Minding Our Bodies Newsletter, Issue No. 2

Building capacity to promote physical activity

Minding Our Bodies is a capacity-building initiative to enable community mental health organizations to provide physical activity programs for adults with a serious mental illness. The project is being led by the Canadian Mental Health Association, Ontario, in partnership with York University and YMCA Ontario. Support is being provided by the Ministry of Health Promotion through the Communities in Action Fund.

The Minding Our Bodies team has been spreading the message that physical activity can have significant positive effects in preventing chronic disease, improving chronic disease outcomes and supporting recovery for people with mental illness. We have also been creating new resources for activity-based programs: a toolkit, a social networking website, and a one-day training program for the organizations chosen to test our toolkit during the pilot phase. Read on to learn more about exciting new developments in the Minding Our Bodies project.

Contents

  • Pilot Site Selection
  • What You Told Us: Findings from the Environmental Scan
  • A Sneak Peek Inside the Toolkit
  • The New Website
  • How to Get Involved
  • Dates to Keep in Mind!

Pilot Site Selection

In early January 2009, we issued a Request for Proposals to become a pilot site for the Minding Our Bodies project. We received 22 unique proposals to develop physical activity programs for people with mental illness. Applicants included consumer/survivor initiatives, hospitals, Canadian Mental Health Association branches, and other community mental health agencies.

Geographically, the applicants represented all four corners of the province and were located in both rural and urban settings. We were excited and encouraged to see that many of the applicants had reached out into their communities to create partnerships with other organizations for the benefit of the consumers they support.

Three applicants have since been selected to receive seed funding of up to $7,500 to develop and deliver a physical activity program. We have also invited three other organizations that applied for support to participate in the training and pilot program without funding from the Minding Our Bodies project. Together, these six organizations will help us to evaluate the effectiveness of the resources we are creating. Staff and volunteers from the pilot sites will attend a training session in April 2009. From May through October, these pilot organizations will be responsible for planning, implementing and evaluating new programs of physical activity for people with a serious mental illness. The purpose of the pilot phase is to assess the strengths of the Minding Our Bodies toolkit and training session and to identify gaps and areas for improvement. When the final toolkit is released early in 2010, the pilot programs will be showcased and serve as examples for other organizations that want to use the toolkit.

To ensure that the finalized toolkit will be effective in addressing the barriers and needs of various organizations in settings both urban and rural, the pilot sites chosen represent a diverse cross-section of service providers. They differ in geography, population served, and size and type of organization, as well as in their proposed physical activity programs. The three organizations that will receive funding as Minding Our Bodies pilot sites are the Gerstein Crisis Centre in Toronto; Canadian Mental Health Association, Thunder Bay Branch; and Haldimand-Norfolk Resource Centre, with sites in Simcoe and Dunnville. The three additional pilot sites are Search Community Mental Health Services, in Strathroy; Sunnybrook Health Sciences Centre in Toronto; and Community Resource Connections of Toronto.

Congratulations (and thanks!) to all of the organizations who have been selected to become Minding Our Bodies pilots.


Pilot Site Profiles

Gerstein Centre – Gerstein on Bloor in Toronto provides 24-hour supported short-term residential crisis beds, offering up to 30-day stays for individuals in crisis who are dealing with a mental health issue and current involvement in the criminal justice system and/or homelessness. Gerstein on Bloor is creating a program called FRESH — Finding Recovery through Exercise, Skills and Hope. Consumers who have previously stayed at the Gerstein Centre will be trained as FRESH workers to support and connect with individuals while they are staying at Gerstein and for up to six months afterwards. They will support the participants in building skills that enable them to be physically active, eat well and connect with community activities. Group as well as one-to-one activities will be offered, along with monthly nutrition and stressreduction sessions. Gerstein is partnering with COTA Health, the Parkdale Activity Resource Centre and the local YMCA.

Canadian Mental Health Association, Thunder Bay Branch, delivers a full range of mental health services: case management, crisis response, early intervention in psychosis, education and training, and skills development. Their new physical activity program, Energize Your Mind, Body and Spirit, will consist of an eight-week rotation of various physical activities (yoga, Qi Gong, walking/hiking, bowling, team sports, swimming) and an education series on health and wellness. To improve sustainability and ensure the program meets the needs of their participants, they will be training consumer leaders who will be actively involved in the program planning and service delivery. CMHA Thunder Bay is partnering with Thunder Bay District Health Unit to provide consumer leadership training, Diabetes Health Thunder Bay for health education, and the City of Thunder Bay for access to community venues.

