Gaps (Expanded - thinking that we do mostly vid to cover topics and then for some we have the expanded bit people can read through if they want)

The global burden of mental health conditions represents one of the most significant challenges facing humanity today. According to the World Health Organization, in 2019 approximately 970 million people worldwide were living with a mental disorder, ranging from highly prevalent conditions like anxiety and depression to more severe disorders such as schizophrenia and bipolar disorder (WHO, 2023b). Despite this staggering prevalence, access to mental healthcare remains severely limited across much of the world. Poor mental health affects all aspects of human life, causing immense suffering and diminishing quality of life by impacting physical health, educational attainment, employment opportunities, and social relationships. Mental health problems are bidirectionally linked with other diseases, both causing and being exacerbated by physical conditions, and are strongly associated with suicide risk. The scale and impact of this crisis make it a serious development challenge that demands innovative approaches.

Given its profound impact on human development, mental health has been explicitly incorporated into the global development agenda through Sustainable Development Goal 3 (Good Health and Well-being). Target 3.4 specifically calls on nations to "promote mental health and well-being" by 2030 (WHO, 2023c). Moreover, mental health is cross-cutting across all SDGs, serving as a foundation for achieving numerous other development objectives. The COVID-19 pandemic has further underscored the urgency of addressing mental health globally. According to official WHO statistics, in the first year of the pandemic alone, the global prevalence of anxiety and depression disorders increased by 25% (WHO, 2022a). This dramatic surge has served as a wake-up call, highlighting the need for comprehensive mental health support systems and innovative interventions.

Even before the COVID-19 pandemic, mental health disorders such as depression and anxiety constituted a significant portion of the global burden of disease. The pandemic, however, acted as a catalyst, amplifying stressors worldwide and dramatically increasing the prevalence of these conditions. Simultaneously, necessary public health measures like lockdowns and social restrictions severely curtailed access to traditional coping mechanisms, creating a critical gap in mental health support. This convergence has intensified an already pressing global mental health crisis, characterized by staggering numbers: approximately 301 million people living with anxiety and 970 million with depression (Moitra et al., 2023; World Health Organization, 2023). Alarmingly, only about 27.6% of those affected receive adequate care, highlighting a vast and urgent treatment gap.

In response to this complex challenge, innovative and accessible solutions are paramount. Nature-based interventions are emerging as a promising avenue, supported by compelling evidence. A meta-analysis demonstrated significant effect sizes in reducing depression (-0.64) and anxiety (-0.94) (Coventry et al., 2021), while initiatives like Green Social Prescribing show substantial social return on investment (£1.88 per £1 invested in 2024). The Clinical Ecopsychology framework explains these benefits, noting how natural environments activate parasympathetic responses that promote well-being (Thoma et al., 2021). Astronomy, as a profound gateway to the natural world, offers unique potential within this domain. Activities that evoke awe, a core experience in astronomy, are scientifically linked to enhanced well-being (Chirico et al., 2018; Piff et al., 2015).

What works (evidence snapshot)

• Nature-based interventions (NBIs). A meta-analysis of randomized trials found NBIs improved depressive mood (SMD = −0.64) and reduced anxiety (SMD = −0.94), with many programs delivered over 8 - 12 weeks (Coventry et al., 2021). 

• Pathways from clinical ecopsychology. Natural settings can help engage parasympathetic and biobehavioral pathways linked to stress recovery and resilience (Thoma et al., 2021).

• Awe and well-being. Astronomy-evoked awe is part of a growing evidence base: awe can reduce self-focus and support prosociality (Piff et al., 2015) and is associated with shifts that benefit mental and physical health (Monroy & Keltner, 2023). 

How the OAD approaches mental health and well-being

Recognizing the critical role of mental health in overall well-being and human development, as well as the current global challenges in addressing mental health needs, the Office of Astronomy for Development (OAD) is exploring how astronomy's unique tools and perspectives can contribute to promoting good mental health. By leveraging the inspirational power of astronomy and its ability to foster awe, perspective, and connection, the OAD aims to develop novel approaches that complement traditional mental health interventions and expand access to support worldwide.

The Office of Astronomy for Development (OAD) works to complement, not replace, clinical care by leveraging astronomy’s unique capacity to inspire awe, perspective, connection, and meaning. Our program principles:

• Evidence-informed design. We translate the science of NBIs and awe into accessible, low-cost activities (e.g., guided night-sky sessions, dark-sky walks, perspective-taking exercises), aligned with local culture and context (Coventry et al., 2021; Monroy & Keltner, 2023). 

