Date

2-13-2026

Department

School of Health Sciences

Degree

Doctor of Health Sciences (DHSc)

Chair

Christopher R. Strunk

Keywords

military-to-civilian transition, nature-based interventions, veterans' mental health, inpatient psychiatric care, Veterans Health Administration, PTSD, environmental therapy, locked psychiatric units, qualitative research, implementation science, veteran, Peer Support, Recreational Therapy, VA, Military, PTSD, anxiety, depression

Disciplines

Medicine and Health Sciences

Abstract

The purpose of this study is to evaluate the effectiveness of implementing nature- based interventions in locked psychiatric units of the Veterans Health Administration to support veterans during military- to- civilian transition who experience severe mental health crises. The transition from military service to civilian life represents one of the most significant psychological adjustments and individuals can experience, involving fundamental changes in identity, social structure, purpose, and daily routine. This transition creates vulnerability for developing mental health conditions including PTSD, anxiety, and depression. Veterans experiencing severe health mental crises during transition often require intensive inpatient psychiatric care, yet current VHA treatment approaches face limitations and address the complex needs of this population. Despite growing evidence supporting nature- based therapies for mental health recovery, significant gaps remain and understanding how to adapt and implement these interventions within secure inpatient environments. Drawing parallels between human and animal adaptation processes reveals that successful transitions require gradual exposure to new settings, social support, and meaningful activities. The social research question examined how nature- based interventions can be effectively implemented within VHA locked psychiatric units and what lived experiences, organizational factors, and implementation considerations influence intervention success. This qualitative multi method study employs three Data collection approaches: digital surveys through Google Forms, semi- structured interviews with healthcare providers, and combined interviews with personal narrative collection from veterans. Cross- method integration and triangulation compared findings across data sources. Recommendations will address evidence-based implemented protocols, staffing training strategies, adaptation frameworks, integration with existing treatments, and policy recommendations for environmental modifications and innovative therapeutic modalities within the VHA system.

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