Green pathways to mental health: Relationships between treescapes and well‐being and distress

Despite the well-researched general effect of physical activity on mental health, less is known about specific effects, such as qualitative and contextual aspects of physical activity. Thus, this review aimed to systematically synthesise evidence on the effects and experiences of different types of leisure-time physical activity (LTPA; e.g., running, fitness, yoga) on distinct positive mental health (PMH) outcomes among adolescents. We searched in seven databases (MEDLINE, Embase, PsycINFO, Cochrane, SPORTDiscus, CINAHL, and Web of Science) without language restrictions for records from January 2009 to 16 June 2025. Inclusion criteria were defined according to the PICOS framework: population (adolescents from non-clinical studies); intervention (specific LTPA type); comparisons (with and without comparator); outcomes (measures or experiences of PMH); study designs (longitudinal quantitative and qualitative studies). We appraised included studies using the mixed-methods appraisal tool. 44 articles from initial 8,149 records were included. Following a convergent segregated approach, the meta-analyses for synthesising the quantitative studies showed different effects depending on the LTPA type. Additionally, the effects depend on the PMH outcome in focus. We identified four facilitators to promote PMH outcomes from the synthesis of qualitative studies: social facilitators for all types of LTPA and various configurations of other facilitators (mastery-related, setting-related, affective-related) for specific LTPA types. The mixed-methods synthesis shows the interplay between LTPA and PMH outcomes depending on the LTPA type. The effects of LTPA on PMH in adolescents depend on the LTPA type and PMH outcome in focus. Perceived facilitators highlight possible explanations for the effects found. By investigating specific LTPA types and different PMH outcomes, ecologically valid implications for specific contexts to foster adolescent mental health may be derived. The limited number of studies per LTPA type, PMH aspect, and study design emphasises the need for more research to derive more specific and robust implications for tailored mental health promotion.

Burnout is a mental health problem that appears to be increasingly common among athletes. Importantly, burnout may also simultaneously increase the risk for other health consequences. In order to examine this idea further, in the present study we provide the first systematic review and meta-analysis of the association between athlete burnout and mental and physical health outcomes. A literature search returned 54 studies (N = 13,976 athletes) examining various negative (e.g. depression, anxiety, insomnia; 27 studies) and positive (e.g. satisfaction, vitality, quality of life; 19 studies) mental health outcomes and physical health outcomes (e.g. biomarkers, somatic symptoms, physiological indices; 18 studies). A systematic review of this literature showed that athlete burnout was associated with both increases in negative mental health outcomes and decreases in positive mental health outcomes. However, evidence for an association between athlete burnout and physical health outcomes was mixed. This broad pattern of findings was supported by a meta-analysis. Our review suggests that burnout may indeed have many negative implications for athletes’ health. The findings also identify a need for further research in this area, especially in relation to burnout and its longitudinal association with biomarkers and physiological indices.

Risk and protective factors of mental health in children in residential care: A nationwide study from Luxembourg

ObjectivesThe objectives of this study were to compare the prevalence of three positive mental health (PMH) outcomes (self-rated mental health, life satisfaction, sense of community belonging) in postpartum women to the general population, and to examine the relationship between protective factors and the three PMH outcomes among postpartum women.MethodsThe national cross-sectional Survey on Maternal Health (n = 6558) was analyzed. Analyses were weighted and 95% confidence intervals were calculated. Three adjusted logistic regression models were generated. To compare this sample to the general population of women, estimates from the Canadian Community Health Survey—Annual Component (2018) were used.ResultsCompared to the general population of women, a larger proportion of postpartum women reported a strong sense of community belonging. The odds of postpartum women with high self-rated physical health having high self-rated mental health were approximately seven times greater (aOR 6.9, 95% confidence interval [CI] 5.9, 8.1) than postpartum women with lower self-rated physical health. The absence of symptoms of postpartum depression (PPD) or generalized anxiety disorder (GAD) and high self-rated physical health were significantly associated with all three PMH outcomes. Frequent availability of maternal support was associated with greater odds of high life satisfaction (aOR 1.6, 95% CI 1.4, 1.9) and sense of community belonging (aOR 1.4, 95% CI 1.2, 1.6).ConclusionsOur study demonstrated that availability of maternal support, self-rated physical health and absence of symptoms of PPD or GAD were associated with PMH among postpartum women. As physical health had the strongest association with mental health, we encourage further examination of this relationship.

