A Look at the Ecotherapy Research Evidence

Campus outdoor environment, learning engagement, and the mental health of college students during the COVID-19 pandemic: From the perspective of students in different grades

Introduction

During COVID-19, the mental health of Chinese university students has been a pressing concern. But the internal mechanism of perceived campus outdoor environment and learning engagement affecting college students' mental health during the COVID-19 pandemic has not been fully discussed.

Methods

The current study used cross-sectional data from 45 Chinese universities to explore the relationship among perceptions of campus outdoor environments, learning engagement, and college student mental health, and focused on differences among college students in different grades.

Results

Our study revealed the mental health problems of Chinese college students during the COVID-19 pandemic were more severe. The mental health of postgraduates was generally poor, and their risk of depression was higher than that of undergraduates. More importantly, for postgraduates, the direct impact of the perceived campus outdoor environment on their mental health was stronger. For undergraduates, the indirect impact of learning engagement on the effect of the perceived campus outdoor environment on their mental health was stronger.

Conclusion

The results of the study have implications for campus planners, landscape architects, and university planners to pay particular attention to the needs of postgraduates for campus outdoor environments, which is of great significance to improve the overall mental health of students during the COVID-19 pandemic.

Integrating positive psychology and spirituality in the context of climate change

In the context of climate change and its accompanying impact on stress and mental health, we argue that positive psychology (PP) may benefit from an integration of spirituality to better support people’s wellbeing. Starting with an overview of climate change’s impact on wellbeing and health, we explore the paradoxical and complex relationship between humans and nature. Following which, we will briefly define spirituality and present an evocative metaphor of the wave to portray the evolution of the field of PP. In our conclusive remarks, we argue that the field of PP has gradually become more open to integrate spirituality (since the first wave), as it evolves towards greater complexity (in its third wave). In addition to meaning, some spiritual perspectives potentially relevant to positive psychology facilitate an ecocentric view (i.e., eco-spiritualities) which allow for a better understanding of the paradoxical human-nature relationship, as we struggle to deal with the complex issues related to climate change.

The Impact of COVID-19 on Horticulture: Critical Issues and Opportunities Derived from an Unexpected Occurrence

The COVID-19 pandemic is causing many victims worldwide and has generated a serious economic crisis. Substantial changes have occurred in the food and ornamental production chains. The aim of the present review has been to summarize some of the main effects that the pandemic is having on horticulture and on the new habits of people. Infections and quarantine measures have prevented the regular flow of certain goods and of connected services. Cases of shortages and/or surpluses, a lack of the availability of labor, and a reduction in demand for some food products and flowers have occurred. New food production approaches have emerged and a reconnection between farmers and consumers has been spreading, thereby facilitating product distribution. Moreover, during the forced isolation, people have had to face periods of stress. The benefits that can be derived from leisure activities related to flowers and ornamental plants, and from access to nature and urban green spaces are increasingly being recognized as relevant. The seriousness of the pandemic will inevitably lead to lasting changes. Therefore, the vulnerability of the pre-COVID-19 distribution chains should be considered and a new food production chain should be drawn up, to increase the resilience of such systems.

Green Care as Alternative Therapy: The Situation in Ghana

Green care, an alternative healthcare system that involves the use of nature, is proven to be useful in the management of organic and psychological disorders worldwide. There are various forms of Green care including Animal-Assisted Therapy (AAT), a type where animals play pivotal roles in the healing process and is widely used in many developed countries. We assessed the level of awareness and attitude towards Green care among medical students of Ghana. Using a cross-sectional study design and a semistructured questionnaire designed on Google Forms, data were collected from randomly selected 4th-, 5th-, and 6th-year medical students of the University for Development Studies, Tamale, Ghana. The data submitted by 206 of the students were analyzed using Statistical Package for the Social Sciences, Version 25, and the results were presented as frequencies, percentages, and charts. The association between sociodemographic characteristics of respondents and awareness about Animal-Assisted Therapy (AAT) was considered significant at $p<0.05$ . The study found that only 7 (3.4%) of the medical students had ever heard of Green care while a higher number of 36 (17.5%) were aware of AAT mostly through movies and television. However, the majority, 122 (59.3%), had a positive attitude towards the introduction of AAT, into their medical training curriculum. Up to 146 (70.9%) of the respondents suggested lectures and practical sessions as their preferred way of acquiring knowledge and skills on AAT. Only the sex of the respondents was significantly associated with awareness of AAT, with females having a better awareness of AAT (28.6% vs. 11.0%, $p=0.003$ ). We conclude that awareness of Green care practices among medical students in Ghana was highly inadequate, but the desire of the majority of them to acquire knowledge and skills in this proven alternative therapy makes its future use in Ghana promising.

