Exercise prescription for people with mental illness: an evaluation of mental health professionals’ knowledge, beliefs, barriers, and behaviors

Abstract

The aim of this study was to understand the knowledge, beliefs, barriers, and behaviors of mental health professionals about physical activity and exercise for people with mental illness. Methods: The Portuguese version of The Exercise in Mental Illness Questionnaire was used to assess knowledge, beliefs, barriers, and behaviors about exercise prescription for people with mental illness in a sample of 73 mental health professionals (68.5% women, mean age = 37.0 years) from 10 Psychosocial Care Units (Centros de Atenc¸ã o Psicossocial) in Porto Alegre and Canoas, state of Rio Grande do Sul, Brazil. Results: Most of respondents had received no formal training in exercise prescription. Exercise ranked fifth as the most important treatment, and most of the sample never or occasionally prescribed exercise. The most frequently reported barriers were lack of training in physical activity and exercise prescription and social stigma related to mental illness. Professionals who themselves met recommended physical activity levels found fewer barriers to prescribing physical activity and did so with greater frequency. Conclusion: Exercise is underrated and underused as a treatment. It is necessary to include physical activity and exercise training in mental health curricula. Physically active professionals are more likely to prescribe exercise and are less likely to encounter barriers to doing so. Interventions to increase physical activity levels among mental health professionals are necessary to decrease barriers to and increase the prescription of physical activity and exercise for mental health patients.

Mental health of older people in social isolation: the role of physical activity at home during the COVID-19 pandemic

“…It is recommended that older adults perform at least 150–300 min of moderate intensity or 75–150 min of vigorous intensity physical activity or an equivalent combination of moderate intensity and aerobic physical activity of vigorous intensity, per week [ 25 ]. However, these guidelines are still underused and underestimated by health professionals in general, requiring methods to overcome these barriers [ 28 ]. The medical and sports sciences and physiotherapy, for example, have the opportunity to seek alternatives, innovations and solutions to these problems and limitations.…”

Dilemmas in delivering health promotion activities: findings from a qualitative study of mental health nurses in Denmark

“… 44 A recent study suggests that new interventions must connect with existing practices, and that local management support is important when implementing health promotion initiatives in community mental health services. 20 …”

“…44 A recent study suggests that new interventions must connect with existing practices, and that local management support is important when implementing health promotion initiatives in community mental health services. 20 In the study by Mwebe, 5 mental health nurses viewed the monitoring and screening of the physical health needs of service users as vital, as they acknowledged that both physical and mental health needs were equally important and should receive the same attention from health professionals. Our study provides further nuancing to this picture.…”

The perceptions of mental health clinicians integrating exercise as an adjunct to routine treatment of depression and anxiety

“…These specialists should work with the client to tailor exercise programmes to the specific needs of their client and create cognitive and behavioural strategies to encourage personal recovery-oriented practice and develop positive behaviours towards exercise (Lederman et al 2016). Despite the benefits of exercise, mental health clinicians often do not prescribe exercise or refer to an appropriately trained physical activity specialist as part of traditionally accepted models of care for people with mental illnesses such as depression (Kleemann et al 2020;Rosenbaum et al 2018). The rationale for this is not fully understood; however, barriers may relate to mental health clinicians not being cognisant of the research supporting the benefits of exercise, lack of expertise to prescribe exercise, or not having access to or not knowing who appropriately trained physical activity specialists are (Korman et al 2020).…”

“…This is notwithstanding that the evidence previously outlined demonstrating that many mental health consumers would benefit both physically and psychologically from increased exercise and physical activity (Exercise and Sports Science Australian 2017 ;Firth et al 2020;Hui et al 2021;Rosenbaum et al 2018). Despite awareness of the benefits, health professionals that do not specialize in exercise prescription have frequently identified that prescribing and or advocating for exercise is beyond their knowledge and training or acknowledged it required an exercise professional (Kleemann et al 2020;Radovic et al 2018;Way et al 2018) ), but is not common practice. Health professionals in mental health settings have identified other barriers to exercise prescription focused on the client such as concerns for their physical and mental health and difficulties with social interactions as well as adherence (Glowacki et al 2019;Radovic et al 2018;Way et al 2018).…”