Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia

Abstract

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.

Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis

“…Of the included studies, four included people with a diagnosis of schizophrenia or schizoaffective disorder [ 37 , 48 – 50 ], three included adults with bipolar disorder [ 35 , 41 , 54 ], three included adults with schizophrenia, schizoaffective disorder and bipolar disorder [ 39 , 56 , 58 ], two included adults with any psychotic disorder [ 55 , 57 ], and one study included young people (aged 18–35) with first episode psychosis [ 47 ]. The other eight studies used the term severe mental illness to describe the participants without specifying diagnoses [ 36 , 40 , 42 – 46 , 52 , 53 ].…”

Feasibility and Acceptability of a Student-Led Lifestyle (Diet and Exercise) Intervention Within a Residential Rehabilitation Setting for People With Severe Mental Illness, GO HEART (Group Occupation, Health, Exercise And Rehabilitation Treatment)

“…pedometers or accelerometers) and mobile phone apps to target autonomous motivation to address lifestyle behaviors (53)(54)(55). Additionally, in future, utilizing principles of co-design, by consulting service users regarding optimal development and implementation of exercise interventions, may increase autonomous motivation to engage (23,56,57).…”

From impact factors to real impact: translating evidence on lifestyle interventions into routine mental health care

“…Specific characteristics of real-world clinical settings and multilevel barriers for successful implementation are two key challenges in this [ 29 , 30 ]. In this context, knowledge on factors at the individual level (e.g., patients and health care professionals) [ 31–35 ] and using co-design principles with adequate representation from and consultation with those individuals is vitally important [ 36 , 37 ]. This could contribute to a more tailored approach, improving the meaningfulness and suitability for both patients and health care professionals and thereby their autonomous motivation, which was suggested to enhance sustainable engagement [ 38–41 ].…”