Scaling new heights: a prospective survey of rock climbing's impact on mental health.

Background: Sport climbing, officially added to the 2020 Summer Olympics, has grown rapidly, with U.S. climbing gyms increasing from 310 in 2013 to 591 in 2021. Over the past decade, European research has identified bouldering as a potential psychotherapeutic treatment for anxiety and depression. Randomized controlled trials have compared bouldering psychotherapy (BPT) to cognitive behavioral therapy (CBT), showing that BPT produces comparable results and positively impacts mental health.

Purpose: There have been very few studies dedicated to the use of rock climbing as a therapy in the United States; further, there are few surveys that investigate whether American climbers would even consider climbing as beneficial towards mental health or not. With the ever-growing prevalence of mental health disorders and as climbing gains more traction, it is important to explore the potential of climbing as a therapeutic modality. It is hypothesized that rock climbing will be viewed as beneficial towards mental health amongst the population surveyed.

Methods: A prospective survey was conducted to assess rock climbing's impact on mental health, focusing on participants' climbing habits and perceptions of its therapeutic benefits. The protocol was approved by the Rowan-Virtua IRB (Reference #: PRO-2022-353) in accordance with the latest guidelines of the International Committee of Medical Journal Editors. Participants were recruited using flyers and posters at climbing gyms, an online climbing forum, and social media. The survey included individuals aged 18 years and older who engage in rock climbing at least once per week. No specific exclusion criteria was set in place, though participants were given the option to omit the mental health portion. The survey included questions on climbing frequency, mental health impact, and demographics. The survey was distributed online via Qualtrics Forms between February 2023 to June 2023, with informed consent obtained from participants, explaining both risks and data safeguards in place. Univariate graphs and bivariate analyses via chi square analysis were done using R Studio.

Results: A total of 748 survey responses were received, with 50.4% of participants aged 26-40 years. Most were White Non-Hispanic (59.7%) and resided in the Mid-Atlantic/Tri-State Area. Climbing preferences showed indoor bouldering (24.9%) as the most popular, followed by indoor top rope (16.4%) and indoor lead climbing (12.4%). Outdoor climbing activities were less common, with traditional climbing at 10.1% and speed climbing at 0.2%. Significant associations were found between climbing frequency and age (p = 0.0045), session length and age (p = 8.2e-10), and climbing frequency by gender (p = 0.0024). Regarding social behavior, 46.8% identified as introverts and 37.1% as ambiverts. Mental health data revealed that 73.1% of climbers felt rock climbing positively impacted their mental health. Depression and anxiety were the most reported conditions. When compared to therapy and medications, 73.3% of participants found rock climbing more beneficial than medications, and 64.8% found it more beneficial than therapy. Gender and race were significantly associated with perceptions of climbing's mental health benefits (p = 0.0448 and p = 0.0422, respectively).

Conclusion: Survey results offered future focal points of interest and affirmed that BPT would be received well as a therapeutic modality in the United States. Further, survey participation of 748 completed responses illustrates the community's support and open communication regarding mental health, creating a promising field to continue exploring. Overall, rock climbing holds potential as a treatment modality for mental health disorders, further bridging the gap between physical and mental health.