After 11 deployments overseas with the United States Army, Mitch Vazquez was having trouble adjusting to life at home in North Carolina with his wife and four kids. Trivial, everyday occurrences, like one of his daughters spilling her milk, would set him off yelling. He couldn’t turn off the hypervigilance and obedience that had kept him alive while on duty.
Vazquez was eventually diagnosed with adjustment anxiety disorder, a stress-induced condition, and referred to group therapy. The sessions didn’t have an impact. What did was his decision to step away from his home life and into the wild. Vazquez grew up in a military family that enjoyed recreating outside, primarily camping, fishing and hunting. So, in the fall of 2018, he drove to Colorado, where his mom lived, and hiked and hunted alone in the Rocky Mountains for 26 days. It was the mental reset he desperately needed. “There are no huge triggers in the outdoors. It’s just so calming. It’s quiet,” the now-45-year-old says. “It’s definitely calmed me down a lot … made me understand that the bigger world things probably don’t matter as much as what’s to my left and right.”
At the time, Vazquez wasn’t aware of the extensive network of outdoor adventure programs available to veterans—hunting trips, rock climbing clinics, weekend hikes—that have popped up across the country in increasing numbers in recent years. Though limited, research has shown these excursions can reduce symptoms of PTSD and major depressive disorder among active-duty military and veterans. As awareness of their therapeutic benefits grows, veteran communities are trying to determine how to increase access and ensure that outdoor therapy is considered as part of mental health professionals’ prescriptions for these issues.
Such programs are desperately needed, as the number of veterans suffering from serious mental health concerns is only growing. Seventeen veterans died by suicide every day in 2019, according to the 2021 National Veteran Suicide Prevention Annual Report. The National Center for PTSD estimates that, on average, 7 percent of all veterans will have PTSD in their lifetimes; that number is elevated among female veterans, at 13 percent, in part because of higher rates of military sexual trauma among women. Other studies have shown that veterans sustain several other health conditions at higher rates than the general population: More than one in ten have a diagnosed substance use disorder, and at least two-thirds of veterans who served after 9/11 have “diagnosable mental health concerns.”
The healing power of nature is not a new revelation. The Ancient Greeks used to visit natural springs to recharge; legend has it that Hercules bathed in them to rest and regain his strength between his Labors. Gardens were included in the designs of 19th-century asylums to aid with recovery. Doctors prescribed horticulture therapy for soldiers returning from both World Wars. And the first person to thru-hike the Appalachian Trail was Army veteran Earl Shaffer, who said he undertook the challenge to “walk the war out of my system.”
More recently, studies have demonstrated that spending time with Mother Nature has a direct impact on our brains and bodies. Outdoor experiences lower blood pressure, heart rate and cortisol; reduce stress and anxiety; and improve cognitive function and one’s ability to focus. “The natural scenes allow for the parasympathetic part of our stress response—the part that calms us down—to kick in,” says Patricia Hasbach, a licensed professional counselor and clinical psychotherapist. “It starts to remind us that we can trust ourselves again. … People feel better. You can breathe better.”
Though colloquially referred to as “outdoor therapy,” many recreational programs aimed at veterans do not involve trained clinicians. They range from strolling through the local botanical gardens to multiweek expeditions, which may be guided or not. Chelsey Cook, a U.S. Army veteran and current mountaineering guide in Alaska, finds benefits even when she’s simply sitting in a lawn chair with her journal. “I’m a much better person to myself and to everyone else in the world if I set aside time to be outside every day,” Cook says.
Hasbach calls those sorts of experiences “healing activities”; others refer to them as “therapeutic adventures” or “outdoor adjunct therapy.” Ecotherapy, which Hasbach practices from her home base in Eugene, Oregon, is the clinical version, and it must involve the trifecta of client, therapist and nature. The intentional, directed experience—co-created by the patient and their clinician—is the therapeutic aspect, she says. “As a species, we developed embedded in the natural world … so it’s this deeper reconnection with our own primal roots that’s impactful.”
