Intended for healthcare professionals

Editorials Christmas 2021: What a Wonderful World

Help nature to help us

BMJ 2021; 375 doi: (Published 09 December 2021) Cite this as: BMJ 2021;375:n2747
  1. Jacob Krzanowski, associate registrar for sustainability
  1. Royal College of Psychiatrists, London, UK
  1. Jacob.krzanowski{at}

The natural world has a critical role in mental health

Although it is said that we live on Earth, humanity has spent its brief history within a thin film on the surface known as the biosphere. This layer, relative to the Earth’s radius, is as thick as the skin of an apple. Wedged between the vacuum of space and the continental plates, it is remarkable for containing all that we know and do. Nearly every ecosystem, life form, death, landscape, conversation, birth, and conflict began and ended here. For many, this space comes close to encapsulating what is meant by nature.

To understand how mental health is informed by the natural world, our dependency on the biosphere is a helpful starting point. An ambitious but necessarily crude international framework, “ecosystem services,”1 identifies the following benefits of nature to humanity: resources such as food, water, timber, medicines, and fibre; regulation of climate, disease, waste, and water quality; cultural experiences such as recreation, aesthetic enjoyment, and spiritual fulfilment; and support of soil formation, photosynthesis, and nutrient cycling. It is not an overstatement to say that “nature underpins all dimensions of human …

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