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From PEKN 1P93 Winter 2014: Group 10: Health Promotion, Mental Health

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[edit] PEKN 1P93 - Physical Activity Wiki Template

Mental Health- Group 10

[edit] Background

Mental health issues come in such a variety that finding a common activity that helps with almost all mental disabilities is somewhat of a miracle. Many people are affected by mental disabilities, either directly or indirectly, and there are many physical activity programs that help remove some of the external stress on the effect of mental illness. Physical activity has advantageous effects on the mental health of a person. Even if the effects on mental health are minimal, the overall well-being of the population can be benefited through physical activity as it positively affects various body functions and tissues. Mental health is critical in regards to the strengthening of skills of individuals to encourage behaviours that are healthy, and building healthy social and physical environments to support these behaviors. It includes a wide variety of activities either directly or indirectly related to the mental welfare component, as described by the Worlds Health Organizations definition of mental health "a state of complete physical, mental and social well-being, and not merely the absence of disease" (World Heath Organization, 2014). The term ‘mental health’ includes disorders such as Alzheimer’s, stress, anxiety and many more. It is important to explore the ways in which physical activity can play a role in either helping those already with mental health issues, lessening the risk of developing them or even preventing them altogether. Physical Activity is important not only because it keeps the body healthy, but also because it keeps the mind healthy by providing a positive outlet for stress relief and channeling negative energy. Stress affects several aspects of our lives including social interaction, productivity and motivation, daily routine, and overall mood (i.e., depression). Therefore, elimination/minimization of stress through physical activity will allow individuals to be more successful both short and long term.

The brain is a complex organ. Its basic functional unit is the neuron, which is responsible for producing different actions using its connections to other neurons, sensory receptors and muscle cells. The information is passed along an axon and through a synapse using neurotransmitters. Many scientists believe that most mental illnesses result from problems with communication between neurotransmitters in the brain. An example of this would be the neurotransmitter seratonin that appears to show lower levels in individuals who have depression. It is also believed that there may be disruptions in the neurotransmitters dopamine, glutamine and norepinephrine in individuals who have schizophrenia (Bliss et al, 2005). These are some of the underlying causes of mental disorders that have been discovered by scientists over the years. Scientists have discovered that dopamine levels can be increased with physical activity and exercise because this particular neurotransmitter responds well to pleasure and activity. This is due to the fact that physical activity has a positive effect on neurotransmitter synthesis (Ramgopal, 2013).

[edit] History

The history of exercise for mental health leads back to ancient civilizations (such as Greek or Roman cultures) who had a strong belief that the development of a healthy body leads to a healthy mind. Millon (2004) found that many cultures believed that mental illness was a form of religious punishment or demonic possession, in fact, in ancient Egyptian, Indian, Greek and Roman writings mental illness was categorized as a religious or personal problem (Millon, 2004).

Moving out of ancient times, there was a strong religious influence and, therefore, little concern for the development of the body. Richard Mulcaster, living in Britain in the 16th century, was one of the first persons to push for incorporation of sport and physical activity in the school curriculum, demonstrating the early recognition of the importance of physical education in ‘shaping the mind.’ In 1842, Dr. Egerton Ryerson was appointed the first Superintendent of Education in Upper Canada in Ontario. He used this influence in order to implement new physical activity programs in schools, as he also believed in the development of the mind and the body as a whole.

Furthermore, Philippe Pinel (1745-1826), “the father of modern psychiatry”, made notable contributions to the classification of mental disorders and was instrumental in the development of a more humane approach to the custody and care of mentally ill patients. He concluded that all patient's treatment plans must be designed around that specific individual's needs as opposed to in conjunction with any 'umbrella' category of diagnosis.

