Eco-anxiety as a public health imperative: from individual resilience to culturally informed holistic engagement

Eco-anxiety has increasingly drawn public health attention. Although often conceptualized as an individual psychological burden, eco-anxiety may also serve as a catalyst for collective action. However, prevailing coping strategies largely center on individual resilience, with insufficient focus on social connectedness and the human-nature bond. This narrative review critically examines the limitations of individual resilience as a coping mechanism for eco-anxiety and advocates for a paradigm shift toward holistic engagement informed by Indigenous knowledge systems and traditional Chinese philosophy. Evidence indicates that eco-anxiety disproportionately affects vulnerable populations, including Indigenous groups, women, and youth; yet most research remains Western-centric and individually oriented. While beneficial for personal mental health, individual resilience often overlooks the systemic and sociopolitical drivers of ecological distress, potentially intensifying feelings of isolation and helplessness. In contrast, holistic engagement emphasizes reciprocal human-nature relationships, social connectivity, and collective action, offering more enduring coping mechanisms. Addressing eco-anxiety as a public health issue requires moving beyond individual resilience toward culturally attuned, holistic, and collective strategies. Integrating Indigenous and Chinese philosophical insights into mental health interventions may promote environmental stewardship, social cohesion, and emotional wellbeing, particularly for vulnerable populations disproportionately affected by ecological crises.