciences have worked in acute medicine, you can't really be a psychiatrist unless you've been a junior doctor. And then, I mean, in my case, it was a very wiggly route. And I've done quite a lot of things before I came back into psychiatry, but for most people, they come into it having having been doctors, firstly, don't guess that influences the way you think.

And one way into that is that we're particularly interested in the brain and the brain from the point of view of having seen it. And the physicality of what the human body does. The the embedding of that amazing structure in the chemistry and biology of the human body, its influence from the circulatory system, for instance, all of those things, I would say that psychiatry is sort of medically minded cycle psychologists and therapists.

And broadly speaking, then the training gives you a chance, it's often still rooted in general adult, acute psychiatric care. So often, you know, the grindings for most psychiatrist is being in acute acute medicine, dealing with people with self harm presenting to casualties in crisis. But pretty soon, then there's a sort of a divergence of different areas. So there aren't really general psychiatrist. I mean, I would say that what I've ended up doing, which sounds very specialist is actually probably the most generalist and I'll explain that because my speciality is I after I did my general training was I specialised in helping people with learning disabilities. So that had a particular interest in developmental mental health problems. In other words, problems that didn't just start in adulthood, but might have their origins in the early years of someone's life.

It might have been an adversity, a head injury or something like that. early in life, but the idea of my specialty is that there are quite a lot of difficulties that people have that don't just come on in adulthood and And, indeed, to understand someone in adulthood, it's very important to get a good sense of what they were like as a kid as they were growing up, what was their development, like physically, psychologically, socially, their family relational experiences.

So in that sense, learning disability psychiatry is a little bit like child psychiatry, and, you know, you're interested in development, you're dealing with something that has a history, and you can't understand the present without looking at the past as it were. And the other thing that I think, you know, my specialties shared in common with child psychiatry is that you might well be dealing with an individual and that's your, that's the focus of you know, who you're trying to help.

But in order to help that person, you might very well need to help the people around them, I mean, parents, carers, paid unpaid carers your your, you have to be interested in the systems around someone in order to because sometimes the problems are in the systems, rather than in the person themselves, all the way from stigma and how people are treated in society.

So, but then, just to briefly mention some other areas of psychiatry, I mean, there are psychotherapist so there are people particularly interested in sort of medical psychotherapy, often dealing with people with complex issues that needs specialist psychological interventions, and everything from sort of therapeutic communities to specialist psychological trauma, personality relational therapies. And then there's old age psychiatry, you know, people with dementia, people with end of life, people present with different conditions and issues at different times in life.

And then there's sort of addictions, liaison work, which has people working in general hospitals. And then there's a whole field of forensic psychiatry of people who might be running into trouble with the law, and might have broken the law or be at risk of it, who might need an interface between I mean, they might have done awful things, but there might be psychological and other reasons for it, and they may be treatable.

So to give you an example, over the course of my career as a sort of learning disability psychiatrist, there were times when I had to work in locked inpatient units, where people were under the order of the home office. So you know, they were subject to the courts, as well as to the health service, all the way through to community care, doing home visits. And working with people in a whole variety of settings from clinic basis, often in communities.

Rather than clinics, I mean, the characteristic of things, the needs of people with learning disabilities is that they don't fit into clinics, or boxes very easily, you have to individualise your approach. And that includes where you might see them, how you might see them how you might communicate, how you might establish a relationship. And that's yeah, that's what really interested me. So that's what I've been a sort of specialist psychiatrist, to help the brains, the psyches and the social environments of people with complex needs. That's, that's the area that I've mainly worked in.

Marina Robb: It's a lot broader and wider than I actually understood. But I'm particularly interested in the fact that whilst you have all that training, all that experience, you've often said to me, so if we're looking at these wider systems, maybe the history of a person or like you said their parents or their perhaps their schooling, or all these different influences. Were then if at all, does this notion that the wider system of the earth the wider your natural world does that get a look in in traditional let's say, psychiatry or mental health per se, because I think this is obviously what we're really I know, we're both interested in this as well. And I'm wondering for you, you know, in one way we're saying hey, look, you know, we are interested in these systems. But where does let See the natural system play? Or does it as far as you're aware, in the, in these, this understanding of what it is to be human or the, the what it is to be?

