Experiences of outdoor nature-based therapeutic recreation programs for persons with a mental illness: a qualitative systematic review protocol.

Objective: The objective of this review is to identify, appraise and synthesize the best available qualitative evidence on participation in outdoor therapeutic recreation programs for adults with a mental illness living in the community.

Introduction: Therapeutic recreation is posited to be beneficial for persons living with a mental illness. Research indicates that therapeutic recreation programs can foster mental health recovery. It is necessary to understand how nature-based therapeutic recreation programs are beneficial from the perspective of persons living with mental illness.

Inclusion criteria: The review will consider studies that have collected qualitative data on the experiences and perspectives of adults with a mental illness of their participation in nature-based therapeutic recreation programs.

Methods: The databases PsycINFO, CINAHL, MEDLINE, Scopus and Informit and unpublished sources in gray literature databases (Google) will be searched and reference lists will be checked to locate any additional studies. Studies published in English will be considered with no date limit. Two reviewers will independently assess the methodological quality of the studies which meet the inclusion criteria using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. Data will be extracted by one reviewer using the standardized qualitative extraction tool and checked for accuracy by a second reviewer. The qualitative research findings will be pooled using JBI methodology. The JBI process of meta-aggregation will be used to identify categories and synthesized findings.