Exercise physiology services for inpatients in an acute transdiagnostic mental health service

BACKGROUND & AIMS Exercise interventions are increasingly utilised in mental health services to mitigate the poor physical health and elevated health risks seen in mental illness. To-date much of the research has focused on specific diagnostic classifications, rather than the commonly occurring transdiagnostic presentation. We sought to determine the feasibility of exercise physiology services for inpatients in an acute, transdiagnostic mental health service and whether general affect changed following exercise sessions. METHODS Data was collected from service records over a period spanning January 2020 – August 2022, and patient demographics and service information were explored. Additionally, a subset of inpatients (n= 108), reported perceptions of exercise and associations between variables were assessed between- and within-person. RESULTS During the 32-month audit 371 inpatients engaged, mean age 36 years (SD=12.33, range = 18-69) and mean length of stay was 36 days (SD=45, range = 3-445). The most frequent principal diagnosis was Schizophrenia or other psychotic disorder (38.4%), with 72% of inpatients had multiple psychiatric diagnoses. Physical health comorbidity was common, with 56% of patients having physical health diagnoses, predominantly cardiometabolic diseases (n= 94). There were 1386 exercise service engagements, with patient engagement ranging from 1-36 exercise session during their stay, of which 98.7% were in the hospital gym. There was a significant positive change in affect, with exertion was not related to changes in affect, however those who exercised for greater than 30min saw larger positive changes in affect. CONCLUSION Embedding Clinical Exercise Physiology services within mental healthcare settings can provide tailored exercise interventions for people with transdiagnostic presentations to address both physical and mental health outcomes. Participation in—and importantly, enjoyment of—exercise was linked to changes in general affect and may present a novel and important component of acute mood support for those in inpatient services.