This section outlines the value of walking groups and their role in supporting recovery for people who experience mental health issues. The topics covered include:
- How to incorporate physical activity interventions into mental health services
- The physical, mental, and environmental health benefits of walking outdoors
- Existing green exercise programs in mental health services
The Need for Physical Activity in Mental Health Services
The importance of physical activity for the maintenance of both physical health and psychological well-being has been well documented. However, people who experience serious mental illness (SMI) tend to be more sedentary than the general population. People who experience SMI encounter multiple barriers to engaging in physical activity. Social determinants of health, such as limited income and lack of transportation, may limit engagement in mainstream exercise programs. People who experience SMI may lack the confidence and self-esteem to join mainstream groups, and may fear they would be met with stigma and discrimination in such programs. In addition, serious mental illness is often associated with such disabling effects as medication-related weight gain, cognitive impairment, and lack of motivation and energy, all of which pose further challenges to engaging in physical activity.
There is a growing body of evidence demonstrating the extensive physical, mental, and social benefits of engaging in physical activity among people who experience SMI. Physical activity can effectively reduce the heightened risk of chronic illnesses such as heart disease, diabetes and obesity that people who live with SMI experience. Physical activity bestows a range of mental health benefits, such as decreased stress, improved mood and self-esteem, and increased energy levels. For people who experience SMI, physical activity can help to facilitate recovery. Engaging in physical activity is a “normalizing” experience, focused away from the experience of mental illness. Moreover, physical activity interventions can empower participants by introducing them to an effective, accessible way to manage their own mental well-being.
As community mental health services continue to shift toward a recovery-oriented framework, physical activity interventions become an integral part of service provision. Mental health service providers have established professional relationships with people who experience SMI, and have an understanding of the barriers to engaging in physical activity that this population experiences. Furthermore, community mental health service providers are well positioned to partner with local health-promoting agencies to create programming that is innovative, effective, and sustainable.
Walking is an attractive physical activity for use by mental health service providers, as it is accessible by most participants and can be sustained with minimal funding. It requires little training or equipment, so almost anyone can incorporate walking into their own lives as a wellness-promoting activity. Walking lends itself to socializing, providing a means to counteract the limitations to social interaction that people who live with SMI often experience. Walking groups provide opportunities for people who may otherwise spend limited time in the community at large to feel supported in exploring their environment. Groups allow participants to develop communication skills, expand social ties, and become more comfortable in social settings. Groups also offer opportunities for peer leaders to emerge, which may add new and valued roles to participants’ lives.
The Benefits of Being Outdoors
Recent literature has been focused on the health benefits of being in nature. As we become increasingly reliant on technology and spend less time outdoors, our society has become increasingly removed from the natural world. Some experts argue that we have an innate biological need for connecting with nature. Evidence shows that simply being in nature has benefits for mental health, such as decreased stress, improved concentration, and enhanced mood, and some doctors are prescribing time spent outdoors for their patients.
People who undergo the greatest threats to overall mental well-being, such as high stress, low self-esteem, difficulty concentrating, and depressed mood, experience the greatest benefit from being in nature. Outdoor physical activity interventions are therefore well-suited for people who experience SMI.
Therapeutic use of the natural environment may even have environmental benefits. An emerging field, ecotherapy, is concerned with therapeutic methods committed to both human and environmental health. Ecotherapy posits that as we recognize the health benefits that nature has for us, we may increase our awareness of and concern for the natural world in a mutually beneficial relationship.
Existing Green Exercise Programs in Mental Health Services
Several well-established green exercise programs in mental health services are in the UK. Discovery Quest is a well-known walking and nature therapy program in England. Weekly walks over a 6-month period have resulted in improved self-esteem, communication skills, and overall psychological well-being among participants.
Mind, a national mental health charity in the UK, funds environmental projects through Ecominds. Projects support mental health and well-being for people who experience mental illness. Participants gain confidence and build social connections through outdoor interventions. Although participants experience physical health benefits, interactions with the environment and social contact have been found to be the major motivating factors for participants to sustain their involvement with Ecominds projects.
To find more information about these programs, please see “The Natural Environment and Mental Health Services” in the Helpful Resources section.