Nature and Mental Health

By Katy Heggen on November 25, 2019 in Blog


A doctor, a lawyer and a pharmacist walk into the woods… Slowly. 

They’ve assembled at the edge of the woods with a dozen other Iowans at Jester Park in Polk County on a misty evening in early September to partake in  forest bathing, a form of nature therapy that has become increasingly popular in the United States in recent years. 

Medical practitioners, mental health professionals and agencies across Iowa are beginning to incorporate various forms of nature therapy into their practices and programming, taking note of the growing interest in and ever-expanding base of evidence around the connection between nature and wellness. As it turns out, not only is time spent outdoors good for people, nature itself stands to benefit from the relationships forged in fresh air, too.  

Taking root

Shinrin-yoku, or forest bathing, was developed in Japan in the 1980s. Unlike a hike, nature walk or sightseeing trek, forest bathing is not about exercise, species identification or scenic overlooks. Rather, it’s a slow, contemplative walk focused on immersing oneself in nature and experiencing the benefits of being fully present in the outdoors. 

“It’s really about taking in nature in a more mindful way,” said Dr. Suzanne Bartlett Hackenmiller, a Cedar Valley-based physician and our guide for the evening.

Hackenmiller first began leading these walks as part of a series of workshops about nature and wellness at Prairiewoods, a Franciscan ecospirituality retreat tucked into 70 acres of woods and prairie in the Cedar Rapids metro. The workshops were so well received that she decided to become a certified nature therapy guide in 2017. In addition to her medical practice, she now leads nature therapy walks and provides workshops combining outdoor adventure, integrative wellness and nature therapy.

“There’s just been an explosion of interest in this in the last couple of years, and an increasing understanding that this is real medicine, both by people who practice it and in health care,” Hackenmiller said.

Big medicine

By her own admission, Hackenmiller was once one of the most conventionally minded physicians she knew. However, after 12 years as an OB-GYN in the Cedar Rapids area, she was burnt out. Around this same time, her husband Dave was diagnosed with stage four cancer, passing away in 2012. These experiences, along with her personal journey raising a son on the autism spectrum, led Hackenmiller to explore integrative medicine, and later, having found personal solace in outdoor adventure, nature therapy. 

“Once you go down this road, you can’t go back to seeing things the same way,” she said. “We all have an inherent need to be outdoors. There’s power in that connection, if we just allow ourselves to experience it.”

The bond between nature and human health is well documented. Among other benefits, time spent simply being in natural areas has been scientifically proven to reduce blood pressure, lower stress indicators, improve mood, increase the ability to focus, accelerate recovery from injury or illness, boost energy and improve sleep. Recent research has also shown that time spent outdoors has the ability to boost immune system functioning, increasing both the count and activity of the body’s natural killer (NK) cells, which routinely sweep through the body, guarding against tumors and  viral infections.

“To me, it’s exciting when science confirms what we know intuitively: that being in nature is good for us,” Hackenmiller said. 

Dr. Amanda Hardy, a Des Moines and Ames-based licensed mental health counselor specializing in perinatal mental health, is an enthusiastic advocate of nature therapy as a tool for improving mental health. She integrates elements of nature therapy into her practice and workshops centered around reconnecting people with nature. 

“There’s a metaphor we use a lot in mental health about climbing the mountain,” she said. “In nature therapy, we’re doing that in a more literal sense.”

Wilderness therapy programs, which cater to people scaling physical, mental and emotional peaks of all kinds, have long recognized the healing qualities of nature. Though she’s a proponent of such programs, Hardy notes people don’t need to be going through life-changing events to reap the mental health benefits of incorporating elements of nature into their daily lives.

“Nature therapy helps us recognize our existence within a broader system,” Hardy said. “When we begin to recognize the connection between nature and ourselves and nature as therapy, we begin to understand what our disconnection from nature does to our mental health.”

Lay of the land

According to 2010 census data, 82 percent of Americans now live in urban areas, up from 64 percent in 1950. Experts project that 90 percent of the U.S. population and 68 percent of the world population will live in urban areas by 2050.

While the shift to the city has been more gradual in Iowa with 64 percent of Iowans now living in urban areas, that number has been steadily increasing since the early 1900s, and the state’s metropolitan areas have seen significant growth in the last decade. Iowa’s population has increased by nearly 100,000 since 2010, with Dallas (32%), Linn (14%) and Polk (12%) counties seeing the most growth.  

Unlike many major metropolises, in Iowa, urban living does not equal the absence of nature. Many municipalities have invested in parks, trails and other outdoor amenities, recognizing the importance of natural spaces for their communities. Public lands, along with private nature preserves, offer opportunities for Iowans to explore outdoor areas outside the cityscape — a benefit recognized by the state’s leading health experts.

Just this fall, the Iowa Board of Health issued a resolution in support of the Natural Resources and Outdoor Recreation Trust Fund, which would provide permanent, reliable and substantial funding to support Iowa’s outdoors, outlining the ever-growing base of evidence of the physical and mental health benefits of time spent in nature.

Creating connection

As a naturalist with the Warren County Conservation Board (WCCB), Karen Johlas-Szalkowski is always keen to find new ways for people to experience nature. She took a personal interest in nature therapy, and after a bit of research, decided to invite some guest guides to lead forest bathing walks through WCCB parks. 

It wasn’t long before Johlas-Szalkowski and fellow WCCB naturalist Kelsey Longnecker decided to become certified nature and forest therapy guides themselves, a move that was supported by the Friends of Warren County Conservation, which funded their guide training.

“It’s different than any other programming we offer,” said Johlas-Szalkowski. “It’s about taking time to slow down, be in the moment, and using all of your senses to experience nature.”

Johlas-Szalkowski also knows that just as those that come to bathe in WCCB’s prairies, woodlands and other natural areas are likely receive something from the experience, be it medicinal or simply memorable, so too will the lands. 

“It’s a good way to reconnect with nature,” Johlas-Szalkowski said. “If you don’t appreciate those places, you’re not going to take care of them.”

Jacques Cousteau once said “people protect what they love.” But to love something, you must first know it. At the heart of nature therapy is the belief that in coming to know nature, we come to know ourselves; that we are part of nature, not separate from it. In that knowledge, there is healing power, for people and wild places.