Improving Mental Health: Outdoor Activity for Adults with Depression

This research report investigates the potential benefits of outdoor physical activity programs for improving the mental health status of adults diagnosed with clinical depression. The study highlights the prevalence of depression and its impact on mental well-being, referencing common symptoms and risk factors such as suicidal tendencies. It explores the role of outdoor activities as a means of diverting attention and alleviating symptoms, emphasizing the importance of physical fitness and positive experiences. The report reviews existing literature, considering various perspectives on clinical treatments versus physical activities, and outlines the research methodology employed, including the use of secondary data sources like articles, books, and journals. The research aims to determine the effectiveness of outdoor physical activity programs, identify suitable activities, and recommend strategies for managing depression among adults. The background of the title incorporates Eco-therapy and its use in the improvement of mental health. The study concludes by discussing research limitations and dissemination strategies.

DOES AN OUTDOOR PHYSICAL ACTIVITY PROGRAM IMPROVE THE
MENTAL HEALTH STATUS OF ADULTS WITH CLINICAL DEPRESSION?

ABSTRACT
Physical outdoor activities is an essential aspect that improves the mental health status of
depressed adults especially when they get clinical assistance. The present research study has
been emphasizing on the importance of physical activities program in improving the mental
health status of adults with clinical depression. In this respect, researcher has discussed how the
state of depression can be managed with the help of conducting outdoor physical activities. It has
been observed that depression usually impedes the mental status of individuals and as a result,
that sometimes also leads to suicidal attempts. Concentration on physical activities can assist the
adults to divert their mind and this can also help in overcoming the health problems that are
prevailing along with depression. Outdoor physical activities are crucial for the adults because
that not only helps them to remain fit; but also it aids in developing new feeling to live the life
happily.
Thus, it can be said that the present study has been emphasizing on the importance of
physical activities in improving mental health status of clinical depressed patients. Thus, in such
context focus has been laid on adults who have clinical depression because of many reasons and
factors. Therefore, according to the research title, the study has been focusing on involvement of
adults in physical activities and how it is considered as a remedy to deal with clinical depression.
Specific key terms are also used for the purpose of collecting data about the subject matter.
Depression, physical activities, mental health capacities and clinical depression are some of the
terms that are being used in the present study for data collection process.

Table of Contents
TITLE................................................................................................................................................4
INTRODUCTION.................................................................................................................................4
Rationale of the study..................................................................................................................5
Research questions.......................................................................................................................7
BACKGROUND OF THE TITLE............................................................................................................7
AIM AND OBJECTIVES......................................................................................................................7
LITERATURE REVIEW........................................................................................................................8
Use of clinical treatment in improving mental health status of depressed adults........................9
Effectiveness of outdoor physical activities in improving mental health status........................11
Issues of depression among adults.............................................................................................12
METHODOLOGY..............................................................................................................................13
RESEARCH LIMITATIONS................................................................................................................17
DISSEMINATION..............................................................................................................................18
REFERENCES...................................................................................................................................20

