Forest-Based Interventions for Depression: A Narrative Synthesis of Global Evidence and Practical Applications

Background: Depression, a leading global cause of disability, continues to challenge mental health systems due to issues of treatment resistance, accessibility, and adverse effects associated with conventional therapies. Complementary and alternative approaches, such as forest therapy, have gained prominence as non-pharmacological interventions for enhancing mental well-being. Objectives: This review critically examines the effectiveness of forest therapy in alleviating depression, synthesizing findings from global randomized controlled trials, observational studies, and meta-analyses. Methods: A narrative review methodology was employed, integrating data from diverse disciplines. Empirical studies were selected based on predefined inclusion and exclusion criteria, focusing on interventions involving structured forest therapy and depression-related outcomes. Results: Evidence indicates that forest therapy significantly reduces depressive symptoms, cortisol levels, and improves psychosocial parameters such as self-esteem, emotional regulation, and social connectedness. Theoretical frameworks such as Attention Restoration Theory, Stress Reduction Theory, and the Biophilia Hypothesis support these findings. However, methodological heterogeneity, small sample sizes, and limited cross-cultural research pose challenges to generalizability. Conclusions: Forest therapy emerges as a promising, low-cost, and accessible intervention for depression, complementing traditional treatments. Future research must focus on standardizing protocols, conducting longitudinal and comparative effectiveness trials, and expanding cross-cultural investigations. Policy integration and technological innovations could further enhance its scalability and public health impact.