Abstract
Mental illness affects the lives of a significant number of Australians. In addition to pharmacological and psychological interventions, exercise has demonstrated benefits for people with mental illness including symptom reduction, improved cardiovascular risk profile and improved physical capacity. Unfortunately, evidence shows that clinician-delivered exercise advice is not routinely offered. This is despite patient acceptability for exercise. This article summarises the recent evidence supporting the prescription of exercise for people with mental illness and offers a model incorporating basic exercise prescription, and referral pathways for specialised advice. Current exercise prescription patterns for people with mental illness may not meet patient expectations; therefore, clinicians should consider exercise referral schemes to increase the accessibility of interventions for people with a mental illness.
Highlights
7.3 million Australians will be affected by mental illness during their lifetime (AIHW 2013)
* We show that patients consider exercise to be a highly regarded treatment option and suggest the use of referral schemes to increase the uptake of exercise by mental health consumers
Cochrane reviews on exercise and mental illness have confirmed the effectiveness of exercise in the treatment of both depression (Cooney et al 2013) and schizophrenia (Gorczynski and Faulkner 2010)
Summary
7.3 million Australians will be affected by mental illness during their lifetime (AIHW 2013). A survey of Victorian GPs (McGarry et al 2005) reported that more than 80% prescribed medication to patients with depression This trend in prescribing rates of psychotropic medication is consistent with cross-sectional analysis of Pharmaceutical Benefits Scheme (PBS) data showing a 95% increase in antidepressant medication prescriptions between 2001 and 2011 (Stephenson et al 2013). Australian clinical practice guidelines for the treatment of some mental illnesses, including schizophrenia and related disorders (McGorry et al 2005) and depression (Ellis 2004), advocate for the inclusion of physical activity or exercise. These guidelines do not include recommendations on the frequency, intensity, time (duration) or type of exercise intervention (FITT). Despite some evidence for the effectiveness of exercise to manage overweight and obesity in people with bipolar disorder (Elmslie et al 2001), the most recent Australian guidelines for the management of bipolar disorder (Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Bipolar Disorder 2004) make no mention of the potential therapeutic benefits of exercise
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