Meditation has been demonstrated to benefit adolescent mental health. This research examined various meditation styles practiced in northern Thailand to determine which were associated with positive and negative mental health outcomes in adolescents. High school students who were 15-18 years old and who were enrolled in grades 10-12 in either secular or Buddhist Thai boarding schools were recruited following their school's willingness to participate. They provided information about meditation styles and their practice frequency during the last month (i.e., breathing, kasina (color), Buddha image visualization, Manomayiddhi, mindfulness, recollections, and vipassanā). The Rosenberg Self-Esteem Scale (RSES), Resilience Inventory (RI-9), Outcome Inventory-21 (OI-21), and Perceived Stress Scale (PSS-10) were completed. Multiple linear regression model analysis was used to identify the effects of meditation styles on mental health outcomes. Among 443 participants, 390 were females (87.9%). The mean age was 16.35 ± 0.96 years. The three most common meditation styles practiced were breathing, Buddha image visualization, and mindfulness (46.5%, 26.2%, and 22.8%, respectively). Buddha image visualization was a significant predictor of RSES (B = 1.69, 95%CI = 0.77, 2.61), RI-9 (B = 2.95, 95%CI = 0.68, 2.95), OI-Anxiety (B = -2.38, 95%CI = -3.34, -1.41), OI-Depression (B = -1.94, 95%CI = -2.64, -1.24), and PSS-10 (B = -2.47, 95%CI = -3.65, -1.28), whereas Manomayiddhi was a predictor of RI-9 (B = 2.47, 95%CI = 0.74, 2.47), OI-Anxiety (B = -2.32, 95%CI = -3.41, -1.23), OI-Depression (B = -1.53, 95%CI = -2.32, -0.74), and PSS-10 (B = -2.14, 95%CI = -3.46, -0.81). Breathing meditation predicted OI-Depression (B = -0.87, 95%CI = -1.45, -0.29). Daily meditation frequency was associated with the best mental health scores (p < 0.001). Buddha image visualization, Manomayiddhi, and breathing meditation were predictive of adolescents' mental health. A higher practice frequency is associated with positive mental health outcomes.

PurposeMeditation has been demonstrated to benefit adolescent mental health. This research examined various meditation styles practiced in northern Thailand to determine which were associated with positive and negative mental health outcomes in adolescents.Population and methodsHigh school students who were 15–18 years old and who were enrolled in grades 10–12 in either secular or Buddhist Thai boarding schools were recruited following their school’s willingness to participate.They provided information about meditation styles and their practice frequency during the last month (i.e., breathing, kasina (color), Buddha image visualization, Manomayiddhi, mindfulness, recollections, and vipassanā). The Rosenberg Self-Esteem Scale (RSES), Resilience Inventory (RI-9), Outcome Inventory-21 (OI-21), and Perceived Stress Scale (PSS-10) were completed. Multiple linear regression model analysis was used to identify the effects of meditation styles on mental health outcomes.ResultsAmong 443 participants, 390 were females (87.9%). The mean age was 16.35 ± 0.96 years. The three most common meditation styles practiced were breathing, Buddha image visualization, and mindfulness (46.5%, 26.2%, and 22.8%, respectively). Buddha image visualization was a significant predictor of RSES (B = 1.69, 95%CI = 0.77, 2.61), RI-9 (B = 2.95, 95%CI = 0.68, 2.95), OI-Anxiety (B = −2.38, 95%CI = −3.34, −1.41), OI-Depression (B = −1.94, 95%CI = −2.64, −1.24), and PSS-10 (B = −2.47, 95%CI = −3.65, −1.28), whereas Manomayiddhi was a predictor of RI-9 (B = 2.47, 95%CI = 0.74, 2.47), OI-Anxiety (B = −2.32, 95%CI = −3.41, −1.23), OI-Depression (B = −1.53, 95%CI = −2.32, −0.74), and PSS-10 (B = −2.14, 95%CI = −3.46, −0.81). Breathing meditation predicted OI-Depression (B = −0.87, 95%CI = −1.45, −0.29). Daily meditation frequency was associated with the best mental health scores (p < 0.001).ConclusionBuddha image visualization, Manomayiddhi, and breathing meditation were predictive of adolescents’ mental health. A higher practice frequency is associated with positive mental health outcomes.