Alan Kellas: Yeah, it's a really big and important question. And I suppose at one level, it's often there, but it's not spoken about, it's silent. It doesn't feature explicitly in much training. There isn't that much attention to it. But yet, if you asked people in practice, who are trying to help individuals, let alone people like myself who've see themselves partly and have to look after themselves as patient as well, as practitioner, you know, if you've had your own experiences of a have a mental health event, then most people will say, well, nature is just really important to me. And if you ask,

Well, what have there been special times special experiences, even special places, special relationships in the past that have helped you? What keeps you well, very, very, very often people will refer to the natural world. But I'm still shocked and frustrated that, and I suppose over the last few years towards the end of my career, and since I gave myself more time to train insofar as I could a bit in permaculture ideas, a bit in Eco psychology in various nature based practices.

I came to see that yeah, you can't be a biologically minded, I mean, the idea of, you know, the medic, being interested in the psyche, but not interested in the biology of the mind, the nature of the brain, how, how the brain evolves, the relation between the sensory world and the arousal systems in the body.

Or be interested in from a therapeutic point of view in how we develop not just in relation to our caregivers, our mothers, our fathers, but also in what was the role of the natural world as we were growing up in our play? How did children relate to, to nature in all of its many forms, from water to animals to plants, so an attachment based theory of the mind, which is fairly pervasive, doesn't have to be extended that much before people start seeing that attachment.

And connectedness doesn't just relate to other humans, it relates to our human non human connections, and we can't understand, I don't think the development of a human being or the human psyche without looking at nature, in development, and play and I mean, things that you know more about that than I do, but So nature is clearly important in development. Nature is absolutely embedded in the brain and in everything to do with the brain and that influence on the mind. But like you say, also any systemic view, you don't need to ask a kid that much about, well, who's at home and what who's important in your family, and it might well be those mum or dad if, if they're there and grandparents, but very often there's a dog or a cat or, or a place, if not in their immediate life, certainly in their family life.

And so culturally, and maybe then the other thing to say is that I suppose psychiatry is becoming more aware of it sort of cultural envelope, as it were, you know, and what we have developed that sort of works in, in this country and this culture works to some extent, for some people, but when you're trying to help people from other cultures from other backgrounds, you really have to take each person is an individual and their history completely individually and their history of place. And relationship with the natural world is very individual and you're quite often fragmented and may be split. You know, as more people have mixed heritage is a different thoughts and have different places of origin, don't they that might be important for them.

Marina Robb: I mean, I am really interested in why it is the case that but without any blame, because I think it's so easy to kind of try and point the finger, I'm absolutely not trying to do that. Here we are, you know, in in 2020s. And we know that we have multiple crisis's, including climate crisis and crisis and mental health. And, and they seem to me connected, and I don't think it's like, as, as an educator, I can hear a voice in my head going, you know, you can't expect teachers to do everything like, and I've got the same voice going on, you can't expect psychiatrists listen to all the training you've just described, and the capacity of that, and you can't expect them to also, you know, have an understanding of the importance of the senses or that, so but somewhere, I feel like we're reaching a kind of time and place.

That is some kind of I mean, I'm speaking really just off the off the cuff here, but a time and place where things are merging in some way, there's a sort of convergence of understandings from different disciplines. And we can't sort of just ignore that, like, I know, you're one of these people that I would say, it seems to be like a kind of a bridge person that can go hang on, I'm a psychiatrist, but I also really feel and understand the value of the power of nature. So so if that's some in some way, correct, what what can we what can we do, I suppose to to support people who are psychiatrists, and patients and clients? And, you know, what can we do? Do you think to Close to close the gap a little bit? If that's if that's what we're trying to do? Big Questions? I've got it today, haven't I? You didn't think you were coming? First? Question.

Alan Kellas: I mean, in a way, I'm maybe the worst person to ask because to me, it just seems so obvious and so outrageous, that it's not included more, I mean, to give you just a few examples, with all that's being spoken about the climate, and, you know, the threats to our being and our future, let alone the future generations from carbon and emissions.

