I'm lying face down on a surfboard in the North Sea, being instructed to look forward and rapidly paddle as a wave comes up behind me. This will be the third time I have tried this afternoon, and the rhythm is beginning, slowly, to take hold. I feel myself speed up as the wave comes underneath me. I push down on the board and manage to keep it level. I get up to my knees, the board now catching the crest of the wave as it comes into the bay. And then, just as I feel like I can make a go at jumping to my feet, I lose my balance and crash into the water.
This is my first time on a surfboard. I’m being guided through the process by Alison Young, Project Coordinator at The Wave Project in Scotland, a charity that delivers surf-therapy courses to young people in the UK – many of whom surround me on the waves and have a great deal more competence on them than I do. “The Wave Project is a safe space where every small achievement is rejoiced and you learn that falling off your board is ok, you just get right back on," Alison says. "It’s learning the skills of perseverance and resilience which are so important and can then hopefully be transferred into everyday life.”
Aged between nine to 18, some have physical disabilities, some have learning difficulties, some have mental health issues – from anxiety or general adolescent or pre-adolescent self consciousness, to more serious, long-term pathologies that wouldn’t be appropriate to list here.
They go farther out and can tell when the bigger waves are coming in, jumping back onto their boards to face the shoreline and effortlessly leaping to their feet to ride in, before striding back out and doing it all again. It’s quite hypnotic, like watching the penny falls at a seaside arcade.
Surf therapy is a relatively new concept, the term itself having only been in common usage for the last five years or so. This is according to Jamie Marshall, who's currently undertaking the world’s first PhD in surf therapy at Edinburgh Napier University.
"When you're on a wave, you can’t think about anything else," he tells me. "It gives you that escape from, potentially, a negative reality that you’re existing in. I often refer to it almost as stealth therapy. Once you’re in the water surfing, you don’t actually realise what’s going on."
If this sounds a little soft-touch, then it masks the fact that surf therapy is actually pretty effective. So effective, in fact, that The Wave Project has built established referral pathways with the NHS, and there are waiting lists at sites across the country. Elsewhere, Warrior Surf work with military veterans in the US to "counteract" the effects of war (such as trauma and PTSD) through "using the ocean as a healing remedy". There are also surf therapy charities and organisations operating in Ireland, New Zealand, Spain, Portugal, The Netherlands, Panama and in more states in America, as well as an international body that’s been running since 2017.
Each project looks slightly different and works with different groups of people, but the reported results have many common denominators: improved wellbeing, a sense of achievement, a feeling of awe coming from working so closely with nature.
"Something that's come up time and again is how people are able to let go and be present when they’re surfing, so I’m sort of starting to move into flow theory, the psychological theory behind being 'in the zone'," Jamie explains. "When you’re at a classic flow state, you’re so in the moment that your sense of time gets distorted. Something that keeps getting reported back is that they always find that, with surfing, you have to be so focused on what you’re doing, you’ve got no time for anything else in your head."
Scott comes to The Wave Project from Gullane, about 15 miles up the coast. Living with a physical disability, he tells me he has trouble with his balance. "According to many of my friends and family," he says, "being disabled gives me a really strong spirit, but it kinda got stronger with this. When someone's focusing on a wave, everyone else is also focusing, but there’ll be one or two people who, when you stand up, will be cheering you on. You never feel like you’re alone."
Corinna, from Dunbar, is nearly 18. She's been surfing for six years. She has a learning disability and her mum tells me that, as a result, she's a target for bullies and has had issues with self esteem. "I used to not be a very confident person," she says. "Surfing's really helped me."
The catchment area for the Scottish branch of The Wave Project is currently restricted to Edinburgh and the Lothians. At the moment the project is lottery funded. However, given its NHS links, it is free at point of access for all participants – something that's replicated for the most part across the world.
For those who want to continue with the project, or with surfing in general, there are some accessibility factors to take into account: surfboards aren’t the cheapest things, although there is a growing second-hand market. Wetsuits aren't either, but are essential if you’re chucking yourself into the water somewhere as cold as Scotland. In terms of physical accessibility, many of the UK’s beaches are out of bounds for wheelchair users, or can be difficult to access. However, the overall goal of surf therapy and research around it isn't to engage whole swathes of land-locked young people, but to benefit the sector as a whole.
"The lessons we’re learning about why surf therapy is effective can be translated into other sports, other activities," Jamie explains. "We’re actually working with some guys here who are trying to run something similar with mountain biking. They want to look at what we’ve learnt so they can then design this programme with these things in mind. That it’s not applicable for every situation is a fair criticism of surf therapy, [but] that doesn’t mean we shouldn’t explore it thoroughly to make sure we’ve learnt every lesson we can to then translate into other situations."
Current conversations around mental health provisions are centred on psychotherapy or pharmaceuticals, but it’s probably worth us having more than two modes of support. A lot of funding and campaigning is going into making sure we are all aware, at any point in the day, that mental health is A Thing and we should Do Something About It.
Recently, for Mental Health Awareness Week, the Houses of Parliament, alongside 27 other iconic buildings in London, were lit up green to raise awareness of mental health in the workplace. We’re also good at talking now. Time to talk. Talk about it. A Royal Team Talk. In maybe the most pervasive and long-lasting legacy of David Cameron’s "big society", we have all been encouraged to be each other's therapists, talking about our anxieties and pathologies. This messaging has remained the same for many years, and has become so dominant in the conversation around mental health that politicians are happy to join in, safe in the knowledge that doing so obfuscates them from any responsibility when it comes to funding actual mental health services, or looking into why we are experiencing a mental health crisis in the first place.
All of this is intended to “end stigma”, which is fundamentally very important. It would be good if young people – or anyone – with mental health issues were able to see a psychiatrist in the same way they can go to a GP and not feel bad about it. But if the result of ending the stigma around mental health is to embolden people to seek help, not providing adequate care feels like a bit of a cruel punchline. Instead, the main result seems to flatten out "mental health" as one all-encompassing problem that doesn’t recognise there is no one-size-fits-all cure.
Things like surf therapy are useful because they're trying something new with a goal of helping people feel better about themselves and the world they live in. And that surely should be the main goal of all mental health treatment: to give people the tools to get back up on the board after they’ve fallen, to help them balance, to recognise that the world is not their opponent, even when it feels like it is.
All photography by Andrew Perry