The transition to adulthood, including mental health, has been a focus of research; however, little is known about the mental health outcomes of emerging adults with high incidence diagnoses including ADHD and specific learning disabilities (SLD). This scoping review describes the current state of the research on our understanding of both positive and negative mental health outcomes in these populations. Results of this scoping found an emphasis on emerging adults with ADHD (78%) over those with SLD (12%) or with ADHD and SLD (10%), and over half focused on those who attended postsecondary institutions despite low percentages of these populations going on to postsecondary education. Studies included frequently provided limited information on race or ethnicity, sex or gender, or ADHD or SLD subtypes. Additionally, there was greater focus on negative mental health outcomes (e.g., anxiety, depression) than positive mental health outcomes (e.g., wellbeing, flourishing). We end by discussing implications for future research.0020.

Many young adults experience chronic pain and given its wide availability and potential pain reducing properties, young adults may use cannabis to self-medicate for pain. However, little is known about young adult users’ perceptions of potential health risks and benefits of cannabis, and whether these perceptions differ by chronic pain status. As a part of a larger study, young adult recreational cannabis users (N=176, ages 18-29) who reported using at least once a week completed assessments of use frequency and perceived cannabis-related risks and benefits. The sample had a high proportion of participants who met criteria for chronic pain (51.1%). The majority of the sample reported using daily or multiple times daily (80.7%) with an average of 2.68 (SD=1.42) sessions per day across administration modes (e.g. smoking, edibles, tinctures). Participants answered questions about their lifetime chances of experiencing five cannabis-related risks (personal harm, negative health outcome, negative mental health outcome, harming someone else, increased pain) and benefits (personal benefit, positive health outcome, positive mental health outcome, benefitting someone else, decreased pain; 1=Very low to 7=Very high). Overall, young adult users perceived their risk to be very low (M=1.62, SD=.73) and 40.3% of the sample had an average risk score (combined across the five risk items) of 1.00, while only one participant reported an average risk above 4.00. In particular, participants reported a low lifetime chance of experiencing personal harm (M=1.51, SD=.90), harming someone else (M=1.20, SD=.58), or experiencing increased pain (M=1.24, SD=.74) due to their cannabis use. In contrast, young adult users perceived somewhat high chances of experiencing benefits related to their cannabis use (M=4.78, SD=1.46). In particular, participants perceived a high chance of experiencing reduced pain (M=5.88, SD=1.55), personal benefit (M=4.84, SD=1.86), and positive mental health outcomes (M=4.82, SD=1.77). There was no difference based on pain status on frequency of use, average daily sessions, or perceived risks, and only one difference in perceived benefits. Participants without chronic pain anticipated more personal benefit from cannabis use (M=5.15, SD=1.74) than those with chronic pain (M=4.53, SD=1.94, t(171)=2.21, p=.03). Overall, results suggest young adult recreational users perceive very low risks of their cannabis consumption and moderately high benefits, regardless of pain status. Looking at individual areas of potential risk and benefits may yield targets for future health education campaigns. For example, perceptions of low risk/high benefits regarding mental health outcomes may not be accurate for this heavy using sample.