TITLE
“Does an outdoor physical activity program improve the mental health status of adults with
clinical depression”?
INTRODUCTION
Depression varies from person to person, but there are some common signs and
symptoms that shows that depression is affecting the mental health status of an individual.
Depression is a major risk factor for suicide and the deep despair and hopelessness that goes
along with depression can make the person attempt suicide (Lubans and et.al., 2016). In this
respect, the present research study has emphasized depression in adults which leads to anger and
agitation. In such state, people usually complain of headaches, stomach-aches and other physical
pain (Wheeler, Acord-Vira and Davis, 2016). However, in the study brief discussion is also
included about older adults who have issues related to depression. Thus, in this respect, older
adults tend to complain more about the physical rather than the emotional signs and symptoms of
depression (Vandvik, Brignardello-Petersen and Guyatt, 2016). It has been observed that among
adults, depression lasts for many years which affects the mental health capacity of the individual.
People with a typical depression experience a temporary mood lift in response to positive events
such as receiving good news or while out with friends (Dobbins, Husson, DeCorby and LaRocca,
2013).
The research study will be carried out through focusing on the adults who experience
more issues due to depression. Along with this, focus will also be laid on role of physical
outdoor services in managing the state of depression amid adults. Along with this, researcher will
also emphasize on social aspects that are associated with depression. In this way, various
research studies have been reviewed that are made on adults with depression. As per the research
background, focus has been laid on use of outdoor physical activities in improving mental health
status of adults (having depression) (Eldredge and et.al., 2016). In the study, opinion of different
authors such as (Dobbins, Eldredge and Fredriksen-Goldsen) have been taken into account so
that the importance of physical activities in managing clinical depression in adults can be stated.
Along with Fredriksen-Goldsen and et.al., 2014, there are several authors (Simmonds and et.al.,
2014) as well that have given contradict opinion about the subject matter due to difference in

opinion and views. Viewpoints of the above mentioned authors have been taken into account so
that to include all the aspects of the study in adequate manner.
Henceforth, specifying about the concept of the study, it is clear that focus has been laid
on adults (experiencing clinical depression). They are also selected to as to specify the benefits
of physical activities in managing clinical depression. In terms of research survey, adults with
depression have been selected so that they can give their opinion regarding the need of outdoor
physical activities in improving mental health status. In the subsequent study, research question
is identified as an issue because depression is more common in adults. The practices are
somewhere similar especially in the realm of care and treatment. However, this is a research
issue since number of people are experiencing issues because of clinical depression. A few are
also getting assistance from physical activities; however most of the people get assistance
through medicines and therapies (Fillenbaum, 2013). The current study has improved the
research skills of researcher because varied sources are assessed in this aspect. Therefore, in this
context focus has also been laid on searching various research articles which emphasizes on
adults having clinical depression. Moreover, in this context emphasis has also been given on
finding out the importance of physical activities on improving clinical depression.
In the present research study, different methods has been used under research
methodology because it is the major protocol through which the entire process of research work
can be initiated. This is also helpful in reducing biasness in the review process and along with
that, it also ensures that the procedures are not over influenced by the results of the studies. In
this section, the use of clear research method protocol is effective not only in guiding researchers
throughout the process; but also it helps in keeping record of every task (Simmonds and et.al.,
2014). At the same time, it is being selected because it improves the methodological
transparency of the review (Schmidt and Günther, 2016).
Rationale of the study
The present research proposal seems to be beneficial as that includes detailed information
about contribution of physical activities in treating adults (with clinical depression). In the
subsequent proposal, discussion has been included about all the methods which are available
with the adults while experiencing clinical depression. Depression is a state that is caused by
several reasons; hence in the present research proposal all such reasons have been discussed that

leads to depression among adults. The research proposal holds more importance because it
specifies how a depressed person can get assistance through conducting physical activities.
PICO FRAMEWORK
Research title study: Does an outdoor physical activity program improve the mental health
status of adults with clinical depression.
Study rationale: insert here.
Population: Adult patients who are getting clinical assistance to overcome depression.
Intervention: Outdoor physical activities.
Comparison: N/A
Outcome measure (primary):
 The degree of effectiveness of physical activities in improving mental health.
Outcome measure (secondary):
 Treatment effectiveness of the patients will be ascertained. This will be done through
analysing the health aspects of adults.
 At the same time, feedback will also collected from them on regular basis.
Aim and Objectives
Aim: To determine the effectiveness of outdoor physical activity program in improving the
mental health status of adults with clinical depression.
Objectives:
 To identify the significance of outdoor physical activities for adults facing depression
 To ascertain physical activities that are useful for mental health status

