黄色仓库

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Dyfodol, in collaboration with the 黄色仓库’ Public Mental Health Implementation Centre (PMHIC), has published a comprehensive framework to embed physical activity into mental health care pathways across Wales.

Commissioned by the Welsh Government, Physical Activity for People Using Mental Health Services: A Framework for Action in Wales outlines priority actions to address the life expectancy gap for people living with severe mental illness (SMI). Individuals with SMI face a reduced life expectancy of 7 to 25 years compared to the general population, largely driven by preventable physical health conditions such as cardiovascular and metabolic diseases.

Key evidence and findings

The report synthesises international literature alongside Wales-specific studies, highlighting both the therapeutic benefits of physical movement and current barriers to access:

• Mental health outcomes: Regular physical activity, ranging from brief 10-minute walks to structured group exercise, can reduce symptom severity in depression, anxiety, and psychosis while improving sleep quality and social connectedness.
• Community-led and outdoor programmes: Community initiatives and outdoor 'green exercise' (such as The Outdoor Partnership in Wales) foster peer support, reduce mental fatigue, and deliver strong mental health benefits. However, local delivery is often hindered by short-term funding and a shortage of qualified exercise professionals.
• Challenges in secure settings: Inpatient psychiatric units and prisons can become 'obesogenic environments' due to restrictive leave, sedentary routines, and medication side effects. Tailored interventions led by trained fitness professionals in secure settings are essential but frequently constrained by staffing limits.
• Exercise referral schemes: National exercise referral schemes show positive wellbeing impacts for participants who adhere to them, but require person-centred support and relapse prevention strategies to address drops in motivation.

Strategic recommendations and quality statements

To establish consistent, person-centred care across health boards and local authorities, the framework establishes four core Quality Statements:

1. Co-design with fitness professionals: Partnering with qualified physical activity professionals to design safe, effective, and tailored delivery models.
2. Inclusive programme design: Ensuring physical activity options are adaptable for isolated or housebound individuals who cannot attend group sessions.
3. Equitable care in secure settings: Guaranteeing tailored physical activity support for individuals in prisons and secure psychiatric units.
4. Sustainable community investment: Allocating long-term funding for community-based group activities to address regional disparities in provision.

Additionally, the report calls for a re-evaluation of exercise referral scheme durations (noting longer schemes yield better outcomes), mandatory physical health training for healthcare staff, and culturally sensitive, trauma-informed delivery.