Rebecca Files is a recent Pharmacy degree graduate from the University of Strathclyde. For her final year dissertation she carried out a scoping review of the impact of wild swimming on mental health and shared her findings with NHS Forest.
As an avid lover of the outdoors, one of the main perks of studying pharmacy in Scotland is escaping to the hills and lochs at weekends and during holidays. In early September 2024, after a summer walking on Skye and cycling in the Outer Hebrides, my main task was choosing a dissertation topic. Reminiscing on simpler times when my “showers” were dips in lochs or the sea, one topic stood out: The Impact of Wild Swimming on Mental Health. Being immersed in natural water made me feel alive yet calm, and I was curious whether research could support its use for patients with common mental disorders (CMDs).
Research from 2024 indicates that people feel their mental wellbeing is getting worse with 7.8% of adults feeling lonely ‘always or often’ (1). According to Mind, instances of CMDs, are rising and those affected are struggling to cope (2). With 1.2 million people on England’s mental health waiting list and antidepressant prescribing up 34.8% since 2015/16, deprescribing antidepressants and using alternative interventions are recommended to reduce costs and avoid adverse effects associated with antidepressants. Social prescribing, such as NHS England’s £5.77 million Green Social Prescribing Programme (3), focuses on treating conditions which have heavy social causes and implications by connecting patients to locally run activities such as walking, community-gardening, and wild swimming. Against this backdrop, a scoping review was conducted to explore the impact of wild swimming on mental health and its potential as a clinical treatment. Twelve studies, combining qualitative and quantitative data, were included. The findings suggested that wild swimming can positively impact mental health through the cumulative effect of several beneficial factors such as connection to nature, social interaction, solitude and mindfulness. This fostered stress reduction, contemplation, restoration, meditation and a sense of belonging in participants.
Connection to Nature
Participants expressed a unique sense of belonging in nature while wild swimming. The cold water forced participants to be present in the moment and allowed them to achieve a state of mindfulness which they otherwise struggled to reach. For some, it offered a respite from life’s stressors such as work and caregiving responsibilities.
Solitude and Social Connection
The benefits participants sought often aligned with their chosen setting, creating the swimming experience they desired. Participants who loved to swim in Scotland’s lochs often desired a tranquil experience and valued the solitude and contemplation which came with that. Relaxing and meditating which are central to other social prescribing activities like yoga, are recognised to benefit mental health and are recommended by the NHS (4). Other participants valued a group setting and highlighted the importance of friendships they formed within the swimming community. Positive social interactions in a wild swimming context were shown to be healing to participants living with mental illness. Social connectedness is a key feature in other social prescribing initiatives, such as team sports, and aligns with evidence that participation in group-based activities can reduce loneliness (5), a major risk factor for depression.
Resilience
Some participants expressed initial fears about entering the cold water and facing the harsh conditions, but overcoming this challenge seemed to contribute to the positive emotions experienced after swimming. Confronting fears and overcoming challenges in this context can foster pride and a sense of accomplishment which enhance self-esteem and life satisfaction. These mirror principles of Adventure Therapy, an intervention that uses adventure sports and outdoor activities to support mental health (6-8). Moreover, the coping strategies and resilience gained through wild swimming translate into participants’ everyday lives, with many using the soft skills which they learned to help manage daily stressors.
Barriers
Despite the positive outcomes of wild swimming, it is important not to overlook the barriers and risks which can be involved such as cold shock which causes hyperventilation and arrhythmias which increases the risk of drowning (9). Key barriers to wild swimming are the needs to be a competent swimmer and access to suitable swimming locations (10). National data shows that Black and Asian adults in the UK have lower swimming participation rates compared to White British adults (11). Budding participants must live near appropriate sites, have transport to get there and the physical ability to reach the water. These factors alone may exclude individuals living in urban areas, those without cars, or people with physical disabilities. Therefore, peoples access to wild swimming as a realistic intervention for treating mental illness varies depending on race and socioeconomic background. Furthermore, access to wild swimming in the UK is increasingly challenged by pollution. The current sewage crisis has rendered many blue spaces, including beaches, unsafe for swimming. Surfers Against Sewage reported 1,924 cases of illness linked to waterborne sewage exposure between October 2022 and September 2023 and the true figure is likely much higher (12).
While writing my dissertation, I often escaped to North Berwick or Loch Lomond for a dip, reflecting on both the benefits and barriers of wild swimming. Ultimately, I realised that if we are to use nature’s offerings to support public health, we must first protect the health of our blue spaces.
I would like to thank my project supervisor Derna Campbell who supported me throughout writing my dissertation. Also, a huge thank you to Dr Natalie Weir for her valuable feedback and encouragement.