 To recommend strategies through which mental health status of depressed adults can be
improved.
Research questions
 Why physical activities are important for improving mental health status of adults having
depression?
 Which outdoor activities are more vital to treat depressed patients?
 What is the impact of physical activities on mental health of patients?
BACKGROUND OF THE TITLE
Eco-therapy is a concept in which a range of nature based programmes are included that
supports the wellbeing of a mental health patient. This has been included since eco-therapy is
one of the interventions under physical activities. The therapy is also useful for the purpose of
enhancing patient’s mental capacity. It has been observed that Eco-therapy can improve mental
health through providing an alternative perceptive on life. It also helps the mind and body to
relax which assists the adults to reduce the level of depression prevailing in the mind (Rubin and
Babbie, 2016). More physical activities are involved in eco-therapy wherein adults are more
involved in social contact with people (Simmonds and et.al., 2014). This assist them to reduce
loneliness and at the same time, it boosts self- esteem of the person. Being surrounded by nature,
the use of therapy can boost the overall mood and sense of wellbeing (Pomerville, Burrage and
Gone, 2016).
It is an apparent aspect that dealing with nature aids a person to improve the health status;
hence in such respect physical activities are being emphasized on greater extent. There are
several reasons for which outdoor activities are considered as important such as it aids the patient
to heal faster. As per the research done by Nauert (2013), it is evident that focusing on physical
activities can aid a person to improve the health status; hence most often practitioners
recommend for the same. At the same time, it is also ascertained that because of physical
activities, a person can improve the health aspects in the best possible way.
AIM AND OBJECTIVES
Aim: Does an outdoor physical activity program improve the mental health status of adults with
clinical depression”?

Objectives
 To identify the significance of outdoor physical activities for adults facing depression
 To ascertain physical activities that are useful for mental health status
 To recommend strategies through which depression among the adults can be managed
LITERATURE REVIEW
In order to carry out the literature search process; researcher has emphasized on different
sources such as articles, books and journals so as to shed light on the importance of physical
outdoor activities on depressed adults (Jenkinson and et.al., 2013). In this respect books of
(Fillenbaum, 2013), (Sarafino and Smith, 2014) and (Strine and et.al., 2015) have been
considered to collect appropriate data about the subject matter. This has also helped in analysing
the concept of appropriate practices in dealing with the state of depression. The main theoretical
perspectives that are contained in the literature is the importance of physical activities in
improving mental health status of adults with depression. In this respect, researcher will also
focus on all those activities that are important for the purpose of making the patients feel more
motivated and encouraged. Secondary data is the major resource through which researcher
completed the section of literature review; thus according to such aspect it can be said that
opinions of authors were extremely helpful for the subsequent study (Dobbins, Husson, DeCorby
and LaRocca, 2013). For instance- studies done by previous authors have helped the researcher
in collecting specific data about the subject matter. This is useful in ascertaining information
about the contribution of physical activities in improving mental status of adults. Previous
studies have made it clear that physical activities are vital in improving the mental health status
of depressed adults. However, on the other hand, there were several literatures which focused on
clinical treatment more to improve the mental health aspects of patients (Strine and et.al., 2015).
The process of literature search will be conducted with the help of analysing different
cases, studies, research work, books and journals. This will come under the category of
secondary search in which different sources will be utilized for completing the research work.
The study conducted by Strine (2015) has many strengths like it would assist the researcher to
identify the mental health status of adults suffering depression from many grounds. However, on
the other hand, the main weakness of the study is that it does not define how the person can be
prevented from depression through physical and outdoor activities. The research work seems to