And the language around temperature rise. How quickly that becomes reduced to in discussions around sustainability, that don't mention nature and biodiversity. I just find totally shocking Marina, and I can't understand why people's see the climate. And, and that goes all the way to political level to the structures of, you know, the cop conferences, and it goes to live discussions that I've been part of and you were invited to be part of with the College of Psychiatrists around what should a college like the Royal College of Psychiatrists say about the climate, and to get at least, the ecological crisis there.

And to see that maybe mental health might be under threat, you know, because of future adverse events and the traumas that can be created by, you know, flooding and drought and all of that aspect. But the question that lies in the heart of all of that is, what's going on with our relationship with the natural world? And how is it that we managed to commit such such self harm on such a big scale, that we create these environments that are threatened us?

How? How is it that we can't see the the interdependence that we have with the natural world? So then, to me, as a psychiatrist, in trying to understand behaviour, that's risky, you try to deal with the risk, but you also tried to deal with, you know, the underlying causes? And I don't think it's a surprise that our psychologists and our psychologies are really asking the question and I see it as a progression from where does the body fit into the mind?

Many therapies are moving to a much more bodies embodied practice. But then the next stage is how does how do we connect not just to the climate but to the natural world around us? How can we practice therapy in a way that is practice as if nature matters, both where we, where we practice the stories that we listen to? In the recommendations that we might, we might make, how we listen to people's language, there are 101 different ways that we can reconnect on nature connectedness. And I think some of that starts with revisioning psychology into a broader, you know, not just a biopsychosocial model, but one that really properly embraces all that eco psychologies have been working on for at least 40 years, isn't it? It's not. It's not new this?

Marina Robb:
Well, it's certainly not new. It's certainly not new for a wider conference, wider cultures. I mean, within our western paradigm, it's, it feels like there's a little bit more of a kind of realising, realisation. Should I say, of that, but yeah, you're right, I think, you know, in western world would be better. 40 years is probably a good, a good, a good timeframe.

Alan Kellas:
I suppose I was talking a bit about theory and ideas and some of the social movements that are going on, like, you know, climate protest and the climate justice protests, because I think, you know, the coming together of how can marginalise people and populations and all of the all of the reparation work around looking at our history of what we've done to and with Indian and other cultures is time for a reckoning.

But beyond that, then I suppose the other bit that I think is beginning to change, and I could say a little bit more about how I see that is that practical ways that working with animals or working in natural environments, or having conversations with people outside of clinic spaces, have the value of walking and talking of growing, of being in woodlands of the power of water, let alone and, you know, I'm aware that one of our shared interests is how education and health mental health come together. You know, as I've been a child, psychiatrists worked quite a lot with kids with learning disabilities, complex needs.

And it's, it's obvious there that when you go into special schools, who might have made adaptations to their curriculum, but for those kids who often come to the attention of psychiatrist, the role of Forest School adapted, outdoor learning opportunities, clearly really, really important to the point that it's so obviously, the wrong way round say, Well, let's try to look at kids who aren't doing well in the classrooms. You sort of asked the question, well, who said that the classroom was the best environment for, you know, for these kids.

And surely, we should have a much more sensitive understanding of the best environments for learning to take place. And for many kids, that's, you know, that's not in classrooms, and to label them as sometimes I've been in the business of trying to, you know, write recommendations for an Education and Health Social Care Plan. And you hear very loud that, you know, kids do badly in certain settings socially, or more in the built environment. It just seems the wrong way round, doesn't it, that we're trying to fit it in health and education just within the built environment?

Marina Robb:
Absolutely. And I mean, that's the main reason why I, you know, offer and try and support practitioners to take their practice outdoors, it's not that I think it's the only place of course not, or even the only thing to do to kind of that inverted commas do nature based practice, but, but it clearly is a place and it's not just for children.

It's also increasingly as I see it, for the adults, you know, for the for the NHS staff that are accompanying the groups or the teachers that accompany in the groups because actually, as you say, when we're in our bodies, or our bodies, which, you know, are in the way, the bigger holding of our brains are really often really benefitting by the movement at a basic level, isn't it?

