Exploring links between socio-ecological systems and psychological distress: a case study in rural Uganda


THOMAS P IENKOWSK I * 1 , 2 ,AIDAN KEANE 3 ,EUGENE KIN Y ANDA4 B IRTHE LOA KNI ZE K 5 ,CAR OLINE ASIIMWE6 , 7 GE O FFREY MUHANGUZI8 and E . J . MILN E R-GU LLAND1


Abstract Poor mental health is a leading contributor to the global burden of disease but there is poor understanding of how it is influenced by people’s interactions with ecological systems. In a theory-generating case study we asked how in- teractions with ecosystems were perceived to influence stres- sors associated with psychological distress in a rural setting in Uganda. We conducted and thematically analysed 45 semi-structured interviews with residents of Nyabyeya Parish. Poverty and food insecurity were the primary re- ported causes of ‘thinking too much’ and related idioms suggesting psychological distress. Households bordering a conservation area reported that crop losses from wildlife contributed to food insecurity.However, forest resources re- presented important safety nets for those facing poverty and food insecurity. Commercial agricultural expansion also emerged as a salient theme in the lives of residents, report- edly exacerbating poverty and food insecurity amongst poorer households but contributing incomes to wealthier ones. Our exploratory study suggests how two globally prevalent land uses, nature conservation and commercial agriculture, may influence social determinants of psycho- logical distress in the study area. We highlight co-benefits and trade-offs between global sustainability goals that could be managed to improve mental health.


Keywords Biodiversity conservation, commercial agricul- ture, mental illness, nature conservation, planetary health, psychological distress, socio-ecological systems, Uganda


The supplementary material for this article is available at doi.org/10.1017/S0030605323001710


Introduction


isms’; IPBES, 2019,p. 14) underpins diverse aspects of human health and well-being (Whitmee et al., 2015). Mental health is a core aspect of health, described as a state of well-being through which individuals can cope with daily stressors, realize their abilities and function pro- ductively (WHO, 2004). A large body of research has ex- plored relationships between natural ecosystems and mental health. However, much of this research focuses on a comparatively limited range of linkages (e.g. the psycho- logical benefits of green space exposure), largely from stud- ies in the Global North. This evidence may not reflect the potentially diverse psychological consequences of interact- ing with natural ecosystems in the rural Global South, par- ticularly amongst those whose livelihoods are closely coupled to natural systems. Here we aim to identify under- explored ways in which interacting with ecosystems could influence psychological distress, through an exploratory case study in Uganda, located in the Global South. The fol- lowing summarizes existing literature linking nature and mental health, identifies key evidence gaps and presents our conceptual framework. One increasingly well-studied linkage relates to the psy-


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*Corresponding author, t.pienkowski@imperial.ac.uk 1Department of Biology, University of Oxford, Oxford, UK 2Centre for Environmental Policy, Imperial College London, London, UK 3University of Edinburgh, Edinburgh, UK 4Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe,


Uganda 5Norwegian University of Science and Technology, Trondheim, Norway 6Budongo Conservation Field Station, Masindi, Uganda 7Jane Goodall Institute, Entebbe, Uganda 8Independent researcher, Masindi, Uganda


Received 19 May 2023. Revision requested 18 August 2023. Accepted 9 November 2023. First published online 11 September 2024.


chological benefits of exposure to green and blue space (Collins et al., 2020). This linkage suggests that people’s dir- ect sensory exposure to nature can promote positive psycho- logical states and mental health (Bratman et al., 2015). For example, a study amongst 16,307 respondents in 18 countries found that the frequency of visits to green and blue spaces was positively associated with self-reported mental well- being and negatively associated with psychological distress (White et al., 2021). Other research has examined how green and blue spaces facilitate exercise (Barton et al., 2016), support cultural ecosystem services (Nawrath et al., 2022) and mitigate environmental stressors such as noise and heat (Dzhambov & Dimitrova, 2015), all of which are potentially linked to mental health (Marselle et al., 2021). However, much of this research examines people’s non-use interactions with nature. For example, Marselle et al. (2019) reviewed multiple frameworks connecting nature and mental health. These frameworks and their corresponding


This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. Oryx, 2024, 58(5), 641–649 © The Author(s), 2024. Published by Cambridge University Press on behalf of Fauna & Flora International doi:10.1017/S0030605323001710


ature (‘the nonhuman world, including coproduced features, with particular emphasis on living organ-


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