ARTICLE BY DR MARK HARPER, CONSULTANT ANAESTHETIST AT BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS AND
MICHAEL MORRIS, DIRECTOR OF CHILL UK. COMMUNITY INTEREST GROUP

Chill Therapy CIC is a not-for-profit organization that was founded in North Devon at the height of the Pandemic in July 2020.

Its goal is to help as many people as possible with mental health issues and other long-term conditions through cold-water immersion and open water swim courses. Now that we have established hubs all around the UK, we are concentrating on our long-term plan of having this therapy accepted as a form of treatment on the NHS. Not only are people able to access our courses nationally, but we have also set up the infrastructure to carry out research alongside which, we hope, will demonstrate that this is a cost effective and viable treatment for anxiety and depression.

Over 500 people completed a Chill course in 2021 and our figures indicate that three months after it had finished, over 60% were still participating in open water swimming. With more hubs up and running this year we expect that over 1000 people will take one of our courses.

The feedback from the courses we have undertaken so far has been outstanding, with a majority of those participants who filled in a feedback form stating that the course had been life changing in a positive way. Reasons stated were the group bonding that takes place; euphoria lasting for the rest of the day; improved sleeping patterns; improved energy levels; reduced anxiety and a great confidence booster.

All our locations are risk assessed and updated every year. Added to this, there is a dynamic risk assessment which is carried out on the day, and if the risk is deemed too great the session is cancelled (wave size, storm wind etc).

All participants are also assessed, and in the case of a medical condition which might affect them in the water, they would have to get a go ahead from their GP. It is surprising how many people who have a controlled medical condition can participate in our course. Finally, the course and the safety cover are designed for people who are mobile (can walk one mile) and can swim two lengths of a 25m pool.

We have completed two studies. One was the first carried out looking at open-water swimming as a therapeutic intervention for anxiety and depression. While only a single-armed feasibility study, this suggested that the recovery rate at the end of the course in 53 participants was around 70% for both anxiety and depression and that, even 3 three months after it had finished, over 50% remained in the recovered category.

The other study was of using the intervention to refresh and revitalize NHS staff emerging from the stress of the pandemic. Of the 133 participants, around a third completed all three questionnaires. Of these, compared to scores before the course, those at its conclusion were reduced by 25%, 18% and 18% in personal, work-related, and client-related burnout respectively and wellbeing scores rose by an average of 14%. The qualitative analysis produced feedback of which this was typical: “Pressures at work continue to increase but I feel I am managing them better now I have the swimming to help de-stress and clear my head. Always feel more relaxed and happier once in the water and can leave work behind.”

The feedback from the courses we have undertaken so far has been outstanding, with a majority of those participants who filled in a feedback form stating that the course had been life changing in a positive way.

On the basis of these results, the RFPB scheme awarded a grant for the first randomized, controlled trial of this intervention to be carried out on our participants in collaboration with Portsmouth University during 2022.

There is also a lot of anecdotal evidence for the effectiveness of outdoor swimming for other inflammatory- related conditions. We had feedback from several participants, who had attended the Chill courses for mental health issues, that they discovered it reduced their symptoms of fibromyalgia, chronic pain and type-2 diabetes.

In the process, we have forged contacts with local social prescribers in North Devon, who have started to refer their patients to us. Caen Medical Centre in Braunton, Litchdon Medical Centre, Brannam Medical, Queens Medical Centre Fremington Medical Centre, Northam Surgery in Westward Ho and Ilfracombe Medical Centre. Samera Ismael (Social Prescriber: Social Prescribing link/Health coach for the Barnstaple Alliance Primary Care Network) said “Chill has not only been a transformational process for patients but has facilitated peer support, self-management and lifelong friendships. The benefits have been pivotal to both wellbeing and better management of chronic health conditions A massive well done to all involved including participants.”

Dr James Szymankiewicz from Ilfracombe writes: “Chill has had a huge impact on patients and the wider community. It has brought people together and empowered them to do something they never would have felt able to do before. Seeing the mental health benefits has been fantastic and I am really impressed with what Chill has achieved. I look forward to seeing it continue to build momentum and eventually I hope it will become accessible to everyone.”

In conclusion, our studies have backed up our hypothesis that outdoor swimming is a potentially effective intervention for anxiety, depression, and other inflammatory conditions.

Chill has not only been a transformational process for patients but has facilitated peer support, self-management and lifelong friendships. The benefits have been pivotal to both wellbeing and better management of chronic health conditions.

Given the explosion in mental health issues following the pandemic, there has never been a greater need for a self-sustaining, drug-free, and low-resource intervention. At the very least, outdoor swimming reduces social isolation and increases physical activity. Additionally, our data indicates that it has an even greater effect than these aspects can explain. While we are not yet certain of the underlying mechanisms, this is largely irrelevant when we see that, not only does it work, but participants seem to get so much out of it. One of our participants described his feelings when he came out of the water as “Alert, Alive, and a Sense of Euphoria and Achievement”. You don’t get that from swallowing a pill.

The latest edition of BASEM Today features more articles just like this…

“The Power of Water in People’s Lives…”

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THE HEALTH AND WELLBEING BENEFITS OF SWIMMING 5 YEARS ON – Translating Research into Practice
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EXPERIENTIAL LEARNING: Breathing Technique in Big Wave Surfing

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