People living with severe mental illness experience a significantly reduced life expectancy—15 to 20 years shorter than the general population—a disparity largely attributed to poorer physical health. Exercise has the potential to close this gap, offering both physical and mental health benefits, yet people with severe mental illness often face a complex array of barriers that prevent them from engaging in regular physical activity. These include intimidating gym environments, a lack of social support, medication side effects, and discouraging attitudes from healthcare professionals.

A targeted initiative funded by Sport England and delivered by Rethink Mental Illness sought to address these obstacles through a place-based programme in Tower Hamlets and North East Lincolnshire, areas known for high deprivation and health inequalities. The programme focused on removing barriers by developing inclusive exercise opportunities, such as training leisure providers on severe mental illness and supporting adaptations like accessible swimming sessions. This approach highlighted the essential role that lived experience, collaboration between voluntary and local government sectors, and supportive community settings play in fostering physical activity participation among this population. The findings emphasise that stigma, anxiety, and social isolation exacerbate practical issues such as financial constraints, transport difficulties, and accessibility concerns, which together significantly limit exercise engagement.

Research underscores that barriers to physical activity among people with severe mental illness are multifaceted. Mental health symptoms—including depressive episodes, stress, low motivation, and acute psychotic states—directly impede the ability to exercise. Social barriers like isolation, financial pressures, and competing time demands further complicate participation. Additionally, side effects from psychiatric medication and coexisting physical health problems have been identified as considerable obstacles. This complexity calls for tailored interventions that not only address external access issues but also work to enhance intrinsic motivation through techniques such as motivational interviewing and health coaching.

Exercise is not just important for physical health but has significant therapeutic potential when integrated into mental health treatment plans. Innovative approaches such as ‘walk-and-talk’ therapy sessions and in-house yoga have shown promise in improving mood and cognitive functioning by harnessing the neurological benefits of exercise—including endorphin release, improved neurotransmitter balance, and neurogenesis. Such integration of physical activity within therapy can reduce stress and elevate overall mental wellbeing, suggesting the need for mental health services to embed movement more consistently within care pathways.

Despite these benefits, systematic reviews reveal recurring barriers that include limited access to open, welcoming spaces and pervasive self-stigma among service users. The support of multidisciplinary teams and development of personalised care plans are crucial for combating these challenges. Furthermore, when service users lead initiatives and collaborate with community organisations, meaningful progress can be achieved in making exercise more attainable.

In conclusion, expanding equitable access to physical activity for people with severe mental illness requires multifaceted, context-sensitive strategies. These must dismantle stigma, overcome practical constraints, and integrate exercise into therapeutic frameworks—facilitated by partnerships between healthcare providers, local authorities, and the voluntary sector. The evidence is clear that with such joined-up efforts, substantial improvements in health outcomes and life expectancy are within reach for this vulnerable population.

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Source: Noah Wire Services