What and all these senses as you, as you said, but also these other relationships, these other relationships that are so important, and actually, you know, for me, and we've talked about this, before that, you know, when you're struggling and you've had a really challenging mental health, time, it can be momentary it can be years. Often, as you said earlier in the podcast, these can be issues often from your relationships with other humans. Let's A Not always. So for me, in my life, having other relationships that weren't just human were really helpful.

And I often talk about, you know, every week, I probably mentioned the notion of being having Cabin Fever, you know, I need to get out, I need to be in a different space. And that helps me. And so I absolutely think we need to be offering opportunities, because of course, not everyone has access. So offering opportunities within hospitals, schools, everyday lives to be able to get outside what things have kept you well or supported your wellness in your life and has nature played?

Alan Kellas:
Yes, it has for sure. And, you know, some of that is because I was lucky that it was an important part of my early family life, I suppose part of it. My dad wasn't a great speaker, but I knew that something happened to him. And to us when we went for a walk when we climbed a mountain or so, you know, I think I'm lucky that I had some of those early life experiences.

But I mean, just picking up on, you know, I've had in the course of my career, I've definitely had times when that toxic dialogue of I have to, but I can't, I have to, but I can't, I have to, but I can't, which, which basically led to a couple of times of burning out and having to stop and recharge. And those times of burnout were I think deep at a deep level, I knew that.

People I just I'd had it with people. And I think that the human psyche has a limit to making sense of human relationships, certainly, the tech world, the human world, organisational life, careers, all of that. It's complicated, isn't it just being a human. But I found it, you know, when, when I spend time in nature, and I think for me, it was coming across a practice of finding a sweet spot and taking a sort of meditation in into the outdoors. That really, really helped. I just found an acceptance, the sense of friendship, a sense of wisdom, a sense of calm. I mean, quite bizarre insights.

You know, I think that we are magical beings. And at, I've had experiences that have been bordering on psychotic trance, you know, transpersonal experiences of the natural world speaking to me, and helping me at a very deep level. So, yes, I think I think a lot of these, that's what inspired me to explore how much that might be important for other people.

You know, when in doubt, try slowing down is a good motto, isn't it? And see whether nature might have a wisdom. I mean, right now, one of the things Marina, I think we've talked about this is water, I just, I've only really recently come to appreciate how wonderful water is not only through sort of swimming and immersing, but being near water being on it. It's just a wonderful presence, isn't it? And, you know, there are many things flow from that in terms of therapeutic possibilities.

Marina Robb:
Yeah, I think. I mean, you said something, you said, Look, humans are also magical. And, and I'm interested by that, because actually, I think there are models that help us understand that perhaps this idea of magical is, you know, beyond our understanding, you know, so there's, there's aspects of us to be human that are beyond our understanding that, yeah, who knows, in 100 years, there may be there may be people will understand why they're not magical, let's say, but from our perspective, in that moment, it does seem extraordinary that we can have an insight, you know, I always think of, I'm gonna get hope this is like Newton's apple and then understanding gravity. I mean, that's a classic kind of thing that you don't understand why you understand.

But suddenly, you understand and I do have friends and colleagues who will talk about this wider intelligence that exists this living intelligence that you know, the moment you're outdoors, you're not just being influenced by it. The human moment you're you're being influenced by other things.

And that's presumably having a biochemical impact within your systems, that that's having a thing. So I like I appreciate the that you use that word. And I can also feel in me, which, you know, this kind of Western awkwardness of, you know, did I say magical? You know, and is that acceptable?

And I think, so I'm holding that at the same time, as this notion of, you know, you said, bordering on psychosis, and as you know, we've run programmes in nature with young people that have had psychotic episodes. And, you know, they're, and I had that as a 19 year old. And, you know, my memory of that, and was that I was not grounded. My, my feeling was that I was not able to be grounded that I was, I was, I was not able to, yeah, be connected, I guess it felt like I was quite vastly disconnected, but at the same time, having a whole nother experience.

