Depression, physical activity and mental health: an interpretative phenomenological analysis of healthcare professionals’ attitudes to exercise referral schemes

Depression is, today more than ever, a profoundly serious public health concern in the UK, impacting upon the lives of individuals from all social backgrounds and strata (Yohannes & Caton, 2010). Moreover, and contrary to the often-held stereotype of a relatively simple disorder of mood, the condition manifests in an additional array of psychological and somatic symptoms such as “…loss of interest and pleasure, loss of appetite, weight loss/gain, sleep disturbance, psychomotor agitation or retardation, energy decrease, sense of worthlessness, guilt, difficulty in concentrating, or thoughts of suicide.” (Legrand & Heuze, 2007, p.348). In recent years a body of research has emerged dedicated to exploring the value and impacts of exercise in assisting individuals suffering from depression (see Callaghan, Khalil, Morres, & Carter, 2011; Carter, Callaghan, Khalil, & Morres, 2012), and Exercise Referral Schemes (ERS) have been developed to provide access to structured programmes of physical activity. Robust evidence indicates that such physical activity can have strong positive impacts upon the rehabilitation process, not least in terms of enhancing happiness with physical appearance and providing venues for social interaction (Daley, MacArthur, & Winter, 2007; Johnson & Taliaferro, 2011). Despite the well-documented success of various ERSs, and the relative affordability thereof when compared to CBT or pharmaceutical options, however, rates of such referral in cases of mild to moderate depression are low (Callaghan, Khalil, Morres, & Carter, 2011). The research reported in this paper stems from a high-definition investigation of the attitudes of a small number of General Practioners in the North West (N=4), utilising Interpretative Phenomenological Analysis (Pringle, Drummond, McLafferty, & Hendry, 2011; Smith, Flowers, & Larkin, 2009) to reveal how such attitudes are embedded in first- and second-hand experience of ERSs, with a view to illuminating why progress toward their wider use remains slow in the locale. References: Callaghan, P., Khalil, E., Morres, I., & Carter, T. (2011). Pragmatic randomised controlled trial of preferred intensity exercise in women living with depression. BMC Public Health, 11, 465-465. Carter, T., Callaghan, P., Khalil, E., & Morres, I. (2012). The effectiveness of a preferred intensity exercise programme on the mental health outcomes of young people with depression: A sequential mixed methods evaluation. BMC Public Health, 12, 187-187. Daley, A. J., MacArthur, C., & Winter, H. (2007). Brief report: The role of exercise in treating postpartum depression: A review of the literature. Journal of Midwifery and Women's Health, 52, 56-62. Johnson, K. E., & Taliaferro, L. A. (2011). Relationships between physical activity and depressive symptoms among middle and older adolescents: A review of the research literature. Journal for Specialists in Pediatric Nursing, 16(4), 235-251. Legrand, F., & Heuze, J. P. (2007). Antidepressant effects associated with different exercise conditions in participants with depression: A pilot study. Journal of Sport & Exercise Psychology, 29(3), 348-364. Pringle, J., Drummond, J., McLafferty, E., & Hendry, C. (2011). Interpretative phenomenological analysis: A discussion and critique. Nurse Researcher, 18(3), 20-24. Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. London: Sage. Yohannes, A. M., & Caton, S. (2010). Management of depression in older people with osteoarthritis: A systematic review. Aging & Mental Health, 14(6), 637-651