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Published Online:https://doi.org/10.1176/appi.ps.1154

Advances in psychopharmacology improve symptom outcomes for young adults with mental illness. However, functioning and social participation can remain impaired. Alternative models, including outdoor adventure camping programs, encourage social and practical engagement and increase functioning, providing promise as adjuncts to traditional therapeutic treatments. Adventure therapy promotes positive changes through therapeutic group activities. The adventure component allows clients to engage in appropriate risk-taking behaviors, and the group context closely approximates social situations that may be encountered outside the program and support the premise that skills learned in this manner may be generalized beyond the program setting.

The Mental Health Access and Participation Project was conducted on the basis of this hypothesis by YMCA Victoria, which was supported by the State Government of Victoria via the Department of Planning and Community Development and Sport and Recreation Victoria. YMCA Australia, government representatives, local mental health agencies, and community providers were involved in the development of a four-day camping program aimed to enable participants to develop positive identity, improve social competencies, and broaden supportive relationships. Camp activities were selected to provide positive, challenging, supportive, and meaningful experiences. Orygen Youth Health Research Centre was commissioned to evaluate outcomes of this adventure camping program specifically designed for young adults and adults with mental illness.

A total of 108 persons from mental health services across Victoria participated in and evaluated a total of 12 camps (run from 2007 to 2011). Five camps were for youths between the ages of 18 and 25, and seven were for ages 26 years or older. The evaluation had two goals: to determine camp impact on self-esteem, mastery, social competence, and quality of life of participating youths with mental illness and to capture participants’ experiences of the program. Camps were run at YMCA-managed campsites. A range of structured activities were included—giant swing, low and high ropes courses, mountain biking, water activities, trust and fellowship activities, and so on—with the intent of facilitating positive identity, social competencies, and connectedness and of providing support. An evaluative questionnaire was administered at baseline before camp, after camp, and approximately four weeks postcamp.

There was significant change over time in terms of mastery (F=5.32, df=2 and 142, p=.006), self-esteem (F=6.39, df=2 and 144, p=.002), and social connectedness (F=8.33, df=2 and 131, p<.001), with significant improvement in each characteristic from baseline to end of camp (p=.001). Quantitative and qualitative information was also derived from a camp evaluation questionnaire. All activities were rated favorably, especially more challenging activities such as the low and high ropes courses and giant swing. Camp logistics, leaders, venue, and food were also very well received.

This study highlighted the collaborative work across sectors of state government, mental health programs, and community recreational services—a relationship relatively novel in Australia—toward promoting social inclusion of youths and adults with mental illness. Data were collected for a large number of individuals of various backgrounds, disorders, and life stages. Across the total cohort, participation in the camping program resulted in significant improvements in mastery, connectedness, and self-esteem, as well as reports of better mental health, general medical health, well-being, confidence, teamwork and trust, and communication and interaction with others. The positive personal and social mastery and connecting experiences of the camping process have created a window of opportunity for the community mental health services involved. Offering follow-up programs for the participants may sustain these positive changes over a longer period. One participant offered this advice to others who may wish to participate in the camping program: “Have a go and really challenge yourself! Why? Because you will be amazed by how much you can really do!”

The authors are affiliated with Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, 35 Poplar Rd., Parkville, Victoria, 3052 Australia (e-mail: ).