This article reviews evidence supporting the need for interventions to promote physical activity among persons with serious mental illness. Principles of designing effective physical activity interventions are discussed along with ways to adapt such interventions for this population. Individuals with serious mental illness are at high risk of chronic diseases associated with sedentary behavior, including diabetes and cardiovascular disease. The effects of lifestyle modification on chronic disease outcomes are large and consistent across multiple studies. Evidence for the psychological benefits for clinical populations comes from two meta-analyses of outcomes of depressed patients that showed that effects of exercise were similar to those of psychotherapeutic interventions. Exercise can also alleviate secondary symptoms such as low self-esteem and social withdrawal. Although structured group programs can be effective for persons with serious mental illness, especially walking programs, lifestyle changes that focus on accumulation of moderate-intensity activity throughout the day may be most appropriate. Research suggests that exercise is well accepted by people with serious mental illness and is often considered one of the most valued components of treatment. Adherence to physical activity interventions appears comparable to that in the general population. Mental health service providers can provide effective, evidence-based physical activity interventions for individuals with serious mental illness.
The purpose of this study was to determine the effects a health education and exercise program would have in limiting weight gain and in improving fitness and psychological parameters in adults with mood or psychotic disorders. Thirty volunteers were randomly assigned to the healthy lifestyle group (HL) or a control group. The HL group engaged in exercise for 12 weeks. Pre- and post-exercise testing was conducted to assess body fat, lipid profile, and cardiovascular fitness. Educational seminars were held weekly. The intervention group evidenced greater weight loss than the control group, although not statistically significant. Significant differences were observed in ratings of general health (p < .05) and empowerment (p < .01). Trends suggest that exercise interventions may encourage weight loss, particularly if barriers to full participation can be addressed. Additionally, such interventions may contribute to "perceived" well-being even among those with subclinical participation.
Findings suggest that a standardized program designed to provide peer training was used successfully and participants' recovery and employability were improved. Further studies are recommended to rigorously test peer providers' impact on their clients and to examine the advantages that accrue to the agency when mental health recipients are employed as peer providers.
This study examined the effectiveness of an educational approach to psychiatric rehabilitation called the Recovery Center. Using a quasi-experimental design we recruited 97 intervention and 81 comparison participants and examined the intervention's impact on health, mental health, subjective, and role functioning outcomes. Results suggested that this intervention was effective in improving subjective outcomes, especially empowerment and recovery attitudes, both of which received primary emphasis in the intervention. The Recovery Center, which integrates a bio-psychosocial framework with psycho-educational interventions shows promise as a complement to traditional mental health services in developing readiness for rehabilitation and promoting recovery among individuals with severe psychiatric disabilities.
The concepts of wellness and its complement, health promotion, have popularized the notion that health itself is more than simply the absence of disease. Furthermore, the wellness concept has advanced the idea of the importance of engaging in certain health promoting behaviors within healthy environments, not simply for the purpose of preventing or better managing a disease, but also to enhance one's well-being and quality of life (Green & Kreuter, 1991; Mullen, 1986). Encouraging this emphasis on wellness is Healthy People 2010 (U.S. Department of Health and Human Services, 2000), a national ten-year plan intended to increase quality and years of life and eliminate disparities which for the now features a new area that recognizes the importance of health promotion and disease prevention in the lives of people with disabilities. Increasingly, the value of promoting wellness--including for people with disabilities--is being recognized (Rimmer & Braddock, 2002).
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