Ethical Challenges to Green Social Prescribing in the UK Mental Health System

Green Social Prescribing (GSP) – nature-based interventions offered through healthcare services – is gaining momentum in the UK. While celebrated for its potential to improve mental health and reduce strain on health services, its ethical foundations remain underexamined. This paper critiques the normative and operational assumptions underpinning GSP, arguing that current implementation risks undermining transparency, autonomy, and equity in healthcare. Using the UK’s NHS as a case study, we identify three critical challenges: (1) a weak and heterogeneous evidence base, (2) lack of referral and outcome tracking infrastructure, and (3) significant inequities in access to prescribed green spaces. We show how GSP, framed as a “prescription,” may mislead patients, burden providers, and responsibilise individuals without adequate systemic support. In response, we outline a three-pronged strategy for ethical implementation: improving transparency and communication, building infrastructure for equitable delivery and outcome evaluation, and embedding GSP within a broader ethics of collective responsibility.