PurposeUnderstanding the individual and joint associations of positive and negative mental health with screen-time and physical activity (PA) among adolescents is essential to develop enhanced guidance for prevention strategies and appropriate interventions.MethodsParticipants (n=879, n = 463 female, mean age 14.71 (SD = 1.51) years) from second-level schools in Ireland completed a battery of well-validated questionnaires assessing hours of daily screen-time use (TV, computer, and phone), PA levels (PACE+) (low (0–2 day/week), moderate (3–4 day/week), or high (5+day/week), and mental health outcomes (anxiety (STAI-Y2) and depressive symptoms (QIDS) and positive mental health (MHC-SF)). Multiple linear regressions examined associations between screen-time, PA and mental health and one-way ANOVA’s examined differences in mental health outcomes between screen-time mode and use categories (none (0 hours), low (0.5-1.5 hours), moderate (2-4.5 hours), and high (5+ hours)). Cohen’s d effect size and 95% confidence intervals quantified the magnitude of the difference.ResultsHigher computer (β=0.112, p≤0.001) and phone use (β=0.138, p≤0.001) were associated with higher depressive symptoms. Higher TV use (β=-0.111, p≤0.002) and PA levels (β=-0.123, p≤0.001) were associated with lower anxiety symptoms. Higher phone use (β=0.113, p≤0.002) and PA levels (β=0.116, p≤0.001) were associated with higher positive mental health. The magnitude of differences in depressive and anxiety symptoms across screen-time use categories were largely small-to-moderate (d = 0.02 to 0.67) and in positive mental health, ranged from small to large (d = 0.03 to 0.88). The sample was then stratified by PA level to assess the potential moderating influence of PA on the screen-time-mental health association, with mixed results.ConclusionsResults are among the first findings regarding the relationship between screen-time mode and PA levels with mental health, particularly positive mental health among adolescents in Ireland. Associations of screen-time and PA with mental health outcomes varied according to PA level and screen-time mode. The variation in these findings suggest the need to investigate the context of screen-time use and the screen-time activity engaged with. These results suggest that not all screen-time is detrimental and some, in moderation, may be beneficial for mental health. Future research should investigate longitudinal associations between screen-time, PA, and mental health.Support/Funding SourceN/A

The goal of this study is to examine the relationship between socioeconomic status (SES) and both positive and negative mental health (MH) outcomes in a population-based sample of colorectal cancer survivors. On the basis of theoretical conceptualizations of trauma and posttraumatic growth, low SES was hypothesized to be positively associated with both greater negative MH outcomes (e.g., distress) and greater positive MH outcomes (e.g., growth). Colorectal cancer survivors (n = 1300; 57% male; mean age 69.4 and 4.0 years post-diagnosis) were recruited using a regional, population-based cancer registry in the Netherlands and completed a questionnaire assessing current negative and positive MH outcomes. Low, medium, and high SES respondents were identified using an area-level indicator of SES based on aggregated individual fiscal data on monetary home value and household income. Analysis of covariance and logistic regression analyses indicated that low SES was a risk factor for greater negative MH outcomes. Relative to high SES survivors, low SES survivors reported poorer status on nine indices of MH, and high SES survivors were about 50% less likely to report clinically important levels of anxiety and depression. Results provided partial support for the hypothesis low SES was a 'risk' factor for greater positive MH outcomes. Relative to high SES survivors, low SES survivors reported greater positive MH outcomes on 2 of 5 positive MH indices examined (Positive Self-Evaluation, Meaning of Cancer). Study findings are the first to suggest that low SES might increase the likelihood of both greater negative as well as positive MH outcomes in cancer survivors.

