Dear Colleagues,

Since the emergence of cognitive behavioral therapy (CBT) in the 1980s, solid evidence-based interventions have successfully been applied for treating and preventing stress, anxiety and depression, and for promoting mental health. Today, despite the success of CBT and new generations thereof, the number of people experiencing stress, mental fatigue, burnout, anxiety, depression, and social isolation continues to increase, suggesting that some, perhaps societal and system level, imbalances exist that challenge mental health in our societies today and pose a threat to public health.

Critical imbalances have been suggested by Dr. Otto Scharmer that may compromise individuals flourishing and wellbeing and pose threats to our societies. In particular, three imbalances constitute; the ecological divide (i.e., the disconnect between self and nature), the social divide (i.e., the disconnect between self and other), and the spiritual divide (i.e., the split between one’s current self and one’s possibility for growth and flourishing), with profound consequences illustrated by, e.g., increasing rates of burnout, depression, and suicide*.

Recent research supports the projected imbalance of the ecological divide demonstrating a marked reduction in the time spent outdoor and in contact with nature among people in our societies today who find themselves more disconnected from nature than perhaps ever before in the history of humans. At the same time, as noted above, a growing number of people with mental health concerns, and experiences of loneliness and social isolation, support the imbalances constituting the social and spiritual divides.

Since spending time in nature provides a playground for building community and markedly impacts restorative processes for attention, nature contact per se may hold the potential, not only for alleviating the negative consequences of the disconnect between self and nature, but also for facilitating social connectedness and individual growth and flourishing.

Over the last decade, growing scientific interest has emerged in the potential health benefits of combining outdoor and nature contact or therapy with behavioral health interventions for improving physical and mental health. Substantial support for the health-promoting effects of outdoor and nature contact has been demonstrated, but gaps still remain in our understanding of its health promoting effects—alone or when combined with other behavioral health interventions.

The scope of this Special Issue is interdisciplinary with relevance to healthcare, spanning from epidemiologic research including observational studies and clinical trials, over the fields of environmental health, clinical medicine, and psychology, to ecology, landscape architecture, urban studies, and anthropology. The landscape and environments that may be covered may include but are not limited to forest, green space, and the blue ocean, in addition to urban areas and parks. 

Topics may include studies on, e.g., the therapeutic value of outdoor and nature therapy in clinical or non-clinical populations, including information on any unintended adverse effects, which is paramount for furthering the field and for future application of outdoor and nature therapy in medicine and public health. Additional topics may include but are not limited to how outdoor and nature contact or therapy are associated with outcomes relevant to physical, mental, and public health, including but not limited to stress (disorders), anxiety, depression, cardiovascular diseases, obesity, and dementia. What are the involved mechanisms of actions, including mediating and moderating factors such as psychological (e.g., stress reduction), physical (e.g., activity), social (e.g., connectedness), neurological (e.g., brain activity and imaging), physiological (e.g., heart-rate variability), immunological and molecular (e.g., biomarkers), and environmental (e.g., landscape quality or type) factors for the health benefits of outdoor and nature contact and therapy in healthcare?

The Special Issue encourages the submission of papers based on both quantitative or qualitative data or with integration of both, in addition to relevant meta-analyses. Finally, emphasis will be on research papers that are relevant and useful for developing the field, or for decision makers, so that the presented research might have the greatest likelihood of being helpful in promoting health and benefiting both people and our societies.

*Suicide is now the leading cause of death for people between ages 15 and 49 and is taking more lives than war, murder, and natural disasters combined (data published in Newsweek, May 22, 2013, obtained from the Institute for Health Metrics and Evaluation, which coordinated the Global Burden of Disease report published in a special issue in Lancet, December 2012).

Dr. Jesper Dahlgaard
Guest Editor

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• physical and mental health
• wellbeing
• social wellbeing and connectedness
• flourishing in childhood
• healthy aging
• stress
• mental fatigue
• restoration
• mechanisms of action (physical, psychological, social, physiological, immunological, molecular, neurological, and environmental)
• lifestyle and neurodegenerative diseases
• prevention and rehabilitation
• nursing
• epidemiology of health benefits
• ethics
• technology
• environmental design and access to nature