HBO Vitality management en Tourism: Exercise & MENTAL HEALTH 23 April 2013

1. HBO Vitality management en Tourism: Exercise & MENTAL HEALTH 23 April 2013

2. INTRODUCTION: • Irene van de Giessen • Expert by Experience at the psychiatric department of the Admiral De Ruyter Hospital • Freelance Expert by Experience Molemann Mental Health • Owner Convalescent Talent

3. Me Health Sickness

8. CHRONIC health conditions and WAY OF LIFE:

9. Some GROUPS are more at risk for chronic health conditions:

10. LACK of physical activity and chronic health conditions:

11. Fysical activity (mixed model of MOTIVATION): Motivational on alternative behaviour targeted interventions Health care policy Fysicalfitness Brain functions Physicalactivity Mentalfunctions Mental well-being Policy Government Interventions aimed at change of living conditions and way of life

12. We are going to talk ABOUT: The backgrounds of motion poverty because of the sedentary way of life we live now a days The consequences of the sedentary way of life for physical and mental health How does physical activity work positive for the psyche How can mental health services promote that its clients are going to exercise more

13. PHYSICAL activity in EVOLUTIONARY and HISTORICAL perspective:

14. The WAY genes behave themselves:

15. Genes express themselves in a BALANCED way: • Balanced diet • Intensive exercise for at least half an hour a day

17. Medical ATTENTION for PHYSICAL ACTIVITY in mental health services:

18. The GAIN of PHYSICAL exercise for mental health: ‘Brain cells grow, like other parts of the body by exercise. The sensory cells can be exercised only by use of the senses. In like manner the motor cells can be exercised and developed only by making them contract the muscles.’ T.M. Balliet http://youtu.be/VaDlLD97CLM Since the 19th century physical exercise was used on and of as a therapeutic method in mental health services ‘A chain of empty Sundays'

19. The GAIN of PHYSICAL exercise for mental health: • In the Netherlands there’s not much research for the relation of physical exercise and mental health • There’s no direct link between the dose of physical activity and mental wellbeing. • Besides de diminishing of symptoms of certain mental disorders, physical exercise is also good for: • Improved self-esteem, • Learning social skills, • Improved cognitive functioning, • The decline of fear en de diminishing of - for heart and blood vascular system – the risky way of reacting on stressors.

20. http://youtu.be/bwYj0crnsuo

21. SLEEPINGPROBLEMS and FATIGUE: • Fatigue is only than a problem, and can only be diagnosed as a disorder, when the fatigue become more chronic • Sleep • The average time for sleeping is diminished • A lot of adults, especially elderly, have sleeping problems • Sleeping problems and depression • Sleeping problems are not only symptoms of depression and symptomatic for elderly but can also be symptoms of other disorders and can be a signee for new depression. • Negative effects of antidepressants can lead to insomnia • The development of a pattern of physical activity and social interaction protects the elderly against incidental and chronic insomnia.

22. http://youtu.be/WxhqjbI7aKc COGNITION: • Short term results • Long term results Positive effects: • Improvement of reactive power and response time • Improvement the powers of concentration • Improvement attention • Improvement problem solving behaviour • Improvement social psychological functioning ‘Physical activity for children is to be discussed in the light of ‘normal’ development’

23. MECHANISMS that improve COGNITIVE function after exercising: • Neurobiological mechanism • BDNF (challenging environment) • More oxygen in the brain • The circulation of glucose • Physiological mechanism • Psychological explanations for the benefit of physical activity for the psyche include: • Improved self-esteem • Feelings of control of the own life • It offers social support • the activity reduces the feeling of ill-being • Relaxation of the parasympathetic nervous system

24. LACK of activity, physical problems, diseases and disorders: Many people with psychiatric disorders have a moderate to poor physical health Clients in mental health care, just like any other people, have to do with the risk of somatic diseases such as lung diseases or cancer There are somatic diseases which, due to biological or social psychological mechanisms, occur more than average in people with certain mental illnesses.

