Jennifer Beal, head of occupational therapy at Cygnet Hospital Beckton, discusses why focusing on physical activity alongside more traditional therapies for mental health treatment can bring positive results.
The physical benefits of exercise are hardly a secret, with barely a day going by without the media discussing the health and wellbeing advantages that regular exercise brings. Whether it’s a 30-minute jog around the park, hitting the exercise bike after work, a weekend yoga class, or regular Zumba session, exercise plays a crucial role in keeping fit, healthy and warding off conditions from heart disease to obesity.
What’s often missing from these articles is clear information about the benefits of exercise on mental health and wellbeing – and how these benefits can complement and enhance existing treatment programmes. At Cygnet Health Care we have been increasingly utilising physical exercise alongside more traditional therapies to create well-rounded and effective treatment programmes that can engage service users in effective occupation centred care.
As far back as 1987, the US National Institute of Mental Health (NIMH) concluded that exercise was positively linked with mental health and wellbeing, reduced stress and anxiety, and had emotional benefits for all ages and for males and females. Increasing volumes of academic work support these conclusions, particularly in cases where exercise is used as a behavioural intervention in alleviating the symptoms of depression. For example, Craft and Landers (1998) demonstrated a significant reduction in the symptoms of clinical depression when patients undertook medium-intensity activity for 20 minutes, three times a week.
However, it is not just depression where effective treatment pathways can include physical activity, but many other psychological illnesses. For example, research suggests weightlifting or running can improve confidence levels and tackle low self-esteem, whilst team sports can help patients overcome loneliness and improve their social skills and building trust (Da Silva, 2002).
One of the new therapies being trialled at Cygnet Hospital Beckton is “Walk and Talk” Therapy. This combines traditional psychotherapy with physical exercise and enables the young people taking part in the pilot to talk about their issues in a relaxed and informal way while benefitting from the physical and chemical reactions that exercise induces. This is just one example of our newly established strategic approach to promote physical health for service users, which included reviewing and improving service delivery.
In November, we trained two occupational therapists as gym instructors. This has enabled us to promote sports as a meaningful activity, to provide access to the gym, as well as focus on outcome measurements using this intervention. Sports service provision and delivery has improved with the gym now open every day, and a range of opportunities for physical activity such as gardening, walking groups, Zumba, ballroom dancing, pilates, swimming and much more. We are monitoring clinical effectiveness in several ways: focusing on personal goals, baseline measurements from the recovery star tool and utilising occupational therapy measurement tools.
Beyond the hospital at Beckton we are increasingly weaving physical activity into our traditional treatments elsewhere within Cygnet. Every service is offered a tailored exercise plan with a focus on collaborative activity planning and outcomes. The aim of the programme is to gradually increase the level of responsibility, skill and outside exposure. Service users begin physical activity at the ward level, before moving outside to the hospital grounds and finally progressing to community-based sports groups as their confidence, fitness and wellbeing improve. Service users are regularly assessed to ensure they continue to find value in the activities and the hospitals create reward schemes and competitions to help maintain motivation and engagement.
As mental health professionals we should be leading the line on demonstrating the benefits of physical activity in the treatment and prevention of mental illnesses. This years’ Mental Health Awareness Week focused on the benefits of physical health complimenting and enhancing mental wellbeing, so now is the time to build on this momentum and keep the ball rolling. I will be working closely with service users to continue developing the physical aspect of our treatment programmes and I hope more professionals will be inspired to work on fitness for both body and mind.
Craft LL & Landers DM (1998) The effect of exercise on clinical depression and depression resulting from mental illness: a meta-analysis. Journal of Sport & Exercise Psychology. 20 339–357.
D Da Silva (2002) This sporting life. The Observer accessed at: http://www.guardian.co.uk/lifeandstyle/2002/sep/29/shopping2