The existing scientific evidence (research results and published studies is more than sufficient to document the relation and the benefits of the Sport/ PE for the Mental Health.
Latest development on research evidence shows the importance to officially connect Mental Health and Sports and physical activities. This has somewhat been supported by initiatives from European Commission among others the 2008 European Union Guidelines on Physical Activity and the 2015 Council Recommendation on Health promoting Enhancing Physical Activity (HEPA). Both these documents are stressing that the benefits of physical activity on Mental Health are supreme, and include among others enhancement of the cognitive function and elimination of the development of depression and dementia, lower stress and improvement of sleep, as well as self- esteem and self-image, increases enthusiasm and optimism. Additionally the benefit from physical activity on Mental Health services users has been demonstrated in many different projects, among them the research results of MENS project that gathered data from all parties involved (Mental health specialists, general public, sport organisations and mental health users) and the results showed that all parties involved expressed the beneficial effect of Sport and Physical Exercise in the therapeutic scheme of Mental health services users.
Furthermore, increased interest has been shown in the development of Sport and Physical Activities guidelines that stressed the importance of Physical activity in sustaining a good level of health. More specifically the 2013 Council Recommendation on Health promoting – enhancing physical Activity across sector stressed the need to develop a cross sectoral HEPA policy approaches, and implement corresponding action plans by exchange information and good practices, as well as identifying successful approaches to promote HEPA .
This increased interest of European Institutions on the physical dimension of health has led to the development of tools that will assist in the implementation of the existing policies. Among those is the EU platform for Action on Diet, Physical Activity and Health which acts as peer learning forum for European level organisations, includes representatives from research, industry and civil society and aims to support governments in EU countries in nutritional and physical activity matters. This platform manages to bring together stakeholders from diverse fields like Food business operators, Consumer organisations, NGOS that are interested in Public Health, as well as Scientific and Professional associations, and its main goal is to mutually agree on Policies and Recommendations on Nutrition and other related health matters.
Even though, as mentioned above, there has been a great interest in the connection between Mental Health and Physical activity there has been a lack in the representation of this relation in relevant policies and tools to support it accordingly. Just recently, in 2016 the European Framework for Action on Mental Health and Wellbeing proposed as a key action for the development of Mental Health and Wellbeing initiative in the Member states, the need to develop a tool that would strengthen the knowledge, the evidence base and good practices in mental health. Additionally, the Commission understanding the importance of implementing policies and good practices in Mental Health and Wellbeing, has put in place a Compass for Action on Mental Health and Wellbeing in order to create this mechanism for the expansion of policy recommendations resulting from the Joint Action and to promote the exchange of information on implementation of activities and good practices. However, even on this recent development the inclusion of Sport and Physical Activity needs a more concrete reference and involvement.
The “Council Recommendation on HEPA and EU Physical Activity Guidelines (2008)” is the fundamental reference document for all initiatives developed within the overall context of the importance of sport and physical activities for health either as a prevention precondition or as an intervention factor.
In this 38 pages’ document, conducted 10 years ago, it is mentioned in the first paragraph (1.1 Benefits):
“At present there is sufficient evidence to show that those who live a physically active life can gain a number of health benefits, including the following:
Maintained cognitive functions and lowered risk of depression and dementia.
Lower stress levels and associated improved sleep quality.
Beyond this initial reference, the term “mental” is unfortunately found just once in the document’s body (Sedentary people who become more physically active report feeling better from both a physical and a mental point of view, and enjoy a better quality of life) till the point of the very significant Guideline 10: Sport organisations should provide activities and events attractive to everyone, and encourage contacts between people from different social groups and with different capabilities, regardless of race, ethnicity, religion, age, gender, nationality, and physical and mental health.
In the “COUNCIL RECOMMENDATION of 26 November 2013 on promoting health-enhancing physical activity across sectors” (2013) we find 5 year later the next highest possible level confirmation of the “positive effects on mental health development and cognitive processes”. (1st paragraph).
The year 2008 is a milestone as the European Commission published the EU Guidelines on Physical Activity. Since then a lot of factors have changed (scientific evidence, ever worsening statistics of mental health field, sensitisation of the general public, changes in attitudes on well being) and bring out the need for a specific policy for the utilisation of Sport & Physical Exercise for the benefit of Mental Health.
Special Eurobarometer findings in “Sports and Physical Activities” concerning the typical European citizen participation in sports and the important role of sports and physical activity in health & well being.
The report, unveiled by Commissioner Navracsics in Sofia during the annual EU Sport Forum, shows that levels of participation have not changed substantially since the previous Eurobarometer survey in 2014. In fact, the proportion of those who say they never exercise or play sport has slightly increased from 42% to 46% Europe-wide, and this is a continuation of a gradual trend since 2009. The above rates when specifically connected with mental health become significantly lower.
A last minute (01/04/2019) communication of the European Commission comes to verify the need addressed as according to recent studies 221 minutes of PE is the minimum effective time for a series of mental disorders.
The London School of Economics and Political Science in cooperation with Rethink Mental Illness charity made a research named “Investing in recovery” - Making the business case for effective interventions for people with schizophrenia and psychosis that highlights the economic importance of prevention compared to the cost of therapy. In their proposition, they also refer to the issues of physical activity intervention, peer support, self-management and anti-stigma campaigns.
(MENTAL HEALTH AND CHRONIC PHYSICAL ILLNESSES - THE NEED FOR CONTINUED AND INTEGRATED CARE, World Federation for Mental Health, 2010).
For the mental health service user, on the other hand, the physical engagement with sports is far more important. Up to 50% of people with serious mental illness have recognisable medical disorders that can be alleviated / prevented through sports. Respectively, chronic physical illness is often accompanied by a co-existing mental health problem. Most people with mental health problems face various lifestyle consequent problems like poor/careless nutrition, smoking, alcohol, obesity, cardio logical problems or diabetes. The mental health service users of the participating sending organisations will genuinely be able to receive a more “holistic” care service that ensures mental health care and physical health care simultaneously. Many health care systems do not provide these two kind of services together, or one service may be incomplete or inadequate.
The proposal also takes into consideration the “European Framework for Action on Mental Health and Wellbeing” the priorities of which come directly in line with the initiative’s philosophy and goals, especially the 4th one: “Investing in implementation of evidence based interventions to treat mental disorders, prevent mental disorders and promote mental health in line with its relevance for individuals and societies and through measures to make more and better data on mental health available”. The connection of the above and also of the “European Mental Health Action Plan 2013-2020" conducted by W.H.O. towards the EU’s objectives as regards Health Enhancing Physical Activity comes to support the present initiative.
The Swedish Prescription of Physical Activity (PPA) initiative was identified as a particularly valuable practice (Best practice) for a large range of diseases among which 4 are the main mental disorders. It is for this reason that European Commission selected for funding the promotion of this practice to the EU MS National Heath Systems. But although it is recognized that for the safe and effective utilization of PE to diverse mental disorders a specific and well elaborated approach is required, such an approach is fully abcent to a so brave, in financial terms (1.350.000 €), decision.
The core need to be addressed by the InALMH project is to fill the gap between general policies and actual / specific incorporation of Sport & Physical Exercise in the wider context of Mental Health.