The role of nature conservation and commercial farming in psychological distress among rural Ugandans

Mental illness is a leading contributor to the global burden of disease, but there is limited understanding of how it is influenced by socio-ecological context, particularly in the global south. We asked how interactions with ecological systems influence stressors associated with psychological distress in a rural Ugandan case study. We conducted and thematically analyzed 45 semi-structured interviews with residents of Nyabyeya Parish, Masindi District. Our results suggest that poverty and food insecurity were the primary reported causes of "thinking too much" and related idioms of psychological distress. The expansion of commercial agriculture may have been associated with the contraction of subsistence farming, reportedly exacerbating poverty and food insecurity among poorer households but contributing incomes to wealthier ones. Furthermore, households bordering a conservation area reported that crop losses from wildlife contributed to food insecurity. However, forest resources were important safety nets for those facing poverty and food insecurity. Our study suggests how two globally prevalent land uses - commercial agriculture and nature conservation - may influence social determinants of psychological distress in our study area. Psychological distress does not necessarily imply mental disorder. Nonetheless, exploring socially-mediated interactions with ecosystems may help explain the etiology of psychological distress. Furthermore, we suggest opportunities to manage socio-ecological systems to support mental health, such as promoting equitable access and control of livelihood resources. We also highlight co-benefits and trade-offs between global sustainability goals that could be managed for mental health, and why these should be recognized in the anticipated New Deal for Nature. HighlightsO_LIFood insecurity and poverty were major stressors reportedly causing psychological distress, characterized as "thinking too much." C_LIO_LIComplex interactions between conservation, commercial agriculture, and poverty influenced psychological distress. C_LIO_LICommercial agriculture displaced subsistence farming, exacerbating poverty and food security among poorer households. C_LIO_LIConserved forests were both home to crop-raiding wildlife and sources of income and food, affecting poverty and food insecurity. C_LIO_LIMental health needs to be included in assessments of the role of the ecosystems in public health. C_LI