Integrating Physical Activity Into Mental Health Services for Persons With Serious Mental Illness

Abstract

This article reviews evidence supporting the need for interventions to promote physical activity among persons with serious mental illness. Principles of designing effective physical activity interventions are discussed along with ways to adapt such interventions for this population. Individuals with serious mental illness are at high risk of chronic diseases associated with sedentary behavior, including diabetes and cardiovascular disease. The effects of lifestyle modification on chronic disease outcomes are large and consistent across multiple studies. Evidence for the psychological benefits for clinical populations comes from two meta-analyses of outcomes of depressed patients that showed that effects of exercise were similar to those of psychotherapeutic interventions. Exercise can also alleviate secondary symptoms such as low self-esteem and social withdrawal. Although structured group programs can be effective for persons with serious mental illness, especially walking programs, lifestyle changes that focus on accumulation of moderate-intensity activity throughout the day may be most appropriate. Research suggests that exercise is well accepted by people with serious mental illness and is often considered one of the most valued components of treatment. Adherence to physical activity interventions appears comparable to that in the general population. Mental health service providers can provide effective, evidence-based physical activity interventions for individuals with serious mental illness.

Understanding the Psychosocial Processes of Physical Activity for Individuals with Severe Mental Illness: A Meta-Ethnography

“…Exercise and physical activity have a clear role in alleviating the secondary symptoms of SMI, such as low self-esteem and social withdrawal (Faulkner, 2005). This chapter provides some suggestions of the underpinning mechanisms by considering psychosocial factors (e.g.…”

Weight loss in overweight patients maintained on atypical antipsychotic agents

“…Such general health-promoting activities are rarely provided in contemporary psychiatric clinical services or covered by health insurance programs for psychiatric illness, despite support for their integration into mental health services. 24 Given the severity and high prevalence of weight gain associated with long-term use of psychotropic drugs, and with certain modern antipsychotic agents in particular, it is essential that weight gain be minimized, and emerging obesity reversed. Behavioral intervention programs including both diet and exercise counseling have provided the best evidence for small weight reductions among patients with schizophrenia over short time intervals, 25 however, few such studies have considered the long-term success of these interventions.…”

Determining the Score for Depression and Its Relationship with the Level of Physical Activity in a Patient at the Family Medicine

“…Physical activity plays an important role in the recovery of mental health. Richardson et al (Richardson, Faulkner, McDevitt, Skirinar, Hutchinson, & Piette, 2005) add two further reasons why physical activity program should be included in psychiatric services: the opportunity for individuals with mental illness to have frequent contact with their mental health service providers and that specific mental illness barriers may be best addressed by people trained in the mental health field.…”