A qualitative evaluation of an exercise practitioner in an outpatient child and adolescent mental health service.

BACKGROUND: Physical activity interventions can confer a range of physical and mental health benefits among young people with mental disorders. In some contexts, such as Ireland, integrated physical activity is not easily available within child and adolescent mental health services. Therefore, an interagency pilot intervention was established in a child and adolescent mental health service in Ireland with the integration of a novel exercise practitioner into the multidisciplinary mental health team. OBJECTIVE: A qualitative evaluation was conducted to understand the impact of the pilot intervention and to understand issues of implementation that arose throughout. METHODS: In-depth qualitative interviews with service users' parents/guardians (N = 3) and a single focus group with existing service providers (N = 3), framed by the RE-AIM framework were conducted to evaluate the pilot intervention. Data were analysed using thematic analysis to explore themes. RESULTS: Three overarching themes were identified. These were as follows: (i) Making changes toward healthier physical activity behaviours; (ii) An intervention of therapeutic holism; and (iii) The integrated service delivery. CONCLUSIONS: This research provides insight on the value of a novel integrated exercise practitioner in outpatient young persons' mental health services in Ireland, indicating an enhanced and complimentary therapeutic service. These findings will be helpful for integrating Exercise Practitioners in this setting going forward.

A randomized controlled trial of the computerized CBT programme, MoodGYM, for public mental health service users waiting for interventions.

OBJECTIVES: To evaluate the effectiveness of the computerized CBT (cCBT) programme, MoodGYM, for the reduction in symptoms of general psychological distress (the primary outcome), depression, anxiety, stress, and impaired daily functioning. DESIGN: A randomized controlled trial, with a waiting list control condition, in a routine clinical setting. METHODS: Participants were 149 public mental health service users (aged 18-61 [M = 35.3 years; SD = 10.3]) waiting for interventions. Self-report outcome measures were administered online at baseline and post-intervention (i.e., after 32 days). RESULTS: After high dropout rates, a post-intervention completers analysis examined 28 MoodGYM participants and 38 waiting list control participants. MoodGYM was significantly more effective than the waiting list control for the reduction of symptoms of general psychological distress (F[1, 64] = 4.45; p < .05) and stress (F[1, 64] = 5.35; p < .05) but not depression, anxiety, or impaired daily functioning. CONCLUSIONS: Due to their high associated dropout rates, self-help cCBT programmes such as MoodGYM should not be provided as front-line treatments. However, as it is likely to be agreeable and beneficial to some service users, perhaps self-help cCBT should be provided as an additional treatment option.