Mood Walks – Hiking for health

In brief

People who experience a serious mental illness sometimes have a difficult time being physically active, so they tend to be at higher risk of having chronic health problems.

As part of its effort to promote physical activity in these individuals, the Canadian Mental Health Association, Ontario, introduced Mood Walks, in partnership with Conservation Ontario and Hike Ontario. Mood Walks is a program that promotes community involvement, physical activity, and safe hiking skills among adults 50 years and older who have a serious mental illness.

In the latest Evidence in Action, EENet’s Tatyana Krimus profiles how the evidence on the benefits of physical activity in individuals with mental health problems helped to develop CMHA Ontario’s Mood Walks program. 

Read it below or access the PDFEvidence in Action profiles knowledge generation, exchange, and implementation activities across Ontario.

Background

Participants on a Mood Walks hike at Jefferson Forest organized by CMHA York Region and South Simcoe Branch    People who experience serious mental illness (SMI) can have a difficult time being physically active for a number of reasons, such as1:

  • Social and economic factors, including poverty and lack of access to community resources;
  • Social exclusion due to stigma and fear of discrimination;
  • Medication-related weight gain, cognitive impairment, and lack of motivation and energy.

For these reasons, these individuals tend to be less active than the general population and face a higher risk of developing chronic physical conditions2

As part of their effort to promote physical activity among people with SMI, the Canadian Mental Health Association (CMHA), Ontario, introduced Mood Walks, in partnership with Conservation Ontario and Hike Ontario. Mood Walks is a program that promotes community involvement, physical activity, and safe hiking skills among adults 50 years and older who have SMI. 

The Mood Walks initiative focuses on older adults because they can face additional barriers to physical activity, such as physical ailments, fear of injuries, mobility issues, and chronic pain3. Also, older adults are more likely to face social and emotional isolation, poverty, insecure housing or homelessness, as well as coexisting conditions, including substance misuse and learning disabilities4. Walking groups can help individuals to counter the effects of these challenges. 

The Mood Walks program is being implemented by 19 community mental health agencies throughout Ontario plus at least half a dozen consumer/survivor and family organizations across the Northeast that are members of the Lived Experience and Recovery Network based in North Bay. CMHA Ontario provides training and support for program leaders to help them plan and evaluate walking group programs for older adults with SMI, connect with local hiking clubs, and improve access to parks, hiking trails, conservation areas, as well as other community resources. Hike Ontario provides Safe Hiker training to all walking group participants and offers Hike Leader training to program staff and peer leaders.

The research: Physical activity and nature

Participants on a Mood Walks hike at Eldred King Woodlands, organized by CMHA York Region and South Simcoe Branch.To better understand the relationship between physical activity and mental health and well-being, CMHA Ontario undertook a literature review and environmental scan as part of an earlier initiative, called Minding Our Bodies. Findings from this research showed physical, mental, and social benefits from engaging in physical activity for people who experience SMI, such as5:

  • Lower stress levels and increased energy levels;  
  • Increased social interaction; 
  • Improved mood and self-esteem;
  • Reduced risk of chronic illnesses, such as diabetes, heart disease, and obesity. 

This scan also identified barriers that community mental health agencies encountered while implementing physical activity programs, including a lack of funding and appropriate staff training, as well as transportation costs and accessibility. Three main strategies were identified to help overcome the barriers, including building and expanding community partnerships, taking stock of and using existing services and volunteer resources, as well as engaging and developing peer leaders.

Another literature review, which CMHA Ontario conducted during the Mood Walks planning process, showed that engaging in physical activity in nature improved concentration, mood, and stress levels. In fact, people who had the highest risk of mental health problems—such as those who experience high stress, low self-esteem, difficulty concentrating, and depressed mood—experienced the greatest benefits from being in nature6

An environmental scan completed for Mood Walks explored existing resources and gaps related to physical activity promotion, activity and aging, health promotion within mental health services, green exercise, walking, and hiking in Ontario7. Although unpublished, the results were used to design the Mood Walks program and develop the program manual.

Applying the Evidence

Participants on a Mood Walks hike at Jefferson Forest organized by CMHA York Region and South Simcoe Branch    CMHA Ontario applied the evidence through each step of program planning. An advisory committee was convened, which included people with expertise in mental health, hiking, conservation, and older adult health. 

The committee confirmed that walking was an ideal physical activity, based on the evidence, which showed it to be accessible, sustainable, easily implemented into community agency settings and participant routines, and it addressed the barrier of social isolation8.

The evidence also guided the development of a program manual for community mental health and addictions agencies to use when implementing and evaluating Mood Walks programs. For example, the manual suggests putting a focus on creating a social atmosphere during walks based on evidence that showed some participants felt social interaction was more important to them than the physical benefits of the activity9.

The program evaluation plan is also based on the evidence, and evaluation results are expected to help determine the benefits of using physical health interventions in mental health services and the impact on mental health of spending time in nature.

Lessons learned

Partnerships have been instrumental in the implementation of this program because they increase community engagement and add to a unique combination of perspectives and expertise. This collaboration was also successful, in large part, because the partner organizations have similar goals, which include:

  • Improve access to the natural environment for all;
  • Increase the evidence base and public awareness about the mental health benefits of spending time in nature;
  • Maintain the impact of Mood Walks beyond the project period. 

CMHA Ontario plans to revise the Mood Walks program manual based on feedback from participating agencies in the fall of 2014 and make all resources available on the project website in early 2015. 

For more information about the Mood Walks initiative, visit www.moodwalks.ca or contact:
Scott Mitchell, Director, Knowledge Transfer
CMHA Ontario, smitchell [at] ontario [dot] cmha [dot] ca

Suggested reading:

References

  1. Bingham, P.B. (2009).  Physical Activity and Mental Health Literature Review. Minding Our Bodies. Retrieved 8 July 2014 from http://www.mindingourbodies.ca/about_the_project/literature_reviews/phys...  
  2. De Hert, et al. (2011). Physical illness in patients with severe mental disorders, I. Prevalence, impact of medications and disparities in health care. World Psychiatry, (10)1: 138–151. 
  3. Rasinaho M., Hirvensalo, M, Leinonen R., Lintunen T., and Rantanen, T. (2006) Motives for and Barriers to Physical Activity Among Older Adults With Mobility Limitations. Journal of Aging and Physical Activity, 15: 90-102. Retrieved 10 July 2014 from http://www.humankinetics.com/acucustom/sitename/Documents/DocumentItem/6...
  4. CMHA, Ontario. (2010). Mental Health and Addictions Issues for Older Adults: Opening the Doors to a Strategic Framework. Retrieved 10 July 2014 from http://ontario.cmha.ca/public_policy/mental-health-and-addictions-issues...
  5. Bingham, P.B. (2009).
  6. Lines, E. (2013). The Nurture of Nature: Natural Settings and Their Mental Health Benefits. Mood Walks. Retrieved 9 July 2014 from http://www.moodwalks.ca/about-mood-walks/the-nurture-of-nature-natural-s...
  7. Town, A. (2013). Mood Walks Environmental Scan, unpublished.
  8. Daw, L. (2009).
  9. Town, A. (2013).

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