25. CO-MORBIDITY: • Various disorders have the same risk factors and physiological processes • Undesirable effects of prescribed medication (bigger risk of somatic disorders) • A pattern of abuse of psychoactive substances is associated with somatic damage • The mental disorder is related to an unhealthy lifestyle in which abuse of substances, poor diet, too much stress and too little exercise are linked together and raise the risk of a somatic disorder

26. DUBBEL PROBLEMS in MENTAL HEALT CARE METABOLIC SYNDROM – central obesity: appel – high bloodpressure – insuline resistence – high cholesterol • Prevalence: • General population20% (andrising!) • Mental Health Care: 30-40% • People whostay in a psychiatric hospital50% (PHAMOUS) COGNITIVE PROBLEMS Problems with: • planning • concentration • memory • Use of antipsychotics • Not enough Exercise • Smoking, drugs, alcohol • Unhealthy food • Bad self-care • Stress • Genetics: link schizophrenia MS

27. Comon CO-MORBID disorders: • Obesity • Metabolic Syndrome • Heart- en blood vessel disease • Diabetes • Diabetes and schizophrenia • Chronic stress • Eating wrong and too much • Inactivity • Smoking

28. Relation between RISK FACTORS and DISORDERS: Smoking/ abuse of alcohol Chronicstress Obesity Diabetes Mental disorders Heart disease Inactivity Eating too much and wrong

29. RECOVERY: ‘Recovery is a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness' (Anthony, 1994)

30. From NO activity to MORE activity: • Casually active!! (cheap, additive) • Nature • helps in recovery from stress and attention fatigue (the way people feel, discipline, concentration, self discipline and physiological stress) • It stimulates to move (one moves in a natural environment and performs better) • facilitates social contact • promotes the development of children (children: the function of attention, self discipline and mental toughness, cognitive-, motor-and social emotional development, social contact) • promotes personal development and spiritual meaning

31. What can aid workers DO (in mental health care): Work together with exercise physiologists, physical therapists, motion scientist and sports doctors to figure out what their clients want and need when it comes to movement Talking to clients about the usefulness of moving (in conjunction with diet, stop smoking, drink less alcohol, or making changes to the way of life that result in less stress and more relaxation /courses). Pioneering in order to make it possible clients participate in sports clubs outside Mental Health Services (affordability, stigma) Stimulate research https://www.health4u.nu/over-health4u/3 http://youtu.be/SL_xegIIIzM

32. Techniques for BEHAVIORAL CHANGE: Identify the characteristics of the problem Searching for realistic goals and reach agreement on that Determining small sub-goals, like this clients can experience success with their efforts Self monitoring and self control No well-intentioned advice.....

33. Preparation of an EXERCISE PROGRAM: Research the history of the client in the field of physical activity Work out together in the beginning as a counsellor (role model) Inform the client on the possible physical and mental health effects of exercise Go after what options there are to workout as functional as possible Use the possibilities offered by the environment of the client Let the client choose from wide offer Take into account the physical condition of someone in the type of activity you choose Let the exercises take place in an positive environment Behavioural self-control strategies make use of strategies for relapse prevention

34. Mental health care ‘in motion’: Implementation of available knowledge on effectively treating mental disorders, effective organisation of work processes and intelligent use of ICT Market mechanism Futuristic biomedical technologies search for disease mechanisms of mental disorders Drug delivery

35. Take home MESSAGE: Sedentary lifestyle increases risk of chronic disease The health effects of exercise are undeniable (In)activity plays an important role in the course of mental disorders and brain development Activity must go hand in hand with an enriched environment Physical activity is good for all people with mental problems and knows hardly any side effects Influencing behaviour is difficult, but not impossible There is more than enough knowledge available to act Questions remain, further investigation is needed The care sector for sure, but maybe you too, need to get started

36. Thank you very much for listening!