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Mental wellbeing

There’s no health without mental health, but gyms very often treat mental wellbeing as less of a priority than physical health. What’s the best way forward?

by Kath Hudson | Published in Health Club Management 2014 issue 6

One in four people in the UK suffers from mental health issues – that’s one person in every typical family.

Mixed depression and anxiety is the most common condition, with 9 per cent of people in the UK meeting the criteria. One of the contributory factors is long-term stress – often a result of pressure at work. There’s also evidence to show that depression and suicide have risen in response to the economic downturn. And it’s a growing problem: the World Health Organisation forecasts that, by 2020, depression will be second only to coronary heart disease as a leading contributor to the global burden of disease.

Although GPs tend to prescribe anti-depressants sooner than they prescribe exercise, research proves exercise can be a very effective treatment for mental health: a study in the British Journal of Psychiatry indicated that people who were not active in their leisure time were almost twice as likely to suffer symptoms of depression than the most active individuals. The more activity, the less chance of being depressed (see p56).

Personally, I’ve found that the mental and emotional benefits derived from exercise are almost instant and certainly come way before any physical benefits. And I’m not alone in this: a survey conducted by mental health charity MIND indicates that many people exercise to keep their mood steady Indeed, 83 per cent of respondents said they exercised to help lift their mood or reduce stress, while seven out of 10 gym users with no mental health issues thought their mental wellbeing would suffer if they didn’t exercise.

This suggests the fitness industry should be doing more to push the mental and emotional benefits of exercise, rather than focusing so heavily on weight loss. But how can operators go about this? How do you engage people with mental health issues and market programmes without applying negative labels? What sort of exercise appeals to people with mental wellbeing issues? What training do staff need? We ask the experts....

Beth Murphy,

Head of information,

MIND

Beth Murphy
Beth Murphy

“We would urge organisations to give their staff mental health awareness training and, when dealing with people who have mental health issues, to just be human and real, and not scared of people showing their feelings. They don’t have to be experts to make a difference, but need to be aware that people with mental health issues may initially need more support, such as being greeted at the door and shown around the first time.

There are some barriers to this group taking part in exercise. One is cost, as some find their mental health makes it difficult to work. Another can be finding the motivation to exercise.

It’s important to remember everyone will need a different approach: group exercise is a good way of connecting with people, but for people living with conditions such as social anxiety, this might be off-putting. MIND encourages outdoor exercise such as walking, running and outdoor group exercise, as research shows exercise in nature offers benefits for mental wellbeing. We run organised cycle groups, Bike Minded, as well as an outdoor physical exercise programme, Ecominds.

Local MIND branches welcome approaches from operators about running partnership programmes, as well as any publicity about the benefits of exercise for mental wellbeing.”

Debbie Lawrence,

Qualification development ,

Active IQ

Debbie Lawrence
Debbie Lawrence

“I don’t think the fitness sector is sufficiently equipped to deal with people who turn to exercise to help with mental health issues. There isn’t a broad enough understanding of the subject and instructors don’t have the necessary skills, especially soft skills.

Maturity and experience is needed to work with people suffering with mental health issues, and all instructors should have some mental awareness training as a minimum. Ideally, each club would have a specialist who is Level 4 qualified in mental health. This is essential if the club is going to be dealing with people who have more acute issues.

With one in four people suffering from mental health issues, this is a large audience – but they are hard to market to, firstly because of the stigma and secondly because someone suffering from depression is very hard to engage with. The best route is therefore via GP referral or mental health charities. On a broader level, operators could start marketing the benefits of exercise for mental health, getting away from the weight loss aspect and moving towards the wellbeing perspective.

Rather than leading to mental breakdown, depression can often lead to a spiritual breakthrough, so practices like yoga and tai chi often appeal to those with mental health issues.”

Harriet Heal,

Co-founder,

Up and Running

Harriet Heal
Harriet Heal

“Mental health problems are very common, so all health club operators will already be catering for people with these issues. However, it can increase staff confidence to offer some basic training and education in this area.

When engaging with customers, talk about the holistic benefits of exercise and how it can lift the mood and keep you steady. Don’t present exercise as a standalone treatment for depression, but as a useful tool for managing mood and energy.

If you want to run specifically targeted programmes, develop partnerships with local mental health services. As well as directing clients to you, they can offer vital support, education and mentoring. Be clear that you are offering exercise, not therapy. People may well want to talk about their problems, but there should be no pressure to do this. Confidentiality is very important: be respectful and don’t gossip afterwards. It’s important to make sessions fun and low pressure. And connect with the individual, treating them as you would anyone else.

We organise progressive running programmes for women with mental health problems (see p56). Feedback shows people are initially wary about who else will be on the course and are relieved to find it’s just normal people, like them.”

Simon Hollifield,

Lecturer,

The Wright Foundation

Simon Hollifield
Simon Hollifield

“When working with this demographic, the exercise is the easy part. It’s the soft skills that are all-important: empathy and active listening. This is where more staff training is needed. The Wright Foundation offers a Level 4 Mental Health course for those wanting to specialise in this area.

An umbrella scheme won’t work – it needs to be patient-centred. Support and flexibility are the two main things we focus on in a programme I run in Wales. We offer a whole range of activities, because different people like different things.

Most mental health exercise schemes are around 15 weeks, but ours is 45 weeks. This means that, even if people relapse – which always happens – there’s time to get them back. We usually find that, by week 25, people are able to operate in the mainstream, but we’re there if they need us. As we’re trying to avoid stigma, we don’t label the programme.

Our clients are all referred by GPs or psychologists. The first thing we do is get them into a positive pattern. If I can just get them to a centre twice a week in the first month, I’m happy. Once they’ve formed the pattern, the exercise becomes more important. There are no real rules – it’s all about individuals’ needs: give them what they need for as long as they need it.”

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