Contemplative practices serve as complementary mental health strategies in nationally representative samples from...

Contemplative practices (including meditation and yoga) are increasingly popular worldwide, especially as alternatives and/or complements to mental health treatment. However, nationally representative samples that allow for accurate estimates of prevalence and relation to mental health are scarce. We conducted a nationally representative, cross-sectional survey in Australia and New Zealand (N = 2640). Sampling was stratified by age, gender, ancestry/ethnicity, region and income. Two pre-registered questions were analysed to explore participants' engagement in contemplative practices and associations to psychological distress and mental healthcare use. We used posthoc regression analyses to further clarify relationships between variables. Overall, 70% of participants engaged in contemplative practices over the past year, most commonly meditation (31%), relaxation (25%), breathing techniques (24%), and yoga (21%). Improving health and wellbeing were the primary motivations for practice. All contemplative practice users reported significantly higher psychological distress and mental healthcare use than non-practitioners (p's<0.05). Adjusting for sociodemographic differences removed associations with distress among yoga and relaxation practitioners (β_relaxation = 0.02, β_yoga = - 0.03, n.s.). For meditators, the association disappeared when we accounted for mental healthcare use (β_meditation = 0.01, n.s.). Breathing practice was associated with increased distress in all models (β_breathing = 0.04-0.11, p's<0.05). Notably, meditators and relaxation practitioners with unmet healthcare needs reported less distress than non-practitioners with unmet needs (d_meditation=0.38, d_relaxation=0.35). Contemplative practices are widespread among Australians and New Zealanders and may play a complementary and/or alternative role in managing mental health. Further research is needed to study their complex associations with mental health, and which types of contemplative practices are beneficial and safe for whom.