| Summary: | Veterans face significant occupational and mental health challenges. This article explores whether an occupational therapy program in combination with SCUBA diving can enhance occupational performance and mental health outcomes for veterans more than SCUBA diving alone. A two-group random assignment pretest–posttest design was implemented to compare outcomes across two groups. Veterans in Group 1 (<em>n</em> = 7) completed SCUBA diving while those in Group 2 (<em>n</em> = 8) completed SCUBA diving in combination with occupational therapy. Outcomes were measured using the Canadian Occupational Performance Measure, PTSD Checklist for DSM-5, and the Depression, Anxiety and Stress Scale. Both groups participated in a semi-structured focus group post-participation. Additionally, those in Group 2 engaged in follow-up phone interviews. Trial registration number: NCT03928392. All participants significantly improved their occupational performance and satisfaction with performance, and reduced symptoms of PTSD, depression and stress. Those in Group 2 also experienced significant reductions in anxiety levels and reported applying learned interventions to daily life. Participating in SCUBA diving may contribute to reduced symptoms of PTSD, depression and stress among veterans. Engaging in occupational therapy may additionally contribute to reduced symptoms of anxiety and aid in therapeutic application of interventions to daily life.
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