Increasing physical activity in a secure psychiatric service for women

DOIhttps://doi.org/10.1108/MHRJ-09-2014-0036
Pages144-155
Publication Date14 September 2015
Date14 September 2015
AuthorClive Long,Rachel West,Samantha Rigg,Rebecca Spickett,Lynne Murray,Paul Savage,Sarah Butler,Swee-Kit Stillman,Olga Dolley
SubjectHealth & social care,Mental health
Increasing physical activity in a secure
psychiatric service for women
Clive Long, Rachel West, Samantha Rigg, Rebecca Spickett, Lynne Murray, Paul Savage,
Sarah Butler, Swee-Kit Stillman and Olga Dolley
Professor Clive Long is based
at Department of Psychology,
University of Northampton,
Northampton, UK.
Rachel West is Assistant Director
of Therapies at Occupational
Therapy, St Andrews
Healthcare, Northampton, UK.
Samantha Rigg is based at
Department of Physiotherapy,
St Andrews Healthcare,
Northampton, UK.
Rebecca Spickett is Physical
Recreation Instructor at
Healthcare Directorate,
St Andrews Healthcare,
Northampton, UK, and Lynne
Murray is based at Healthcare
Directorate, St Andrews
Healthcare, Northampton, UK.
Paul Savage is based at
Occupational Therapy,
St Andrews Healthcare,
Northampton, UK.
Sarah Butler is based at
Healthcare Directorate,
St Andrews Healthcare,
Northampton, UK.
Swee-Kit Stillman is based at
Physiotherapy, St Andrews
Healthcare, Northampton, UK.
Olga Dolley is based at St
Andrews Healthcare,
Northampton, UK.
Abstract
Purpose The purpose of this paper is to evaluate the effectiveness of measures designed to increase
physical activity in women in secure psychiatric care.
Design/methodology/approach A range of interventions (environmental and motivational) designed to
increase participation in physical activities were introduced on two secure wards for women. A pre-post
design assessed frequency, duration and intensity of physical activity, attendance at physical activity
sessions, exercise motivation, exercise-related mood, attitudes to exercise and health and biological indices.
Measures collected over a three-month baseline period were repeated six months post-intervention.
Findings Significant changes occurred in both attitudes to exercise and health, exercise motivation and
exercise behaviour followingchange initiatives. With the exception of resting pulserate and perceived exertion,
the increased levelof activity was not reflected in changes in body mass index, body fat or body muscle.
Practical implications Management led, multi-disciplinary interventions to increase physical activity can
have a positive impact on both lifestyle behaviours and physical health.
Originality/value This study adds to a small literature on increasing physical activity in women in secure
psychiatric settings where obstacles to change are formidable.
Keywords Women, Physical activity, Physical health, Secure care, Secure psychiatric care,
Exercise-related mood
Paper type Research paper
Introduction
The physical health of psychiatric patients is a major problem with 27 forms of mental disorder
associated with an increased risk of pre-mature death (Harris and Barraclough, 1998). Patients
with learning disabilities have a rate of health problems more than twice that of the general
population (Van Schrojenstein Lantman-de Valk et al., 2000). World Health Organization (WHO)
(2007) identified a sedentary lifestyle as one of the top ten killers because its contribution to the
development of chronic disease. However, the UK Governments target that 70 per cent of the
population should be active (engaging in 30 minutes of moderate intensity activity five times a
week) by 2020 (Chief Medical Officer, 2004) is far from being realised. Only 40 per cent of men
and 20 per cent women meet this target (Chaudhury and Roth, 2006), and between a quarter
and one-third of American adults have no regular leisure time physical activity (Otto and Smits,
2011). Among factors that are predictive of a lack of exercise initiation are female gender
(Hays, 1999) and mental illness (Daumit et al., 2005).
In secure psychiatric settings, likely contributors to low levels of engagement include an
obesogenic environment that inadvertently promotes over eating and under exercising (Elinder
and Jansson, 2008). Issues of risk place limits on patientsability to engage in physical activity
and the physical, social and environmental obstacles to exercise engagement are considerable
Received 17 September 2014
Revised 26 February 2015
28 April 2015
Accepted 15 May 2015
PAGE144
j
MENTALHEALTH REVIEW JOURNAL
j
VOL. 20 NO. 3 2015, pp. 144-155, © Emerald Group Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-09-2014-0036

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