Effect of the Outdoors on Mental Health

Effect of the Outdoors on Mental Health Topic: Mental Health Big Ideas Overview Mental health disorders are known to affect most people at some point in their lives (Government Office of Science London 2008, as cited in Barton 2010). Indeed, rates of depression and other psychological illnesses (e.g. anxiety, etc.) are predicted to increase in the future (Maller et al. 2005, as cited in DFH 2008). Over the past several decades, research has shown that contact with nature aids mental health and restoration. Mental health improvements resulting from exposure to natural environments include increased positive emotions and mood, decreased negative emotions and stress, and increased mental balance, energy, and revitalization. Systematic literature reviews conducted in the past five years continue to show a consistent beneficial relationship between exposure to green, natural environments and mental health. Environmental contexts examined in these studies varied from urban to rural, and compared natural and synthetic environments. Exposure to natural environments might include exercising in natural environments, being within a natural place, or even looking at a view of trees from a window. For example, in a hospital, views of nature are associated with a faster recovery, decreased painkiller use, shorter hospital stays and fewer postoperative complications (Dijkstra 2006). Outdoor space and views at a workplace is associated with decreased stress (Singhal, Paney and Pandy 2013). Regular interaction with nature is connected to lengthened lifespan and decreased risk of mental health illnesses in seniors living in megacities (Takano 2002, as cited in Barton 2010). There is also mixed evidence that exercising outdoors in natural environments could have mental and physical benefits above and beyond exercising indoors. Green exercise for as little as 5 minutes has been shown to improve self-esteem and mood (Barton 2010). There is some evidence that people enjoy exercising outdoors more than indoors, and have a greater intention to repeat the activity, and improvement in social connections (Coon et al 2011). If exercising outdoors is more likely to be maintained in the long term, then motivating people to be active outdoors (e.g. gardening, walking, and biking) could be an important means of staying active. If exposure to outdoor green spaces has immediate positive mental health outcomes, then inaccessibility to such spaces could promote health inequalities. Given the associations between mental health and proximity to green spaces, there is an inherent opportunity for planning and designing both public and private open space. What the Research Says Things for Certain (or semi-Certain) Exposure to green outdoor spaces improves mental health. Examples: Barton and Pretty, 2010: The article concluded that exposure to green has positive health impacts. Coon et. Al, 2011, 1762: â€Å"Experimental research has demonstrated that exposure to views of nature can improve people’s health and wellbeing by providing restoration from stress and mental fatigue,12† Design for Health, 2007, 1: â€Å"A strong research base has continued to demonstrate how direct contact with nature (water, trees, bushes, flowers, and other vegetation, whether cultivated or wild) leads to increased mental health and psychological development.† Lee, A.C.K., R. Maheswaran, 2010, 212: â€Å"Physical and psychological benefits have been linked to green spaces through their purported effects on physical activity.7 †¦It also improves mental functioning, mental health and wellbeing16– 22 and may have long-lasting psychological benefits.23 Benefits on longevity have also been reported.24† Even just a view of nature is beneficial to mental health. Examples: Design for Health, 2007: For example, in a hospital context views of nature are associated with a faster recovery, decreased painkiller use, shorter hospital stays and fewer post-operative complications. Since older persons use hospitals more, views of nature are especially relevant to this population. Dijkstra, 2006: Sunlight and views of nature out the window had positive effects on patients’ mental and physical health. Having a sunny window with a view of nature may have a positive impact on aging patients staying at healthcare facilities. It should be noted that some varied effects happened for patients with dementia or depression. Singhal, Paney and Pandy, 2013: Green space surrounding a work environment reduces stress and benefits mental health. This has been demonstrated consistently in the literature, and anecdotally in this article. Things up in the Air General significance for public health. Example: Bowler, 2012: Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health. If greater biodiversity in nature increases mental health benefits. Example: Dean, van Dooren and Weinstein, 2011, 878-879: â€Å"Based upon this review, we identified only one original research paper that directly investigated the link between biodiversity per se and mental health allowing the authors to specifically argue that their results ‘indicate that successful management of urban green spaces should emphasize biological complexity to enhance human well-being in addition to biodiversity conservation ([33, p. 390]).