DRILL Blog and News

Mental health and Physical Activity in Northern Ireland

Most people know that engaging in physical activity is not only important for our physical health, but also our mental wellbeing.

Much of the existing research focuses on the impact of physical activity on depression (Hull, 2012) with multiple studies finding that physical activity is associated with a reduction in depressive symptoms.  The Royal College of Psychiatrists states that a moderate level of exercise can be as good as antidepressants or cognitive behavioural therapy (CBT)[1].

The relationship between physical activity and mental health appears to work both ways (Steinmo, Hagger-Johnson & Shahab, 2014), with increased physical activity resulting in better mental health and vice versa.  Not surprisingly, then, those with severe mental health problems are less likely to engage in physical activity and more likely to be physically unwell (Hull, 2012).

The evidence for the positive effects of exercise on a range of mental health problems is growing, with studies demonstrating that exercise can improve the lives of people with schizophrenia (Rimes et al., 2015).  Despite this, exercise interventions are often neglected in mental health care (Callaghan, 2004) and the mortality gap for people with serious mental health problems continues to widen.  This is particularly pernicious in Northern Ireland, a country in which the recent political turmoil has exacerbated the mental health crisis to catastrophic proportions.

The Mental Health Foundation, along with several partners, including Queen’s University Belfast and three Recovery Colleges (Northern Recovery College, South Eastern Recovery College and Western Recovery College), has received funding from DRILL (Disability Research on Independent Living & Learning) to conduct a one-year pilot study to address the high levels of physical ill-health and preventable deaths of people with serious mental health problems in Northern Ireland.

What the study will involve

Co-production will inform the entire study.  Individuals with lived experience of psychosocial difficulties will receive accredited training from Queen’s University Belfast to become peer-researchers on this study.  They will then have an instrumental role in co-producing the programme design, research methodology, analysis, research findings recommendations and promotion.   The physical exercise programme targeted to people with a range of serious mental health problems will be developed from a series of co-production workshops with people with lived experience, and consultations with recovery colleges, sports organisations and health professionals.  Participants will undergo tailored health checks to determine the programme’s impact on participants’ physical and mental health measures.

[1] http://www.rcpsych.ac.uk/mentalhealthinfo/treatments/physicalactivity.aspx

The sustainability of the programme will be explored via interviews and consultations with partners, and recommendations and next steps will be identified.

The shocking fact that more people in Northern Ireland have died by suicide in the past 18 years than were killed during 30 years of conflict[1] highlights the urgency of the situation.  Mental health problems can no longer be ignored, and innovative, creative approaches and solutions should be explored.

This is exactly what we seek to do with our partners through this large-scale physical exercise programme designed to empower people with serious mental health problems to incorporate physical activity into their lives.  Not only does this innovative study seek to develop the evidence base for physical exercise interventions in mental health, it also hopes to provide practical solutions that will improve the delivery of services in Northern Ireland.

 

References:

Callaghan, P. (2004). Exercise: a neglected intervention in mental health care? Journal Of Psychiatric And Mental Health Nursing, 11(4), 476-483.

Hull, D. (2012) The relationship between physical activity and mental health: a summary of evidence and policy (Paper 198/12). Retrieved from Northern Ireland Assembly website: http://www.niassembly.gov.uk/

Rimes, R., de Souza Moura, A., Lamego, M., de Sa Filho, A., Manochio, J., & Paes, F. et al. (2015). Effects of Exercise on Physical and Mental Health, and Cognitive and Brain Functions in Schizophrenia: Clinical and Experimental Evidence. CNS & Neurological Disorders – Drug Targets, 14(10), 1244-1254.

Steinmo, S., Hagger-Johnson, G., & Shahab, L. (2014). Bidirectional association between mental health and physical activity in older adults: Whitehall II prospective cohort study. Preventive Medicine, 66, 74-79.

[1] https://www.nisra.gov.uk/publications/suicide-statistics

For further information please refer to project

DEPARTMENT FOR SNAKES & LADDERS?