The World Health Organization (2004) says that stigma and discrimination against patients and families prevented people from seeking mental treatment and that, today, it is important to live a healthy and active lifestyle in order to reduce diseases worldwide. [1]

[edit] Target Audience

Late adolescence to early adulthood (17-21) is the targeted audience for the following best practice and program sections. The majority of individuals in this age group are either entering or attending post-secondary education and can be bombarded by the stresses associated with student life. Building new routines and habits around physical activity has been shown to benefit mental health and also aid in the prevention of future mental illnesses.

[edit] Research

Physical activity drastically improves mental health by creating a positive attitude; reduce anxiety, and depression as well as boosting self-esteem. Exercise can help with social interaction that can develop better moods and reduced stress. Activities such as jogging, biking, swimming, walking, gardening and even dancing reduces depression, which all have major boosting effects on mental health. Improvements in your daily life cause better circulation of the blood and releases hormones that will helps us to achieve and sustain a state of good mental health. Exercise triggers the production of endorphins that is a natural pain reliever and improves the mental health effects of exercise. The following articles relate to the physical aspect of mental health and how increasing your daily activity can help improve mental disorders:

An article written on placing physical activity in mental health care programs describes the importance of physical activity in these kinds of therapy. It is said that “people with mental illness experience poorer physical health and decreased longevity compared to the general population, partly due to neglect in health-care coordination and provision” (Happell et al, 2011). There are many benefits to physical activity other than physical well being, such as in a social aspect, or enjoyment, involvement and achievement. All of these components of physical activity are said to improve overall health and in fact, allow most people with a mental health disorder to appreciate a non-pharmaceutical approach to treatment (Happell et al, 2011).

Kim, et al. (2012) found the optimal threshold for mental health benefits was 2.5 to 7.5 hours of physical activity weekly. Individuals who engaged in the optimal amount of physical activity were more likely to have reported better mental health although the associations varied by gender, age and physical health status. These results may have important and extensive implications from a public health perspective, since mental health disorders, particularly depression and anxiety, are so common in adults and adolescents.

A peer reviewed journal article “The Intersection Between Physical Health and Mental Health: A Global Perspective” relates how mental, physical and social health are closely related and reliant on each other. The link between the mental and physical significantly impacts people’s quality of life, demand on health care and other publicly funded services, and produce consequences to society. Mental health is a huge risk factor for physical conditions as people with mental health conditions can develop a high risk of chronic physical conditions as well as people with chronic physical conditions are at a high risk of mental health conditions. A better understanding of the relationships between mental, physical, and social health specifies that each is crucial to the general well-being of individuals, societies, and countries. Because mental health and mental disorders have been ignored or overlooked in many parts of the world, the mutual impacts between physical health and mental health are not willingly obvious.

In a journal on the website for the American Psychological Association, writer Kristen Weir (2011) explains the benefits of physical exercise on those suffering from mental health problems. She explains all of the evidence leading to the betterment of people’s moods through physical activity, which is extremely beneficial in the case of depression. She explains that not enough mental health professionals prescribe exercise as a way to improve the situation of the patient. However, she continues to say that researchers do not yet have enough knowledge on which exercises are most beneficial or how much to prescribe.

Asztalos et. al (2012), in the article ‘Sport participation among women and men’ demonstrates the importance of engaging in physical activity (specifically sports participation) as a way of improving mental health by eliminating stress. Over 1400 men and women were evaluated in order to determine which specific sports resulted in the greatest stress relief. It was discovered that there was very little variability in the effects each sport had on stress elimination compared to other sports while all participants who engaged in sport had greater stress relief than individuals who did not engage; therefore, it is concluded that any participation at all in sports will result in stress elimination (stress elimination is not sport-dependent, but engagement-dependent). This article reinforces the idea that any and all forms of physical activity will result in mental health promotion by reducing stress regardless of which specific ‘type’ of physical activity is being engaged in.

