Boundaries Without Walls: The Ethical Challenge of Outdoor Mental Health Treatment

Outdoor mental health treatment, including walk-and-talk therapy, has emerged as a novel extension of psychiatric care grounded in theories of nature's restorative effects. Despite potential clinical benefits, such practices raise ethical concerns insufficiently addressed by frameworks developed for indoor settings. Challenges arise in preserving confidentiality within public environments, maintaining professional boundaries amid increased informality, ensuring patient and provider safety, addressing inequities in access, and securing adequate liability coverage. These concerns warrant deliberate adaptation of established ethical norms to guide responsible implementation of care in outdoor contexts.