be similar with other authors as well because other studies are also depicting the importance of
physical and outdoor activities for adults facing clinical depression. Apparently, many research
work and studies have developed yet which emphasizes on contribution of physical activities for
depressed adults. However, in this context the present proposal is also defining about the
importance of physical activities in improving the mental health status of adults.
Use of clinical treatment in improving mental health status of depressed adults
Some of the studies greatly emphasized on clinical treatments; hence this shows that up
to some extent, natural therapies and clinical treatment both works for patients suffering from
depression (Nauert, 2013). Thus, with this description, it is evident that used literatures have
some strengths and some weaknesses too. Some of the literature were similar; however
somewhere were totally different; but as per the feasibility aspects, researcher has made use of
varied articles (Marlow, Salas, Landon and Presnell, 2016). In terms of differences, various
authors stated that when adults are in depression, they feel more isolated and even physical
activities does not work during that time. However, most of the health care practitioners argued
that focusing on physical activities diverts the mind of adults and keeps them positive about their
life (Sarafino and Smith, 2014).
This particular research work of (Sarafino and Smith, 2014) will be considered in the
present study because the content is highly appropriate according to the subject matter. Further,
the content has also shown critical approaches of the topic; therefore it is being considered in the
present study. Several previous research works have been used in the study; however with the
help of thorough analysis, various new aspects related to the research work have been identified
certainly. Thus, it can be said that there are several gaps in the literature which have been
properly addressed in the current study (Jenkinson and et.al., 2013). Comparing all the studies,
done by different researchers and authors, it has been identified that all the studies are crucially
focusing on importance of outdoor activities in overcoming the state of depression from adults.
Focusing on various studies helps the researcher to analyse how mental status of adults can be
improved through carrying out physical activities. At the same time, assessing all such studies
are also useful because that gives detailed data about the effective clinical treatment which
improves mental status of adults. In order to prepare the current proposal, varied studies have
taken into account; therefore it is clear that physical outdoor activities are useful in improving
the mental status of the patients.

As per several research done by (Jenkinson and et.al., 2013), it has been identified that
taking a walk in nature can reduce depression of around 71% of participants. Researchers have
also compared the effect with a control group who also take walk but in different ways. Thus, as
per the comparison it is clear that adults suffering depression should walk and run frequently so
that to reduce the ill impacts of the disorder. Recent studies have shown that exercise can treat
mild to moderate depression as effectively as antidepressant medication (Sallis and et.al., 2012).
In this regard, it has been observed that exercise is a powerful depression fighter for several
reasons and most importantly it promotes all kinds of changes in the brain including neural
growth, reduced inflammation and feelings of calm and well-being. The entire discussion has
been stating about different ways through which the state of depression can be managed. This
supports the present literature by stating that physical activities can aid the person to distract the
mind-set and also to get involved in healthy lifestyle. Therefore, it can be said that natural
remedies are typically useful through which a person can fight against depression.
Adults who have issues related to clinical depression must undergo with proper treatment
so that their mental capability and lifestyle can get changed. In addition to the same, adults
should also emphasize on bring health schedule so that they can enhance their life cycle.
Exercise or physical activities will not only assist in improving health dimensions; but also it will
aid the person to remain fit (Fillenbaum, 2013). Moreover, this can also contribute in switching
towards a healthy life. Along with the same, health standards can also be enhanced.
For adults (suffering from clinical depression), exercise is a nature and effective anti-
anxiety treatment as it relives tension and stress. At the same time, it also boosts physical and
mental energy and encourages wellbeing of the person through the release of endorphins. It has
also been analysed that counsellors prescribe physical activities for mental health patients
because it serves as a distraction and allows the person to find some quiet time to break out the
cycle of negative thoughts that feed depression in mind. Exercise has long been recognized as an
effective tool for those who face problems due to depression (Fredriksen-Goldsen and et.al.,
2014).
However, most of the studies do not differentiate between indoor and outdoor physical
activities. Environmental context is a classic confounding variable that, when controlled, can
help the adults to clarify the exact problem that is being faced by the person (Eldredge and et.al.,
2016). Mind and body both are closely linked to each other; therefore exercise and other