• We co-create with mental-health professionals, community organizations, educators, and support centers to ensure safety, relevance, and referral pathways. 

• Equity & rights. We follow rights-based practice to reduce stigma, enhance inclusion, and emphasize dignity

• Measurement & learning. Each activity includes simple outcome tracking (e.g., stress, mood, connectedness, awe) and feedback loops to improve quality and scale what works. 

Important note: Again, OAD activities are well-being and development interventions. They do not provide clinical diagnosis or therapy; participants are signposted to qualified services when needed.

Integrating ACT with Astronomy

The Office of Astronomy for Development (OAD) has developed an innovative interdisciplinary approach that integrates Acceptance and Commitment Therapy (ACT) principles with astronomy-based interventions. ACT is a form of cognitive-behavioral therapy that focuses on developing psychological flexibility, the ability to be present, open, and committed to value-based action even in the face of difficult thoughts and feelings (Hayes et al., 2016). The OAD's choice to base their interventions on ACT was informed by its ease of application, focus on helping individuals identify their core values, and practices that encourage self-reflection and exploration.

Astronomy for mental health aligns naturally with ACT's six core processes, creating a powerful synergy between cosmic contemplation and psychological flexibility:

1. Acceptance: Astronomy provides a unique context for practicing acceptance of life's uncertainties and challenges. The vast timescales and distances of the cosmos help put personal difficulties into perspective, making it easier to accept situations that cannot be changed. As participants contemplate the immense scale of the universe, they often develop greater acceptance of their own limitations and the inherent uncertainties of existence.

2. Cognitive Defusion: Astronomy offers powerful metaphors for defusion, the process of creating distance from unhelpful thoughts. The "sky and weather" metaphor commonly used in ACT, where "you are the sky and your experiences are merely the weather," takes on literal meaning when participants observe the actual night sky (“The Sky and the Weather - a Metaphor - Dr M Joann Wright,” n.d.). This cosmic perspective helps individuals recognize that their thoughts and feelings, like weather patterns, are temporary and do not define their essential nature.

3. Contact with the Present Moment: Stargazing and astronomical observation naturally cultivate mindfulness and present-moment awareness. The focused attention required to observe celestial phenomena, whether tracking planets, identifying constellations, or witnessing meteor showers, anchors participants in the present moment, reducing rumination about the past or anxiety about the future.

4. Self-as-Context: Astronomy powerfully facilitates the development of "self-as-context", the ability to observe oneself from a transcendent perspective. The cosmic perspective gained through astronomical contemplation helps individuals experience themselves as part of something much larger than their personal concerns or immediate circumstances. This shift from "ego-centric" to "cosmo-centric" perspective is central to developing psychological flexibility and has been termed "Cosmic Insignificance Therapy" in psychological literature (Anna Katharina Schaffner, 2024).

5. Values: Astronomy-based activities provide rich opportunities for values clarification and exploration. Contemplating one's place in the universe naturally leads to questions about meaning, purpose, and what truly matters in life. The OAD's "Planetary Self-Care Activities" workbook specifically uses planetary themes to guide participants through values exploration, helping them connect with their core aspirations and commitments (Vertue, 2023).

6. Committed Action: Finally, astronomy inspires committed action toward valued goals. The wonder and perspective gained through cosmic contemplation often motivates individuals to take meaningful action in their lives and communities. The awe elicited by astronomical experiences has been shown to increase prosocial behavior and concern for collective welfare (Piff et al., 2015), aligning perfectly with ACT's emphasis on value-based action.

The OAD has operationalized this ACT-astronomy integration through practical tools like the "Planetary Self-Care Activities" workbook, which includes themed exercises such as "Jupiter Joyful Journaling" designed to foster reflection, goal setting, and exploration of aspirations. These activities leverage astronomical concepts and metaphors to make ACT principles more accessible and engaging, particularly for audiences who might be resistant to traditional therapeutic approaches.

This interdisciplinary approach recognizes that astronomy can make a meaningful difference in mental health outcomes, particularly for individuals and communities affected by trauma, stress, and psychological distress. By combining the inspirational power of the cosmos with evidence-based psychological principles from ACT, astronomy-based interventions offer a promising complementary approach to traditional mental health care, one that is accessible, engaging, and capable of fostering profound psychological transformation.