Physical activity is a recognized health topic worldwide. Individuals and health professionals are increasingly aware of its benefits and the implications of inactivity. Beyond the Physical Benefits, Research Shows Physical Activity Has Positive Effects on the Body personal mental health. People with mental illness have higher rates of disability and mortality , and further research is needed in this area.
The World Health Organization (WHO) defines mental health as; “a state of complete physical, mental and social well-being, and not merely the absence of disease”. 
Specifically for mental disorders, which are defined by the World Health Organization (WHO) as; “a broad range of problems with distinct symptoms”. 
NICE (National Institute for Excellence in Nursing) guidelines show that the most common mental health disorders include depression and anxiety. These conditions are considered “common” because they affect more people than any other mental health condition. 
- In the UK, one in four people experience a mental health problem each year.
- Mental health disorders are the largest contributor to the global economic burden, estimated to cost £1.6 trillion
- Half of all mental health problems begin before the age of
- In England, women have a higher prevalence of common mental disorders than men (19.7% vs 12.5%) .
- Only about 50% of people diagnosed with a mental illness receive professional help .
- In the United States, more than 50 percent of people are diagnosed with a mental health disorder at some point in their lives, and one in five people experience a mental health disorder each year.
- In the United States, 1 in 25 people suffers from a serious mental illness such as schizophrenia and depression.
- For one in five children, they will experience a serious mental health problem at some point in their lives.
- According to the National Institute of Mental Health
Benefits of Physical Activity
Many people find physical activity fun, boosts confidence and helps regain a sense of control. Physical activity can also encourage social interaction by being around like-minded people.  It can help bring about social support, which in turn can improve Personal confidence and sense of accomplishment 
Studies have been found to show the positive effects exercise can have on an individual’s overall mood. The following exercises have been shown to increase levels of the neurotransmitter serotonin. This increase in serotonin is supposed to help prevent the progression of certain physical or psychological problems.
Physical activity has been shown to increase self-esteem and acceptance levels. Research shows that patients should participate in less stressful and less competitive activities to help improve their mental health. 
There is evidence that exercise is effective in improving depressive symptoms.  Aerobic exercise Resistance and strength training have been found to be beneficial in improving individual condition.  The impact of physical activity has been reported in both clinical and non-clinical settings. In a clinical setting, people with severe mental illness improved even more. 
Physically active participants benefited from improved cardiovascular and muscular fitness. Maintains bone strength and aids in healthy function. It can reduce an individual’s risk of several diseases such as high blood pressure, chronic heart disease, stroke, diabetes, breast/colon cancer and depression. 
Mechanism of effect
There are many hypotheses attempting to identify the mechanisms by which physical activity affects mental health. These can be identified as psychological or physical. Research on hypotheses is limited, and it is believed that the real effect is through Psychological and Physiological Mechanisms.
Mindfulness is thought to be induced by individuals withdrawing and turning away from stressful stimuli which in turn have the enhanced effects associated with physical activity.
Many people find exercise difficult. By engaging in an exercise-related routine, an individual’s mood and self-confidence will improve.
This is thought to be where exercise increases neurotransmission in the brain. Research is limited in this area.
Exercise releases opioids. Exercise positively affects common symptoms of depression and anxiety by increasing beta endorphins post-exercise. Endorphins are associated with a positive mood and a greater sense of overall well-being.
Thermogenesis is concerned with the production of the body. Physical activity increases body temperature. Exercise is thought to unleash a greater sense of relaxation and improve mood. 
Barriers to Physical Activity
Even though many people are aware of the benefits of physical activity and how it can improve quality of life they still face barriers that prevent them from doing it. Barriers can be seen as physical psychological or social environment.
PhysicalMental and economicSocioeconomicPhysical illnessFatigue/exhaustionDistressedDepressionLack of mental motivationLow confidenceLow confidenceHigh costs lack of access to areas without access to social supportLack of information/knowledgePoor environmentHigh crime rates
We all create barriers to exercise even when we are aware of the potential benefits. People with mental illness are no exception, but there are other factors that may prevent an individual from being physically active.
- Body image – especially with regard to excess weight. Sensitivity to weight gain may not be due to lack of exercise, but may stem from medication. 
- Fatigue – Evidence has shown that fatigue and tiredness can be caused by substance use.
- Environmental factors – People are afraid of others in their neighborhood or community finding out about their mental illness and fear stigmatization.
Those with common mental health conditions are found to have symptoms that reduce the likelihood of physical activity.Side effects of medications can also be a barrier to physical activity. There are a variety of medications that individuals can take for their mental health; antidepressants anti-anxiety drugs antipsychotics and mood stabilizers.
Possible adverse effects associated with medications include: nausea vomiting weight gain drowsiness loss of appetite headache and blurred vision. Both conventional and unconventional drugs are said to affect certain neurotransmitters in the brain that can cause individuals to be high on weight. Finding the right medication for an individual can sometimes be a lengthy process especially when trying to determine dosage. In many cases individuals report being in a period of sedation this increases periods of passive physical activity.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a type of talk therapy that helps individuals change the way they think and behave. It has been shown to have positive effects on various mental health disorders . The approach is divided into 5 areas; Situational Thought Emotional Body Feeling and Action This type of therapy can stop the negative loop many people may find themselves in and allow them to better manage their condition. 
