MENTAL health is integral to overall well-being, influencing how individuals think, feel, and act. In recent years, and especially after the COVID-19 pandemic, mental health has been thrown into the spotlight as not just a global issue but a national one.

This article explores the benefits of physical activity on mental health, highlights relevant statistics, and discusses practical and affordable ways to stay active. Additionally, it examines policies like the National School Nutrition Policy and re-imagines the role of professions such as physiotherapists in improving mental health care access.

Benefits of physical activity on mental health

Mental illness is acknowledged as a global health and development priority, resulting in its inclusion in the 2030 Agenda for Sustainable Development, as nations, including Jamaica, consider the 2030 agenda pledge to leave no one behind. Mental health conditions consequently impose a high burden on almost all sections of society, from the individuals who are affected to families but also on the economy, as those who suffer from mental disorders are more likely to work at a reduced capacity (presenteeism), miss days of work (absenteeism), exit the labour force and experience premature death.

Physical activity profoundly impacts mental health, offering numerous benefits that contribute to improved mood, reduced anxiety, and enhanced cognitive function. Regular physical activity stimulates the release of endorphins, often called “feel-good” hormones, which help alleviate stress and elevate mood. Additionally, exercise promotes better sleep patterns, increases energy levels, and enhances overall quality of life.

The importance of prevention

The statistics surrounding mental health issues are alarming. According to the World Health Organization, approximately one in four people globally will experience a mental health condition at some point in their lives. In Jamaica, around three per cent of the population has a depressive disorder, whereas 4.1 per cent has an anxiety disorder. Women are at a higher risk for both disorders.

Mental illness imposes a significant financial burden in Jamaica, with an estimated US$2.76 billion in lost economic production from 2015 to 2030, more than any other category of non-communicable disease (NCD) conditions save cardiovascular disease.

The number of people seeking treatment for mental illnesses has risen. From 2013 to 2014, more than 90,000 people sought mental health treatment at public health institutions. Visits increased by almost 20 per cent per year over the next two years, reaching over 108,000 in 2015 and 132,000 in 2016, as seen in Ministry of Health and Wellness data.

We often discuss the preventive nature of physical activity and other NCDs like cancer and heart disease. However, multiple studies have shown that physical activity has a favourable influence on mental health. A meta-analysis published in the journal
Depression and Anxiety discovered that those who engaged in regular physical activity had a 20-30 per cent reduced chance of getting depression and dementia than those who were inactive. Physical activity appears to lessen the incidence of cognitive deterioration in adults who do not have dementia. Another research published in
The Lancet Psychiatry found that people who exercised had 1.5 fewer days of poor mental health each month than those who did not.

Prevention is a crucial aspect of mental health care. By promoting physical activity and other healthy lifestyle choices, individuals can take charge of their well-being and reduce their risk of developing mental health conditions. Prevention efforts should focus on creating supportive environments that encourage physical activity, healthy eating, and stress management. Schools, workplaces, and communities all have a role to play in fostering these environments, empowering individuals to take proactive steps for their mental health.

Physical activity vs exercise

It is essential to distinguish between physical activity and exercise to ensure a comprehensive understanding of their roles in mental health. Physical activity encompasses any movement requiring energy, such as walking, gardening, or household chores. Conversely, exercise is a planned, structured, repetitive activity to improve or maintain physical fitness. Physical activity is encouraged as part of a healthy lifestyle, while exercise is prescribed to achieve specific health outcomes. Both are important for mental health, but exercise tends to have more targeted benefits. This knowledge empowers individuals to make informed choices about their physical activity and exercise routines.

Practical and affordable ways to stay active

One of the best things about physical activity is that there are so many options that there is something for everyone. The average adult should exercise for 75 to 150 minutes each week. This can be moderate-intensity activity, such as walking, hiking, or biking, or more high-intensity activities, such as running, quick swimming, aerobics, or rope skipping. Maintaining an active lifestyle does not need costly gym subscriptions or specialised equipment.

Walking to or from work or school and using the stairs instead of the elevator are two simple and affordable ways to incorporate additional physical activity into your daily routine. These provide exercise while exposing individuals to nature and promoting mental wellness. Home exercises using online resources or fitness apps offer flexibility and cost savings. Participating in community sports leagues or recreation activities like dancing may be an enjoyable way to maintain physical and social activity. At the same time, gardening and household duties are other examples of physical activities that can assist adults in meeting their weekly physical activity requirement of 150 minutes.

The National School Nutrition Policy

Government policies have a critical role in encouraging healthy and active lifestyles. The National School Nutrition Policy aims to promote students’ well-being by including physical activity in the curriculum. Anxiety is the leading cause of disability among Jamaican teenagers aged 15-19 boys and 10-19 girls. Depressive disorders are the leading cause of disability in boys aged 15-19. The policy promotes physical activity for better health, mental wellness, and academic achievement.

Schools can help students build good habits for life and reduce the likelihood of mental health conditions. As a result, I implore the Ministry of Education and Youth to implement the policy before the start of the next school year because if we do not act decisively, our children and young people will continue to believe that their leaders do not prioritise their health, as evidenced by UNICEF mental health polls. The poll results revealed that many young people experienced emotional distress, yet 90 per cent believe mental health is not treated seriously.

Physiotherapists and mental health care

Improving mental health care requires increased funding, integrating mental health screenings into routine check-ups, and expanding access to mental health professionals. Uniquely positioned are Physiotherapists to fill the gap in mental health care. Their training in exercise prescription and physical rehabilitation makes them well-suited to address their patients’ physical and mental health needs. However, accessing physiotherapy services can be expensive, especially in private settings.

Making these services more accessible requires policies that support the integration and further expansion of physiotherapy and other specialist services into all levels of the public healthcare system.

Exercise can reduce the need for medication in managing mental health conditions. Regular exercise enhances the effectiveness of medications and can serve as an alternative treatment, especially for mild to moderate depression, reducing reliance on antidepressants and associated costs. Incorporating exercise into mental health treatment plans leads to sustainable long-term benefits.

Physiotherapists can design and implement personalised exercise programmes tailored to individual needs to enhance adherence and outcomes. While exercise can be an effective means of reducing the medication load for individuals diagnosed with mental health conditions, it is essential to note that it is not a cure-all. For example, a study published in
JAMA Psychiatry found that exercise was as effective as antidepressants in reducing symptoms of depression for some individuals. However, it is not a replacement for professional mental health care.

Additional research has shown:

• Short, high-intensity exercise programmes had the most significant benefit.

• People with depression, HIV, kidney disease, pregnant and post-partum women, and otherwise healthy individuals benefited the most from exercise in terms of mental health.

• An extensive review of available evidence finds that physical activity should be considered the first line of treatment for people suffering from mental illnesses. The study summarises the findings of approximately 100 meta-reviews of randomised controlled trials.

• Physical activity is 1.5 times more effective in treating mild-to-moderate symptoms of depression, psychological stress, and anxiety than medicine or cognitive behavioural treatment.

By incorporating exercise into treatment plans, health-care providers can offer patients a natural and empowering way to manage their mental health. However, it should always be used in conjunction with other treatments, such as therapy or medication, as part of a comprehensive mental health care plan. It should be highlighted that not just anyone can or should be allowed to implement these programs; however, based on all the training, physiotherapists are best placed to do this.

Offniel Lamont is a physiotherapist with a specialised focus on physical activity, sports medicine, exercise, and health. He is also an active member of Healthy Caribbean Youth, dedicated to promoting health and well-being across the Caribbean.