: A large-scale, multi-decade, qualitative analysis
Author links open overlay panelR.C.Buckley
International Chair in Ecotourism Research, Griffith University, 4222, Australia
Received 13 August 2018, Revised 23 November 2018, Accepted 12 December 2018, Available online 20 December 2018.
Associate editor: Juergen Gnoth
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https://doi.org/10.1016/j.annals.2018.12.017
Contents lists available at ScienceDirect Annals of Tourism Research journal homepage: www.elsevier.com/locate/annals Research Note Therapeutic mental health effects perceived by outdoor tourists: A large-scale, multi-decade, qualitative analysis R.C. Buckley International Chair in Ecotourism Research, Griffith University, 4222, Australia ARTICLE INFO Associate editor: Juergen Gnoth
Introduction The mental healthcare sector wants to prescribe outdoor therapies, but as yet lacks outdoor capabilities. The tourism sector has those capabilities, but as yet has not shown therapeutic outcomes. Here, therefore, I reanalyse previously published qualitative datasets, to examine mental health effects perceived by outdoor tourists. Outcomes indicate that nature, eco and adventure tourism enterprises could potentially become certified providers of prescribable outdoor therapies in mainstream healthcare. This represents a large economic opportunity, significantly greater than current investment in outdoor education and recreation. From a healthcare perspective, the analysis presented here provides proof of concept only: clinical testing and medical certification are still required. From a tourism perspective, it indicates an opportunity to apply existing skills, under a different commercial model. From a tourism research perspective, it demonstrates a need for more rigorous research on mental health outcomes, beyond emotional experiences. Context In the Western health sector, 35 years’ research (Ulrich, 1984; Twohig-Bennett and Jones, 2018) has demonstrated therapeutic benefits of exposure to nature, especially for mental health. This reflects longstanding practices such as forest bathing in some Eastern nations (Chen, Yu, & Lee, 2018; Oh et al., 2017). As yet, Western research is at proof-of-concept level, lacking quantitative doseduration-response data for patients with different characteristics and symptoms (Buckley, Brough, & Westaway, 2018; Frumkin et al., 2017; Shanahan et al., 2016). Also lacking are practical implementation plans within mainstream healthcare systems (Buckley et al., 2018). Policy pressures to create such plans have arisen only recently. These pressures derive from budget shortfalls in developed nations, owing to ageing populations and increases in chronic disease syndrome, CDS: depression, dementia, diabetes and obesity. Treatment costs for CDS, from health insurance and government healthcare budgets, have increased greatly (Buckley et al., 2018). Poor mental health imposes additional costs, ∼10% of GDP, through reduced workplace productivity and increased antisocial behaviours, both private and public (Buckley et al., 2018). This drives demand for new approaches to CDS. Outdoor therapies, modelled on physiotherapy and psychotherapy courses, are the most promising opportunity (Buckley et al., 2018). To be prescribed by general practitioners, and funded by government or insurers rather than patients, courses must be tested clinically, and delivered by certified providers. These providers must be capable of safe and insurable operations outdoors. This includes equipment, land access, logistics, risks and safety, staff skills and training, and client choreography. The mainstream healthcare industry has little experience in these. https://doi.org/10.1016/j.annals.2018.12.017 Received 13 August 2018; Received in revised form 23 November 2018; Accepted 12 December 2018 E-mail address: r.buckley@griffith.edu.au. Annals of Tourism Research 77 (2019) 164–167 Available online 20 December 2018 0160-7383/ © 2018 Elsevier Ltd. All rights reserved. T
Author links open overlay panelR.C.Buckley
International Chair in Ecotourism Research, Griffith University, 4222, Australia
Received 13 August 2018, Revised 23 November 2018, Accepted 12 December 2018, Available online 20 December 2018.
Associate editor: Juergen Gnoth
crossmark-logo
Show less
https://doi.org/10.1016/j.annals.2018.12.017
Contents lists available at ScienceDirect Annals of Tourism Research journal homepage: www.elsevier.com/locate/annals Research Note Therapeutic mental health effects perceived by outdoor tourists: A large-scale, multi-decade, qualitative analysis R.C. Buckley International Chair in Ecotourism Research, Griffith University, 4222, Australia ARTICLE INFO Associate editor: Juergen Gnoth
Introduction The mental healthcare sector wants to prescribe outdoor therapies, but as yet lacks outdoor capabilities. The tourism sector has those capabilities, but as yet has not shown therapeutic outcomes. Here, therefore, I reanalyse previously published qualitative datasets, to examine mental health effects perceived by outdoor tourists. Outcomes indicate that nature, eco and adventure tourism enterprises could potentially become certified providers of prescribable outdoor therapies in mainstream healthcare. This represents a large economic opportunity, significantly greater than current investment in outdoor education and recreation. From a healthcare perspective, the analysis presented here provides proof of concept only: clinical testing and medical certification are still required. From a tourism perspective, it indicates an opportunity to apply existing skills, under a different commercial model. From a tourism research perspective, it demonstrates a need for more rigorous research on mental health outcomes, beyond emotional experiences. Context In the Western health sector, 35 years’ research (Ulrich, 1984; Twohig-Bennett and Jones, 2018) has demonstrated therapeutic benefits of exposure to nature, especially for mental health. This reflects longstanding practices such as forest bathing in some Eastern nations (Chen, Yu, & Lee, 2018; Oh et al., 2017). As yet, Western research is at proof-of-concept level, lacking quantitative doseduration-response data for patients with different characteristics and symptoms (Buckley, Brough, & Westaway, 2018; Frumkin et al., 2017; Shanahan et al., 2016). Also lacking are practical implementation plans within mainstream healthcare systems (Buckley et al., 2018). Policy pressures to create such plans have arisen only recently. These pressures derive from budget shortfalls in developed nations, owing to ageing populations and increases in chronic disease syndrome, CDS: depression, dementia, diabetes and obesity. Treatment costs for CDS, from health insurance and government healthcare budgets, have increased greatly (Buckley et al., 2018). Poor mental health imposes additional costs, ∼10% of GDP, through reduced workplace productivity and increased antisocial behaviours, both private and public (Buckley et al., 2018). This drives demand for new approaches to CDS. Outdoor therapies, modelled on physiotherapy and psychotherapy courses, are the most promising opportunity (Buckley et al., 2018). To be prescribed by general practitioners, and funded by government or insurers rather than patients, courses must be tested clinically, and delivered by certified providers. These providers must be capable of safe and insurable operations outdoors. This includes equipment, land access, logistics, risks and safety, staff skills and training, and client choreography. The mainstream healthcare industry has little experience in these. https://doi.org/10.1016/j.annals.2018.12.017 Received 13 August 2018; Received in revised form 23 November 2018; Accepted 12 December 2018 E-mail address: r.buckley@griffith.edu.au. Annals of Tourism Research 77 (2019) 164–167 Available online 20 December 2018 0160-7383/ © 2018 Elsevier Ltd. All rights reserved. T
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