Attitudes and declared practices of Polish psychiatrists toward nature-based interventions: a nationwide cross-sectional study

Introduction
Exposure to nature is increasingly recognised as an effective approach to supporting mental health. However, knowledge, attitudes, and clinical practices of psychiatrists regarding nature-based interventions (NBIs) remain underexplored. This study aimed to assess Polish psychiatrists’ awareness, beliefs, and reported clinical behaviours related to NBIs.

Material and methods
A cross-sectional survey was conducted among 193 psychiatrists attending 3 major national psychiatric conferences in Poland during the first half of 2025. The survey assessed the frequency of exposure to scientific information on the mental health benefits of nature, beliefs about the therapeutic potential of nature contact, and clinical recommendations regarding specific nature-based activities. Statistical analyses included descriptive statistics and chi-square tests to explore associations with gender, professional experience, and workplace setting.

Results
Although 62.7% of respondents reported infrequent (rare or sporadic) contact with scientific literature or professional information about nature’s mental health effects, a substantial majority (63.2%) reported frequently recommending nature contact to patients. The most commonly advised activities were walking in natural environments (88.5%) and spending time away in nature (60.7%). Forest bathing and other forest therapy forms were recommended less often (23% and 15.1%, respectively), as was birdwatching (14.3%). Statistically significant differences were found regarding the frequency of recommendation: women and psychiatrists with more than 10 years of experience more often indicated frequent or very frequent recommendations of nature contact, whereas younger psychiatrists with less experience tended to recommend it less or not at all. Psychiatrists working in private practices reported more frequent exposure to scientific information about NBIs than those in hospital wards or outpatient clinics. No significant gender differences were found in knowledge or beliefs about the effectiveness of NBIs, but women were more likely to recommend nature contact very often. Specialty status also influenced recommendations, with specialists recommending nature contact more often than non-specialists.

Conclusions
Despite limited formal exposure to scientific evidence, psychiatrists in Poland frequently integrate nature-based recommendations into their clinical practice, highlighting the role of clinical intuition and personal experience in driving the adoption of NBIs. These findings underscore the need for enhanced educational efforts to disseminate scientific knowledge on nature’s therapeutic benefits and promote systematic integration of NBIs into psychiatric care.