Outdoor Activities for the Well-being of Refugee Youth

Refugee and asylee youth often struggle with many issues and barriers after resettlement. Amongst those issues are loneliness, isolation, lack of social and community support, and connection. The major barrier that aggravates these issues is the lack of accessibility due to transportation, finances, lack of social connections and networks. These issues and barriers often have negative effects on their mental and physical health and can be improved by providing them with access to community outdoor activities.

There are a wide range of studies conducted about the mental health of refugees after resettlement.

The accumulation of stress due to forced migration and trauma that occurred before resettlement puts refugees at great risk for depression, anxiety, PTSD, overall stress, and emotional and behavioral problems. Bronstein and Montgomery (2011) conducted a systematic review of research into the mental health of refugees living in Western countries and found that the main factors that influence their level of distress are age, gender, country of origin, separation from parents, injuries, time spent in refugee camps, loss of family members, language, and most importantly, the absence of structural and personal support.

For their review, they retrieved 247 full research texts about refugees in six different countries and measured various forms of psychological distress, such as PTSD and depression. Their findings showed that refugee youth scored between 19% and 54% above the clinical cutoff for PTSD and 3% to 30% above the clinical cutoff for depression (Bronstein & Montgomery, 2011). The review also showed that while the immigration process itself is linked to higher scores of PTSD, problems related to the absence of personal and structural support was linked to increased internalisation and higher depression scores.

In a study conducted by Strijk, Meijel, and Gamel (2010) thirty refugee participants were quantitatively surveyed and eight participants were subsequently qualitatively interviewed to assess the needs and problems that currently affected their quality of life. The study was performed at a mental health hospital that specializes in treating refugees who had experienced trauma and violence. During their research, they determined that all of the refugees were currently experiencing psychological distress and struggling with several other issues: loneliness, lack of daytime activities, transportation, and the absence of shared experiences (Strijk, Meijel, and Gamel, 2010).

The interviews revealed the many refugees felt lonely and had trouble connecting with new people because they were scared of misunderstandings and discrimination. Most of the refugees they surveyed also stated they were bored, felt like they did not have a purpose, and wanted to fit in with people by doing "normal" activities. During the interviews, the researchers also found that many refugees were uncomfortable using public transportation due to discrimination and past trauma. Lastly, they also discovered that refugees felt less lonely when they connected with other refugees who had shared some of their experiences (Strijk, Meijel, and Gamel, 2010).

In a qualitative study, Groark, Sclare, and Raval (2011) interviewed six asylee adolescents and also determined that the losses they had experienced put them at higher risk for depression, anxiety, PTSD, and other behavioral problems. They identified that the some of main factors associated with those issues were the loss of the children's homes, communities, way of life, trust, and cultural identity. The participants of the study described various coping systems that help them in adjusting to their new lives, such as avoiding stressful thoughts and feelings, accepting the changes, using professional and personal support systems, such as engaging in friendships even though some of them found it difficult to build close friendships (Groark, Sclare, and Raval, 2011).

Additionally, in a review paper of studies conducted in Canada, the United States, Australian, and European countries, Marshall, Butler, Roche, Cumming, & Taknint (2016), found that there were several modifiable factors that could predict the social and emotional well-being of young refugees caused by the losses and stresses they experienced during their immigration journey. They identified that the main alterable factors that affect the mental health of refugee youth are language learning, education, adjusting to cultural differences, proximity to own ethnic community and general community support, along with access to health, social, and economic resources.

El-Bialy & Mulay (2015) conducted an ethnographic study in a small urban community for which they interviewed ten refugees to determine the factors that support and challenge the wellbeing of resettled refugees. The data from the interviews revealed that in their community, the lack of sunlight, language fluency, access to social support and services, led to loneliness and social isolation for the refugees. The participants shared that being in a natural environment and performing outdoors activities gave them a sense of wellbeing and enhanced their emotional healing. The researchers also found that the support of cultural and linguistic communities strongly affected the mental and emotional wellbeing of refugees (El-Bialy & Mulay, 2015).

An article published by McCurdy, Winterbottom, Mehta, and Roberts (2010) describes a rise in chronic illnesses that affects low income and minority children disproportionately. They identify that the lack of physical activity is contributing to to children developing chronic health conditions and mental health issues, such as depression, anxiety, behavioral issues, and higher levels of stress. They examined the relationship between outdoor activities and physical and mental health and determined that children's levels of depression and anxiety showed were strongly affected by the amount of time they spent in natural environments. Their final discussion also emphasized the dire need to promote outdoor activities for children's physical and mental health.

During depression-related treatment in a mental health facility, Fr??hauf, et al. (2016) conducted a study to compare the effects of performing outdoor physical activity against the effects of performing indoor physical activity, and performing no physical activity. They assessed 14 different patients using the Mood Survey Scale, Feeling Scale, and Felt Arousal Scale to see if there were significant differences between the results of those who performed outdoor, indoor, and no activity. They concluded that there is evidence that performing physical activity outdoors had a greater impact on the patients' mental health than the alternatives (Fr??hauf, et al., 2016).

In an effort to determine whether individuals who spent more time in nature experienced fewer symptoms of stress, anxiety, depression, and overall better health, Dean, et al. (2018) surveyed 1538 people in Australia. They discussed the benefits and role of nature in influencing mental and physical health as well as lowering stress levels in individuals.

The survey was sent out online and aimed to assess how much every person identified and connected with nature, their views about nature. It also included an assessment about the participants health and the Depression Anxiety Stress Scales-21 (DASS-21). An analysis of the results determined that people who spent more time outdoors were generally healthier, both physically and mentally, less stressed, and felt more socially connected to others.

Triguero-Mas, et al. (2017) conducted a cross-sectional study to examine the relationship between natural outdoor environments and mental health in four European cities located in different regions of the continent. They invited 8760 people to participate in their study and ended up with a sample of 406 individuals. They asked the participants of the study to wear a smartphone and use an application called CalFit along with daily writing in a diary.

The study evaluated the environment of the participants to see if they were near or around nature areas and assessed the participants' mental well-being, along with other factors, through daily morning and evenings diary entries in forms of questionnaires and self-assessments. The results of the study showed that participants who were had more contact with nature reported better mental health and lower stress levels (Triguero-Mas, et al. 2017).

Mutz & M??ller (2016) analyzed two pilot studies to examine the benefits of outdoor programs on mental health for student-aged youth. The participants in the first study participated in a nine day long hike in the alps. The students were assessed shortly before and after the hike. The second study was conducted on a group of fifteen undergraduates who spent eight days in the remote wilderness in Norway.

The study assessed the students' stress levels with the Perceived Stress Questionnaire, self-efficacy levels with the General Self-efficacy Scale, mindfulness with the Mindful Attention and Awareness Scales, and short and long-term subjective well-being with a questionnaire. While the results of the first study were limited because there was no control group, the results showed a significant increase in mindfulness and well-being. The second study had a control group and the results showed a moderate to significant improvements in mental health, especially in the areas of mindfulness, self-efficacy, and overall happiness and life satisfaction (Mutz & M??ller, 2016) .

Both pilot studies indicate that there is a strong connection between outdoor activities and improved mental health. It suggests that outdoor programs cultivate resilience and overall well-being among teenagers but also points out that all the students who took part in the study were attending school or a university and came from privileged families. Mutz & M??ller (2016) point out that low income children who are not privileged encounter barriers when it comes to accessing outdoor activities and need the most help to access these type of outdoor adventures because they are likely to benefit from such programs even more than their more fortunate peers.

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