Abstract
Mental health issues, particularly among military veterans, are a growing concern. Veterans disproportionately experience anxiety, depression, and PTSD, often exacerbated by combat-related stressors. While pharmacological treatments yield mixed outcomes, interest in nonpharmacological interventions like surf therapy is increasing; however, empirical evidence remains limited. This study evaluated the impact of a weeklong surf therapy program conducted by Operation Surf on 41 veterans with PTSD using a mixed-methods approach: self-reported surveys and wearable technology (Whoop bands) measuring physiological data. Psychological outcomes were assessed using GAD-7, PHQ-8, and PCL-5; physiological outcomes included heart rate variability (HRV) and sleep quality. Results revealed: A 59% reduction in general anxiety (GAD-7) immediately after the event (mean decrease = 7.38, p < 0.01), and 30% reduction at 30 days (p < 0.05). A 44% reduction in depression (PHQ-8) immediately after the event (mean decrease = 4.94, p < 0.01), and 30% reduction at 30 days (p < 0.01). A 38% reduction in PTSD symptoms (PCL-5) immediately post-event (mean decrease = 16.95, p < 0.01), and 35% reduction at 30 days (p < 0.01). Wearable technology indicated a statistically significant decrease in HRV during the intervention (p < 0.05), and sex-specific changes in deep and REM sleep, particularly in female participants. These findings demonstrate statistically and clinically meaningful improvements in psychological functioning and highlight the utility of wearable technology in evaluating complementary mental health interventions. While cost and stigma were not directly measured, the results support further investigation into the broader applicability and accessibility of surf therapy for veterans with PTSD.