activities can help the person’s body to feel better with the mind. Physical activity immediately
boosts the brain’s dopamine, norepinephrine, and serotonin levels which assist the person to
focus more on attentive aspects (Dobbins, Husson, DeCorby and LaRocca, 2013).
Effectiveness of outdoor physical activities in improving mental health status
From the views of Fillenbaum (2013), it is identified that regular exercise can boost the
mood if the person has depression and it is especially useful for people with mild to moderate
depression. Regarding this, researchers say that more physically active people have greater
general feelings of excitement and enthusiasm as compared to less active people. Exercises are
very effective in reducing fatigue and at the same time it improves alertness and concentration.
This enhances overall cognitive function of the patient and as a result, patient feels better while
undertaking different exercises (Sarafino and Smith, 2014). When stress affects the brain, it
impacts the nerve connections and along with this, rest of the body also gets disturbed. As a
physical activity, exercise produces endorphins chemicals in the brain that act as a natural
painkiller. In this respect, Eldredge and et.al., (2016), said that socializing is also important as
that helps the person to get involved somewhere. This is also essential in terms of diverting the
mind which is yet another source of emotional support and compassion (Jenkinson and et.al.,
2013). Most of the doctors and practitioners recommend physical outdoor activities to adults
(with depression) so that they may not lose hope of living.
Along with this, physical activities are also important because that assists the person to
remain fit and strong which gives more physical strength (Strine and et.al., 2015). Exercise
improves mental health by reducing anxiety, depression and negative mood and at the same time,
it also improves self- esteem and cognitive function (Simmonds and et.al., 2014). Exercise has
also been found to alleviate symptoms such as low self-esteem and social withdrawal. It is
especially important in patients with schizophrenia as these patients are already vulnerable to
obesity. Additionally, they have other risks which are associated with antipsychotic treatment.
With the help of Simmonds’s study, it is being identified that physical activities like
walking and running are important for people especially who are depressed with different
reasons. Henceforth, in order to measure the outcome of several studies, researcher has applied
the tool in which it is being analysed that physical activities play crucial role in transforming the
mood of the depressed patients (Bushak, 2013). There is a direct association between physical
activities and mental health status of a person; hence considering the same thing, medical

practitioners usually recommend this sort of treatment to adults with clinical depression. In
addition to the same, outdoor physical activity drives adults to get involved more in sports and
physical activities which develops a urge of maintaining fitness among them (Fillenbaum, 2013).
Issues of depression among adults
Nearly a one fifth of adults in the UK experience anxiety or depression wherein there is a
higher proportion of women who suffers from this condition (Dobbins, Husson, DeCorby and
LaRocca, 2013). As per the research study, 19% of people aged under 16 years or above faces
depression in which 21% are women. Hence, it can be said that women are facing more
depression as compared to men more than 16%. In UK, people who are living separately from
their parents experience depression on higher extent and they also have moderate symptoms of
mental ill health. Due to this, they prefer to undergo for clinical treatment wherein they get
recommendation to indulge in physical activities. Hence, there is one thing common that is
suggested by every practitioner and that is physical activities for relieving mental depression. In
this respect, behavioural activation is also recommended as a treatment option for patients with
depression (Lubans and et.al., 2016).
The study conducted by Lubans and et.al. (2016), is quite essential for the researcher for
the purpose of addressing the issues that are faced by depressed adults at the time of undertaking
clinical treatment. Current facts and figures have been identified in the study for the purpose of
ascertaining the degree of accuracy about the subject matter. Although, several gaps were there
in the literatures; but that did not affect the suitability of the study (Bushak, 2013).
It has been stated that to overcome the level of depression and anxiety among the
individual it is essential for them to focus on the performing physical exercises that it assists in
improving numerous of health related issues and problems such as blood pressure or diabetes.
From the conducted research it was investigated that physical movement or exercises improve
the circulation of blood within the body and also improves the mood (Simmonds and et.al.,
2014). Along with this regular exercise also assists in releasing the brain chemicals that may
comfort the depression level. Moreover, it also increases or raises the individual body
temperature that support them in becoming active. Besides, improving the individual mood
regular and continuous physical exercise also benefit the individual towards protecting them
against the cardiovascular diseases and even enhances their self-esteem level (Nauert, 2013).