Research Digest

Addressing adolescent mental health through nature engagement

Both direct and indirect nature-related experiences can be effective in promoting the mental health of adolescents as either prevention or intervention measures. In this Digest, we present six research-supported recommendations for capitalizing on the power of nature to enrich the lives of young people as they navigate the complexities of adolescence and deal with climate change anxiety. We hope that mental healthcare providers, educators, city planners, landscape architects, and researchers will find these recommendations and supporting research studies helpful.

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Adolescent mental health and nature

The Centers for Disease Control and Prevention (CDC) reports that persistent feelings of sadness or hopelessness have increased by 40% for high school students in the U.S. in the years between 2009 and 2019. This concern, however, isn’t limited to the United States. As noted by the World Health Organization (WHO), teen mental health is a global concern. Recent WHO data show that one in seven youth (age 10–19) worldwide are currently experiencing a mental-health disorder, including anxiety and depression. While the cause is certainly complex, a research summary published in The Journal of Pediatrics reports that a decrease in children’s opportunities for independent activity is a cause of decline in children’s mental well-being. As noted in this report, independent activity promotes children’s immediate happiness and long-term psychological resilience. Also noted in the report is the fact that independent activity for young people often takes the form of play. Outdoor natural environments support many forms of play.

Research provides strong support for tapping into the potential of outdoor natural environments for promoting the independent activity and mental health of children and youth. There are, in fact, over 450 studies in the Children & Nature Network Research Library documenting mental health benefits of nature for children and youth. Some of these studies have been highlighted in previous Digests (see especially the November 2018 and November 2020 Digests). Most of those studies, however, focus on children before the age of adolescence. The studies in this Digest, therefore, have been selected to highlight research, and related recommendations, about nature and adolescent mental health.

RECOMMENDATION 1:

Consider adolescents’ specific needs and interests when planning urban greening initiatives.


Urban teens indicate that small, safe spaces in natural areas and open spaces with good views help them feel good in outdoor urban environments

Specific characteristics of eight different urban green spaces in Turkey were linked to self-reported mental health indicators of 384 teenagers while they were in those spaces. According to the participating teens, the characteristics of “nature” (more natural), “refuge” (a small, safe place with opportunity for solitude), and “prospect” (open views) were especially important to their feelings of restoration, stress relief, and mental health.
Akpinar, 2021. How perceived sensory dimensions of urban green spaces are associated with teenagers’ perceived restoration, stress, and mental health?
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Adolescent girls indicate that being in nature and interacting with animals support their health and well-being

Interview responses from 19 teenage girls from Finland indicated that they had positive feelings while engaged with animals and other aspects of nature and that they were happier and more vivacious during summer than winter. Their responses indicate that giving teen girls more opportunities to interact with different aspects of nature, including animals, could promote their mental health.
Wiens, Kyngas & Polkki, 2016. The meaning of seasonal changes, nature, and animals for adolescent girls’ wellbeing in northern Finland: A qualitative descriptive study.
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RECOMMENDATION 2:

Increase opportunities for outdoor recreation and leisure for adolescents.


Increased opportunities for physical activity can add to adolescents’ enjoyment of the outdoors

Essays written by 184 Finnish teens (age 15-16) indicate that adolescents often connect nature and happiness. Many of the essays linked happiness in nature with opportunities for physical activity, and emotional and cognitive renewal. These findings suggest that increased opportunities for outdoor recreation and leisure may promote the mental health of adolescents.
Hakoköngäs & Puhakka, 2021. Happiness from nature? Adolescents’ conceptions of the relation between happiness and nature in Finland.
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Nature is an important part of adolescents’ leisure time experiences and everyday well-being

Thirty-nine students (age 15-16)  from two different schools in Finland wrote about their experiences in natural environments and the meanings they gave to these experiences. Nature for most of the students was “a place of everyday activity” and an important contributor to their well-being. The well-being benefits they experienced in nature include mood enhancement, stress relief, and positive connections with family and friends.
Puhakka & Hakoköngäs, 2023. Adolescents’ experiences in nature: Sources of everyday well-being
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RECOMMENDATION 3:

Use nature-based interventions for youth experiencing mental health problems.


