Exercise Is Medicine For Mental Illness: Insights From Mental Health Professionals

Abstract

PURPOSE: Serious mental illness (SMI) is a major public health concern linked with adverse outcomes (premature mortality, cardiovascular disease, obesity).1,2 Physical activity (PA) has effectively reduced health risks,3-6 yet challenges exist for effective PA treatment delivery and sustainability in SMI populations.7,8 Certified peer specialists (CPSs), trained persons with lived recovery experience working in mental health settings, offer a potentially sustainable and reimbursable delivery mechanism for Exercise Is Medicine (EIM) PA interventions.9 This study examined CPSs’ insights on the feasibility and acceptability of an EIM intervention in adults with SMI delivered in peer group settings. METHODS: Qualitative data were collected Spring/Summer 2018 through 4 focus groups of 3-6 people per group. CPSs were recruited through two behavioral health facilities in Kansas (n=11) and Georgia (n= 8). Semi-structured focus group guides elicited information regarding knowledge of PA, current PA with SMI peers, role of the CPS to promote PA, and feasibility of administering a PA intervention. Audio files were transcribed verbatim and analyzed with NVivo11 using qualitative content analysis with an inductive approach.10,11 RESULTS: Focus groups averaged 49±8 minutes. Data were coded into four themes: knowledge of PA, current PA with SMI peers, role of the CPS to promote PA, and PA intervention administration. CPSs stated their knowledge of PA is general and mostly comes from personal experience or internet searches. CPSs agreed their role covers Whole Health Action Management principles including promoting and participating in PA with SMI peers. CPSs were eager to participate in a PA intervention and willing to complete PA training or certification. PA intervention administration included input on PA duration, frequency location, time of day, resources needed, motivators (e.g., buddy systems, competitions, rewards) and overcoming common SMI barriers (e.g., transportation). CONCLUSIONS: CPSs were willing to facilitate EIM interventions and offered valuable insights on current practices, program feasibility and administration. Findings will aid development of a PA intervention delivered through mental health services to address low rates of PA and reduce health disparities in adults with SMI.