Community-led conservation, nature exposure, and nature-based mental health in rural Ghana

Nature-Based Mental Health (NbMH) is conceptualized as the psychological benefits individuals derive from direct or indirect interactions with natural environments, including reduced stress, improved mood, emotional resilience, and overall well-being. Although increasingly recognized, NbMH remains underexplored in rural and climate-vulnerable settings. Grounded in the Social-Ecological Model (SEM), this study examines how environmental exposure, measured through residence in Community Resource Management Area (CREMA), frequency of nature contact, and proximity to natural environments, shapes subjective NbMH among farmers in northern Ghana. NbMH was assessed using a 15-item scale capturing stress, anxiety, sleep quality, coping capacity, and emotional resilience. Drawing on cross-sectional survey data from 1107 respondents across 16 CREMA and non-CREMA communities, we employed nested ordered logistic regression models to examine multilevel determinants of reporting "good" NbMH. Findings show that residence in CREMA communities was consistently associated with a higher likelihood of reporting "good" NbMH (OR: 1.75-2.20; p < 0.001). Similarly, an increase in frequency of weekly nature contact increased the likelihood of "good" NbMH (OR: 1.06-1.07; p = 0.011), while an increase in the distance from natural spaces decreased the likelihood of reporting "good" NbMH (OR: 0.84-0.85; p < 0.001). Additional significant predictors included age, livelihood diversification, financial stressors, enrollment in social protection programs, and distance to health and water facilities. Poorly perceived social support systems were also negatively associated with reporting "good" NbMH. It is recommended that nature-based strategies be integrated into rural mental health policies and that support be provided for community-led conservation initiatives to enhance well-being.