Physical activity and mental health: Clinical and implementation considerations

Although the importance of movement for overall health and wellbeing has long been recognised, the relationship between physical activity and mental health is complex, bidirectional and driven by underlying mechanisms that require further examination to comprehensively understand. Mental disorders account for the greatest global burden of disease of all health conditions. The rising level of physical inactivity in the general community is impacting on health and wellbeing by contributing to the onset of preventable, non-communicable diseases. This effect is even more pronounced in people who have a mental illness; demonstrating a reduced life expectancy, greater rates of preventable disease and lower engagement in healthy lifestyle behaviours, including physical activity, than the general population. Physical activity interventions for mental health have the potential to promote mental health and wellbeing through universal prevention, improve mental health difficulties through indicated or targeted prevention, and treat mental illness and prevent comorbid health problems with early intervention and treatments. This presentation will focus on the extensive clinical trial and systematic review findings of our research team to address the clinical considerations of integrating physical activity interventions into treatment as usual, with a focus on depression, anxiety and early intervention. The barriers and facilitators to implementing a physical activity intervention in a youth primary mental health setting will be identified and reviewed, from the perspective of mental health clinicians and the clients of the service. Future directions on further research and the delivery of physical activity interventions will be provided, including consideration of the appropriate workforce, treatment settings and modality of physical activity interventions.

“Personalised Health Budget”: an innovative approach to individual wellbeing and welfare community.

The Personalised Health Budget (PHD) is an innovative approach to mental health and a new integrated social and health instrument that supports the Therapeutic Rehabilitative Personalised Project (TRPP) for persons with mental disabilities. It is a method of giving people more choice and control over the type of care they have and how it is arranged. It is formed by individual, family, social and community resources aimed to improve health, wellbeing, psychosocial functioning, inclusion of marginalised and disadvantaged people, promoting their active participation in the community and helping them in constructing an autonomous life. At the centre of a PHB is the care plan that helps the persons decide their health and wellbeing goals, together with a team of practitioners who offer support and guidance. There are benefits for the beneficiaries (fostering capabilities and empowerment), the providers and the local community (increase of social capital).
Aims: A research will be presented that analysed the experimentation of the PHB in the Mental Health Departments of the Metropolitan City of Bologna (Italy), concerning more than 700 psychiatric patients, focusing on the representations of this approach according to the actors involved.
Methodology: 7 Focus groups (in each of the seven Districts of Bologna) were realised, with a total of 113 participants (social workers, health practitioners, members of parents’ associations, workers of the social cooperatives). The issues of the focus were: analysis of the current situation of the PHD in each territory, the critical points emerged, the proposal for the implementation of the method.
Results: Different narratives and proposals re the PHB emerged from the actors according to their role: the need to integrate health and social care, the importance to put the person at the centre, to change the way of working, to be more flexible, to foster the community assumption of responsibilities.

Fostering community alliances to address obesity: Community researchers and the WE Project

A flaw of traditional community-based research is that it creates a seemingly insurmountable power imbalance between academic researchers and the marginalised communities they work with. The inclusion of community residents engaged in the role of co-researcher provides a logical and local solution with the potential to foster more collaborative and equitable alliances between academic researchers and communities. Given their local expertise, positionality, and proximity to their own neighbourhoods, community researchers provide a distinct perspective and experience that is invaluable to the research design and implementation. The goal of this study was to build capacity amongst local residents and as part of the research team they conducted an extensive needs assessment addressing obesity. Community researchers were hired as Wellness Ambassadors and were engaged in various aspects of the research including design, recruitment, data collection, and dissemination. Data sources include Wellness Ambassador applications, meeting minutes, and bi-monthly reports. Findings indicate the emotional and physical proximity and commitment Ambassadors have to improving health factors and outcomes in their community. Results indicate their commitment to scientific rigour within a real-world setting. This active collaboration between academic and community researchers demonstrates a sustainable approach to working together to address ongoing power imbalances through critical reflexivity about research implementation in a real-world context.