Depression is significant mental health issue among university students and can decrease their ability to succeed academically. While various factors associated with mental health problems have been identified, researchers are increasingly exploring the role of positive mental health, such as character strengths and inner strengths, in relation to mental health problems. This study aims to build upon previous research by examining the influence of positive mental health on the mediation model of depression among students enrolled at Chiang Mai University. This study will employ an observational and longitudinal study that collects data from undergraduate students at Chiang Mai University during the 2023-2024 academic year. The primary outcome of this study will be depression. In the mediation models, insecure attachment and negative family climate will serve as predictors, while borderline personality symptoms will be the mediator. Positive mental health, including character strengths, inner strengths, and resilience, will be tested for moderation effects on the mediation models. Data will be collected at three intervals, with a three-month gap between each collection period. This study will provide insights into the positive and negative mental health outcomes of university students in Chiang Mai. Through comprehensive analysis, this study intends to offer valuable insights into both positive and negative mental health outcomes among university students in Chiang Mai. Moreover, by employing a longitudinal approach, it aims to establish a more robust understanding of the causal relationships between positive mental health, predictors, mediators, and depression. The study's limitations will also be discussed.

A growing concern for universities is the state of mental health with a clear need for positive mental health campaigns and strategies to shift the culture surrounding mental well-being. Our campus has adopted a holistic framework, Act-Belong-Commit, to improve mental health through positive intentional engagement in activities. PURPOSE: The purpose of this study was to examine the mental health climate and well-being of current students on a primarily residential collegiate campus before the implementation of Act-Belong-Commit campaign. METHODS: 176 students (21.2±2.5yrs; 162 female, 19 male, 2 gender non-binary) participated in the campus-wide survey. There was equal representation of the students across years in school with little ethnic/racial diversity: (Caucasian=93%; African American=2%; Hispanic/Latinx=3%; Asian=2%) and some diversity in sexual orientation (heterosexual=87%; homosexual=2%; bisexual=8%, or other=2%). Measures included: Satisfaction With Life (SWL), Multidimensional Scale of Perceived Social Support (MSPSS), Self-Stigma of Seeking Help Scale (SSSHS), Depression Anxiety Stress Scale (DASS), Resilience and the Meaning of Life Questionnaire (MLQ). A small subset (n=55) completed an ABC self-assessment. RESULTS: Social Support was significantly correlated (p<0.05) with many positive mental health outcomes: SWL (r=.62); Resilience (r=.39); Meaning of Life (r=.34); Depression Subscale (r=-.56); Anxiety Subscale (r=-.34); Stress (r= -0.35). High perceived social support and positive mental health were also seen in people high on ACT (Social Support r=.32; resilience r=.37, depression r=-.32, anxiety r=-.26, and stress r=-.36) and BELONG (SWL r=.35, resilience r=.39, depression r=-.29, stress r=-.28). CONCLUSION: Social support and a sense of belonging was integrally tied to measures of positive mental health and improved satisfaction with life measures. Belonging comes from being engaged in an active life with people and activities that bring meaning and purpose. Campus recreation and exercise science programs will lead the implementation of the ABC campaign, promoting physical activity, mindfulness/mediation, and play as activities to engage in a various levels as part of this positive mental health campaign.

The prevalence of HIV in adolescents is a major global health concern, and research into the influence of HIV on mental health outcomes in this demographic is ongoing. We will conduct a comprehensive systematic review of common mental health outcomes in adolescents with HIV infection (aged 10-24 years). Recognising the specific psychosocial issues that adolescents living with HIV infection are confronted with, this review aims to integrate existing research on the prevalence, risk factors and protective factors related to both positive and negative mental health outcomes in this population. The following electronic databases will be searched for publications from 1959 up to December 2025: PubMed, PsycINFO, Global Health, Embase, African Journals OnLine and African Index Medicus. The review will focus on both positive and negative mental health outcomes: positive outcomes include resilience, subjective happiness and post-traumatic growth, whereas the negative outcomes include depression, anxiety, post-traumatic stress disorder, substance use disorder and suicidality. Peer-reviewed primary observational studies that report prevalence rates for common mental health outcomes outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, and the International Classification of Diseases, 11th Edition, their associated factors, as well as barriers to and facilitators of use of mental health support services among this population, will be included in the review. Google Scholar and ProQuest Dissertations & Theses Global as well as Electronic Theses and Dissertations from Ghana, South Africa, Uganda and Kenya, will also be searched for grey literature. The review will be limited to publications in English or French. To assess the methodological rigour of the selected studies, the Joanna Briggs Critical Appraisal Tools will be used. The synthesis will include a narrative summary and, if applicable, a meta-analysis of quantitative data depending on the extent of heterogeneity observed in the included studies. Subgroup analyses will be conducted to investigate differences in mental health outcomes by age, sex and socioeconomic position, where applicable. This systematic review will be reported in accordance with the PRISMA statement. This review will use secondary data and does not require ethical approval. The findings will be shared through peer-reviewed publications and conference presentations. The emphasis will be on translating research findings into practical mental health interventions and HIV-specific support services for adolescents. CRD42024568512.