Fionn is 60, and has two long-term conditions for which there are no effective treatments. He wanted to be able to call on a social safety net; the best thing on offer at the moment seems to be a spectacularly uncomfortable hammock.

 

I’m exactly the same as anyone else who’s gathered up a lifetime of training and experience. I have a lot of skills. People come to me for advice. They offer me work. They offer me money to do that work.

 

And I can do the work, but it makes me ill. I don’t mind; I’ve always been ill, and I love my work. I just have to stop every now and again till I get better, then I can do some more.

 

Now that I’m older, those pauses have got longer. I might work for five months and have to stop for another four. The trouble is that when the income stops, the bills don’t. I live alone, so I have to claim benefits.

 

When I do get ill, it can be sudden and severe. One day I can be leading a seminar, the next I can’t fetch a bowl of cereal without help. What I need at this point is a benefit system that that can cushion me during those down times, and enable me to get back to work again as soon as my health allows. Instead I’m faced with a disability benefit system that appears to be based on bizarre assumptions:

 

“Disabled People Will Avoid Claiming If You Make It Inaccessible Enough

 

So, I have to scan a 50-odd page ESA booklet because I can’t write by hand, type 6,000 words, print it out, and then transport it a mile to a post box.

 

Things Medicine Can’t See Are Likely Fake

 

So, I have to have to demonstrate the invisible, to someone who’s been told I’m probably lying.

 

“Ill People Can Stay In Work If You Just Make the Alternative Unpleasant Enough

 

So, the first 13 weeks of my claim are paid at such a low rate that I can’t afford to heat my home, fund my special diet, or keep on the business services that mean I can return to work easily in future. The stress of the mounting debt delays my recovery.

 

Ill People Either Get Better Or Die

 

 

Because neither outcome has occurred I will have to repeat the whole miserable cycle over and over again, year after year, even though my condition(s) has not changed.  And who does this benefit?

 

 

So why don’t I just use the Permitted Work Scheme? It allows me to work a few hours a week, and even to keep some of the money. I thought it was a great idea when I heard about it. Then I asked for the form.

 

What is your job title?

“It depends. Every project I take on has a different title. I’ve been working since I was 15, and I can do quite a lot of things.”

 

How many hours per week do you work?
“I’m self-employed. I can’t work consistently, so I can’t build my business up, and I never know how much work I’m going to be offered. I might go three weeks without a call, then get several offers at once.”

 

How much do you earn?

“It depends who I’m working for. My average pay’s a bit low for someone with my experience, but I do sometimes get well-paid projects, especially if the client’s desperate for help. But I’m also keen to support new businesses that can’t offer much. So, anything from £15 to £45 per hour.”

 

I was warned against saying I that can earn more than minimum wage by a welfare benefits officer, who told me it may lead to questions about why I’m in the Support Group.

It’s deeply depressing that DWP still hasn’t realised that severe disability doesn’t preclude academic achievement or good business skills, but I saw his point. Trouble is, I can’t lie about my earnings, yet clients would think I was mad if I asked them to pay less. And there are now no specially trained Jobcentre disability advisors to build relationships with individuals and gain an understanding that they’re chronically ill, not trying to play the system.

 

If I can’t return to my Employment & Support Allowance claim when I get ill – without a financial punishment for trying to go back to work, without having to write the same 6,000 words on the same form about the same conditions, and without another stressful and humiliating assessment – then it’d be lunacy to keep going back to work.

 

Why did I spend years doing it? Truthfully, I don’t know.

 

But I’ve had enough now. My talent, my determination, my courage, and my optimism are no match for public policy that confuses equality with treating everyone the same, and where my disabilities are regarded as excuses put forward by work-shy scroungers (and where a 40-year continuous work history evidently doesn’t suggest otherwise). It’s beyond the realms of possibility that either the welfare system or employers will begin properly supporting disabled people before I retire, so I’m taking the safe option now.

 

I’m giving up trying.

Author: “Fion”

For further information please see report chronic illness citizenship mobilising collective voice social change

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