On the need for an ecologically dimensioned medical humanities

Increasing calls from medical professionals and scholars suggest an urgent need for better and more widespread understandings of the ecological dimensions of health. Such calls have included: two recent Lancet special commissions on impacts of climate change on health; and recognition by senior figures from the WHO and United Nations of relationships between human impacts on the natural world and disease pandemics, with some suggesting prevention of future pandemics may require a radical reassessment of modernity's relationship with the natural world.Among the medical humanities as a whole, however, calls for better and more widespread understandings of the ecological dimensions of health have not always been as prominent, or urgently expressed, as they might be.This paper, which presumes there is an urgent need for better and more widespread understandings of the ecological dimensions of human health, draws on ecological public health and other models to propose an ecological re-visioning of our conceptions of health and medical humanities; and in ways that challenge some contemporary assumptions about health, well-being and the 'good society'. Indeed, once we begin to heed what ecocritic Tim Morton terms 'the ecological thought', we may discover few areas of healthcare and the humanities remain untouched by its implications.With growing recognition that the fate of global human health and the fate of the biosphere are inextricably entwined, the project of a more ecologically dimensioned medical humanities appears both timely and urgent. Such a project may represent a significant opportunity for the medical humanities, and a significant responsibility.

"Recovering With Nature": A Review of Ecotherapy and Implications for the COVID-19 Pandemic

Connection with nature has been considered beneficial for psychological well-being since times of evolution. Differences in Indian and Western thoughts have viewed natural elements in different lights, varying between eco-centrism to anthropocentrism. The intrusion of technology and digitalized lives as a result of globalization has decreased connectedness with nature. Ecotherapy is a novel form of psychotherapeutic technique based on explicit environmental or ecological interventions. Social and therapeutic horticulture, animal-assisted interventions, care farming, green exercise, environmental conservation and wilderness therapy are some of the ecosystem-based approaches used in mental health. Based on the principles of positive and client-centered psychology, ecotherapy-related techniques have been shown to be effective in medical disorders like hypertension, obesity, post-surgical recovery and psychosocial conditions like depression, stress reduction, post-traumatic stress disorder (PTSD), attention deficit hyperkinetic disorder (ADHD) and adjustment disorders. The principles of ecotherapy have been integrated into other psychotherapeutic techniques for better efficacy. This review attempts provides an overview of techniques, applications and challenges related to ecotherapy in psychology. The implications of its use during the ongoing Coronavirus 2019 (COVID-19) crisis, social isolation and consequent psychosocial aftermath are also discussed.

Sustainable Co-Design with Older People: The Case of a Public Restorative Garden in Milan (Italy)

The demographic aging and the evolution of lifestyles require new strategies to promote the well-being and active aging of elderly. Active aging depends on many factors: some of these are related to objective data such as physical environment, others are personal elements; it is important to improve environmental physical factors to encourage personal attitudes to the green spaces in use. To design a small sustainable restorative green space in Milan, Italy, restorative garden design criteria are summarized in the first section of the paper and both social and environmental sustainability are considered. The methodology section describes the co-design process and how it was applied to include different older user groups in the design of the area. In the results section authors apply a taxonomy based on the four properties of restorative settings according to the Attention Restoration Theory by Kaplan (compatibility, being away, extent, fascination): this provides a unified system to classify users’ expectations and to describe the final project. The proposed co-design process combines social and environmental sustainability, as it provides designers an insight about the user’s experience in nature. Such information can be fruitfully integrated with professional competences about comfort aspects and environmental protection in order to improve the whole design project.

