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

Abstract

Individuals with depressive symptoms often experience changes in physical activity and lifestyle factors. Despite the benefits of exercise, mental health clinicians often do not refer for or prescribe exercise as part of traditionally accepted models of care for consumers with depression and anxiety. The aims were to investigate: (i) mental health clinicians' understanding of the relationship between exercise and mental health, (ii) if and how exercise is used by mental health clinicians in treatment for depression and anxiety, and (iii) the barriers to prescription of exercise. A descriptive qualitative method was used, and data were collected via individual semistructured interviews. Ten mental health clinicians with varying backgrounds participated in this study. The data driven inductive analysis of participants views identified three themes: (i) knowing and not knowing, (ii) consumer comorbiditiesthe risk and benefit dilemma, and (iii) protecting vulnerable consumers. Enhancing clinicians' knowledge of the beneficial role of exercise in treatment for consumers' experiencing depression and anxiety is an important step. Mental health services can support integration of exercise by implementing policies and training for staff to support exercise prescription, and the role and referral of exercise and physical activity specialists, as part of routine care to improve clinical outcomes for consumers. Additional considerations should be given to fiscal support to access exercise as an adjunct therapy.

Healthcare Practitioners’ Perceptions of the Barriers to Prescribing or Promoting Exercise in the Treatment of People with Mental Illness: A Scoping Review

“…On average, only 13% of respondents across fve studies had received any formal education in exercise prescription [38,40,42,45,51], and, when asked, almost all respondents stated that they were interested in further training [32,44,45,51]. A similar knowledge barrier was identifed in several qualitative studies [30,31,34,36,39]. Radovic et al [44] found that while 41.2% of participants could identify current physical activity guidelines, only 13.3% could describe them.…”

Personalized training as a promoter for physical activity in people with depressive disorder—a randomized controlled trial in Germany

“…Not all barriers to an active lifestyle are related to the patients. Garvey et al ( 24 ) identified barriers to the prescription of exercise on the part of healthcare providers: lack of knowledge on how to prescribe exercise and establish contact with trained physical activity specialists, concerns about the patient’s ability to exercise, risk factors, such as comorbidities, or placing more stressors on their clients ( 24 ). Improvement in cooperation between the different professions is needed in addition to the establishment of routine referral methods with the possibility of individual support for physical activity.…”

“…Professional assistance in setting goals, overcoming barriers and maintaining motivation ( 17 ), and the inclusion of health care professionals qualified in exercise prescription ( 20 ) are recommended strategies to assist patients with depressive disorder. The importance of increasing autonomous motivation ( 21 ) and self-efficacy ( 22 ) is recognized and Motivational Interviewing techniques can support behavioral change on the basis of patients’ own decisions ( 23 , 24 ). In previous studies, personal or telephone contact provided an opportunity for patients to speak about their goals and any potential reservations regarding exercise ( 25 ), and to explain the effects of physical activity ( 26 ).…”

Perspectives of mental health clinicians on physical health of young people with early psychosis

“…The empowerment and support provided by Exercise Physiologists and PHPN to the YMH team were described as contributing to more proactive discussions on the PH of young people with EP. It was recognised in the literature that allied health clinicians may not feel comfortable to provide PH care due to a perceived lack of knowledge and confidence in the PH care domains (Butler et al., 2020; Garvey et al., 2023). Our results highlighted the PHPN has proven to provide great empowerment in encouraging allied health clients to conduct assessments and ensure more are participating in the process.…”