Sport-related activities as a psychosocial strategy for mental health recovery following natural disasters: a narrative review

Natural disasters-earthquakes, floods, tsunamis, wildfires, and storms-inflict profound and often enduring psychological trauma on affected populations. Survivors exhibit elevated rates of post-traumatic stress disorder (PTSD), depression, anxiety, peritraumatic dissociation, social dysfunction, and somatic complaints. Despite this burden, mental health services in disaster-affected regions remain under-resourced, particularly in low- and middle-income countries. This narrative review provides a conceptual synthesis of findings from 11 studies that examined the role of sport-related activities in mental health recovery following natural disasters. Recognizing the heterogeneity of the literature, this review proposes a conceptual distinction between "participatory" (e.g., exercise, structured sport) and "spectator-based" (e.g., team identification, media narratives) sport activities, collectively referred to as "sport-related activities." Through thematic synthesis of quantitative, qualitative, and mixed-methods evidence, the review identifies four interconnected dimensions of post-disaster psychological distress: (a) trauma-specific disorders (PTSD and peritraumatic reactions); (b) affective disorders (depression and generalized anxiety); (c) social dysfunction (isolation, loss of community cohesion); and (d) somatic symptoms (sleep disturbances, pain, fatigue). The review further delineates three proposed mechanisms through which sport-related activities may facilitate recovery: (a) physiological regulation-modulation of the hypothalamic-pituitary-adrenal axis, reduction of cortisol reactivity, and enhancement of neuroplasticity; (b) psychological empowerment-restoration of self-efficacy, meaning-making through narrative reconstruction, and cognitive reframing of traumatic memories; and (c) social reconnection-rebuilding peer support networks, fostering collective identity, and strengthening community resilience. The review concludes that sport-related activities represent a promising, low-cost adjunctive strategy for post-disaster mental health recovery. However, given the methodological heterogeneity and observational nature of the included evidence, these findings cannot establish causal effects. The review serves as a foundational step for future, more rigorous systematic and scoping reviews to build upon.