Jump Step - A Participatory Approach to Physical Activity & Mental Wellness

Mental disorders, including anxiety and depression, contribute more than either cardiovascular disease or cancer to the burden of disease worldwide. Individuals with chronic diseases and major depression use more health resources, have higher degrees of functional disability, and experience higher productivity losses, compared to their counterparts without major depression. Within Canada, 6.7M people live with a mental illness and when family and caregivers are included almost everyone is affected.

A Cochrane Review examined the effectiveness of exercise in treating depression and the results of 39 trials and over 2,300 subjects confirmed a moderate effect for exercise when compared to no treatment or a control group. A smaller number of studies found no differences in efficacy between exercise and Cognitive Behavioural Therapy (CBT) and/or antidepressant therapies, the current "gold standards" for depression care. A systematic review (2014) concluded that physical activity has a significant potential for reducing depressive symptoms in people with a mental health challenge.

Globally, physical inactivity is "pandemic". Current guidelines recommend a minimum of only 150 minutes a week of moderately vigorous exercise but 85% of Canadians do not meet the national recommendations. There is no question that physical activity can be an effective treatment; how then can people dealing with depression be motivated to become physically more active?

The majority of psychiatric care for mood disorders is delivered through one-to-one consultations between a patient and psychiatrist or family physician. Treatment plans rarely include physical activity despite evidence for its effectiveness. In fact, efforts to promote physical activity within traditional clinical settings are fraught with challenges such as a lack of practitioner resources, reimbursement, time, and confidence, and poor patient retention. Instead, people are commonly prescribed powerful pharmaceuticals despite mounting evidence that these drugs should be reserved for the most serious cases of anxiety and depression. While drugs have their place, this place is firmly behind interventions such as psychotherapy and physical activity in the majority of cases of depression.

Novel strategies are needed for promoting physical activity and self-management that are also physically, financially, and psychologically accessible. Group Medical Visits (GMVs) are a promising approach to mental health care. Group Medical Visits are organized around a group of people living with a specific condition. The structure and formats of GMVs vary. Typically, in lieu of a short individual visit, a patient will participate in a longer (60-120 minutes) group visit with six to 14 other patients, led by a physician and/or other healthcare practitioner.