People with mental health problems are at higher risk of physical health comorbidities and early mortality. A key risk factor for poor health outcomes is a lack of regular physical activity. Mental health services have typically responded by focusing on screening and promoting lifestyle programmes within secondary care mental health settings. The aim of this study was to better understand the barriers and enablers for Australian mental health consumers to participate in physical activity or exercise programmes from the perspectives of consumers and exercise practitioners. Interviews with 15 consumers experiencing serious mental health problems and five exercise practitioners were undertaken, followed by two focus groups (involving eight consumers and two exercise practitioners) to gain consensus on themes from the interviews, and codesign a set of recommendations for services to support and increase the engagement of mental health consumers in regular community-based exercise. Barriers that impacted on engagement in physical activity included: lack of social support, insufficient knowledge and information, difficulties with work/life balance, impact of physical and mental health issues, fear and lack of confidence, and financial cost. Enablers or motivators assisting engagement in community-based physical activity programmes included: social support, access to person-centred individualised exercise options, connection and a sense of belonging, and access to information and education. Recommendations and a checklist were developed to assist services to increase the involvement of mental health consumers in community-based exercise and to ensure that exercise practitioners and their employing organisations are adequately equipped to work with this population.
Mental health presentations to the emergency department (ED) have increased, and the emergency department has become the initial contact point for people in a mental health crisis. However, there is mounting evidence that the ED is not appropriate nor effective in responding to people in mental health crises. Insufficient attention has been paid to the subjective experience of people seeking support during a mental health crisis. This review aims to describe the qualitative literature involving the subjective experiences of people presenting to the ED during a mental health crisis. The method was guided by Arksey and O’Malley’s framework for scoping studies and included keyword searches of PsycINFO, CINAHL, Medline and Embase. A narrative analysis, drawing on the visual tool of journey mapping, was applied to summarise the findings. Twenty-three studies were included. The findings represent the experience of accessing EDs, through to the impact of treatment. The review found points of opportunity that improve people’s experiences and characteristics associated with negative experiences. The findings highlight the predominance and impact of negative experiences of the ED and the incongruence between the expectations of people presenting to the ED and the experience of treatment.
The peer workforce has increased significantly in recent years; however, structured development and support for the roles are lacking. This paper explores the role of executive and senior management understanding in the employment of peer roles. In‐depth, semi‐structured interviews and one focus group were conducted with 29 participants from a range of nongovernment and public mental health services within Queensland, Australia. Findings of this study suggest management exposure to and understanding of peer work are essential to the development of an effective peer workforce. Exposure and understanding of peer roles reportedly led to greater acceptance and commitment from management. This commitment inspired action in the form of; enhanced support including advocacy/championing, increased development of roles and influenced culture within the organization to be more accepting of peer work. There was a perception that developing an ‘accepting’ organizational culture supported the integrity and expansion of peer roles including designated ‘peer management’ positions. Development of peer management positions is suggested as an effective means of improving the impact of peer perspectives, advocating for peer work and providing ongoing and timely supervision. Recommendations include the need for training and information for management on the unique function, purpose and value of peer roles; and the development of networks, including mentoring opportunities, for organizations with limited experience to gain support and advice from those with greater experience developing peer roles.
Mental health peer work is attracting growing interest and provides a potentially impactful method of service user involvement in mental health design and delivery, contributing to mental health reform. The need to effectively support this emerging workforce is consequently increasing. This study aimed to better understand the views of management in relation to peer work and specifically explores the value of peer work from the perspective of management. This qualitative research employed grounded theory methods. There were 29 participants in total, employed in both peer designated and non-peer designated management roles, in not for profit and public health organisations in Queensland, Australia. The value of peer work as described by participants is found to be partially dependent on practical supports and strategies from the organisation. There were high benefits for all facets of the organisation when effective recruitment and ongoing support for peer workers was prioritised and a higher perception of limitations when they were not. Due to some parallels, it may be useful to explore the potential for peer work to be conceptually and/or practically considered as a form of diversity and inclusion employment.
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