Another article, 'A strength-based exercise training model of psychotherapy' (Hyman, 2013) has to do with psychotherapy treatments using principles from physiotherapy. The principles that cross over are: The Principle of Individuality, The Principle of Specificity, and The Principle of Reversibility. It is proposed that using a mental health twist on these common principles can help people with poor mental health achieve a higher standard of healthy living. The article goes on to suggest that if there were more psychotherapists that developed techniques using physical activity that the patients would be developing mental health faster with the added benefit of a healthy physical postion as well.

Asztalos, M., Wijndaele, K., De Bourdeaudhuji, I., Philippaerts, R., Matton, L., Duvigneaud, N., et al. (2012). Sport participation and stress among women and men. Psychology of Sport and Exercise, 13, 466-483.

Happell, B., Platania-Phung, C., & Scott, D. (2011). Placing physical activity in mental health care: A leadership role for mental health nurses. International Journal of MentalHealth Nursing, 20, 310-318.

Kim, Y., Park, Y., Allegrante, J., Marks, R., Ok, H., Cho, K. & Garber, C. (2012) Relationship between physical activity and general mental health. Preventive Medicine. 55, 458-463.

Sowers, M. K., Rowe, W. S., Clay, J. R. (2009). The intersection between physical health and mental health: A global Perspective. Journal of Evidence-Based Social Work, 6.

Hyman, S. M. (2013). A strength-based exercise training model of psychotherapy: Can principles derived from exercise and sport physiology guide behavioral prescriptions for physical and mental wellness?. American Journal of Psychotherapy, 67(4), 367-383 p17.

[edit] Existing Physical Activity Programs

1. Healthy Minds, Healthy People [2]

There is a program that is active in British Columbia, Canada called Healthy Minds, Healthy People; that emphasizes the importance of physical activity in mental health improvement. There is an overview of the program that discusses a ten-year plan to address mental health and substance use in British Columbia. They include ways to help prevent mental health disorders in the prenatal stage, as well as physical activity promotion for people of all ages being affected by mental health disorders. This program aims to improve mental health and well-being of the population, improve the quality and accessibility of services for people with mental health and substance use problems and reduce the economic costs to the public and private sectors resulting from mental health and substance use problems.

2. Physiotherapy and Exercise [3]

The Ministry of Health and Long Term Care has physiotherapy and exercise programs set up in Ontario Long-term care residences. Focusing on exercise and fall prevention, these classes are publicly funded. Participation in these programs help seniors stay active, independent and maintain a healthier mental and physical state.

3. Walking [4]

It has been shown that approximately thirty minutes of moderate-intensity exercise such as speed walking at least three days a week can be beneficial to those suffering from schizophrenia. It can reduce social withdrawal issues and also can improve self-esteem (Sharma et al, 2006).

4. Quality School Intramural Recreation [5]

The Quality School Intramural Recreation (QSIR) Program is being introduced in schools and post-secondary institutions all over Canada. Intramurals allow students to (1) interact with their peers, (2) learn cooperation and team-building skills, and (3) increase daily physical activity and by extension of all of these, eliminate stress. Intramurals are an ideal way to engage a maximal amount of students because there is an extensive variety of different games and sports offered, allowing every student to find an activity that he or she would enjoy.

5. Bell Let's Talk [6]

Bell Let’ s Talk is a multi-year program for charity that is dedicated to mental health. This program allows you to raise money for mental health by creating text messages, mobile and long distance calls, tweets and Facebook shares. Bell provides $5,000 to $50,000 grants to establishments, hospitals and agencies on educating people on mental health in their communities. Bell Let’s Talk takes a giant step towards making meaningful change and building knowledge, acceptance, and action. Bell shows that many Olympic athletes such as Clara Hughes, Stéphane Richer, and Darryl Stawberry have all suffered from mental illnesses and provide awareness for physical activity. Clara has set up a national bike ride through every province and territory, starting in Toronto and finishing in Ottawa in 110 days, covering 12,000 km and visiting communities along the way while encouraging individuals to come out an participate in the event while raising awareness of mental illness. The ride will create a platform for the support and value of local mental health organizations across Canada. (Bell Let’s Talk, 2014)


[edit] Best Practice Activity Suggestions

The American Psychological Association suggests that exercise and mood are directly linked. They have found that after just five minutes of moderate exercise (walking, jogging, swimming) that mood enhancement will begin. Evidently, increasing engagement times in physical activity past this recognized 5 minute stimulation period will only be beneficial in increasing the positive results associated with more and more time spend being physically active.

