Health activities

CfR.1/2016/2 Which types and components of urban and peri-urban blue/green spaces have a significant impact on human mental health and mental well-being?

This request was initially put to EKLIPSE by the Expert Working Group Biodiversity & Health of the 3rd French Plan on Health and Environment (PNSE3) – Ministry in charge of the Environment (MTES), France. 
The current requesters are the Expert Working Group Biodiversity & Health, 3rd National Action Plan on Health and Environment (PNSE3) – Ministry in charge of the Environment (MTES), France, and the World Health Organization (WHO).
Date request received: 27/09/2016
Date of the first meeting with requesters, EKLIPSE KCB-Health group and Expert Methods Group: 15/02/2017
Call for Knowledge: March –April 2017
Call for Experts: September-October 2017 
Expected deliverables: July 2020 (this request was paused in 2018 and resumed again in 2019)

Background and context of the request

For several years, papers have been published about the positive impact of greenness on health, including some synthesis and systematic reviews. Yet, none of them has so far addressed the question of the type of habitats and components of such habitats that have a significant (and preferably positive) effect on mental health and psychological well-being. This is important to be able to provide recommendations to designers and managers of green and blue space in and around cities. This request, brought to EKLIPSE by the French Ministry in charge of the Environment and supported by different European countries, will be addressed by a group of experts selected by EKLIPSE. They work officially started on November 14th, 2017.

Mental Health Expert Working Group

The Expert Working Group (EWG) gathers 11 European experts with a broad range of expertise and EU-wide geographical representation.
The co-chairs of this group are:
• Maria Beatrice Andreucci (Sapienza Università di Roma)
• Annamaria Lammel (Université Paris 8)
• Sjerp de Vries (Wageningen Environmental Research (Alterra), Wageningen University and Research)
The other members of the expert working group are:
• Zoe Davies (University of Kent)
• Julie Glanville / Hannah Wood (York Health Economics Consortium)
• Hans Keune (University of Antwerp)
• Melissa Marselle (Friedrich Schiller University Jena)
• Liz O'Brien (Forest Research, Forestry Commission UK)
• Agnieszka Olszewska-Guizzo (National University of Singapore/ Neurolandscape)
• Roy Remmen (University of Antwerp)
• Alessio Russo (Far Eastern Federal University)
Research assistant: Femke Beute
More information about health EWG can be found here.

Current status of the request 

The draft report developed by the expert working group to answer the question of “which types and components of urban and peri-urban blue spaces have a significant impact on human mental health and mental well-being" was released for external review (22nd January 2020-28th of February 2020). The comments from this process are currently being integrated by the EWG, and the final report will be available in June 2020.
In parallel, the Expert working group is working on the second systematic review to understand “which types and components of urban and peri-urban green spaces have a significant impact on human mental health and mental well-being". This process is being supported by a research assistant, and a draft report is envisaged for May 2020.

Process documentation of the request

The whole process of the request is documented in the Document of work.

Past activities

In order to refine the request, the following scoping activities were carried out before the Call for Experts was launched: 
a. Literature scoping to identify already existing publications/projects/reports on the
request, with a particular focus on existing synthesis
b. Call for Knowledge open and public call to identify existing knowledge on the request. 
c. Evaluation of the policy and stakeholder relevance via bilateral telephone interviews, personal meetings, and email requests to ensure the policy relevance of the request detailed below and to refine the request.
The resulting Document of Work (DoW) described the results of the scoping activities, the background of the request and was the basis for the Call for Experts.
Based on the results of the discussion between the KCB and the requesters, and the Call for Knowledge, it was agreed to refine the request question, to target mental health and psychological well-being, and omit physical health (unless linked to mental health in existing research). Psychological disorders were also included in the scope of the request, but indoor greenness (houses, workplaces) would not be considered. 
The requester has a specific interest in positive impacts to generate recommendations for the design and management of green and blue spaces in cities or nearby neighbourhoods and initially required a systematic review approach. 
The EKLIPSE Expert Methods Group and the KCB-Health group identified five appropriate knowledge synthesis methods that could be integrated to achieve optimum results. These methods are the Cochrane-style systematic review, solution scanning, meta-analysis, rapid evidence assessment, and causal chain analysis (see the DoW).
After that, EKLIPSE launched a Call for Experts No.2/August 2017 to invite scientists, policy-makers, practitioners, and other societal actors. This call aims to assess and synthesise relevant knowledge related to the types and characteristics (components) of urban and peri-urban natural spaces (blue and green) that have a significant impact on human mental health and mental well-being. Read more about the Health Expert Working Group here.
The next step is for the Expert Working Group to develop a methodological protocol based on the DoW, including the scientific aspect of a thorough literature search and possible appraisal. From the identified methods, the expert working group decided on performing  a systematic review that will follow the following steps:
1) eligibility criteria for the articles will be formulated,
2) a systematic search strategy will be employed to yield relevant articles,
3) meta-data will be extracted and coded for each eligible study,
4) each study will be critically appraised,
5) a narrative and descriptive synthesis will be performed, and
6) outcomes of the synthesis will be discussed
Review of the method protocol of EKLIPSE expert working group
The expert working group integrated the comments from the external review process on the methodological protocol. The final version of the Methodological Protocol that assesses the types and characteristics of urban green & blue spaces having an impact on human mental health and wellbeing is available here.