Haldimand-Norfolk Resource Centre, with locations in Simcoe and Dunnville, is a consumer/ survivor initiative that provides advocacy, peer support, and a range of social/recreational and education opportunities. They will be initiating a program called Get Moving, Get Fit, Enjoy Life. The resource centre developed a multi-level proposal to address and meet their members’ diverse needs at various stages of recovery and change. They will train and provide ongoing support to Peer Specialists who will lead physical activity opportunities and connect participants with existing community programs, offering a peerled lifestyle education program, developing a physical activity program specifically for beginners, sharing motivational stories in their newsletter and distributing a resource list of community options for active living. The programs developed by the resource centre will be delivered at both of their sites to the consumers associated with three partners: CMHA Haldimand- Norfolk Branch, Assertive Community Treatment Team of Haldimand and Norfolk, and Community Addiction and Mental Health Services of Haldimand and Norfolk.

Search Community Mental Health Services provides community support, social/recreational programs, counselling, and crisis response services to the rural setting of Strathroy and the surrounding county of West Middlesex. Their proposed program Search for Fitness will include walking/hiking, yoga/stretching and swimming/cycling components three times a week. They will also be providing education on physical activity and nutrition. Search has formed partnerships with Strathroy-Caradoc Family YMCA, Middlesex Hospital Alliance Diabetes Education Centre, Strathroy-Middlesex ACT, and Strathroy and Area Seniors’ Centre.

Community Resource Connections of Toronto provides case management, court support, family programs, housing, early intervention, hostel outreach, and health promotion. Staff include Somali, Cantonese, Mandarin and Tamil-speaking workers who focus on those communities. CRCT will be starting a consumer-led walking group, using pedometers and journals to track progress. They will also circulate two handheld Nintendo DS units with a coaching program for additional fitness and lifestyle education. Participants will be involved in two Wellness Recovery Action Planning (WRAP) groups and in educational sessions on diabetes and nutrition. CRCT is working in equal partnership with the North York General Hospital Participants’ Council, DECNET (Diabetes Education Community Network of East Toronto), and a Recovery Education Consultant.

Sunnybrook Health Sciences Centre: Inpatient Adult and Older Adult Psychiatry provides in-patientservices for people with serious mental health concerns requiring admission to hospital for assessment, treatment and stabilization. Their proposed Wii Move! program will provide opportunities for inpatients without off-ward privileges to be physically active. The program will make use of stationary bikes and Wii Fit and Wii Sport technology, in group as well as individual sessions, with staff-facilitated warm-up and cool-down stretching. Partnership opportunities with various community agencies and the YMCA are being explored.


What You Told Us: Findings from the Environmental Scan

To better understand the barriers experienced by mental health agencies developing a physical activity program and to gather evidence of effective practices from organizations already engaged in such, we conducted a literature review and an environmental scan.

Findings from this research are helping us build a better toolkit. If yours was one of the over 150 organizations that participated in this phase of the project, thank you! Our environmental scan included an Internet search, a survey made widely available online, and a series of in-depth telephone interviews.

The online survey was announced on the Minding Our Bodies website and in invitations e-mailed to more than 350 community mental health organizations. It was also promoted by our Advisory Committee through their own member networks.

Participants were asked to answer between 15 and 26 questions, depending on whether or not they already had a physical activity program in place. More than 140 surveys were completed. Eight organizations with existing physical activity programs participated in telephone interviews that probed more deeply into the challenges they faced and the successes they experienced.

Our literature review examined 56 published articles on a range of relevant topics. Findings have been summarized under these categories:

  • Health factors affected by exercise (emotion and mood, quality of life, self-esteem, social activity and sense of mastery, sleep, cognitive functioning)
  • Exercise as related to specific conditions (dementia, depression, anxiety and stress, eating disorders, drug and alcohol rehabilitation, schizophrenia)
  • Physical activity as a strategy to promote mental health • Barriers to implementing and accessing physical activity programs
  • Elements of a successful physical activity program
  • Issues of adherence
  • How much exercise is required for improved mental health

Highlights from the Online Survey

Expected challenges for organizations when initiating and sustaining a physical activity program

  • Inadequate space (88% of respondents expected space to be a major barrier)
  • Funding (76%)
  • Lack of staff time (65%)
  • Liability for injury (45%)
  • Inadequate staff knowledge (45%)
  • Lack of client interest (45%)
  • Other barriers identified: weather, lack of transportation, and the challenge of ensuring proper clothing and footwear (due to the poverty prevalent in this client group)

Requirement for staff training

  • A majority of respondents (63%) indicated that training would be needed to ensure their staff was comfortable in organizing and/or leading physical activity programs.