Purpose This paper aims to evaluate the links between health importance, mindfulness aspects and positive mental health outcomes in consumers. It uses both symmetric and asymmetric methods to study these complex relationships. Design/methodology/approach A structured questionnaire was distributed to obtain data from consumers, and 721 completed the questionnaire considering our research objectives. Structural Equation Modelling (SEM) was used to analyse the links between the constructs, whereas Fuzzy Set Qualitative Comparative Analysis (fsQCA) was used to find sets of conditions associated with beneficial mental health outcomes. Findings The study found substantial positive correlations between health importance and all aspects of mindfulness, including attention to one’s body, environment and emotions. Furthermore, attention to one’s body is identified as a strong predictor of positive mental health, highlighting the relevance of bodily awareness in promoting well-being. However, causal asymmetry is evident, implying that diverse combinations of causes result in higher or lower levels of positive mental health. Research limitations/implications While the study sheds light on the relationship between health importance, mindfulness and healthy mental health, it is not without limits. The survey-based methodology of the research may create biases, and the sample is predominantly made up of customers, limiting the generalisability of the results. Future study could investigate these correlations in more diverse groups, using longitudinal designs to gain a better grasp of causality. Practical implications The findings have practical implications for programmes designed to promote positive mental health. Individuals’ well-being and resilience can be improved by emphasising the value of health and fostering mindfulness activities. Targeted therapies can use these findings to create successful strategies for improving mental health outcomes. Originality/value This study fills a gap in the literature by adopting a holistic approach to examine the interplay between health importance, mindfulness and positive mental health. Unlike prior research focusing on isolated mindfulness aspects or singular methods, it uniquely integrates symmetric and asymmetric analyses. This approach reveals novel pathways and causal configurations contributing to well-being. Highlighting mindfulness’s mediating role and multidimensional nature, the study offers actionable insights that bridge theory and practice, advancing mental health promotion and guiding more comprehensive interventions.

The military is a unique cultural institution that significantly influences its members, contributing to the development and transformation of their identities. Despite growing interest in identity research in the military, challenges persist in the conceptualization of military identity, including understanding how it forms, assessing the influence of military culture on identity development, and evaluating the implications for mental health. The primary objective of this scoping review was to map the complexities of military culture's impact on military identity and its effects on mental health. A scoping review of the literature was conducted using the Joanna Briggs Institute Scoping Review Methodology. Studies were included if they described military culture, military identity, and mental health, resulting in 65 eligible studies. The extracted data were thematically analyzed to identify how military culture impacts military identity and mental health and well-being. Multiple identities were evident within the military population, with 2 overarching identities, loyalty and military, overall conferring positive mental health outcomes. Where these identities were hidden or disrupted, poorer mental health outcomes were observed. The scoping review conducted in this study challenges the notion of military identity as a singular concept promoting positive mental health outcomes. It highlights its multifaceted nature, revealing that individuals may face identity concealment and disruptions during periods of transition or adjustment, resulting in adverse mental health outcomes. To capture the complexity of military identity, the authors developed the Military Identity Model (MIM). Military leaders, policymakers, and health care professionals are encouraged to recognize the complex nature of military identity and its impact on mental health and well-being. We recommend using the Military Identity Model to explore military identity and adjustment-related difficulties.