Tag: mental health

Woman in a yellow sweatshirt and jeans riding a red bike in a park

Natural Health: Access to Nature Improves Mental Health, Physical Activity and Chronic Diseases

Have you ever wandered to a local park after a long day or a long week, taken a deep breath, and felt stress and tension leave your body? You are not alone. Just 20 minutes per day of exposure to natural environments decreases stress and improves cognitive function, blood pressure, mental health, physical activity and sleep. Chronic stress raises blood pressure and heart rate and is linked to anxiety, depression, heart disease and obesity. The ACSM American Fitness Index 2023 annual report found that, on average, 30% of residents in the 100 most populous U.S. cities have high blood pressure and/or obesity and 10% have diabetes. We know that physical activity can help to prevent and/or treat these chronic conditions. Spending time in nature can too! Some of the best treatments are not found in your local pharmacy.  

Most adults in the United States are not meeting the ACSM and CDC recommendations of 150 minutes of light to moderate intensity activity every week with muscle strengthening added in two times per week. The Fitness Index found that only 50.9% of people in the 100 most populous cities were meeting aerobic activity guidelines and only 23.7% were meeting the guidelines for both aerobic and strength activities. Access to nature and green space can decrease sedentary activity, increase physical activity and have a bonus of decreased anxiety and improved cognitive function.  

It is difficult to explain why communing with nature has so many health benefits – is it the fresh air, cool breeze, sights and sounds? Or the increased physical activity that often happens when outdoors? I think it is a little bit of both.  One study compared individual responses to different levels of nature by looking at an individual’s pre and post exposure stress levels after visiting a natural setting, a built urban municipal park and a local fitness facility featuring an indoor track and free weights. Levels of cortisol (stress hormone) decreased the most in the natural environment setting. The stress reduction response appeared to be dose dependent with both the natural environment and urban environment providing visitors a decrease in stress through less demands and worries and increased levels of joy. The indoor track provided decreased demands and worries but no change in joy. Moving is good for you. But moving in a natural or outdoor urban environment is even better. 

In the cities ranked by the American Fitness Index, an average of 71.5% of residents live within a 10-minute walk to a park. Only 38% percent of people in Louisville, Kentucky live within a 10-minute walk to a park and the city also ranks among the worst 10 cities for elevated blood pressure, heart disease, diabetes, asthma and obesity. While the cause of these chronic conditions is multifactorial, all of these Fitness Index indicators can be improved with increased physical activity and access to nature or parks. Arlington, Virginia was named the fittest city in America for the sixth time! In contrast to Louisville, 99% of Arlington residents live within a 10-minute walk to a park. They also had the highest percentage of residents exercising in the last 30 days and the lowest percentage of residents with diabetes.  

Find your nature prescription!  Seven out of 10 people can walk to a park within their city. Active transportation, like walking, biking and running, is also a great way to incorporate physical activity and the outdoors into a busy day. If you need help finding your nearest park or walking/biking trail, check out AllTrails. Thirty percent of people have less access to a park within their city. Encourage your community leaders and city officials to incorporate green spaces, walking trails and recreation opportunities into new and existing developments.  

I challenge you to at least 20 minutes in nature every day while meeting exercise guidelines for long term mental and physical health. 

 

Author:  Jessie Fudge, M.D., FACSM

Moving More to Improve Mental Health: What City Officials Need To Know

One of the personal health indicators selected for inclusion into ACSM’s American Fitness Index is a measure of the mental health status of city residents. Mental health and physical health are both important components of overall health and are themselves closely connected. Mental health plays a major role in maintaining good physical health. Mental health issues, such as depression and anxiety, are known to reduce people’s ability and desire to participate in health-promoting behaviors. In addition, poor mental health increases the risk of developing a chronic physical health problem such as diabetes, heart disease and stroke.

Given the importance of good mental health to overall health, investing in resources to increase physical activity would be one way community leaders could improve their residents’ overall health and fitness. There is a growing body of evidence that recognizes the positive effects of exercise on reducing anxiety, stress and depression.

Current research shows why physical exercise is essential to mental health. In addition to other biochemical mechanisms, exercise is well known to stimulate the body to produce endorphins and enkephalins, the body’s natural “feel-good” hormones, which can improve an individual’s mood and make problems seem more manageable. Psychological mechanisms influence the effects of exercise on mood states, as suggested by both the distraction hypothesis and the self-efficacy hypothesis. The simple act of focusing on exercise can give us a break from current concerns and damaging self-talk.

Other research has shown that physical activity may play an important role in the prevention, treatment and management of mild to moderate mental health illnesses, especially depression and anxiety. Although people with depression tend to be less physically active than non-depressed individuals, increasing their participation in aerobic exercise and/or strength training has been shown to reduce depressive symptoms significantly. Anxiety symptoms and panic disorder also improve with regular exercise, and beneficial effects appear to equal that found with meditation or relaxation. Data suggests that acute anxiety responds particularly well to physical activity.

While participating in exercise generally is beneficial for both physical and mental health, it is important to note that people have widely varying preferences for the types of activity in which they may want to engage. Clearly, the mental health benefits are associated with physical activities that people want to do and enjoy doing. Consequently, cities should provide access to a variety of types of activity so that residents can choose those that are most attractive to them and that would be of greatest benefit to both their mental health and physical health.

Increasing access to physical activity resources like parks, trails and community centers is particularly important now that the COVID-19 pandemic has increased the need for mental health care in an already strained mental health system. The most recent published literature has documented a notable increase in reported depression and anxiety as a result of the COVID-19 pandemic. At the same time, there has been increased demand for public spaces to be physically active. Being physically active outdoors is particularly beneficial for mental health.

