Is physical activity in green, blue and natural settings helpful for people with severe mental illness?

I will present my current plans for my PhD thesis, which aims to investigate the relationship between nature, physical activity and mental health outcomes/wellbeing in people with severe mental illness (SMI). Bipolar disorder and psychotic disorders are considered SMIs and affect 45 million and 20 million people respectively worldwide.

It has been suggested that SMIs may contribute to physical health inequalities. Current treatment interventions including anti-psychotics have known adverse side effects. Therefore, lifestyle interventions are on the incline, as not only are they more accessible they are less costly than other interventions. In general population studies, having more exposure to nature particularly green and blue spaces has been known to increase levels of physical activity, which is associated with mental wellbeing. Furthermore, in the general population doing exercise outdoors has improved mental wellbeing more than doing physical activity indoors. This has also be supported in a sample with clinical depression.

The proposed studies will examine this relationship in a SMI population, which has yet to be done. The first study, using secondary data from the UK Biobank (n=37,154), will examine the relationship between accessibility to green and blue space, levels of physical activity and acute mental health outcomes in people with an ICD-10 diagnosis of bipolar disorder and/or a psychotic disorder. The second cross-sectional study (n=128) builds upon the first study, examining how much physical activity people with SMI are actually doing in these different natural environments and whether this is related to their mental health outcomes. The final study will use experimental methods to test this relationship to establish whether physical activity in nature affects acute mental health symptoms in people with SMI (n=24). The current studies will work towards interventions that capitalise upon any benefits of physical activity in green and blue spaces for people with SMI.