Many people with depression find that their behavior is associated with prolonged inactivity, which in turn lowers mood. CBT therapy can help change behavior and increase physical activity levels by doing things that may bring you pleasure and feelings Achievements
Implementing public health interventions to try to address inactivity can be done in a variety of ways, such as:
Information provided directly to individuals through the logo. These are usually located in the stairwell or next to the elevator.  These signs can be motivating, educational and inspirational. 
The community engages in the exercise through media campaigns and other strategies. Support groups and risk factor screening are used in community projects. 
Mass media campaigns
Movement uses the media television broadcast cinema and the internet to encourage physical activity. 
Classroom-based health education
Interventions in educational settings such as school university or work. These classes attempt to educate individuals about the importance of physical activity and the effects of inactivity. 
Many different tools/interventions have been developed to help address physical inactivity.
Scot-PASQ (Scottish Physical Activity Screening Questions)
Identify what individuals think about physical activity and what they are currently doing. To determine whether brief recommendations or interventions were implemented if individuals demonstrated acceptance of increased physical activity. Those Who Are Not Ready Get Informed Through Physical Activity Leaflet
National Physical Activity Pathway
After Scot-PASQ screening, health professionals can use this pathway to provide advice or implement interventions to help encourage inactive individuals to increase the level of physical activity they achieve. 
Lester Positive Cardiometabolic Health Resources
This program is designed for individuals with psychosis who are taking antipsychotics helps identify any risks these individuals may have for heart disease and type 2 diabetes.
Walking Football groups
These teams see individuals age 50 and older competing in soccer. The walking nature of the game allows even those with travel issues to participate. It improves both physical and mental health.
The aim here is to improve individual self-esteem work in the community helping to achieve social inclusion and ensuring that recreational facilities are set up to support people with mental illness.
The Scottish Mental Health Association is working to educate leaders to be more aware of mental health and able to communicate how exercise can improve an individual’s mental health. 
A scheme involving forestry in Scotland. Individuals who use mental health services can enroll in a 12-week program that encourages physical activity. Individuals learn conservation work and bush techniques. Photography and other skills are also 
The Motivate2Move website, created by Wales Deanery, has a comprehensive section on physical activity and mental health.
CDC, learn about mental health.
- World Health Organisation, 2013. Mental Health Action Plan 2013-2020 [online]. World Health Organisation. [viewed 24 August 2016].
- World Health Organisation, 2016. Health Topic – Mental Health [online]. World fckLRHealth Organisation. [viewed 24 August 2016].
- World Health Organisation, 2016. Health Topic – Mental Disorders [online]. World Health Organisation. [viewed 24 August 2016]. Available from: http://www.who.int/topics/mental_disorders/en/
- NICE, 2011. Common mental health problems: identification and pathways to care [online]. National Institute of Health for Care and Excellence. [viewed 24 August 2016].
- Mental Health Foundation, 2015. Fundamental Facts about Mental Health [online]. Mental Health Foundation. [viewed 24 August 2016]. Available from:
- McManus, S. et al., 2009. Adult psychiatric morbidity in England, 2007; Household survey [online]. National Centre for Social Research. [viewed 24 August 2016].
- World Health Organisation, 2016. WHO Regional Committee for Europe 63rd session [online]. World Health Organisation. [viewed 24 August 2016].
- Royal College of Psychiatry, 2012. Physical Activity and Mental Health [online]. Royal College of Psychiatrists. [viewed 24 August 2016].
- Fox KR. The influence of physical activity on mental well-being. Public health nutrition. 1999 Mar;2(3a):411-8.
- Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current opinion in psychiatry. 2005 Mar 1;18(2):189-93.
- Young SN. How to increase serotonin in the human brain without drugs. Journal of psychiatry & neuroscience: JPN. 2007 Nov;32(6):394.
- Shamus E, Cohen G. Depressed, Low Self-Esteem: What Can Exercise Do For You?. Internet Journal of Allied Health Sciences and Practice. 2009;7(2):7.
- Blumenthal JA, Smith PJ, Hoffman BM. Is exercise a viable treatment for depression?. ACSM’s health & fitness journal. 2012 Jul;16(4):14.
- Wang PW, Lin HC, Su CY, Chen MD, Lin KC, Ko CH, Yen CF. Effect of aerobic exercise on improving symptoms of individuals with schizophrenia: a single blinded randomized control study. Frontiers in psychiatry. 2018 May 15;9:167.
- Blackdog Institute, 2012. Exercise and Depression [online]. Blackdog Institute. [viewed 24 August 2016]. Available from:
- Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health psychology review. 2015 Aug 7;9(3):366-78.
