Mental health practitioners’ reported barriers to prescription of exercise for mental health consumers

KirstenWay, Lee Kannis-Dymand, Michele Lastella, Geoff P. Lovell
Mental Health and Physical Activity
Volume 14, March 2018, Pages 52-60

Abstract

Exercise is an effective evidenced-based intervention for a range of mental health conditions, however sparse research has investigated the exercise prescription behaviours of mental health practitioners as a collective, and the barriers faced in prescribing exercise for mental health. A self-report survey was completed online by 325 mental health practitioners to identify how often they prescribe exercise for various conditions and explore their perceived barriers to exercise prescription for mental health through thematic analysis. Over 70% of the sample reported prescribing exercise regularly for depression, stress, and anxiety; however infrequent rates of prescription were reported for conditions of schizophrenia, bipolar and related disorders, and substance-related disorders. Using thematic analysis 374 statements on mental health practitioners' perceived barriers to exercise prescription were grouped into 22 initial themes and then six higher-order themes. Reported barriers to exercise prescription mostly revolved around clients' practical barriers and perspectives (41.7%) and the practitioners' knowledge and perspectives (33.2%). Of these two main themes regarding perceived barriers to exercise prescription in mental health, a lack of training (14.7%) and the client's disinclination (12.6%) were initial themes which reoccurred considerably more often than others. General practitioners, mental health nurses, and mental health managers also frequently cited barriers related to a lack of organisational support and resources. Barriers to the prescription of exercise such as lack of training and client's disinclination need to be addressed in order to overcome challenges which restrict the prescription of exercise as a therapeutic intervention.

The research is here.

Getting Fat and Fatter

By Kim McPherson
The Lancet
doi:10.1016/S0140-6736(12)60966-0

Book Review
Fat Fate and Disease: Why Exercise and Diet Are Not Enough
By Peter Gluckman and Mark Hanson
Oxford University Press

"We need a public debate about what it means to keep markets in their place. And to have this debate, we have to think through the moral limits of markets. We need to recognise that there are some things that money can't buy and other things that money can buy but shouldn't."

Michael Sandel, “Market and Morals”

We live in a world where it is increasingly apparent that markets have all sorts of unwanted consequences, but they remain the bedrock of our civilisation. That we should relentlessly pursue economic growth is unquestioned, while the planet is drying up and we are becoming increasingly obese. And by a dominant political account the way to grow is to liberate the markets wherever we can. Thus the planet nears extinction more quickly and the prevalence of type 2 diabetes increases alarmingly across the globe. So is some kind of consensual good will required, as Michael Sandel suggested in his 2009 Reith Lecture?

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We have yet to discover an acceptable way to make markets properly balance all the pay-offs caused by unhealthy production, one of which is to suffer loss at the point of production commensurate with the harm of causing bad health in the longer term. We are not even close. Good will and responsible citizenship are not, I suspect, going to solve this problem simply because profit and growth trump everything.

The entire review and commentary are here.