Adolescents with mental health challenges report therapeutic benefits through sea swimmingChildren and adolescents are especially vulnerable to mental health issues. Depression among young people is widespread and often linked to other detrimental outcomes, such as low academic achievement, substance abuse, and self-harm. To effectively support the mental health of children and adolescents, it is essential to identify developmentally appropriate interventions and strategies. While research with adults suggests that sea swimming improves well-being and can alleviate symptoms of depression, there is a paucity of research on the use of sea swimming with younger populations. Therefore, this study explored the potential of sea swimming as a therapeutic intervention for adolescents with mental health challenges. The study aimed to investigate the perspectives of young people and mental health services staff members through a qualitative descriptive approach.
The study was conducted with young people (age 14-18) who were inpatient service users of child and adolescent mental health services (CAMHS) in Ireland. The therapeutic sea swimming intervention consisted of approximately 20 minutes of cold-water ocean swimming, followed by warming up, getting dressed, and having snacks on the beach. The intervention was offered weekly during the summer and was available by request year-round. Groups of four or five young people and two to three staff attended sea swimming sessions. The intervention prioritized visits to safe, shallow beaches to enable the participation of non-swimmers. Young people who had experienced the intervention were recruited to participate in the study through advertisements displayed in the CAMHS inpatient unit. Eight young people and six mental health services staff members agreed to participate. The young people were mainly female (7 female, 1 male) and identified as White Irish. Two experienced mental health nursing researchers (who did not attend sea swimming sessions) conducted individual semi- structured interviews with each participant. Interview responses were analyzed with reflexive thematic analysis.
Analysis revealed a series of themes that emerged from interviews with the young people and staff, with a large degree of overlap between the two groups. In the first theme, ‘<em>More at Peace’: The Mental Health Benefits of Sea Swimming</em>, young people described sea swimming as a fun, energizing, and relaxing experience that enabled a sense of freedom. Young people who were anxious about swimming in the sea felt their worries were replaced with a sense of peacefulness in the water. A sustained improvement in their well-being was also reported by young people who stated that the sense of relaxation remained throughout the day. Staff members echoed the mental health benefits young people described. The theme ‘<em>I am Brave’: Accepting the Challenge</em> revealed young people’s perceptions of their ability to overcome the challenge presented by cold water. Overcoming this challenge facilitated a sense of accomplishment and confidence in their ability to succeed over other challenges in their lives. The theme ‘<em>Something We Could Do Together’: Enhanced Social Connections</em> highlighted the importance of the intervention’s social benefits. Young people indicated that sea swimming as a group enabled peer support, a sense of safety in the water, and made for a more enjoyable experience. Staff members also reported the benefits of the intervention’s social elements for young people’s bonding. Additionally, they indicated that the intervention improved social dynamics and balanced power between young people and staff members by bringing “everyone together on a common level.” The perception of a distinction between other therapies and sea swimming was highlighted by the theme ‘<em>They Actually Seek to Avoid Them’: Sea Swimming Compared to Other Therapies</em>. Young people indicated a preference for sea swimming over other therapies (such as talk therapy). According to staff, the intervention's informal structure and the sense of accomplishment experienced by young people distinguished sea swimming from other approaches. The final theme, ‘<em>We Do a Lot of Positive Risk Taking Anyway’: Acknowledging Risk</em>, revealed staff members' awareness of the potential risks associated with sea swimming. While staff acknowledged the intervention posed risks, overall, they felt it was very safe. They also discussed that while mental health services are traditionally risk-averse, positive risk-taking can be an important component of mental health interventions.
The study reveals the important benefits that young people with mental health challenges experienced through sea swimming. The findings indicate that sea swimming can promote mental health and well-being by providing an enjoyable and calming experience, which strengthens young people's capacity to overcome adversity and fosters improved interpersonal relationships. Findings also highlight “important considerations for staff relating to types of therapeutic interventions, the centrality of relationships and the need to develop positive approaches towards risk-taking and management.” The study demonstrates the benefits of sea swimming as a therapeutic intervention. Researchers should continue to explore sea swimming in mental health practice.
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