This systematic review of the literature examined evidence of the mental health benefits for children and teenagers interacting with different types of nature. This research differs from some other studies relating to children and teenagers' mental health status in that it focuses on external influences (including home and neighborhood environments) versus individual-level factors (such as biological and socio-economic characteristics). A specific objective of the review was to determine how interacting with different types of nature may benefit the mental health of children and teenagers. Such a determination could have long-term implications, as mental health issues developed during childhood may persist into adulthood.
Studies included in this review met the following criteria: (1) the population included children and teenagers 18 years and under, (2) the intervention incorporated an element of nature, (3) the outcome or outcomes included a component of mental health, and (4) the study was based on quantitative versus qualitative data. Additional search parameters included publication dates 1990 to March 1, 2017 and published in English or French. Studies deemed to be of poor quality were eliminated. The remaining 35 papers meeting all the selection criteria were included in this review.
Eleven of the studies were conducted in the USA, 8 in the UK, and 2 in Canada. The 14 remaining studies were conducted in other countries. The studies addressed eight categories of mental health outcomes: emotional well-being, attention deficit disorder/hyperactivity disorder, overall mental health, self-esteem, stress, resilience, depression, and health-related quality of life. Of these, emotional well-being and attention deficit disorder/hyperactivity disorder were studied the most often. Childhood depression was rarely studied, and anxiety was not studied at all. Approximately half of the studies reported statistically significant positive relationships between nature and mental health outcomes; approximately half reported no statistical significance. The studies addressed various forms of interactions with nature, including accessibility, exposure, and engagement. Of these, engagement was the most commonly used interaction to assess the relationship between mental health and nature; however, engagement was the least likely of the three forms of nature interaction to yield positive results. In contrast, exposure was the most likely to yield positive results.
The overall findings of this review support the understanding that nature positively influences the mental health of children and teenagers. While additional and more rigorous research is required to confirm these findings and to include a broader population, the evidence of a positive link between nature engagement and mental health is strong enough to support planning and policy initiatives designed to increase children's and teenager's access to natural environments.
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