Advancing Understanding on Greenspace and Mental Health in Young People

Poor mental health outcomes among young people, including anxiety, depression, and suicide, have increased substantially in recent years. Given this concerning rise, more research into low-cost mental health interventions is needed. Research suggests that greenspace may be protective of mental health. This study aims to further understanding of the greenspace-mental health association among young people in five distinct urbanities (i.e., urban, suburban, micropolitan, small towns, rural/isolated). We apply publicly available greenspace datasets, which were used to derive greenspace quantity, quality, and accessibility metrics. Emergency department visits for young people (< 24 years) for the following mental health disorders were examined: anxiety, depression, mood disorders, mental and behavioral disorders, and substance use disorders. Generalized linear models investigated the association between greenspace and community-level drivers of mental health burden in North Carolina. Mood disorders saw the highest increase in prevalence in urban communities with low greenspace quantity (PRR: 1.19, CI: 1.16–1.21), anxiety disorders were associated with the greatest increase in rural/isolated communities with poor greenspace quality (PRR: 1.61, CI: 1.43–1.82), and both substance use disorders (PRR: 2.38, CI: 2.19–2.58) and depression (PRR: 2.09, CI: 1.72–2.53) were associated with the greatest increase in prevalence in rural/isolated communities with poor greenspace accessibility. Greenspace quantity interventions may be most effective in urban and suburban areas, greenspace quality interventions may be most beneficial in small towns and rural/isolated communities, and greenspace accessibility interventions may be most useful in urban, micropolitan and rural/isolated communities. Our analysis provides community-specific findings to guide targeted greenspace-mental health interventions.