† How different user groups, subcultures and types of outdoor environments differ in impact. Example: Design for Health, 2007: â€Å"†¦ more limited knowledge on aspects of nature most relevant, maintenance importance, and different user groups/subcultures. Varied definitions and types of outdoor space make it difficult to compare studies.† Whether there is a causal relationship between green space and mental health. Example: Lee, 2010, 212: â€Å"Most studies reported findings that generally supported the view that green space have a beneficial health effect. Establishing a causal relationship is difficult, as the relationship is complex. Simplistic urban interventions may therefore fail to address the underlying determinants of urban health that are not remediable by landscape redesign.† If exercising outdoors (or with a view of nature) has mental and physical benefits above and beyond exercising indoors. Examples: Coon et al., 2011: found exercising outdoors did have greater mental and physical benefits above and beyond exercising indoors, whereas Lee 2010 found mixed results at best. Implications Standards Mental health benefits can come from very little exposure to natural spaces. Just a glimpse of green will do. Example: Design for Health, 2007, 5: â€Å"Working thresholds for HIA: Provide views of green spaces, with canopy trees, from all buildings. These can be trees at the street level or, for upper-level situations, views to parklands, etc. Tree densities with greater than 22 trees per acre have a positive effect in terms of presence and sense of safety in a population of low-income, public housing residents (Kuo et al., 1998, 45). This is not a very high density of trees.† As little as 5-minutes of activity outside is enough for mental health improvements. Example: Barton and Pretty, 2010: A quantifiable exposure to green was set as a threshold. As a result, greatest changes come from 5 min of activity, and thus suggest these psychological measures are immediately increased by green exercise. Insights Exercising outdoors may be easier to stick to than exercising indoors. Example: Coon et. Al, 2011, 1762: It might be argued that physical activity in health club gyms is a viable alternative to outdoor exercise, but the failure to persevere with indoor exercise initiatives on a long-term basis is well recognized. For example, 40-50% of individuals terminate gym membership within a year of joining.19 Anecdotal evidence suggests that long-term adherence to exercise initiatives conducted in outdoor natural environments or urban green spaces may be superior to that of indoor exercise interventions.20 Urban Chinese migrants have worse mental health than non-migrants. Example: Lin et al., 2011: Rural migrants in China’s cities experience more discrimination and this discrimination is connected to worse mental health. Sources Jo Barton and Jules Pretty, What is the Best Dose of Nature and Green Exercise for Improving  Mental Health? A Multi-Study Analysis, Environmental Science and Technology, 2010 May  15;44(10):3947-55. doi: 10.1021/es903183r. Bowler, Diana E., et al. A systematic review of evidence for the added benefits to health of  exposure to natural environments. BMC Public Health 10.1 (2010): 456. Coon, J. Thompson, K. Boddy, K. Stein, R. Whear, J. Barton, and M.H. Depledge. 2011. â€Å"Does  Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on  Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review.†Ã‚  Environmental Science and Technology 45:1761-1772. Accessed February 20, 2014. doi: 10.1021/es102947t. Dean, Julie, Kate van Dooren, Philip Weinstein. 2011. â€Å"Does biodiversity improve mental health  in urban settings?† Medical Hypotheses 76: 877-880. Accessed February 20, 2014. doi:  10.1016/j.mehy.2011.02.040. Design for Health. 2007. Key Questions: Mental Health. Version 2.0. www.designforhealth.net Dijkstra, Karin, Marcel Pieterse, and Ad Pruyn. 2006. â€Å"Physical environmental stimuli that turn  healthcare facilities into healing environments through psychologically mediated effects:  systematic review.† Journal of Advanced Nursing 56 (2): 166-181. Accessed February 20,  2014. doi: 10.1111/j.1365-2648.2006.03990.x Lee, A.C.K., R. Maheswaran. 2010. â€Å"The Health Benefits of Urban Green Space: A Review of the  Evidence.† Journal of Public Health 33(2): 212-222. Accessed February 21, 2014. doi:10.1093/pubmed/fdq068. Lin, Danhua, Xiaoming Li, Bo Wang, Yan Hong, Xiaoyi Fang, Xiong Qin, and Bonita Stanton. 2011.  Ã¢â‚¬Å"Discrimination, Perceived Social Inequity, and Mental Health Among Rural-to-Urban  Migrants in China.† Community Mental Health Journal 47:171-180. Accessed February 21,  2014. doi:10.1007/s10597-009-9278-4. Singhal, Vijai, Deep Pandey and Pushp Deep Pandey. 2013. â€Å"Workplace Green Space for Health  and Happiness.† Rajasthan State Pollution Control Board, Jaipur India.