Evaluation of a participatory approach to improve healthy eating and physical activity in a secure mental health setting

Abstract

Purpose The prevalence of obesity in secure mental health units is higher than in the general population, having a negative impact on the physical health and mental well-being of people with severe mental health illness (SMI). The purpose of this study was to describe the feasibility of a programme aimed to help people with SMI to eat healthily and be physically active. Design/methodology/approach A mixed-methods approach was used. A questionnaire administered to patients in both wards measured acceptability, demand, implementation and practicality of the project. Individual semi-structured interviews and focus groups were used to explore staff and patients’ perceptions of the project; as well as the barriers and enablers towards an effective implementation and participation in the project’s activities. Findings Patients were, overall, satisfied with the activities implemented. Successful activities were easy to implement, had staff actively engaged and did not require logistic or administrative planning beforehand. Barriers included unawareness around funding mechanisms of activities, staff capacity issues or lack of patients’ permission to leave the ward. Originality/value Few studies have assessed the feasibility of real-life interventions aimed to improve healthy eating and physical activity in secure mental health units. The results of this study can inform commissioners and providers of mental health services to design and implement new interventions and programmes.

Systematic review of physical activity interventions assessing physical and mental health outcomes on patients with severe mental illness (SMI) within secure forensic settings

“…Accommodating senior‐level staff, encouraging staff buy‐in can increase participation and improve outcomes in physical activity interventions (Mateo‐Urdiales et al, 2020). The studies included in our review reported varied levels of attendance, with group sessions the best attended.…”

“…Secure settings by their isolated and restrictive nature, can influence levels of physical activity (Mateo‐Urdiales et al, 2020) and obesity (Long et al, 2014). Prescription medication, comorbid cardiometabolic and other health issues may also influence motivation or capacity to exercise (Stubbs & Rosenbaum, 2018).…”

“…Prescription medication, comorbid cardiometabolic and other health issues may also influence motivation or capacity to exercise (Stubbs & Rosenbaum, 2018). Opportunities for physical activity may be limited due to a lack of resources, insufficiently stimulating environments, low patient motivation and limited opportunities to leave the ward for activity (Long et al, 2014; Mateo‐Urdiales et al, 2020; Rogers et al, 2019). Within one study, participants reported that the environment is monotonous and boring with little happening throughout the days (Marklund et al, 2019).…”

Motiv8: A study protocol for a cluster-randomised controlled feasibility trial of a weight management intervention for adults with severe mental illness in secure forensic services

“…Furthermore, they often have little input from service users throughout their development, consequently underrepresenting the 'patient voice'. This is important as co-design is likely to increase sustainability of the intervention and improve engagement by valuing patient experience throughout development (17,31).…”

Physical activity in adult users of inpatient mental health services: a scoping review

“…While some of the reasons for insufficient physical activity and excessive sedentary behaviour are common across both inpatient and community settings, such as the sedative effects of psychotropic medicine [15] and mental health symptoms (lack of motivation, anhedonia, fatigue and negative body image) [13], there are some unique barriers presented by inpatient settings. For example, lack of appropriate facilities, lack of suitably trained staff to support physical activity, and restrictions on leave for people detained under mental health legislation all contribute to decreased opportunities for physical activity in inpatient settings [16][17][18][19]. However, inpatient physical activity programmes provide an opportunity to improve patients' physical and mental health.…”