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Student's story educates healthcare assistants on the benefits of exercise for those living with severe mental illness

A fictional story created by a Loughborough University student is being used by St Andrew’s Healthcare to educate staff on the benefits of exercise for those with severe mental health problems.

Nessa Millet says it is “very rewarding” to know John’s Story – the narrative she penned as part of her master’s degree in Sport and Exercise Psychology – is being valued and shared by the charity, which provides specialist mental healthcare for patients with some of the most challenging mental health needs in the UK.

John’s Story is written from the perspective of a physically inactive and overweight patient with diagnoses of autistic spectrum disorder and obsessive-compulsive disorder.

It portrays the benefits of exercise by outlining the mental and physical improvements seen in John as he rediscovers his love for sport and exercise.

The story is aimed at healthcare assistants that may lack knowledge regarding exercise and its benefits for those with mental health needs.

Nessa – who is now studying for a PhD with the NCSEM-EM – designed the story as part of her MSc dissertation, which explored whether healthcare assistants were receptive to narrative health communication.

To ensure the story was authentic, Nessa drew upon various real-life success stories identified during interviews with St Andrew’s staff. She then integrated key information about the mental health benefits of exercise and the psychology of exercise adherence.

The story sees John discuss his concerns, the motivating factors that drive him to explore different sports and the emotional and physical benefits he sees from exercising.

It also looks at the relationship John has with a healthcare assistant called Alex and the story demonstrates how influential healthcare assistants can be in getting patients to take part in exercise.

When asked about the formation of John’s Story, Nessa said: “The exercises included in the story were solely a reflection of the conversations I had with the sports therapists.

“I really loved an example of a patient who reflected on his childhood through playing squash and decided to include it as it also fitted in nicely with theory relating to self-efficacy and motivation for exercise.

“The narrative describes specific diagnosis-related mental benefits such as a reduction in condition-specific anxieties and a need for clear exercise plans as part of a rigid daily structure.

“Healthcare assistants were specifically chosen as the target audience as they tend to have the most contact with patients in a caring role and so have a great capacity for encouraging patients to exercise.”‌

Nessa believes a narrative outlining the benefits of exercise for those with mental health needs is more effective than a formal piece of writing.

She said: “Storytelling is a skill that we, as humans, are intuitively trained in practising and in receiving; stories just make sense to us and they have the ability to emotionally affect us. In a way, storytelling is something we are all inherently passionate about as it is a key mechanism for our self-expression.”

Nessa trialled the narrative by giving it to 15 St Andrew’s healthcare assistants to read; she asked them to share their opinions and the results were very positive.

They found reading the story to be effective in communicating the benefits of exercise for patients and in acting as a means for them to reflect on their own promotion practices and interactions with patients.

The effectiveness of John’s Story is thought to be a result of healthcare assistants being able to personally relate to the characters and storyline and the subsequent opportunities for emotional engagement throughout it.

St Andrew’s Healthcare has now disseminated John’s Story to all staff at the hospital in Northampton with the hope that it will help them in effectively promoting exercise to patients.

“It makes me feel like all the hard work was worthwhile,” Nessa said of St Andrew’s decision to share the story.

“By creating a story, we were able to translate academic theory into a form that can be understood and engaged with by the wider non-academic community.

“The fact that John’s Story has been made available to all staff members at St Andrew’s and that it may go on to play a small role in patient wellbeing and quality of life through exercise, is an amazing feeling which is extremely motivating and fulfilling.”

Nessa’s project was supervised by Dr Anthony Papathomasof the School of Sport, Exercise and Health Sciences. He said of her success with John’s Story: “A good story is memorable, easy to take in and connects with people on an emotional level. The skill is to merge the psychology of good storytelling with evidence-based health information.

“What Nessa has produced is engaging and authentic at the same time as being informative and educational. It is an outstanding achievement that this will now be used as a training tool in one of the largest mental health providers in the UK.”

Alan Jones, Sports and Exercise Therapy Manager at St Andrew’s Healthcare, commented: “Nessa’s project is a great example of a researcher taking an evidence-based theory and merging it with a practical concept to deliver a tool that can be easily transferred across the wards – aiding healthcare assistants to interact with patients to increase engagement with physical activity.”

A PDF of John’s Story can be downloaded here

The research is part of a memorandum of understanding between Loughborough University and St Andrew’s Healthcare.