“My best card against my mental health”: A Qualitative Analysis of Blue Space and The Self-Management of Mental Health Symptoms.

Abstract

Objective: Theoretical and empirical evidence suggests a relationship between exposure to blue space (outdoor water environments) and positive mental health and wellbeing. To date, studies indicate that people’s proximity to and use of blue space is associated with good mental health, but additional exploratory research is required to understand interactions between blue space and mental health outcomes in people with mental health difficulties. This study explores how people with mental health difficulties experience blue spaces in a non-clinical, non-intervention context. A broader aim of this research is to consider the mechanisms/pathways connecting blue space and mental health outcomes. Methods: The population of interest in this study were adult men and women living in British coastal communities who self-identified with having a mental health difficulty. Data consisted of semi-structured interviews from primary (N=6) and secondary (N=7) data sets. The data was analysed using constructivist grounded theory. Results: Findings indicate that blue spaces provide conditions where people can gauge their mental health, assess their needs, and get them met. The analysis highlighted that blue space exposure has both a reactive and preventative impact on mental health symptoms and suggested that this may be mediated by the severity of mental health difficulties. This study supports the notion that social (i.e., meaningful relationships with others) and attentional (i.e., mindfulness and gratitude) mechanisms are important in explicating the relationship between blue space and mental health but highlights occasions where blue space exposure can worsen (i.e., heightened anxiety related to the perception of threat from others on beaches at night) or have no effect on mental health symptoms (i.e., the persistence of suicidal ideation). Conclusion: Overall, this study suggests that an added value of blue space environments specifically for people living with mental health difficulties is that they provide the necessary conditions that empower people to feel able to self-manage their mental health symptoms.