Nature-Based Interventions for Improving Health and Wellbeing: The Purpose, the People and the Outcomes

Engagement with nature is an important part of many people's lives, and the health and wellbeing benefits of nature-based activities are becoming increasingly recognised across disciplines from city planning to medicine. Despite this, urbanisation, challenges of modern life and environmental degradation are leading to a reduction in both the quantity and the quality of nature experiences. Nature-based health interventions (NBIs) can facilitate behavioural change through a somewhat structured promotion of nature-based experiences and, in doing so, promote improved physical, mental and social health and wellbeing. We conducted a Delphi expert elicitation process with 19 experts from seven countries (all named authors on this paper) to identify the different forms that such interventions take, the potential health outcomes and the target beneficiaries. In total, 27 NBIs were identified, aiming to prevent illness, promote wellbeing and treat specific physical, mental or social health and wellbeing conditions. These interventions were broadly categorized into those that change the environment in which people live, work, learn, recreate or heal (for example, the provision of gardens in hospitals or parks in cities) and those that change behaviour (for example, engaging people through organized programmes or other activities). We also noted the range of factors (such as socioeconomic variation) that will inevitably influence the extent to which these interventions succeed. We conclude with a call for research to identify the drivers influencing the effectiveness of NBIs in enhancing health and wellbeing.

Rooted in the Community: Assessing the Reintegration Effects of Agriculture on Rural Veterans

OBJECTIVE

To assess the effect of a veteran-oriented community agricultural initiative on transitioning rural veterans.

DESIGN

Convergent mixed-method program evaluation.

SETTING

Veteran-oriented farm-to-market community agricultural initiative.

PARTICIPANTS

Veterans (N=43) who were members of the community agricultural initiative.

MAIN OUTCOME MEASURES

Health, well-being, and reintegration were assessed by self-reported data from interviews, a demographic survey, a validated health quality of life measure (Veterans RAND-12 [VR-12]), a validated reintegration measure (Military to Civilian Questionnaire), and a general satisfaction survey.

RESULTS

Veteran participants were primarily white (88.4%, n=38) and men (74.4%, n=32), and most had a service-connected disability rating (58.2%, n=25). Qualitative and quantitative data revealed that the veterans participating in this community agricultural initiative experienced health and reintegration benefits. Results on the Military to Civilian Questionnaire, VR-12, and satisfaction survey suggest that participating in this community agricultural initiative contributed to improved mental, physical, and emotional health and vocational skills, community connectedness, and interpersonal communication. Qualitative interviews supported quantitative findings and revealed that participating in the community agricultural initiative provided veterans with a sense of satisfaction, a sense of belonging, and helped decrease the stigma surrounding their veteran status.

CONCLUSIONS

Veterans who participate in this community agricultural initiative reported general improvements in physical and mental health, including improvements in sleep, nutrition, and exercise, and decreases in anxiety, pain, depression, and medication and substance use, all known factors which effect veteran reintegration.

The role of nature in coping with psycho-physiological stress: a literature review on restorativeness

Physical settings can play a role in coping with stress; in particular experimental research has found strong evidence between exposure to natural environments and recovery from physiological stress and mental fatigue, giving support to both Stress Recovery Theory and Attention Restoration Theory. In fact, exposure to natural environments protects people against the impact of environmental stressors and offer physiological, emotional and attention restoration more so than urban environments. Natural places that allow the renewal of personal adaptive resources to meet the demands of everyday life are called restorative environments. Natural environments elicit greater calming responses than urban environments, and in relation to their vision there is a general reduction of physiological symptoms of stress. Exposure to natural scenes mediates the negative effects of stress reducing the negative mood state and above all enhancing positive emotions. Moreover, one can recover the decrease of cognitive performance associated with stress, especially reflected in attention tasks, through the salutary effect of viewing nature. Giving the many benefits of contact with nature, plans for urban environments should attend to restorativeness.

Embedment in the environment: A new paradigm for well-being?

Dominant models of health view people as essentially separable from their environment, affected directly by specific physical events or indirectly through idiosyncratic perceptions. Health is therefore a function of the individual, whether they are treated alone or in a group of similar individuals. A different (ecopsychological) view is that we are embedded within the environment; that notions of self, illness and well-being relate to where we are. Health practitioners and policy makers have realized that mind and body cannot be seen as being separate when promoting well-being, but ‘self’ and ‘environment’ is an equally false dichotomy. Although rarely acknowledged, we are continually interconnected via two-way physical interactions (electromagnetic, chemical and mechanical), and all we can know of the world comes via such interactions. Our concepts of self and other, health and disease, and all the relationships between them, are based on such interactions. If our environment changes, then these interactions change, yet our concepts often remain rigidly fixed. By introducing research into restorative, natural environments, the notion of adaptive mental states and the practices of ecotherapy, this paper offers an alternative view of well-being, shifting the emphasis away from the individual and his/her illness and instead inviting consideration of the more dynamic relationships between people and place.