In addition to improving access to physical activity resources, city officials must partner together with business and community leaders to increase access to mental health services and reduce mental health stigma. Innovative initiatives are particularly important now to help those in need of mental health care access the care they need, including:

  • Using public service announcements to decrease mental health stigma,
  • Expanding access to community mental health centers,
  • Co-locating mental health services with primary health care services,
  • Supporting the use of telemedicine to increase the availability of mental health services,
  • Improving health care providers’ and first responders’ awareness and use of mental health referral networks, and
  • Expanding evidence-based training for mental health providers.

Many cities have implemented initiatives like these to improve access to mental health care for their residents. ACSM applauds their efforts and encourages other cities to adopt programs that have been shown to be effective elsewhere.

 

Author:  Terrell W. Zollinger, DrPH, Professor Emeritus, Indiana University

The Cost of Mental Health: Seeking Community Solutions

Good mental health is effective functioning in daily activities resulting in good productivity (e.g., work, school), healthy relationships and the ability to cope with adversity. A threat to good mental health is mental illnesses, which are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Those experiencing mental illness may have difficulties functioning in social, work or family activities. Millions of Americans are affected by mental illness each year. Approximately one in five (20%) U.S. adults experience mental illness each year, with one in 20 experiencing a severe mental illness yearly. The great news is that mental illness is treatable, with most people continuing to function in their daily lives despite their mental illness.

Of the millions of U.S. adults experiencing mental illness in 2020, only 46% received treatment, leaving millions to deal with their mental diseases alone. Those dealing with depression have a 40% higher risk of developing cardiovascular and metabolic disease than the general population. People with serious mental health illnesses are twice as likely to develop these same health complications. On the community level, it is estimated that almost 21% of the people experiencing homelessness have at least one serious mental health condition. And of those incarcerated, approximately 37% have a diagnosed mental illness. Untreated mental illnesses have a devastating impact on a person’s physical health and economic health, as serious mental illness accounts for $193.2 billion in lost earnings every year. With so much at stake, the solution appears to be simple—increase the percentage of people receiving mental health treatment.

Unfortunately, of the almost 330 million people living in the U.S., 148 million (45%) live in a designated Mental Health Professional Shortage Area, placing these individuals at considerably higher risk of experiencing the ripple effects of mental illness. With so many not having ready access to mental health services, community mental health centers are critical to meeting the demand for mental health treatment. Community mental health centers are community-based and provide mental services, often as an alternative to hospitals. These community centers are mainly funded by federal, state and county programs. Local governments, which allocate funds to various programs on their level, are often forced to decide where the limited funds are given. Community mental health centers need to be prioritized for funding, considering the effects of poor mental health on the individual and community.

In addition to the mental health professional shortage areas, there is a shortage of providers. The lack of providers has caused many people not to be able to receive treatment, even when proactively seeking it out. Many adults will simultaneously experience a substance use disorder with mental illness, often as a coping mechanism. The shortages of mental health professionals have resulted in inadequate access to treatment, at an alarming rate of 11% of individuals in need of substance abuse treatment receiving treatment. Mental health professionals commonly found in community health centers include social workers, psychiatrists, counselors, psychologists and peer support specialists. With funding shortages, community centers cannot hire professionals that can be of service to the community member. Some community centers also serve as assertive community treatment centers, where they provide services for mental health and offer housing assistance, financial management and employment services for the community members.

In 2014, the Protecting Access to Medicare Act of 2014 created the concept of certified community behavioral health clinics, which provide comprehensive mental health and substance use services to individuals, often at no cost. In 2021, new federal funding aimed to expand the number of certified community behavioral health clinics to 340. Local officials should encourage the community centers in their areas to adjust to meet the guidelines set forth to establish themselves as a certified community behavioral health clinic. With funding a constant issue for local municipalities, any investment in community mental health centers can also be cost-saving for other more expensive programs.

Author:  Alvin L. Morton III, M.S., Doctoral Candidate, University of Tennessee at Knoxville

6 Ways to Support Your Clients’ Mental & Physical Well-Being

Regular physical activity provides several long-term benefits that can help prevent and treat mental health disorders. Fitness professionals can support the mental and physical well-being of their clients by implementing some basic strategies that address their health from a 360-degree perspective.

1. What do they like to do?

Identify and encourage activities that best fit each client’s preferences and abilities. Aerobic, resistance and mind-body exercises and of light, moderate or vigorous intensity all benefit mental well-being. Greater enjoyment of the activity can be more mentally beneficial.

2. How confident are they?

Help identify activities that are in line with your client’s self-efficacy or confidence in their ability to take part. Then focus on incremental improvements toward mastering these activities. This can enhance adherence, enjoyment and overall mental wellness.

3. What are their barriers?

It can be challenging to engage in physical activity when having symptoms of stress, depression or anxiety. Discuss your client’s barriers to being active and provide strategies to help them continue to engage in activity.

4. What motivation do they need?

Increase the likelihood of adherence with regular follow up on progress to help motivate and encourage clients toward achieving goals.

5. Do they have social support?

Help your client identify avenues for social support. This can help with program adherence and provide mental health benefits through positive social interactions.

6. Can you take it outside?

Consider a training session outside or encourage outdoor activities. Time spent in nature and exercising outdoors can help relieve stress, increase energy and boost mood.

Learn more about physical activity for mental well-being and keep these six tactics handy by downloading this handout, developed exclusively for ACSM Certified Professionals, by  ACSM’s American Fitness Index®.