Literature review Several studies have highlighted the widespread problem of patient inactivity on acute psychiatric wards (Sundram 1987, Smith et al 1996, Jones and Crossley 2008). Following this, the Department of Health (2002) reported serious concerns regarding the lack of activity that is useful to recovery. In 2002, the Sainsbury Centre for Mental Health recommended that wards should provide activities and interventions and that even small changes in social and recreational activities can have a beneficial impact (SCMH 2003). Over the last decade, there have been reports in the occupational therapy and mental health journals supporting the use of activity in promoting mental wellbeing (