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Are healthcare workers the answer to improving mental health patients’ physical wellbeing in secure hospitals?

More value needs to be placed on promoting exercise for people with severe mental health issues in secure hospital settings.

Researchers from Loughborough University have explored the way healthcare assistants perceive the benefits of exercise for their adult patients, as well as their attitudes to exercise promotion.

The study was carried out in collaboration with St Andrew’s Healthcare, as part of a wider project which aims to increase physical activity through the most effective methods to improve both physical and mental health of patients.

Following interviews with 11 members of staff from St Andrew’s, who all suggested that physical activity would have a positive impact on their patients, Dr Florence Kinnafick, who led the study, explored the barriers which were preventing regular exercise from taking place.

In a research paper published in the International Journal of Mental Health Nursing, she explained that there are often obstacles preventing physical activity for mental health patients.

She said: “The healthcare assistants considered exercise to hold benefits for the patient. However, patients still engage in significantly fewer amounts of physical activity than the general population.”

Researcher Dr Anthony Papathomas, also from Loughborough, said: “A secure mental health setting can exacerbate barriers to exercise and facilitate physical inactivity and sedentary behaviour further.

“There are a number of core organisational and individual barriers which limit the healthcare assistants’ exercise promotion efforts.

“For example, safeguarding procedures and potential challenges associated with appropriate staffing allocation meant that exercise is often not a formal part of the patient personalised care plan.”

The healthcare assistants who took part in the study were asked about their personal experiences of exercise within a secure facility, as well as their perceptions of exercise as an effective treatment tool for mental health, and their perceived roles and responsibilities for exercise promotion.

Dr Kinnafick said: “An informal approach to exercise promotion was deemed to be the most effective in an environment where exercise could remain a normalising behaviour.

“However, others proposed more formal strategies including compulsory sessions in order to ensure benefits were being optimised.

“With education and organisational support, we propose that healthcare assistants are well placed to be able to identify individual needs for exercise promotion and to put these into practice.

“Their involvement could lead to the development of more efficacious, person-sensitive interventions.”

Dr Kinnafick said that individuals with severe mental illness could experience a premature mortality of up to 20 years.

“This is largely due to physical health inequalities which can largely be improved by healthy lifestyle choices – for example, exercise and better nutrition.”

Johnny Fountain, Research Centre Director for St Andrew’s, said: “Here at St Andrew’s we go to great lengths to encourage our patients to be more active, with access to sporting facilities, gym equipment and group exercise classes.

“We regularly welcome our local sports teams for activities sessions across all of our hospital sites, and run programmes that focus on healthy lifestyles, diet and fitness.

“We are currently discussing with the group at Loughborough University how we can establish future research collaborations which will allow us to develop evidence-based strategies that will optimise the exercise therapies provided by St Andrew’s.”