“And I prescribe you…climbing.”

Posted by Team BMC on 05/04/2024
Wallowbarrow Crag, Richard Chapman

Climber and trainee mountain leader Richard Chapman is changing the way mental health is treated by the NHS with his Climbing Matters course.

This course uses the physical demands of climbing and its subsequent emotional impact to help improve the mental strength and resilience of people recovering from trauma and those with severe mental health illness and behavioural challenges. Funded by NHS England, DEFRA and Sport England, Richard designed the course and now delivers it in person in partnership with groups like Turning Point and Nottingham City Council. Richard draws on his own experiences as a Co-Active Lived Experience Coach after the loss of his first son to a very rare brain tumour in 1998, aged only 14 months. Hear more from Richard when we last caught up with him in the Finding Our Way podcast with BMC ambassador MaryAnn Ochota, here.

What is Climbing Matters?

Climbing Matters is 5-week climbing course designed to aid the treatment and management of trauma and severe mental health challenges. It’s a bit of an experiment. We ran the course 3-4 times last year, and this year will be the same, to understand how it works and the outcomes. We take people with severe mental health conditions to a wall, at a quiet time or before the public opening hours, and we get them climbing to practice responding to difficult feelings like fear, vulnerability and discomfort in a safe environment. With the right coaching and support, the theory is that practicing overcoming these challenges enables the brain to become better at managing difficult situations in other parts of your life. Your brain doesn’t know the difference between the fear of being up high from the fear of going outside your house, for example. Similar things are being done with yoga, theatre groups and choirs because they all produce a genuine emotional reaction in the body.

How’s it going so far?

So far we have worked with Turning Point, [a social enterprise delivering health and social care services across 280 locations in England]. We took people from residential units in Nottingham (where I’m based) to Nottingham Climbing Centre indoor wall. We talk to them about feelings like fear and loneliness first, and then they get on the wall and do things they never thought they could do. In doing so they change their perceptions about what they can do about their emotions. Feelings of vulnerability, fear and discomfort are all provoked by climbing and it causes physical reactions like sweaty palms and jiggling legs too. With the right mindset, participants have been learning to overcome these things.

Why has there been an increase in social prescribing?

There has been an increasing level of discussion in the media over the last few years around the link between the outdoors and health. After the covid lockdown this was quite clear to see, with all those queues at iconic, natural beauty spots like the Llanberis Pass in Snowdonia, Wales, and at Durdle Door in Dorset. That was a real indicator to DEFRA of how much people really do need access to the outdoors for their wellbeing. So £5.7 million was allocated to exploring green, social prescribing across the country. Things like gardening improving dementia, loneliness alleviated with woodland walking groups, and mine - severe mental illness helped by climbing. I applied for a pot of money and received £600 to run a trial. I collected feedback and found people loved it.  

What was the feedback?

The feedback unbelievable. One lady said she gained so much more confidence that she became an activity support person herself. One guy gave up smoking so he could afford to go climbing, and another lady’s family said to her, “Make sure you get up and go to the climbing course because you’re a different person when you come back.” The people with autism loved it especially, because they were doing things they and their carers didn’t previously think they could do. All you need is the right environment and coaching. The 6-8 course members formed a good community bond between themselves and the staff too. At the end of each course I say to them, “You’re climbers now and part of the climbing community. You can go to any wall and have the same experience all over the country.” Now they were climbers who happened to have a mental illness, not just people with mental illnesses. 

How does your own experience relate to this work?

Since losing my son in 1998 and then having four more children, I’ve now finally had time to think and develop a sense of reflection. I realised that going outdoors and climbing helped me mentally, but I don’t think I knew that at the time. My next child, my daughter, was born the following year, then another, then twins! So there was 15 years of the manic-ness you get with young children and it doesn’t give you a chance to heal and reflect, you just get on with life. But it was clear that when my daughter was quite young I was struggling. I’d have irrational, emotional outbursts, head-butting doors, throwing furniture and punching walls. My sleep was disturbed and I’d be awake for an hour or two each night with intrusive thoughts and unpleasant visions. A certain smell or music would take me right back to that place, being triggered. For a long time I just accepted my lot; I didn’t even think to go to the doctor about any of this. It was only when the kids got older and I found time to read more about it that I realised it was PTSD (Post Traumatic Stress Syndrome).

How has climbing helped you with PTSD?

In parallel with all of this, I’ve always been a climber. I grew up in Cornwall, climbing on sea cliffs and hill-walking with my dad. I’ve always had it in my life. What I love most isn't going to do an extremely hard thing but finding somewhere new - a place I’ve never been or a cliff I’ve never climbed before. The absorption in the curiosity and preparation of making that happen, the uncertainty of being there and the discomfort during the process made me realise this is what I really enjoy doing. 

I go on climbing and hiking trips to places like North Wales and the Lake District 4-5 times a year and indoor climbing 1-2 times a week. I feel unsettled and angsty if I don’t go or haven’t got anything planned. I need to escape for a bit and lose myself, it’s fundamental. My wife and all four kids like climbing and we go to Scotland every February for sledging. The outdoors has always been a big part of our family experience, and I’m passing on my navigation and wild camping skills to them. 

It took a long time to realise that I had PTSD and a couple of years more to work out that climbing was part of my recovery. It wasn’t until I read The Body Keeps The Score by Dutch psychiatrist Bessel van Der Kolk that I realised why this is what climbing does for me. The last 5-10 years I’ve found the triggering has reduced, it’s still upsetting to remember the specifics, but I have built the emotional capacity to deal with it. For me it wasn’t medication or therapy, climbing seemed to be the thing. 

Does it work for everyone?

It’s not a panacea for everything and everyone but there is something very interesting about climbing, mountaineering and big days in the hills. I was talking to adventurer Belinda Kirk about this when I spoke at her Adventure Mind conference last year. There’s a level of discomfort to endure, intentionally, to go climbing and this is a really important part of personal growth. If you avoid discomfort you don’t grow, you get smaller. You must lean into discomfort and it’s not pleasant. Being able to endure physical and mental discomfort allows us to grow as people. Experience of climbing has that in spades - you get cold, tired, emotional, frightened, lonely, your feet hurt and you can hate it and think, ‘I’m going to fall off!’. I’ve done a lot of different sports but I don’t know any others that are like climbing. There’s a brutal honesty about the experience that really peels you back and reveals you for who you are, and that’s the start point in starting to get better. We can all improve and all change our perspective. 

What’s next?

There’s no reason that programmes like Climbing Matters couldn’t work at climbing walls and locations anywhere. Every GP is now supposed to have a social prescribing link worker ascribed to the practice so if someone says they are lonely, anxious or have a low mood, they can be referred to initiatives that they’re interested in, like Climbing Matters. Personalised care has been proven to be more effective - if your involve the patient and give them choice and control over their care decisions, it leads to more cost effective, better care outcomes. If you say, “Do this”, they don’t.

What I’d love to see happening in the future is instructor training for different mental health challenges, so we could up-skill them to deliver specific Climbing Matters courses for anxiety, depression, CBT [Cognitive Behavioural Therapy], autism and other specialist needs. It would give instructors the confidence to help in a positive, safe way.

We also need to find more ways of reducing and removing the barriers to climbing and the outdoors for people who think it might not be for them, like diverse populations, people with mental health conditions and on lower incomes. We need guidance from governing bodies like the BMC [see the Outdoors For All manifesto], Mountain Training Association and Natural England to create clear and simple guidelines. 

 



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