Blue health among children, adolescents, and youth psychological well-being: a systematic review of swimming and aquatic therapy for mental health

Introduction: The transition from childhood to youth constitutes a pivotal developmental epoch marked by profound physiological, cognitive, and socio-emotional transformations. This period, while dynamic and formative, also ushers in heightened susceptibility to psychological distress, including anxiety, depression, and stress-related disorders. Objective: Within this context, aquatic therapy and swimming have emerged as promising yet underexplored modalities, offering multifaceted benefits that extend beyond traditional exercise paradigms. Method: Drawing on interdisciplinary evidence, this review synthesises current empirical and theoretical insights into the efficacy of swimming and aquatic-based interventions for enhancing adolescents' mental health. By integrating physiological, neurobiological, and psychosocial perspectives, this review elucidates the mechanisms through which aquatic participation mitigates anxiety and depressive symptomatology while strengthening cognitive flexibility, affective balance, and overall well-being. Result: The synthesis further highlights prevailing gaps in the extant literature, particularly regarding methodological rigor, intervention duration, and the neuropsychological underpinnings of aquatic engagement. Conclusion: In addressing these lacunae, the review advances a substantial framework for understanding water-based physical activity as both a preventive and rehabilitative instrument within adolescent mental healthcare. Ultimately, this work contributes to the evolving discourse on blue health, positioning swimming and aquatic therapy as potent, evidence-informed avenues for cultivating emotional resilience, self-regulation, and flourishing during adolescence.