ArticleInternational journal of environmental research and public health2021
The Cost Effectiveness of Ecotherapy as a Healthcare Intervention, Separating the Wood from the Trees.
Article in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Nature-based interventions: a systematic review of reviews.Frontiers in psychology · 2025Pooled it
- A Pilot Economic Evaluation of a Nature-Based Therapy for Chronic Obstructive Pulmonary Disease in Austria.International journal of environmental research and public health · 2026Trial
- Walk-and-talk versus conventional psychotherapy for men with depressive symptoms: study protocol of a randomised controlled trial.BMJ open · 2026Article
- Nature-Based Interventions for Individuals with Psychiatric Disorders: A Mixed Methods Systematic Review with Random-Effects Meta-Analysis of Mental Health and Functional Outcomes.Behavioral sciences (Basel, Switzerland) · 2026Review
- The Implicit Ecosystem of Outdoor Therapies: A Grounded Theory Exploratory Study of International Practitioners' Guiding Frameworks and the Proposition of a Practice Theory.International journal of environmental research and public health · 2026Article
- Health Economics-Informed Social Return on Investment (SROI) Analysis of a Nature-Based Social Prescribing Craft and Horticulture Programme for Mental Health and Well-Being.International journal of environmental research and public health · 2025Article
- General Practitioners' Perceptions on Prescribing Coastal Visits for Mental Health in Flanders (Belgium).Healthcare (Basel, Switzerland) · 2025Article
- Pilot Testing an Ecotherapy Program for Adolescence: Initial Findings and Methodological Reflections.International journal of environmental research and public health · 2025Article
- Integrating Green Care Initiatives into Conventional Health Systems: Which Governance Dimensions Can Guide This Process?International journal of environmental research and public health · 2025Review
- Article
- Social Return on Investment of Nature-Based Activities for Adults with Mental Wellbeing Challenges.International journal of environmental research and public health · 2023Article
- Mothers' accounts of the impact of being in nature on postnatal wellbeing: a focus group study.BMC women's health · 2023Article
- Exercise-based rehabilitation in and with nature: a scoping review mapping available interventions.Annals of medicine · 2023Article
- Health educationFrontiers in public health · 2022Article
- Views on climate change, climate action and mental health, in young people with and without existing depression symptoms: A qualitative study.The journal of climate change and healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Internationally, shifts to more urbanised populations, and resultant reductions in engagements with nature, have been a contributing factor to the mental health crisis facing many developed and developing countries. While the COVID-19 pandemic reinforced recent trends in many countries to give access to green spaces more weight in political decision making, nature-based activities as a form of intervention for those with mental health problems constitute a very small part of patient pathways of care. Nature-based interventions, such as ecotherapy, are increasingly used as therapeutic solutions for people with common mental health problems. However, there is little data about the potential costs and benefits of ecotherapy, making it difficult to offer robust assessments of its cost-effectiveness. This paper explores the capacity for ecotherapy to be cost-effective as a healthcare intervention. Using a pragmatic scoping review of the literature to understand where the potential costs and health benefit lie, we applied value of information methodology to identify what research is needed to inform future cost-effectiveness assessments. We show that there is the potential for ecotherapy for people with mild to moderate common mental health problems to be cost-effective but significant further research is required. Furthermore, nature-based interventions such as ecotherapy also confer potential social and wider returns on investment, strengthening the case for further research to better inform robust commissioning.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.