The Role for Exercise in the Treatment of People with Severe Mental Health Problems

Abstract

Exercise has been found to have a number of benefits for both the physical and mental health of people with severe mental health problems, yet evidence suggests that exercise is an under-utilised intervention for this clinical group. This thesis aimed to investigate the role for exercise in the treatment of people with severe mental health problems. Paper one reports a systematic review which synthesised and evaluated evidence for the effect of aerobic exercise interventions on the quality of life of people with severe mental health problems. Effects of exercise on overall quality of life, as well as four quality of life domains - physical, psychological, social and environmental - were considered. A systematic search of the literature resulted in identification of twenty-two eligible studies. There was substantial variation in study design and quality, though some evidence for an effect of aerobic exercise on physical quality of life and overall quality of life emerged. Methodological implications, clinical implications of the findings, and recommendations for future research are discussed. Paper two explores mental health professionals’ perspectives on the barriers and facilitators to exercise implementation in inpatient mental health services. Twenty- five clinical staff who worked in inpatient mental health settings were interviewed about their experience of exercise implementation and their views on the role for exercise in treatment of people with severe mental health problems. Thematic Analysis was used to analyse interview data. Participants recognised a number of benefits of exercise for service users but identified substantial individual, systemic and organisational barriers that affected exercise implementation in practice. Based on the findings, a number of recommendations were developed for services to consider when implementing exercise into service delivery. Paper three provides a critical evaluation of papers one and two, including reflection on the planning, implementation and interpretation of both papers. Clinical implications of the thesis, recommendations for future research and personal reflections on the research process are also provided.

Date of Award	31 Dec 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Sandra Bucci (Supervisor) & Alison Yung (Supervisor)