| With the increasing prevalence of mental health problems and thus growing burden on health systems (Mayor of London, 2014; McCrone et al., 2008), there is an increasing appetite for mental health interventions which complement “standard” or conventional treatment. In particular, “recovery-based” interventions outside mainstream psychiatric services that focus on the strengthening of people’s abilities, gaining hope and social reconnection and empowerment are getting rising attention (Le Boutillier et al., 2015; Slade, 2009). Recovery interventions often focus on the principles of fostering inclusion and enhancing self-esteem through social activities and can be seen as a critical counter reaction to treatments that are strongly linked with the medical model of mental illness which advances biological treatments. In addition to this, the medical model is often seen as strongly deficit-oriented whereas approaches whose roots are often attributed to positive psychology usually focus more on the strengths in patients and ways of enhancing them (Seligman and Csikszentmihalyi, 2014). A prominent group of recovery-focussed mental health interventions are based on sport or exercise activity, and some empirical evidence supports its effectiveness. Mood disorder is the most studied with Stathopoulou et al. (2006) concluding from meta-analysis of efficacy studies that “exercise can be a powerful intervention for clinical depression” (p. 188), leading to the suggestion that clinicians “consider adding exercise interventions to their armamentarium to strategies to help patients in distress” (p. 190). Schuch et al. (2016) have recently provided a systematic review of the impact of exercise interventions for people with depression. Exercise as an adjunctive mental health intervention has also been studied, albeit less frequently in aiding anxiety (see, e.g. Asmundson et al., 2013; Jayakody et al., 2013; Anderson and Shivakumar, 2015), self-esteem (Barton et al., 2012), schizophrenia (Faulkner and Sparkes, 1999; Carter-Morris and Faulkner, 2003; Campbell and Foxcroft, 2003) as well as general mood (Barton et al., 2012; Powers et al., 2015). Mechanisms of clinical change have also been the focus of qualitative enquiry such as the narratives of three men with schizophrenia engaging in physical activity (Carless and Sparkes (2008). Mason and Holt (2012a) reviewed the qualitative literature to identify the mechanisms in which participants with mental health problems benefit from mental health interventions and described a range of physical, psychological and social mechanisms that may explain the impact of exercise interventions for people with mental health problems. |
