Creative partnerships for promoting physical activity

Diane Crone and colleagues describe a collaboration between a university sport and exercise science department and the local mental health trust that not only resulted in a number of practice-based research projects looking at the health benefits of physical activity, but also directly improved sports and other physical activity options for mental health service users. It has also provided final year degree students with vocational experiences, improving their career prospects.

Partnership working is central to New Labour's reform of health and social services. Policy documents and implementation guidelines repeatedly emphasise its importance to the delivery of integrated health promotion, prevention and treatment services (Department of Health, 1999, 2000; Social Exclusion Unit, 2004). These and other government documents (Department of Culture, Media and Sport, 2002; Wanless, 2004; Department of Health, 2004) also specifically highlight the importance of partnership working for the promotion of exercise, for both its physical and mental health benefits.

Use of physical activity in mental health services as an adjunct to treatment has increased in recent years, encouraged by the publication of the physical activity and mental health consensus statements (Biddle et al, 2000). Physical activity can take numerous forms (Grant, 2000): sports, exercise and general physical activity, including walking, have been actively promoted within mental health services.

The primary aim of this physical activity is its role in mental health treatment, prevention and promotion, and in addressing physical health concerns such as obesity and inactivity. But it also has a key role as a medium to assist people with social integration - with peers and within the community as whole. This is typically achieved in a number of ways: the organisation of specifically tailored physical activity sessions in mental health units; the use of local leisure centres; the modification of existing services such as exercise referral schemes, or through physical activities in the countryside such as walking or cycling (Crone-Grant & Smith, 1996; Crone-Grant, 2001).

Background

Although in many parts of the country physical activity as mental health promotion is not commonly given serious consideration, Gloucestershire Partnership Trust has actively embraced its potential and has employed a number of exercise specialists (typically, exercise science graduates) to develop physical activity as an integrated part of their routine service.

However, with NHS funding under constant pressure, identifying resources to further develop services is always a conundrum for exercise specialists. This led to discussions between the trust and Gloucestershire University and the evolution of a partnership project. The project was devised with the aim of developing physical activity opportunities for users of the trust's services through an existing volunteer scheme.

Staff from the university's exercise and health sciences team, in discussion with the trust's sports therapists (the exercise specialists), devised a project that would meet a number of aims. For the trust, these included further developing physical activity options for service users. For the university, it was an opportunity to develop vocational experiences for students - something that is central to the principles of today's higher education establishments. The provision of 'real work life' experiences in health services for students who may not have any experience of exercise/health related work not only enhances their educational experiences but also their future employment potential.

The project

Most modular degree programmes offer the opportunity for a vocational experience module. Students taking the Exercise and Health Sciences degree at the University of Gloucestershire have this opportunity in their final year (level 3). Most do not choose it as the prospect of doing something different is often too threatening or time consuming. However, in liaison with trust staff, we devised an advert, similar to a job advert, to encourage students to take up a placement with the trust's sports therapists.

Three students rose to the challenge and signed up for the vocational experience module. Before students could start the placement they needed to apply to the trust to become a formal volunteer. This involved them filling out an application (similar to a job application form), attending an interview with the trust, and undergoing relevant security checks. In the meantime, we devised a ten-week plan for the students, which included assisting sport therapists in a variety of mental health units, ranging from day services to a forensic unit. The students' role was initially to shadow the sports therapists and, once they had gained confidence in the new environment, to co-deliver the sessions. Students were also required to take part in some health and safety training, including a Break and Release course. They also had the opportunity to talk with mental health professionals and develop an understanding of the complexities and protocols of mental health service provision.

The placements took place over a total of ten weeks - typically one day a week. But some students became very enthusiastic and participated in further volunteer work that involved assisting with evening group sessions and escorting users on outdoor activities such as walking in the nearby Forest of Dean.

