Barriers to implementing and accessing physical activity programs

The consensus in the research community that regular physical activity is fruitful in the prevention and treatment of mental illness is strengthening. Nevertheless, there are few programs that implement these research suggestions, and those that exist are often fragmented (Richardson et al., 2005). In their insightful article, "Exercise and Mental Health: It’s Just Not Psychology!" Faulkner and Biddle (2001) identified three challenges to the integration of physical activity into mental health programs:

• Mental health clinics' lack of knowledge about the therapeutic benefits of exercise
• The perceived simplicity of these programs
• An incompatibility of exercise programs with traditional treatments

During a "Mental Health and Physical Activity" workshop in Alberta (Berry, 2006), various mental-health practitioners added to that list of challenges. They argued that "quality of life, normalization of the disease, and recognition of mental illness as a chronic problem [are] key to moving forward. This group recognized that for many of these clients, obesogenic environments (i.e., environments that foster physical inactivity and poor diet) [are] a problem. They recommended emphasizing small, manageable changes. This group felt that 'the system' (i.e., policy-makers) needs to be educated on this topic and recommends forging links between researchers and practitioners and using an integrated teamwork approach" (Berry, 2006, p. 4).
Even after problems about the implementation of physical activity programs in institutional settings are settled, mentally ill people may encounter other barriers. Issues such as motivation, fear of injury, childcare support (Edwards, 2000, p. 22), transportation, available time, social support, and stigma (Berry, 2006) may need to be dealt with. Indeed, in her insightful public presentation, "Reality Check," Val Mayes (2006) identifies similar barriers that she encountered while trying to implement a diabetes prevention program for persons with chronic mental illness. One additional, emerging issue that came to her attention has to do with the changing health care system, and how it disrupted the mental health workers’ schedule to such a degree that they could not appropriately engage in the program. She concludes that staff who are overworked and stressed constitute an additional barrier, for they are not in the position to adequately support their clients' integration into new programs such as those promoting physical activity.