Veterans, in particular, may benefit from that connection. Some are put off by clinical therapeutic settings or may not have access to them. Less than half of returning veterans who need mental health treatment receive it, largely because of persistent stigma and lack of access due to distance or long wait times. But outdoor excursions play to veterans’ strengths: They’re used to having a mission, navigating risk and working with a team. The group atmosphere afforded by these outings creates opportunities for bonding and can decrease feelings of loneliness. Plus, they are generally goal-oriented—hike to the top of this mountain, navigate through these white-water rapids—which can renew veterans’ sense of purpose, something they may lose sight of between deployments or in retirement.
“Time and again, veterans who participate in these programs come back and say, ‘I feel better; it helped,’” says David Havlick, chair of the University of Colorado Colorado Springs’ Department of Geography and Environmental Studies, who has been studying outdoor programs for veterans for nearly a decade.
Veterans themselves are pushing for more support for these initiatives. Many, like Vazquez, have founded their own nonprofits; in 2020, he launched Heroes’ Harvests, which leads veterans on outdoor adventures, including hunting and fishing trips. Some veterans helped to get the Accelerating Veterans Recovery Outdoors Act passed with the Veterans COMPACT Act of 2020. In part, the legislation directs the U.S. Department of Veterans Affairs (VA) to create an interagency task force that will evaluate the benefits of and barriers to outdoor recreation therapy and make recommendations to Congress. “Outdoor adjunct therapy is not a one-size-fits-all. It’s not a magic pill. There may be some veterans who do need other types of treatment from the VA,” says Josh Jespersen, a former Navy SEAL and president and co-founder of Veteran’s Outdoor Advocacy Group, which backed the legislation. “But what we’re trying to push forward in D.C. and with the VA is that veterans will at least have the option to go outside for their therapy or their treatment.” His organization’s goal is for these outings to be “prescribed on a systemic level” in order to build awareness and lower the barriers to entry—making these recreation opportunities more widely available, more affordable and more inclusive for people of varying abilities and backgrounds, including individuals with disabilities, women, people of color and those that identify as LGBTQ+.
Researchers have not yet pinpointed what precisely it is about these activities that is beneficial, or if certain kinds or specific timeframes provide more value. Anecdotally, veterans report lower stress levels, improved home life and, for some, reduced reliance on medication, alcohol or drugs. “Recreation is therapeutic, but you can’t prescribe the particular outcomes,” says Daniel Dustin, a Vietnam War veteran and retired outdoor recreation expert who taught at the University of Utah. “It’s nonspecific.” In other words, nature isn’t a pill with set dosages and clear results.
Mental health professionals and recreation researchers also can’t say how long these impacts last without repetitive doses, or consistent time outdoors. Following his fourth and final combat deployment, Aaron Leonard, now the campaign manager for Sierra Club’s Military Outdoors program, went on a weeklong dog-sledding expedition. “I felt refreshed. I felt like I’d been reset. … My sense of loneliness was gone. I felt that I belonged in my family and in my work. My sense of purpose had been restored,” he recalls. “It lasted maybe a month before everything came crashing back.”
Academics and mental health experts have other concerns about adventure therapy. They explain that some veterans might be triggered by scenery that reminds them of a battleground and that, in some instances, solitude could be detrimental to mental health. Veterans like Leonard also express concerns about equity and the ability for those with physical limitations to access this kind of supportive care. And the University of Colorado’s Havlick says questions exist about what protective guardrails are being used to determine who can safely participate. That’s why nature-based therapy advocates, including Hasbach, often advise using therapeutic recreation in conjunction with other forms of treatment.
Whatever name it goes by, Vazquez has certainly seen the benefits of outdoor excursions for himself and the veterans his nonprofit works with. “A lot of times when veterans get out of the military or they retire, they’re leaving something they did their entire adult life, so they almost feel like they’ve lost their sense of being or their self-worth,” he says. “When we bring them into the outdoors, we reengage those skills they have and give them that self-worth again.”