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Article Excerpt
The purpose of this investigation was to determine if differences exist in the functioning level between adults with severe mental illness who participated in exercise activities and those who did not. The researchers assessed participants' levels of hygiene, nutrition, ability to hold a job, social situations, and pursuit of appropriate independence in a state hospital. The Current Evaluation of Risk and Functioning-Revised (CERF-R) assessed data. Participants engaging in exercise scored significantly (p < .01) better than non-exercise participants did on variables of hygiene (d = .81) and pursuit of appropriate independence (d =. 71). The implications of the study are discussed for mental health counseling.
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There is a growing emphasis on exercise in today's society and research has shown that one gain from physical activity is maintaining, enhancing, and ameliorating mental health (Brill & Cooper, 1993; Pelletier, Nguyen, Bradley, Johnsen, & McKay, 2005; Skrinar, Huxley, Hutchinson, Menninger, & Glew, 2005). A secondary gain from exercise is social contact and interaction (Hesso & Sorenson, 1982; Pelham & Campagna, 1991; Skrinar et al., 1992). For people with severe mental illness (SMI), exercise is a new and unfamiliar treatment option. An exercise regimen provides individuals with SMI the prerequisites required for occupational mental health--staying active and being able to work closely with others (Hesso & Sorensen).
According to Hesso and Sorenson, "Exercise liberates individuals from these psychological and social obstacles by fostering non-demanding behavior in the process of socialization and identification with the general population" (p. 259). Regular exercise promotes social interaction that assists in social training and then in turn gives people with SMI the opportunity to interact in the community. Exercise may bridge the gap between using antipsychotic medications and taking initiative in treatment and can produce positive and life changing effects on the functioning level of people with SMI (Hesso & Sorensen, Pelletier et al., 2005; Skrinar et al., 2005). Functioning level is determined by a person's ability to live, learn, work, and love in the environment of their choice independently (Anthony, Cohen, Farkas, & Gagne, 2002). Exercise can positively affect self-esteem, stress levels, social interaction, anxiety, depression, motivation, sleep, activities of daily living (ADLs), and self-image (Bradley, 1996; Brill & Cooper, 1993; Chamove, 1986; Hesso & Sorenson, 1982; Martinsen, 1987; Skrinar, Unger, Hutchinson & Faigenbaum, 1992).
In general, people with SMI tend to be less fit; furthermore, physical activity has been absent in traditional psychiatric facilities (Hesso & Sorensen, 1982). Moreover, in the last decade, people with SMI have developed a high co-morbidity and mortality rate due to cardiovascular disease, obesity, hypertension, and diabetes (Hutchinson, Skrinar, & Cross, 1999). Research suggests that people with SMI have a higher risk for health-related problems that increase physical, emotional, and psychological difficulties (Hutchinson et al.). Moreover, research has demonstrated that the general physical condition of patients with SMI who spend a long period in a psychiatric facility is so poor that it limits the possibility for occupational mental health (Hesso & Sorensen).
Previous research, however, has not examined the relatedness of exercise and clinical functioning. Accordingly, the purpose of this study is to examine the relationship between functioning levels and participation in exercise. For the focus of this study, the researchers analyzed five functional ability factors, which were chosen largely based on their inclusion in the literature as well as to assess areas not fully studied. The five factors include hygiene, nutrition, holding a job, negotiation of social situations, and the pursuit of appropriate independence. The hypothesis for this investigation is that participants with SMI who exercise regularly will score significantly higher on five scales of The Clinical Evaluation of Risk and Functioning-Revised (Hygiene, Nutrition, Holding a Job, Negotiating Social Situations, and Pursuit of Appropriate Independence) than participants who do not exercise regularly.
EXERCISE AS A TREATMENT FOR SEVERE MENTAL ILLNESS
The majority of research conducted on the effects of exercise has predominantly conducted with single, small samples. However, the literature review also revealed studies that employed meta analyses. Although dated in one case, meta analyses provide a more comprehensive review of the construct of exercise.
Review of Single Studies
Pelletier et al. (2005) studied the effects of exercise of 17 participants with SMI (mood and anxiety disorders and schizophrenia) in a clubhouse for 16 weeks. Results showed an improvement in aerobic capacity (d = 1.16) and general health (d = .54), as well as perceived mental health (d = .65). Participants...
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