So and I remember at that time thinking, I wish that there were places that I could go, where I could be safe. And explore what I was experiencing, in a container that was more was greater, if you like, than what I was being given by that system. And this is 30-35 years ago now. And I wonder, I wonder, you know, what you think about that? I mean, mental health services? Are there opportunities to, to have spaces where people who are perhaps experienced quite, you know, extreme mental health challenges in a moment? I mean, do they exist? As far as you know? And if they don't? Could you imagine that,

Alan Kellas:
I suppose, you know, in extreme states, and where we factor in also risks of harm to self or to or to others, then. Yeah, that's what acute psychiatry is all about. It's, you know, and depending on what the causes might be. I mean, dealing with an acute crisis, those settings, I agree with you that I think the natural world is a very important partner in helping people regulate their moods in acute states.

Often humans, can easily make it worse if people are left alone in safe places, from those people in my career, you know, and having assessed people in police stations and recommended that they do have acute care, I know that very often just being in a safe place with loving, attended attention can be sufficient. It's important not to jump to medications and trying to medicalize something that what's important is to trust the healing processes of a person.

And I'm sure that you're right, that good inpatient settings, and there are quite a few that do have access to gardens, safe places. And organisations like the NHS forest and others are trying to green NHS provisions and bring together the natural world and health settings. I mean, that then there's work that needs to incorporate, how does nature get incorporated as another member of, you know, the multidisciplinary team? And their issues around that?

How, how can that work? It depends on the professionals really seeing the opportunities that are there, and it's difficult work. Obviously, if there's longer time to work with people to get to know someone properly, then you know how to really understand someone's nature connections. What's the relationship between their presentation, their crisis, their issues, and can nature help them and in what way, I think that's a you know, that's the work of care for humble, detailed assessment, understanding, and co creating.

Maybe this helps, you know, let's try movement in nature. Let's try working with breath. Let's see what water can do. Some sometimes people are called to, you know, the presence of a dog can transform someone's thinking horses and in the seaside. So hi, I'm, the question is how do you embed that sort of knowledge with the current system where often the people who are working in the system are so stressed, often so fixed by certain pathways of care that thinking more laterally about what really matters to an individual can be difficult and that you do need a good buy in from all members from the top of the organisation to the direct care staff, to the, you know, to the various members of the multidisciplinary team, if it's in that sort of setting.

Marina Robb: I think there's something about I mean, this is a huge subject, I completely accept that. But I think there's there's something about, again, what you said earlier about, the problem can be personal, it could be my history, what you know, all the stuff that's happening, or whoever it history, but it can also be structural and systemic.

And and, and obviously, it's a combination of both. And I'm wondering nowadays, about as we become more aware of that, and maybe, maybe more, I want to say accept accepting or understanding of the impact of systems, and as you said, the history of systems and the impact that we can perhaps, understand why there might be so many crisis's around or why somebody may be exhibiting strange behaviour or anxiety or, you know, and again, thinking about, let's say climate anxiety, for example, in that, and I always have more to say than I know can be answered is, is this idea that we want to find ways of supporting those with complex needs, as you've done all your life, as well as everyday people going to school?

And I'm aware that you're involved, I wonder if you could share a little bit about what you know, is happening with GPS and Green Prescription because there's a spectrum here isn't There's me talking about psychotic psychosis? And then there's everyday people absolutely needing this for wellness? And yeah, what could you just share a little bit about that?

Alan Kellas:
Well, I think that I did just to distinguish those three areas that there's nature in everyday life for all of us in all settings. And then there's the specialist use and partnership with nature for particular conditions. And the middle area, in what are sometimes described as three circles is sort of targeted, more targeted health promotion, prevention programmes, may be for people with particular needs, who are hard to reach otherwise. And that's the realm of social prescribing the idea that, you know, in primary care and in community settings, medication might not be the best answer to some of the wider issues that people face.

I mean, there's housing and benefits and financial issues, poverty and living conditions, which is an important aspect of getting right. This is speaking from a GPS point of view. But then the question about, could social connection come about through connecting with community resources and groups, whether through arts and heritage type things, cultural activities, faith based activities, but then within physical activity, so arts activity, heritage, benefits, then the final piece is around nature connection.

So that's really the realm of green social prescribing and current state of plays, there have been a number of pilot sites across the country to try this thing out. There are social prescribing link workers in pretty much every primary care network in the country, but the the infrastructure to connect those people and people who might need it with nature based experiences, may be programmes may be dropping experiences, those are still developing.