Natural surroundings and biophilic design may enhance therapeutic work with children and youth

This study focused on the meaning of the physical environment in therapy for hospitalized children and youth. Two contrasting environments at a hospital in Norway were considered: a typical hospital setting and a nature-inspired cabin on the hospital’s wooded grounds. Interview responses from 17 individuals involved with the therapeutic program (leaders, therapists, children, and parents) indicated that a more natural environment enhanced the therapeutic process.
Hauge, Lindheim, Røtting et al., 2023. The meaning of the physical environment in child and adolescent therapy: A qualitative study of the Outdoor Care Retreat. 
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Adolescent girls with mental health risk factors showed improved mental health and well-being after participating in a Forest School program

Eight girls (age 12–13) with mental health issues participated in a Forest School program in Scotland. Responses to interviews about the program indicate that benefits the girls received from the program include positive changes in mood, social skills, confidence and relationships. These outcomes supported the girls’ resilience and their ability to overcome personal challenges.
Manner, Doi & Laird, 2020. ‘That’s given me a bit more hope’ – Adolescent girls’ experiences of Forest School.
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Adventure therapy may potentially provide emotional healing for adolescents experiencing complex trauma

Seven studies were included in this review of the literature focusing on how adventure therapy (AT) might be used as an intervention for adolescents experiencing complex trauma (CT). While all seven studies reported enduring therapeutic benefits as a result of AT, several areas of concern were also noted. In addition to a paucity of research, definitions of CT also vary. There are also potentially harmful effects in instances where power is unevenly distributed within AT programs.
Pringle, Boddy, Slattery et al., 2023. Adventure therapy for adolescents with complex trauma: A scoping review and analysis.
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RECOMMENDATION 4:

Focus on constructive responses to climate anxiety.


Adolescents appreciate ways in which pro-environmental actions can address both environmental and mental health concerns

A group of teenagers in the UK served as co-researchers in an investigation of adolescents’ thoughts and feelings about current environmental issues. While results showed that many adolescents are experiencing negative feelings about the state of the environment, they also tend to be highly engaged in environmental issues and appreciate the healing aspects of nature.
Thompson, Fisher, Dewa, et al. 2022. Adolescents’ thoughts and feelings about the local and global environment: A qualitative interview study.
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“Constructive worry” may be an important precursor to climate action

A longitudinal study involving 3037 Australian teens found that climate change anxiety increased for nearly half of them from their pre-teen to later teen years. While climate worry was often associated with greater depression, results also showed that it can be constructively associated with societal engagement. These findings suggest that climate anxiety in adolescents can be harnessed towards constructive responses to climate change-related issues.
Sciberras & Fernando, 2022. Climate change-related worry among Australian adolescents: An eight-year longitudinal study.
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Clinical ecopsychology recognizes nature contact as a potential protective and resilience factor in addressing climate-related mental health concerns

This paper issues a call for a new field of study – clinical ecopsychology – to examine pathways to the development of mental ill-health in the face of ecological adversity and to investigate positive avenues for addressing these mental health concerns. Contact with the natural world is recognized as one of these avenues.
Thoma, Rohleder & Rohner, 2021. Clinical Ecopsychology: The mental health impacts and underlying pathways of the climate and environmental crisis.
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RECOMMENDATION 5:

Recognize the value of nature to the spiritual aspects of adolescent mental health.


Young people appreciate emotional and spiritual benefits of encounters with urban nature

Twenty-four young people in the UK (age 17-27) participated in a study exploring the value of urban nature to their mental health and wellbeing. Nine of the participants experienced mental health difficulties. Interviews and drawings indicated that benefits the participants received from urban nature included a stronger sense of self, increased connection with and care for both the human and other-than-human world and experiences related to awe, empathy, and gratitude.
Birch, Rishbeth & Payne, 2020. Nature doesn’t judge you – How urban nature supports young people’s mental health and wellbeing in a diverse UK city.
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A brief exposure to virtual nature can promote adolescents’ mental well-being, nature connection and spirituality

Seventy-six adolescents in the UK completed mental health-related surveys immediately after watching a brief video depicting either a “natural” or “urban” environment. Adolescents watching the “nature” video reported more positive mental well-being than the adolescents watching the other video. The nature video group also scored higher on assessments of nature connectedness and spirituality.
Owens & Bunce, 2023. The effect of brief exposure to virtual nature on mental wellbeing in adolescents. 
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RECOMMENDATION 6:

Elevate the role of natural environments in adolescent mental health research.


More research is needed to better understand how outdoor places can meet the developmental needs of adolescents

Research documenting the mental health and wellbeing benefits of nature engagement tends to focus more on adults and children than adolescents. Yet, the increase in mental health problems among adolescents is an international concern. This paper discusses this concern and issues a call for “an elevated focus on the role of outdoor environments in adolescents’ everyday lives as a source of wellbeing.”
Wales, Mårtensson, Hoff et al., 2022. Elevating the role of the outdoor environment for adolescent wellbeing in everyday life.
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Nature has a positive impact on the mental health of adolescents, but little is known about why

Findings from a review of 27 studies indicate that exposure to nature has a positive impact on adolescent mental health. Firm conclusions on factors impacting psychological change after exposure to nature could not be identified due to limitations in the design of the studies. These findings highlight the need for more robust methods and attention to potential mediators of nature exposure on wellbeing in adolescents.
Rowley, Topciu & Owens, 2022. A systematic review of mechanisms underpinning psychological change following nature exposure in an adolescent population.
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