Nature-based health interventions (NBIs) for the treatment of poor mental health are becoming increasingly common, yet evidence to support their effectiveness is lacking. We conduct a pilot study of a six-week intervention, aiming to engage individuals with wetland nature for the treatment of anxiety and/or depression. We employed a mixed methods design, using questionnaires, focus groups and semi-structured interviews to evaluate the intervention from the perspective of participants (n = 16) and healthcare professionals (n = 2). Results demonstrate significant improvements in mental health across a range of indicators, including mental wellbeing (Warwick and Edinburgh Mental Wellbeing Scale), anxiety (Generalised Anxiety Disorder-7), stress (Perceived Stress Scale) and emotional wellbeing (Positive and Negative Affect Schedule). Participants and healthcare professionals cited additional outcomes including improved physical health and reduced social isolation. The wetland site provided a sense of escape from participants’ everyday environments, facilitating relaxation and reductions in stress. Wetland staff knowledge of the natural world, transportation and group organisation also played a considerable role in the intervention’s success. These aspects should be considered in future and existing NBIs to maximise benefits to participants. We propose NBIs based in wetlands are an effective therapy option for individuals diagnosed with anxiety and/or depression.

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The health benefits associated with spending time in natural environments have been highlighted during the COVID-19 pandemic. Lockdowns and restrictions to safeguard public health have exacerbated the pre-existing mental health crisis and rise of non-communicable diseases. Thus, the importance of nature as a health resource has been elevated, hastening calls for a better understanding of how health benefits might differ across user groups and nature provisions. In this regard, urban green spaces have become the greatest research focus; however, blue spaces, especially inland freshwater (e.g., wetlands), remain less studied. First-hand user experiences are also under-represented. This exploratory study examines the motivations and benefits of active wetland centre users in the UK, both during and after visits. Responses to three open-ended questions were collated online from 385 participants, and a qualitative content analysis was conducted based on an existing taxonomy from users of urban green spaces. The results showed strong motivations to visit due to the biodiversity at the site (mainly the birdlife), while less tangible nature (e.g., fresh air) and amenities were also important. In contrast to other studies on natural environments, physical activity was a less influential motivation. Salient derived effects included positive and intensely positive emotions, relaxation and mental restoration. After visits to wetland centres, feelings of vitality and satisfaction were the most prominent effects that emerged. For decision-makers looking to leverage inland blue spaces for public health benefit, our results highlight the broad range and relative prominence of the reasons for use and the associated perceived health benefits derived by users of UK wetland centres. They highlight how biodiversity, abiotic nature and good amenities are important qualities to consider when planning, managing and encouraging people to use natural environments for health benefit, qualities that may also provide important environmental co-benefits.

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Participatory approaches to data collection and knowledge production are widely used to deepen our understanding of how humans perceive, value and use the environment (Bennett et al., 2016). They can be defined as 'a relational process through which new knowledge is produced collectively rather than by an individual on their own. The purpose of that new knowledge is to bring about some form of change or action, whilst the process of doing so is a continual one of learning, reflection and action ' (Abma et al., 2017). Participatory approaches are used globally, across the low-, middle-and high-income countries. Whilst the language used to describe these approaches can be diverse, reflecting their varied origins and contexts of use, they all involve creating data from the vantage point of individuals and communities. This