And we're in a culture where, you know, there's not a lot of money around, but the notion that nature could help time in nature, access to nature, activities in nature, learning about growing, taking exercise outdoors, may be bringing in arts and writing photography. And combining physical activity with being outdoors, you know, those are basically much more mainstream and come under the rubric of green and blue social prescribing, which I think, you know, wasn't widely known about five years ago is now you at a point of being evaluated and rolling out in different ways.

So, yes, I think that's a good example of where nature in all of its many manifestations, can help well being. And there are some people who just with a little bit of nature, two hours a week is the sort of equivalence to achieving a certain amount of physical activity can be transformative for people and and there are initiatives to try to encourage and support and train up GPS, social prescribing workers, people working in community settings with knowing what's on in your local environment, and how might you explore that with individuals and what support to pass it on in a in a trusted way so that people don't suddenly find themselves in an environment that's alien and weird, but you know, it's built on relationships. That's the sort of work that's currently going on.

Marina Robb:
In this, there's something for me about absolutely, that being a very tangible step, next step, Green Prescription screen interventions for a school type things in schools getting more access, I can see hospitals making sure there's gardens and you know, you know, bring in and people being trained, if there's like, if they're psychiatrists, or health practitioners, family workers being able to add to their belt, the possibility of going out so outdoors, I, I see that really clearly,

I think, what I think is harder for me, is this more deeper, I guess, deeper ecology, deeper understanding, and the word deep seems to kind of link quite nicely to the notion of wild though I'm still figuring out what that word means. But this idea of, actually, there's something there's, there's a deeper relationship that we need to explore within ourselves and within each other and wider systems to understand that there is this to and fro between the natural world, and we're part of that. And yeah, it's not just again, about taking a resource and making it work for us. You know,

Alan Kellas:
No, definitely not. I mean, maybe one know that we're running out of time. But this is, we haven't really talked about death and dying and the natural cycles of things coming to an end. And you know, how to make sense of that for ourselves, how to come to terms with it, how to connect with those deeper parts of ourselves that often we do confront when we realise that our life isn't going to go on forever, and then everything has it seasons. So I think as you say, nature isn't all about health and well being. And it's not all about, you know, helping people come to terms of extraordinary transformative or difficult experiences.

But I think there's a really important role that hasn't really been explored in how, how and why is nature so important for our culture, individually and for our healthcare systems? To see what nature how can nature help us face the end of our life and die in, in in a better way? Because I think it's become overly medicalized. And, and that's maybe another way into the sort of magical deeper bits that we're touching on,

Marina Robb:
Well, that's an interesting place to end with considering those roles. But but, you know, as you say, this is a ongoing inquiry, and also the desire to see some significant change in our mental health services. So that we can more fully support ourselves to be Yeah, more well, more full, have more vital lives, and in the end, have more vital death, I guess. So, yeah. So Alan, if people wanted to find out more, I'm just thinking of the Royal College of Psychiatry. Would that be a place they could go to? Do you think to look up a little bit about this?

Alan Kellas:
Yes, there are. There's some pages in the Royal College of Psychiatrists, the Nature Matters pages. There are other resources maybe we can link people to some resource links.

Marina Robb:
Yeah. So on on the podcast, we'll, we'll have the show notes. But we're also have links to some key documents. So what can I say thank you so much, and I hope you can have some time very soon in nature, perhaps by the sea, as I know that is a place that you've really thank you.

Alan Kellas:
Yes, thank you, Marina, and good luck with your wild minds may may wild minds thrive.

Marina Robb:
Thanks again for speaking to me, Alan. Join me next week as I discussed this link between the climate crisis and self harm and discuss some developments in the health sector around Green Interventions and Prescriptions.

Thank you for listening to this episode of The Wild minds podcast. If you enjoyed it and want to help support this podcast, please subscribe, share and leave a rating and review wherever you get your podcasts. Your review will help others find the show. To stay updated with the wild minds podcast and get all the behind the scenes content, you can visit the outdoor teacher.com will follow me on Facebook at the outdoor teacher UK and LinkedIn. Marina Robb, the music was written and performed by Geoff Robb. See you next week. Same time, same place