Consequently, 30-40 minutes of yoga 2-3 times per week showed a statistically significant difference on mental health variables relative to control groups in late adolescents. (Khalsa, S., Hickey-Schultz, L., Cohen, D., Steiner, N., & Cope, S., 2012, p.84)

Generally, it is found that the best practice for mental health is 30 minutes of moderate exercise, which makes you feel energized and boosts your self esteem. Swimming is a good exercise to relieve stress and relax muscles, although any exercise that gets you off the sofa and keeps the heart pumping can improve your day to day mood. People with mental illness often have a higher risk for heart disease, and exercise plays an important role in bettering your wellbeing (Duckworth, 2014).[7]

Research from Taylor, Sallis and Needle (1985) showed physical activity may help improve mental health and even prevent mental disorders by improving self-confidence, self-concept, cognition, or other psychological variables. Cardio activity such as running/jogging or using a stationary bicycle 4 times a week showed a significant improvement in psychological variables compared to a control group.

Many youth feel the desire to attend the gym but are either unsure of how to use the equipment there, or intimidated by other people who do in fact know what they are doing. Also stopping some individuals from trying to develop the habit of regularly attending the gym is the fact that they do not want to go alone. By learning how to do body-weight training at home as well exploring other healthy lifestyle practices such as running, stretching, yoga, etc., youth can build the confidence they need to be able to enter a seemingly more intimidating gym setting. By teaching students various activities they can do at home using household objects and ways to take advantage of their privacy and comfortability at home, they will eventually have built up the confidence in their abilities so as to allow them the confidence to try other things outside of home, such as the gym. Also, by incorporating working out into your regular daily routine, youth will notice they feel happier, healthier, and more productive, also inspiring them to go outside of their comfort zone to get more out into a local or university gym setting. Students will learn very quickly that the more physical activity they are participating in, the better they feel.

Endorphins are peptides released by the hypothalamus which inhibit feelings of pain and despondency and therefore, by extension increase energy, productivity, sociability, and overall happiness. Activities which elicit a release of endorphins include sun exposure, meditation, music and dancing, laughing, and most notably, exercise. By engaging in any of these activities individuals allow their bodies to feel happier and healthier both physically and mentally, and thus decrease the risk of depression and other negativity-based emotions. The image above demonstrates a few of the activities that allow the body to function and feel to its utmost potential by prompting the release of endorphins.

[edit] Future Directions

Early participation in physical activity is crucial to developing healthy habits during early adolescence. Physical activity can be used as a tool to alleviate some of the negative factors associated with mental health. With these habits formed, entering postsecondary school or going through major stresses can have a significantly less negative effect on a student's mental health. Physical Education within elementary and high school should have more variety in activities focusing on inclusivity and physical literacy. Although it is optimal to start in early adolescence, physical activity is beneficial to physical and mental health at any age.

The Canadian Society for Exercise Physiology (CSEP) in cooperation with the Public Health Agency of Canada recommends that individuals in the target group of 17-21 years of age (and older) achieve at least 2.5 hours of physical activity on a weekly basis (PHAC, 2012). In order to meet the recommended levels of physical activity students can join intramural sports in a college or university setting, join a local sports intramural organization with friends, regularly attend the gym or work out at home, sign up for dance or yoga classes, trade driving to work for biking or walking, etc. Any number of the programs listed above as an existing program would also elicit numerous benefits upon participation in any of their differently structured organizations, all with the same goal although by different means. It is important to develop a routine that includes many different types of activities so (a) individuals do not become bored with their routines, and (b) it becomes easier to engage in these activities as they become a regular part of your daily and weekly activity. In developing this routine, it is encouraged that the target group also eliminate their high average engagement in things such as watching television, playing video games, spending a prolonged amount of time on the computer, and other 'sedentary-heavy' activities. It is noted that as little as 10 minutes of engagement at a time in any physical activity will have positive effects on overall health and contributes to the recommended 150 minutes of activity per week (Mandigo, 2014).

