Systematic review of quantitative studies assessing the relationship between environment and mental health in rural areas.

Most included studies measured people at one point in time or looked back at existing records, so they show associations but not cause and effect. The studies were too diverse to combine statistically, so the review used a written summary and cannot give one overall measure of how strong the relationship is. The review was not registered, and it searched only English-language databases and excluded qualitative studies, so relevant studies or mechanisms may have been missed. Most studies focused on farms or agricultural populations, so findings may not apply to rural residents in mining, transport, finance or other sectors. Many studies used general psychological distress measures, so the review could not reliably separate depression, anxiety or other specific conditions. Some data sets were used in multiple studies, so the amount of independent evidence may be smaller than the number of papers suggests. No studies assessed biodiversity or environmental conditions at individual farms, and area-level findings may not match individual experiences.

Funding was provided by the Ian Potter Foundation and the National Health and Medical Research Council. The supplied text does not state author conflicts of interest.

Do not read this as proof that drought, extreme weather or land degradation caused mental ill health. Most included studies measured people at one point in time or looked back at existing records, and the review did not test any intervention. It cannot show that changing the environment or screening patients will improve outcomes.