Living near trees and green space has often been linked with better well-being.
A large study from Scotland now suggests that improving local woodlands may also be connected with lower use of medicines for depression and anxiety, especially in communities facing greater social and financial disadvantage.
Researchers from the Universities of Edinburgh and Glasgow studied health and location data from more than 129,000 people over five years.
The research was published in The Lancet Planetary Health.
The study focused on woodlands in and around Scottish towns and cities. Some of these areas had received improvements through Scottish Forestry’s Woods In and Around Towns program, known as WIAT.
The program was designed to make local woodland easier, safer and more pleasant to use. Improvements included adding or repairing walking paths, providing clearer signs, improving woodland management and organizing activities that encouraged local residents to spend time there.
Importantly, the program gave priority to communities experiencing greater deprivation. These neighborhoods may have green areas nearby but often face practical barriers that make those spaces less attractive or harder to use.
Simply having trees on a map does not necessarily mean people benefit from them. A woodland with poor paths, confusing entrances or little maintenance may be much less useful than one that feels accessible and welcoming.
The researchers wanted to know whether improving these spaces was linked to measurable changes in mental health. They used NHS prescription records together with census information and data from the Scottish Longitudinal Study, which follows people in Scotland over time.
They compared people living within about a 10-minute walk of an improved woodland with people who lived farther away. They then examined prescriptions for antidepressants and medicines used to treat anxiety.
People in deprived urban communities who lived close to improved woodland were about 10% less likely to receive antidepressants. They were also about 6% less likely to receive anti-anxiety medication than people living farther from these improved areas.
The researchers took into account several other factors that could affect mental health and medicine use. These included demographic differences and measures related to poverty and disadvantage.
One particularly useful part of the study was its ability to follow the same individuals over time. When a person’s distance from an improved woodland changed, such as after moving home, researchers could examine whether prescription patterns changed as well.
The study found that moving closer to improved woodland was associated with lower use of these medicines. This type of analysis helps reduce the possibility that the findings simply reflect healthier or wealthier people choosing to live in greener neighborhoods.
There are several possible reasons why good-quality woodland could support mental health. Natural spaces can provide places to walk, exercise, relax, meet other people or temporarily escape traffic, noise and other pressures of urban life.
Time in nature may also help reduce stress and encourage physical activity, both of which can support mental well-being. Well-maintained public spaces may additionally create opportunities for social contact and give communities a stronger sense that their neighborhood is cared for.
The findings could be particularly important for deprived communities. Mental health problems are common worldwide, but people experiencing poverty and social disadvantage often face greater risks while also having fewer resources available to support health.
Professor Catharine Ward Thompson of the University of Edinburgh said the research provides stronger evidence than earlier studies that woodland improvements can benefit local mental health. The findings may also suggest that improving green space could help reduce some health inequalities.
However, the study does not show that woodlands can replace mental health treatment. Antidepressants and anti-anxiety medicines are important treatments for many people, and prescription use is only one measure of mental health.
There are also reasons to be cautious when interpreting the results. Although the researchers followed individuals and adjusted for many differences, this was not a randomized experiment, so it cannot prove with complete certainty that woodland improvements directly caused the reduction in prescriptions.
Other changes in neighborhoods or people’s lives could have contributed to the results. Researchers also cannot assume that every person living near an improved woodland actually visited it or benefited from it in the same way.
Even with these limits, the study is notable because of its large population, five-year follow-up and use of real prescription records. Following the same people as their access changed also provides stronger evidence than a simple one-time comparison between greener and less-green neighborhoods.
The results support the idea that public health is influenced not only by hospitals, medicines and clinics but also by the environments where people live. Relatively modest investments in paths, signs, woodland management and community activities may make existing green spaces more useful.
Further research could examine how often residents actually use improved woodlands and which types of changes provide the greatest benefits. For now, the study suggests that making nature easier to reach and enjoy may be one practical part of a broader strategy to support mental health in disadvantaged communities.
