Up and Running
The benefits of exercise on wellbeing
Jane Shears and Mike Scanlan
Mental Health Foundation
Context
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One in four people will experience a mental health
problem
2020 2nd biggest global health problem
Suicide accounts for 30% of deaths in the 15-24 year
age group
People with mental health problems are at a
significant risk of social exclusion, stigma and
discrimination
Primary care consultations
Between 1994 and 1998 consultations
for depression rose from 4 to 9 million
 Up to 30% of consultations relate to
mental distress
 90% of people experiencing mental
distress are treated in primary care
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Links between physical and mental health
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People with mental health problems have
higher levels of physical ill health – Lawrence
(2001)
 Increased risk of physical illnesses including
CHD, diabetes, respiratory illness,
osteoporosis.
 Excessive weight gain is a common side
effect of many psychiatric medications
Does exercise actually help?
Exercise reduces morbidity and mortality from:
CHD
 Obesity
 Diabetes
 Some cancers
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Exercise and Mental Health –
The Benefits
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Increased release of endorphins
Part of behavioural activation – sense of
achievement and pleasure
Links in with a solution focussed approach
A positive affect on body image
Exercise can enhance self esteem
maintaining wellness.
More Benefits
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High levels of subjective well-being and
improvements in mood ( Biddle 2000)
 Can reduce stress and anxiety (Taylor 2000)
 Antidepressant effect of exercise (Mutrie 2000)
 Success as a treatment approach for mild depression
( NICE 2003)
 Diversion from negative ruminations (Lepore 1997)
 Exercise improves the quality and length of sleep
(NELMH)
Up and Running 2005
180% increase in the number of
antidepressant prescriptions since 1992
 92% of GPs prescribe antidepressants
as one of their three most common
treatment responses
 5% of GPs prescribe exercise as one of
their three most common treatment
responses
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Up and Running 2005
38% of GPs would try antidepressants
as one of their top three strategies if
they became depressed
 42% of GPs would try exercise as one
of their top three strategies if they
became depressed
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Up and Running 2005
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Less than 1% of GPs refer to exercise
programmes as their first treatment response
 NICE 2004 advises against antidepressants
for mild depression whilst exercise has been
recommended as a treatment for mild
depression
Up and Running 2007-2008
Follow-up survey
 Engage Pilot Sites
 In depth data collection
 Toolkit
 Training
 Dissemination
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Book Prescribing – some lessons
Book prescribing – phenomenology
 Wrong book
 Hated school
 Can’t read well
 People with follow up do much better
 Some people may feel the prescription
process itself is stigmatising
 Some lessons for exercise prescribing?
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Good social prescribing practice
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The consultation must be informative and
collaborative
 Look for where the person is on the ‘Cycle of
Change’
 Offer choice – gym, green walks, swimming.
What fits with the lived experience?
 Use phone follow-up to motivate, to maintain,
to encourage continued self management
and recovery.
Mike Scanlan is a user of primary care mental health services.
Jane Shears is a carer.
Thank you.