In the study, published in the journal Mental Health and Physical Activity, researchers argue that ensuring patients have access to the right sort of activities, and the right support to help them take advantage of opportunities is key to enabling patients to improve their quality of life.
“Although it’s well known that exercise can boost mental wellbeing, a more sophisticated approach is needed to help patients suffering from mental illnesses such as schizophrenia and bi-polar disorder, which takes into account individuals’ particular circumstances and recovery journey,” says Dr Jackie Hargreaves, an expert in psychology and physical activity at the Carnegie School of Sport at Leeds Beckett.
Researchers carried out in-depth interviews with eight patients in recovery from bouts of mental illness in which they identified a number of steps taken by patients towards recovery. Often, researchers found, patients can be so absorbed in their thoughts that they become almost unaware of having a physical self, and regaining this sense can be an important first step. Later in recovery, patients might be better able to engage with their environment, and this might make them feel able to try some form of exercise.
They also identified a number of barriers faced by patients to trying physical activity, including lack of access to equipment, or environmental barriers – particularly if patients find it difficult to leave their homes to participate in exercise. Sometimes, too, discouragement from mental health professionals ̶ especially in inpatient hospitals ̶ can also be a barrier.
“Some of the participants said that professionals actively stopped them from conducting physical activity in hospitals, which was really detrimental,” says Dr Hargreaves. “There’s a perception that patients aren’t motivated to be physically active and often, if a patient is seen to be exerting themselves physically, there’s a view that this could lead to them becoming hypomanic, which can lead to aggression.”
Patients being treated in hospital have less opportunity and access to equipment that could help them exercise, but for those being treated in the community, leaving home to exercise can also be a big barrier.
“There’s a real need for an individual approach,” says Dr Hargreaves. “Some patients need quite intensive exercise early on in their recovery process that absorbs their focus so they are able to exclude other thoughts and voices from their mind. Other patients might need to build up to that more slowly – and some people will need exercise that enables them to focus more fully on their natural environment The particular type of exercise, whether it’s football, or walking, lifting weights or going for a swim, will differ from patient to patient and having some support to access the right activity at the right point in the recovery process could make a big difference.”
Ensuring community mental health teams have access to equipment and training that would enable them to assess patients and help them participate in tailored exercise programmes could really aid recovery.