South African mental healthcare providers’ views about exercise for people with mental illness

Abstract

Background: People living with mental illness (PWMI) have significantly reduced life expectancy compared to the general population, yet mental healthcare providers (MHCPs) do not regularly prescribe exercise, despite its proven health benefits.

Aim: This study aimed to evaluate South African MHCPs’ views regarding exercise for PWMI.

Setting: A cross-sectional descriptive study conducted across five public sector specialised psychiatric units in Gauteng.

Methods: Mental healthcare providers were surveyed using the Exercise in Mental Illness Questionnaire – Health Professionals Version.

Results: Most participants were nurses (49.1%) and doctors (26.2%) and reported no prior formal training in exercise prescription (79.4%). The vast majority (up to 89.7%) agreed regarding the physical benefits of exercise, particularly cardiometabolic benefits. The most common barriers, as perceived by MHCPs, to exercise participation for PWMI were: stigma (56.5%) and medication side effects (56.5%). The majority (76.2%) reported prescribing exercise for PWMI at least ‘occasionally’. The method most frequently used was personal discussion (77.3%) and aerobic exercise was most frequently recommended (81.0%). Specific instructions regarding physical activity recommendations however were often not provided. Regarding MHCPs personal exercise habits, only a third (34%) met physical activity guidelines. Most MHCPs (92.1%) indicated an interest in further training regarding exercise for PWMI.

Conclusion: Mental healthcare providers were supportive of exercise for PWMI. Strategies to address the stigma around mental illness and medication side-effects, to improve training regarding exercise prescription, as well as the exercise habits of MHCPs themselves, and collaboration with exercise professionals and organisations are recommended.

Contribution: This study provides insight into the views of South African MHCPs regarding exercise for PWMI.