There has been increasing interest for research on motivation for physical activity (PA) and exercise among individuals with severe mental illness (SMI). The aim of this systematic review is to summarize findings from all intervention studies on PA or exercise that either include empirical data on motivational constructs or apply motivational techniques/theories in their intervention. Systematic searches of seven databases were conducted from database inception to February 2015. Studies were eligible if they: (i) included participants with SMI, (ii) had PA as part of the intervention, and (iii) reported empirical data on motivational constructs related to PA or incorporated motivational techniques/theory in their intervention. Of the 79 studies that met the inclusion criteria only one had motivation for PA as its main outcome. Nine additional interventions reported empirical data on motivational constructs. Altogether these studies yielded mixed results with respect to change in motivational constructs. Only one of those examined the association between motivation and PA, but found none. Sixty-four studies reported using motivational techniques/theory in their intervention. Motivational interviewing and goal-setting were the most popular techniques. Due to the exploratory nature of most of these studies, findings from intervention studies do not so far give very clear directions for motivational work with the patients. There is an urgent need for a more systematic theory based approach when developing strategies that target to increase engagement in PA among people with SMI.

These results underscore the importance of health care practitioners' providing support for their patients' autonomy, competence, and relatedness to improve well-being, physical activity, and RTW in the context of vocational rehabilitation. Implications for Rehabilitation Vocational rehabilitation that emphasizes physical activity is associated with increases in patients' well-being, physical activity, and return to work (RTW). It is important for health care practitioners to provide support for their patients' autonomy, competence, and relatedness in the context of vocational rehabilitation, as doing so is associated with increases in patients' autonomous motivation, perceived competence, and psychosocial outcomes.

BackgroundThere is increasing evidence for physical activity (PA) having a positive impact on physical and mental health as well as illness symptoms in individuals with severe mental illness (SMI). However, individuals with SMI experience several barriers that makes it difficult to take advantage of the benefits associated with PA. One barrier consistently reported to impede PA is motivational issues. Thus, the main aim of the present study was to examine associations between PA and motivation for PA, perceived competence for PA, functioning, apathy, and demographic variables among individuals with SMI. This was conducted within a larger study aiming at including all inhabitants with SMI in one particular small, rural municipality.MethodA total of 106 participants were recruited to the study. Questionnaire-based interviews conducted by two mental health nurses assessed self-reported PA, motivation and competence for PA, functioning, and apathy. Additionally, 71 participants accepted to wear an accelerometer-equipped wristwatch yielding an objective assessment of PA.ResultsThe participants engaged in little PA. However, they did not lack motivation, as over 90% stated that they would like to be more active, and participants across PA level displayed high scores of a motivation reflecting that they valued the benefits of PA. Results showed that higher self-reported PA level was associated with higher levels of integrated regulated motivation and perceived competence for PA while it was unrelated to functioning and apathy. In the subpopulation with objectively measured PA, integrated regulated motivation for PA remained significantly associated with PA level, whereas poor scores on functioning lowered the odds ratio for higher PA level.ConclusionThe results show that PA specific motivation is associated with PA even when controlling for functioning and apathy. This highlight the importance of facilitating context specific motivation (i.e., motivation for PA) and that health care practitioners should emphasise helping people with SMI develop more intrinsic forms of motivation.

Individuals with severe mental illness (SMI) are less physically active than the general population. One important barrier contributing to this inactivity is lack of motivation. The aim of this paper is to systematically review all cross-sectional literature on motivation for physical activity among people with SMI and to use the results as basis for guidance on how mental health nurses can facilitate motivation for physical activity. Systematic searches of seven databases were conducted from database inception to February 2015. Studies were eligible if they included participants with SMI and reported data on motivation for physical activity. In total, 21 articles were included and over half them were published in 2011 or later. The present results indicate preliminary evidence of how the motivational processes do not differ between individuals with SMI and the general population, and that they are independent of diagnosis, medication, age, gender, and body mass index. Results from the current systematic review can give some tentative guidance on how to facilitate motivation for physical activity within mental health-care. However, there is still a great need for developing and examining practical strategies that can enhance adoption and adherence of physical activity among people with SMI.

This study indicates that individuals with SMI can be regularly physically active when provided with suitable opportunities. Furthermore, the present results suggest that it is vital for health-care practitioners to emphasise creating a need-supportive environment when organising physical activity because such an environment is associated with both increased autonomous motivation for physical activity and mental health-related quality of life.