Benefits gained

The contributions of the exercise and health science students enabled the trust's sports therapists to deliver a higher quality and more extensive service than they were previously able to provide. The quality of the service for the user was enhanced, not only because of the improved staff/volunteer/user ratio but also because of the new opportunities interacting with fresh faces brought for users.

From the university's perspective, this project enhances links with local health services. It raises the profile of the university in the local health community, and highlights that it is a multi-faceted resource and not solely a provider of research and consultancy services.

In terms of the enhancement to student experience, this too is of importance. Higher education is increasingly competitive and this project is one that may single out the university from its competitors in attracting students. More importantly, however, it provides the students with enhanced career prospects, because they have undertaken genuine work experience within secondary health care - an area of work that is quite difficult for young graduates to access.

The students have found the placements very fulfilling and rewarding. They have gained both confidence and knowledge about physical activity and its place in mental health services. The placements help to highlight the theoretical principles underpinning professional practice, and allow students to experience first hand how a part of the NHS operates. They also enable students to become more comfortable with the service setting, and with the users and professionals they encounter, as this comment from one of the students shows:

'During the initial meeting with patients I tended to stay back and just observe, but after more experiences with patients I started to begin conversations and develop relationships with them. This has developed over the placement and I now enjoy some fruitful exchanges with patients and staff members, for which I am grateful and would like to thank them. Overall the involvement within this placement has provided me with more empathy for what it may be like to live with a severe and enduring mental illness, as well as to see the benefits that physical activity clearly bring.'

Conclusions

The purpose of this article was to highlight how, through partnership working, shared agendas can be met to enhance provision of physical activity within mental health services. The differing objectives of the three parties were all successfully met. This project is in the process of expanding and plans are under way to develop placement opportunities for students in a wider range of mental health care settings, to further develop physical activity options for service users.

Physical activity provision cannot be accomplished in isolation by one party. Universities are an obvious partner for the development and evaluation of evidence based practice, but they are also a valuable source of trained people who are desperate for experiences that will enhance their employment potential. With the necessary planning and preparation, projects such as this one in Gloucestershire could become commonplace. We hope that this article gives ideas and encouragement to other trusts and university departments who could look to forge similar links and create better physical activity options for mental health service users.

References

Biddle SJH, Fox KR, Boutcher SH (2000) Physical activity and psychological well-being. London: Routledge.

Crone-Grant D (2001) Mental gymnastics: exercise benefits mental health as well as aiding psychological well-being. How can this be better addressed within health clubs? Health Club Management May 36-39.

Crone-Grant D, Smith RA (1996) Pilot study explores links between leisure operators and mental health units. Sports Industry Aug/Sept.

Department of Culture, Media and Sport/Strategy Unit (2002) Game plan: a strategy for delivering government's sport and physical activity objectives. London: Strategy Unit.

Department of Health (1999). Saving lives - our healthier nation: a contract for health. London: the Stationary Office. http://www.officialdocuments.co.uk/document/cm43/4386/4386.htm

Department of Health (2000) The national service framework for mental health. London: Department of Health, http://www.doh.gov.uk/nsf/mentalhealth.htm

Department of Health (2004) At least five a week. Evidence on the impact of physical activity and its relationship to health. Chief Medical Officer's report. London: Department of Health.

Grant T (ed) (2000) Physical activity and mental health - national consensus statements and guidelines for practitioners. London: Health Education Authority.

Social Exclusion Unit (2004) Mental health and social inclusion. London: ODPM.

Wanless D (2004) Securing good health for the whole population. Final report. London: The Treasury.

Diane Crone, Daren Edwards, Laura Price and Emily Webber, University of Gloucestershire

Leon Meek, Gloucestershire Partnership NHS Trust

Contact: Diane Crone, Senior lecturer, School of Sport and Leisure, University of Gloucestershire, Oxstalls Campus, Oxstalls Lane, Gloucester GL2 9HW

Copyright Pavilion Publishing (Brighton) Ltd. Feb 2005
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