- World Health Organisation, 2016. Media Centre – Physical Activity [online]. World Health Organisation. [viewed 24 August 2016]. Available from: http://www.who.int/mediacentre/factsheets/fs385/en/
- Morgan WP. Affective beneficence of vigorous physical activity. Medicine & Science in Sports & Exercise. 1985 Feb.
- Guszkowska M. Effects of exercise on anxiety, depression and mood. Psychiatria polska. 2004 Jul 1;38(4):611-20.
- Craft LL, Perna FM. The benefits of exercise for the clinically depressed. Primary care companion to the Journal of clinical psychiatry. 2004;6(3):104.
- Peluso, M. A. M. & Guerra De Andrade, L. H. S. 2005. Physical Activity and Mental Health: the association between exercise and mood. Clinics [online]. 60(1), pp. 61-70. [viewed 24 August 2016]. Available from: http://www.scielo.br/pdf/clin/v60n1/23108.pdf
- Firth J, Rosenbaum S, Stubbs B, Gorczynski P, Yung AR, Vancampfort D. Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychological medicine. 2016 Oct;46(14):2869-81.
- Manaf H. Barriers to participation in physical activity and exercise among middle-aged and elderly individuals. Singapore Med J. 2013;54(10):581-6.
- Schutzer KA, Graves BS. Barriers and motivations to exercise in older adults. Preventive medicine. 2004 Nov 1;39(5):1056-61.
- National Institute of Mental Health, 2016. Mental Health Medications [online]. National Institute of Mental Health. [viewed 24 August 2016]. Available from: http://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml
- Shor R, Shalev A. Barriers to involvement in physical activities of persons with mental illness. Health promotion international. 2016 Mar 1;31(1):116-23.
- McDevitt J, Snyder M, Miller A, Wilbur J. Perceptions of barriers and benefits to physical activity among outpatients in psychiatric rehabilitation. Journal of Nursing Scholarship. 2006 Mar;38(1):50-5.
- Harvey SB, Hotopf M, Øverland S, Mykletun A. Physical activity and common mental disorders. The British journal of psychiatry. 2010 Nov;197(5):357-64.
- Robson, D. & Gray, R. 2007. Serious Mental Illness and physical health problems: A discussion paper, International Journal of Nursing Studies [online]. 44, pp. 457-466. [viewed 24 August 2016]. Available from: http://www.rcpsych.ac.uk/pdf/physical_health_paper-1%20copya.pdf
- Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012;36(5):427-440.
- Royal College of Psychiatry, 2013. Cognitive Behavioural Therapy [online]. Royal College of Psychiatrists. [viewed 27 August 2016].
- Mental Health Foundation, no date. Cognitive Behavioural Therapy [online]. Mental Health Foundation. [viewed 27 August 2016].
- Martinsen EW. Physical activity in the prevention and treatment of anxiety and depression. Nordic journal of psychiatry. 2008 Jan 1;62(sup47):25-9.Available from:
- Fordham B, Sugavanam T, Hopewell S, Hemming K, Howick J, Kirtley S, das Nair R, Hamer-Hunt J, Lamb SE. Effectiveness of cognitive–behavioural therapy: a protocol for an overview of systematic reviews and meta-analyses. BMJ open. 2018 Dec 1;8(12).
- Kahn EB, Ramsey LT, Brownson RC, Heath GW, Howze EH, Powell KE, Stone EJ, Rajab MW, Corso P. The effectiveness of interventions to increase physical activity: a systematic review. American journal of preventive medicine. 2002 May 1;22(4):73-107.
- CDC, 2015. Motivational Signs [online]. Centres for Disease Control and Prevention. [viewed 24 August 2016].
- CDC, 2011. Strategies to Prevent Obesity and other Chronic Diseases – The CDC Guide to Strategies to Increase Physical Activity in the Community [online]. Centres for Disease Control and Prevention. [viewed 24 August 2016].
- Saucedo-Araujo RG, Chillón P, Pérez-López IJ, Barranco-Ruiz Y. School-Based Interventions for Promoting Physical Activity Using Games and Gamification: A Systematic Review Protocol. International Journal of Environmental Research and Public Health. 2020 Jan;17(14):5186.
- Physical Activity and Health Alliance, 2012. Scottish Physical Activity Screening Question (Scot-PASQ)[viewed 24 August 2016].
- NHS Health Scotland, 2012. NHS Physical Activity Pathway: Practitioner Guidance [online]. NHS Health Scotland. [viewed 24 August 2016]. Available from: http://www.healthscotland.com/uploads/documents/20387-PractitionerGuide.pdf
- RCPSYCH, 2014. NAS Resources [online]. Royal College of Psychiatrists. [viewed 24 August 2016]. Available from:
- Paths for All, no date. Walking football [online]. Paths for All. [viewed 27 August 2016].
- SAMH, no date. Get Active [online]. Scottish Association for Mental Health. [viewed 27 August 2016].
- Foresty Commission Scotland, no date. Branching Out [online]. Forestry Commission Scotland. [viewed 27 August 2016].