Positive outcomes

  • All of the organizations who currently have a physical activity program observed the positive effects of exercise on their participants’ mental and physical health.
  • Observers saw connections to improved mood, concentration, self-esteem, confidence, friendships, motivation, and energy. Consumers found their overall health to be improved and felt empowered to improve themselves.
  • Respondents indicated that medication sideeffects were mediated by physical activity, leading to better sleep patterns, less lethargy, reduced rumination and brighter affect.
  • Other benefits cited were reduced isolation, increased social networks, improved physical fitness, new learning opportunities for skills, and higher interest/motivation.

Partnerships

  • Over 90% of respondents thought that partnerships with other organizations or groups would be of benefit in making a physical activity program more effective and sustainable.

An executive summary of the environmental scan, the complete literature review and results of the online survey are now available to download from our website at www.mindingourbodies.ca.


A Sneak Peek Inside the Toolkit

The Minding Our Bodies toolkit will provide a range of easy-to-use resources to help you create sustainable physical activity programs for people experiencing or recovering from serious mental illness. Developed for use by community mental health agencies, consumer/survivor initiatives and any other organization working with individuals who have a mental illness, the toolkit can be adapted to each organization’s setting and needs.

The toolkit is intended to build capacity within the mental health system to create new opportunities for physical activity. It will:

  • Include a business case for developing physical activity programs for people with mental illness
  • Offer suggestions for reducing barriers to inclusion in the community • Show the steps needed to create partnerships
  • Identify strategies for promoting and developing peer leadership
  • Provide a directory of existing program resources

After the six pilot sites have been evaluated, their feedback on the toolkit will be the basis for changes to ensure that the kit will meet the needs of a full range of potential users. The final version of the toolkit will be launched in March 2010.

During our environmental scan, we asked organizations what resources they would like to see included in the toolkit. Here are the resources most frequently requested:

  • Best practices for physical activity programs for people with mental illness
  • Profiles of existing programs
  • Listings/descriptions of community resources and supports
  • Suggestions for funding resources
  • Information and resources for writing poposals
  • Motivation techniques for participants and staff
  • Visual and other aids to help show how to strengthen different muscle groups
  • Information about considerations of safety and liability
  • Assessment tools
  • Checklists and calendars to chart an individual’s progress

Stay tuned for more information about the toolkit as it progresses!


The New Website

Scheduled for relaunch in mid-April 2009, the Minding Our Bodies website will include new features to support the pilot sites as they develop their new programs.

OpenConcept Solutions, an Ottawa-based web development company, has been retained to build our new website using open-source technology.

As an integral component of the Minding Our Bodies project, the website will:

  • Raise awareness of the project and promote the importance of physical activity for mental health
  • House the current version of the toolkit (including project documents, tools and links to external resources and supports)
  • Provide a venue for social networking among staff, volunteers, and community partners
  • Encourage knowledge exchange and resource-sharing
  • Enable online data collection to support project evaluation

During the pilot study, the toolkit and social networking portions of the website will be restricted and passwordprotected, for use only by pilot-site participants and project staff. After the pilot, when the toolkit has been refined, the lock on the restricted portion of the website will be removed and the entire contents of the toolkit made available to everyone who opens a free account.


How to Get Involved

Here are a few ways for you to get involved in the Minding Our Bodies project:

  • Sign up for the Minding Our Bodies newsletter. Visit www.mindingourbodies.ca and subscribe online.
  • Spread the word about Minding Our Bodies. Encourage your colleagues to visit the website and subscribe to the newsletter.
  • If your organization has a physical activity program, visit the new Minding Our Bodies website and create a program profile that describes the good work your organization is doing.
  • Share your own personal success story about being physically active and how it helped you. Visit the website for details.
  • Contact our project manager (details below) if you are interested in contributing resources or ideas to the Minding Our Bodies project.
  • If you know of an organization who would be interested in sponsoring the MOB project, please refer them to Kendal Bradley, project manager.

Dates to Keep in Mind!

April 10, 2009: Launch of new Minding Our Bodies website

April 15, 2009: Minding Our Bodies “spring training” workshop for representatives of the pilot organizations

May–October 2009: Pilot phase

March 2010: Launch of final toolkit


Minding Our Bodies
Kendal Bradley, Project Manager
kbradley [at] ontario [dot] cmha [dot] ca
180 Dundas Street West, Suite 2301
Toronto ON M5G 1Z8
416-977-5580 ext. 4133