Having less access to nature during lockdowns early in the COVID-19 pandemic was associated with reported symptoms of depression and anxiety, researchers reported in the journal Science of the Total Environment. Below, researcher Sarai Pouso, PhD, explains the findings and what they mean for mental health clinicians treating patients as the pandemic continues.
Q: What led you and your colleagues to study the connection between access to nature and mental wellness in people under lockdown during the COVID-19 pandemic?
A: The study was mainly inspired by two issues: The first reason was to note how differently social distancing measures were impacting me, compared to my family and friends. When the first wave of COVID-19 arrived in Europe, I had recently moved from Spain to Norway. In Norway, the social distancing measures were relatively mild. Despite the closure of shops, restaurants, and preference for remote working, I had a lot of time to enjoy the nature and practice outdoor activities. However, my family and friends in Spain were having a much more complicated experience: they were in strict lockdown and they could only go out for very specific tasks (essential jobs, shopping, or medical reasons). Generally, I noticed that they were sadder and more nervous. Most of them were spending much more time than usual in their gardens and terraces.
The second reason was that prior to the outbreak, during a summer school organized by my PhD supervisor, co-author Dr. Angel Borja, I became familiar with work developed by researchers from the European Centre for Environment and Human Health at Exeter University (Dr. Mat White and Professor Lora Fleming, co-authors) on the positive impacts of nature exposure on human physical and mental health.
After talking with my mentors from [the Basque technology center] AZTI, Drs. Maria C. Uyarra and Angel Borja, we came up with the idea of developing a questionnaire to be able to link all these concepts: lockdown severity, contact with nature and mental health. We asked colleagues from Exeter (Dr. White and Professor Fleming) and Norway (Professor Erik Gómez-Baggethun) to join us, and with their collaboration, we were able to design and carry out the research.
Q: Please briefly describe the study method and your most significant finding(s).
A: We developed and distributed an online and anonymous survey during the first wave of COVID-19. The survey was designed in English and Spanish, and in less than 3 weeks we were able to collect 6769 answers from 77 countries.
The main conclusions are: First, people who were under strict lockdown (eg, Italy and Spain) were more likely to report symptoms compatible with depression and anxiety, compared with countries with more relaxed lockdowns where people could still visit natural places such as parks (eg, the United Kingdom and Norway). Second, among people under strict lockdown, having access from home to outdoor spaces (eg, garden, balcony) and having window views to open spaces or natural elements (eg, sea, coast, park, forest) decreased the probability of reporting symptoms of depression.
The positive effect of access to outdoor spaces and nature views from home was far less important in countries where people were allowed or encouraged to visit parks and other natural locations. Of course, if you still have access to natural locations, having a terrace or nature views from home is less important. But when the only way in which you can “reach” nature is what you can access or see from home, the effect of those elements becomes much more important.
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This study is relevant because it provides new evidence on how important exposure to nature is for mental health. The pandemic gave us the opportunity to reach a large sample of people with no contact with nature over several months, and therefore, to assess the impact of detachment from nature. The COVID-19 pandemic has been a very difficult time for many people in the world, but at the same time provided an opportunity for researchers around the world to continue building evidence in many areas.
Q: Were any of your results surprising or unexpected?
A: At first sight, it surprised us to see that young people were struggling more, showing higher odds of depression and anxiety symptoms than older people. This is interesting, since young people had been less severely hit by the disease than older people, and relevant given that under normal circumstances, the odds of presenting symptoms of mental health disorders increase with age.
Q: How can mental health clinicians use your findings to improve their care of patients as the pandemic continues?
A: I think that the most important result is the confirmation that spending time outdoors in nature, eg, having a walk in a forest, along a coastal path, or practicing sports outdoors, can have a protective effect against negative mental health conditions and also help us improve our current physical health, especially under stressful situations such as lockdowns. Also, our results highlight that clinicians should pay special attention to people without gardens or views of nature, who are more likely to have lower incomes and live in more built-up urban areas.
However, what mental health clinicians can do is conditioned to the lockdown measures in order in each country or region. In this sense, we suggest that if future lockdown measures are needed, governments should consider allowing the population to spend some time outdoors, as it has been demonstrated that it has a protective effect on mental health.
In the longer term, our results are relevant for urban planners. In this sense, future urban developments should pay special attention to the inclusion of elements that would enable to contact with nature (eg, more green areas in public spaces, etc.) by restoring and expanding green and blue spaces. These kind of measures can increase the resilience of cities in the face of pandemics and provide urban dwellers with greater opportunities to access natural environments.
Q: Are you conducting any more research in this area, and are there any related studies you feel are needed?
A: We are going to continue analyzing the responses we got from the survey. Specially we will focus on the subsample of people under the strictest lockdown to see if there are significant differences depending on the type of nature they are exposed to (blue vs green spaces) and the effect of practicing physical activity (indoor vs outdoor activities).
Also, I think it is important to explore if COVID-19 lockdowns led to longer term effects in people’s behavior. For example, after the pandemic, do they visit outdoor spaces and natural settings more frequently than before?
Sarai Pouso, PhD, is an interdisciplinary researcher, working on social, economic, and environmental aspects of ecosystem services, especially studying the recovery of services after ecological restoration. She has more than 5 years of experience working on ecosystem services assessment. She is specially interested in the intangible benefits that the interaction between human and nature provides, and how those benefits contribute to human well-being. She worked as external research consultant in the European Project MOSES (2019) and as a postdoctoral researcher at the Norwegian University of Life Sciences (2020). In her current researcher position in AZTI, Spain, she applies her expertise in statistics and geographic information systems (GIS) in national and international projects related to marine resources management and ecosystem services.
