Many of us believe it’s bad for children to spend too much time indoors or looking at screens – but what does research evidence tell us about the possible mental health benefits of interacting with nature? A major new review of the evidence by Suzanne Tillmann and colleagues at Western University and the The Lawson Foundation in Canada finds there is a positive link – but the researchers say more work needs to be done, as Fran Abrams explains.
We know that mental health issues that develop at an early age have the potential to burden people – and their families and friends – throughout life. And in recent years there have been lots of studies linking these problems to things that happen outside the family home: neighbourhood, environment, school. There have been an increasing number that have looked at positive effects – for example, the possible benefits of activities such as spending time in nature.
The researchers wanted to know more about this last factor – so they decided to look more closely at the connections between the natural environment and children’s mental health.
After searching academic databases, 35 studies published in English or French between 1990 and 2017, focused on children and teens ranging from nine months to 18 years, were included. Early adolescence was the most commonly-studied age, and three fifths of the papers came from the USA, UK or Canada. In those 35 studies there were a total of 100 individual findings.
Parks and green spaces
The papers looked at various kinds of activities which took place in natural areas such as parks, green spaces, water, gardens or forests. Fifteen focused on emotional well-being, 10 on attention deficit/hyperactivity disorder (ADHD), nine on overall mental health and nine on self-esteem, while others looked at stress, resilience, depression and health-related quality of life.
So, what did the findings show? Overall, the review showed nature could have a positive effect on many outcomes measuring mental health. But only around half of all 100 reported findings revealed statistically significant positive relationships between nature and mental health outcomes, with almost half reporting no statistical significance.
For some outcomes – ADHD, stress, resilience, overall mental health and health-related quality of life – there were more positive findings than there were non-significant ones. Studies which looked at emotional well-being, self-esteem, and depression had a greater number of non-significant findings than positive ones. Only one finding, on the impact of greenness on a subgroup of children, showed a negative effect.
So, what did we know already, and what do we know now that we didn’t know before?
We already knew nature had a significant impact on health – including physical, social and cognitive as well as mental health, especially when we look at the research on adults. However, here in this review we can see that there are quite a few studies with inconclusive results.
What has this review added? We now know a little more about the effects of nature on the mental health of those under the age of 18. It has highlighted the need for more rigorous tools to measure those effects and the growth of research on children’s mental health and nature in the past five years.
The research team have also devised a framework that might help future researchers by categorising papers into three groups based on types of nature interaction: ‘accessibility,’ meaning studies that look at mere opportunity to access outdoor space, ‘exposure,’ which means studies that look at incidental interactions with nature while taking part in another activity, and ‘engagement,’ which means a more direct engagement such as participation in a wilderness therapy programme.
Overall, the messages are mixed. But what this review does demonstrate is the need for more in-depth and more rigorous research. Maybe we need a standard way of measuring the effects of being in nature, its authors say. Certainly we need to continue to look at this area to find out why the research shows such mixed results. But the researchers believe spending time in nature can make a difference – so it’s vital that policy makers and planners think about how we can provide opportunities for children and young people to have those experiences.
Mental health benefits of interactions with nature in children and teenagers: a systematic review is research by Suzanne Tillmann, Danielle Tobin, William Alison and Jason Gilliland and is published in the Journal of Epidemiology and Community Health.