The impact of outdoor therapeutic recreation on suicidality: A mixed-method systematic review

The aim of this systematic review was to synthesize the evidence on the impact of outdoor therapeutic recreation (TR) on suicidality. Five databases were interrogated, and critical appraisal, data extraction and synthesis for included articles were conducted according to the Joanna Briggs Institute (JBI) guidelines. Nine studies met the inclusion criteria. Synthesised themes included: Interpersonal Relationships; Self-Discovery; The Therapeutic Milieu; Future-Focused Ways of Thinking; and Program Structure. Meta-analysis revealed no significant difference in suicidal ideation scores among those who received TR and those who did not, however, a reduction in depression rates were observed in people who received TR (SMD –0.74; 95% CI –1.24 to –0.24; p = 0.92; I2 0%). While there was no significant difference in suicidal ideation scores, there was a reduction in depression rates among individuals who participated in TR. Further research is needed to ascertain the effectiveness of outdoor TR in reducing suicidality.