[edit] External Links

ALCOA http://www.alcoa.ca/research_u_docs/2006_04apr_en_update.pdf

WHO Mental Health Gap Action http://www.who.int/mental_health/mhgap/en/

Mental Health Foundation http://www.mentalhealth.org.uk/help-information/mental-health-a-z/E/exercise-mental-health/

Canadian Mental Health Association www.cmha.ca

Healthy U: Physical Activity and Mental Health http://www.healthyalberta.com/620.htm

[edit] Notes and References

Asztalos, M., Wijndaele, K., De Bourdeaudhuji, I., Philippaerts, R., Matton, L., Duvigneaud, N., et al. (2012). Sport participation and stress among women and men. Psychology of Sport and Exercise, 13, 466-483.

Bliss, L., McNee, L., Garcia, C., Burris, T., Eckstein, G., Steingard, R., & Watson, A. (2005). The science of mental illness. Colorado Springs: BSCS. Retrieved from http://science.education.nih.gov/supplements/nih5/mental/default.htm

Brawley, L. R., Jung, M. E., & Glazebrook, K. E. (2006). Physical activity and mental health. Research Update, 11, 1-5.

Duckworth, K. (2014).Mental Illness and Exercise. National Alliance on Mental Illness, Retrieved from http://www.nami.org/Content/NavigationMenu/Hearts_and_Minds/Exercise/Mental_Illness_and_Exercise.htm.

Happell, B., Platania-Phung, C., & Scott, D. (2011). Placing physical activity in mental health care: A leadership role for mental health nurses. International Journal of MentalHealth Nursing, 20, 310-318.

Hyman, S. M. (2013). A strength-based exercise training model of psychotherapy: Can principles derived from exercise and sport physiology guide behavioral prescriptions for physical and mental wellness?. American Journal of Psychotherapy, 67(4), 367-383 p17.

Khalsa, S., Hickey-Schultz, L., Cohen, D., Steiner, N., & Cope, S. (2012). Evaluation of the mental health benefits of yoga in a secondary school: A preliminary randomized control trial. The Journal of Behavioral Health Sciences & Research, 39:1, 80-90.

Kim, Y., Park, Y., Allegrante, J., Marks, R., Ok, H., Cho, K. & Garber, C. (2012) Relationship between physical activity and general mental health. Preventive Medicine. 55, 458-463.

Manidgo, J. (2014, March). Current issues surrounding physical activity. Lecture conducted from Brock University, St. Catherines, ON.

Millon, T. (2004). Masters of the mind: Exploring the story of mental illness from ancient times to the new millennium.

Ministry Of Health Services. (2010). Healthy minds, healthy people: A ten-year plan to address mental health and substance use in British Columbia.

Public Health Agency of Canada. (2012). Physical Activity Guidelines, Retrieved from: http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/pa-ap/03paap-eng.php

Ramgopal, S. (2013). Does exercise release dopamine?. Livestrong, Retrieved from http://www.livestrong.com/article/544214-does-exercise-release-dopamine/

Sowers, M. K., Rowe, W. S., Clay, J. R. (2009). The intersection between physical health and mental health: A global Perspective. Journal of Evidence-Based Social Work, 6.

Taylor, C., Sallis, J., & Needle, R. (1985). The relation of physical activity and exercise to mental health. Public Health Reports, 100(2),195-202.

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