Contact me at becafiles.bf@gmail.com
If you found this blog interesting, you might enjoy this recommended reading:
The Tidal Year by Freya Bromley,
The Cold Fix by Sara Barnes,
Adventure Revolution by Belinda Kirk,
Chill: The Cold Water Swim Cure by Mark Harper,
The Black Swimming Association: https://thebsa.co.uk
Surfers Against Sewage: https://www.sas.org.uk
References:
- Laura Fairey DAaTV. Public opinions and social trends, Great Britain. The Office of National Statistics (ONS): The Office of National Statistics (ONS); 2024.
- MIND. Mental Health facts and statistics 2020 [Available from: https://www.mind.org.uk/information-support/types-of-mental-health-problems/mental-health-facts-and-statistics/#References.
- Englad N. Green social prescribing england.nhs.uk2022 [Available from: https://www.england.nhs.uk/personalisedcare/social-prescribing/green-social-prescribing/.
- Inform N. Breathing and relaxation exercises. 2025.
- Stevens M, Lieschke J, Cruwys T, Cárdenas D, Platow MJ, Reynolds KJ. Better together: How group-based physical activity protects against depression. Social Science & Medicine. 2021;286:114337.
- Mutz M, Müller J. Mental health benefits of outdoor adventures: Results from two pilot studies. J Adolesc. 2016;49:105-14.
- Bowen DJ, Neill JT, Crisp SJR. Wilderness adventure therapy effects on the mental health of youth participants. Evaluation and Program Planning. 2016;58:49-59.
- Rapsey EHS, and Pilcher NM. “The world is a beautiful place – I want to explore that a bit”: the experience of taking part in an adventure therapy sailing project by a group of individuals who have experienced psychosis. Psychosis. 2024;16(2):144-54.
- Tipton M, Bradford C. Moving in extreme environments: open water swimming in cold and warm water. Extrem Physiol Med. 2014;3:12.
- Bates C, and Moles K. Bobbing in the park: wild swimming, conviviality and belonging. Leisure Studies. 2024;43(6):887-99.
- O’Keefe L. Sport for All? Why ethnicity and culture matters in sport and physical activity. Sport England 2020.
- Izzy Ross HS, Eva Perrin,, Annie McKelvey FH, Chloe Flood and Kirsty Davies. Water Quality Report 2023. Surfers Against Sewage 2023.
The papers which were analysed in the scoping review:
- Burlingham A, Denton H, Massey H, Vides N, Harper CM. Sea swimming as a novel intervention for depression and anxiety – A feasibility study exploring engagement and acceptability. Mental Health and Physical Activity. 2022;23:100472.
- Christie MA, Elliott D. From a dark place to a blue space: open water swimming transformed our lives. Sport in Society. 2024.
- Czarnecki J, Nowakowska-Domagała K, Mokros Ł. Combined cold-water immersion and breathwork may be associated with improved mental health and reduction in the duration of upper respiratory tract infection – a case–control study. International Journal of Circumpolar Health. 2024;83(1):2330741.
- Demori I, Piccinno T, Saverino D, Luzzo E, Ottoboni S, Serpico D, et al. Effects of winter sea bathing on psychoneuroendocrinoimmunological parameters. Explore (NY). 2021;17(2):122-6.
- Denton H, Aranda K. The wellbeing benefits of sea swimming. Is it time to revisit the sea cure? QUAL RES SPORT EXERC. 2020;12(5):647-63.
- Hjorth P, Lokke A, Jorgensen N, Jorgensen A, Rasmussen M, Sikjaer M. Cold water swimming as an add-on treatment for depression. A feasibility study. EUROPEAN PSYCHIATRY. 2022;65:S559-S60.
- Kelly JS, Bird E. Improved mood following a single immersion in cold water. Lifestyle Medicine. 2022;3(1):e53.
- Maharja C, Praptiwi RA, Roberts BR, Morrissey K, White MP, Sari NM, et al. Sea swimming and snorkeling in tropical coastal blue spaces and mental well-being: Findings from Indonesian island communities during the COVID-19 pandemic. Journal of Outdoor Recreation and Tourism. 2023;41.
- Massey H, Gorczynski P, Harper CM, Sansom L, McEwan K, Yankouskaya A, et al. Perceived Impact of Outdoor Swimming on Health: Web-Based Survey. Interact J Med Res. 2022;11(1):e25589.
- Massey H, Kandala N, Davis C, Harper M, Gorczynski P, Denton H. Mood and well-being of novice open water swimmers and controls during an introductory outdoor swimming programme: A feasibility study. Lifestyle Medicine. 2020;1(2):e12.
- McDougall CW, Foley R, Hanley N, Quilliam RS, Oliver DM. Freshwater Wild Swimming, Health and Well-Being: Understanding the Importance of Place and Risk. Sustainability. 2022;14(10):6364.
- Murray E, Fox J. The meaning of open-water swimming for adults in Ireland: a qualitative study. Irish Journal of Occupational Therapy. 2021;49(2):89-95.