Does greenery experienced indoors and outdoors provide an escape and support mental health during the COVID-19 quarantine?

Abstract

Background The COVID-19 pandemic has profoundly changed people's ability to recreate in public green spaces, which is likely to exacerbate the psychological impacts of the pandemic. In the current study, we seek to understand whether greenery can support mental health even with insufficient outdoor exposure in times of physical isolation from the outdoor environment. Methods Between 17 May and 10 June, 2020, we conducted an online survey among 323 students (21.99 ± 3.10 years; 31% male) in health-related programs from two universities in the city of Plovdiv, Bulgaria. Severities of depressive and anxiety symptoms over the past two weeks were measured with the Patient Health Questionnaire 9-item and the Generalized Anxiety Disorder 7-item scale. We employed two self-reported measures of greenery experienced indoors (number of houseplants in the home and proportion of exterior greenery visible from inside the home) and two measures of greenery experienced outdoors (presence/absence of a domestic garden and availability of neighborhood greenery). Restorative quality of the home (the “being away” dimension of the Perceived Restorativeness Scale; PRS) and the neighborhood (the “being away” and “fascination” dimensions of the PRS), engagement with outdoor greenery (frequency of different types of interaction) and perceived social support were treated as mediators. Associations between greenery and mental health were tested using generalized linear regression and logistic regression. Structural equation modelling (SEM) techniques were used to test the theoretically-indicated relations among the variables. Results Clinically-meaningful symptoms of moderate depression and anxiety were reported by approximately 33% and 20% of the students, respectively. The relative abundance of greenery visible from the home or in the neighborhood was associated with reduced depressive/anxiety symptoms and lower depression/anxiety rates. Having more houseplants or a garden was also associated with some of these markers of mental health. As hypothesized, the mental health-supportive effects of indoor greenery were largely explained by increased feelings of being away while at home. Neighborhood greenery contributed to neighborhood restorative quality, which in turn facilitated social support and more frequent engagement with greenery, and that led to better mental health. Conclusions Students who spent most of their time at home during the COVID-19 epidemic experienced better mental health when exposed to more greenery. Our findings support the idea that exposure to greenery may be a valuable resource during social isolation in the home. However, causal interpretation of these associations is not straightforward.

Mental Health, Greenness and Nature Related Behaviours in the Adult Population of Stockholm County during Covid-19-related Restrictions

“…Our study is largely in agreement with the findings from the previous studies. For example, two recent publications -from Japan and Bulgaria -have reported that increased frequency of green area use and/or increased access to green views through the windows at home during the Covid-19 pandemic-related restrictions were associated with positive mental health effects (2,10). In the present study, we did not investigate the effect of the green window views; however, we believe that using (among others) the rather small buffer sizes (such as 50m surrounding the place of residence) did reflect the relative difference in the quantity of greenness that people were able to see through their windows.…”

“…During the time of increased uncertainty, nature around our homes may play a key role in mitigating against adverse mental health outcomes (2,10). A myriad of scientific studies have suggested that experiencing greenness and nature is associated with mental health benefits (11).…”

“…When range and contexts of people's movements are curtailed, greenness exposure close-by homes, either through windows or in the immediate neighbourhood, including balconies and domestic gardens, may become increasingly important for psychological restoration and in support of mental wellbeing (2,10,31). Several studies have indicated that seeing greenness though window may promote health and wellbeing by providing micro-restorative episodes that promote healing (32)(33)(34)(35), facilitate psychological restoration (36), increase recovery from stressful events (37) an improve affective and functional wellbeing (38).…”

“…Furthermore, being able to enjoy green window views has been seen to positively affect an individual's cognitive capacity (39) increase life- (40) and job-satisfaction (41) and promote fascination and a sense of being away from everyday life (42). In a recent study, Dzhambov et al 2020 (10) reported that the university students in Bulgaria, who were forced to self-isolate at home because of the Covid-19 restrictions, but had abundant greenery visible from their home windows or in the neighbourhood, showed both reduced symptoms and rates of depression and anxiety. Spending time in a domestic garden has, among other health effects, been associated with reduced depression and anxiety (43)(44)(45).…”

Urban street tree biodiversity and antidepressant prescriptions

“…This everyday contact with nearby nature—either through a window view at the home 35 , 54 , 66 or on the street 18 , 51 —has been shown to be beneficial for mental health and wellbeing. During the COVID-19 pandemic when people were encouraged to stay-at-home, those who had views of trees and greenspace from the home reported lower rates of depression and anxiety 67 . These studies suggest that ‘unintentional’ 17 contact with nearby nature in daily life is important for mental health.…”