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Title: Recreation for Mental Health 101


Abstract: The 'Recreation for Mental Health 101' is an educational presentation that was developed as a part of a Recreation for Mental Health project in Nova Scotia (for a full explanation of the project, see question 7). The key goals of the broader project are to increase collaboration between the mental health and recreation sectors and to advocate for and increase awareness about the use of recreation for individuals with mental illness and mental health problems. Therefore, the presentation describes the relationship between mental health and recreational activities, in that social, creative, and physical recreation activities can be used to maintain mental health or return to good mental health. The presentation’s overall aim is to raise awareness about the benefits of recreation for people living with mental illness and to provide key definitions in order to facilitate conversations between the mental health and recreation sectors. This is an introductory presentation that targets mental health and recreation practitioners and decision makers who are collaborating to provide recreation opportunities for individuals with mental illness and mental health problems. Within the presentation, mental health, mental illness, recovery, resilience, stigma, social determinants of health, and recreation are defined. The benefits of recreation for individuals with mental illness and mental health problems are detailed and barriers to participation are outlined. Anti-stigma resources are provided.


Type of Product: Slide presentation


Year Created: 2014


Date Published: 3/5/2016

Author Information

Corresponding Author
Fenton Lara
Dalhousie University
6320 South Street
Halifax, NS B3H 4R2
Canada
p: 780.886.1798
lara.fenton@dal.ca

Authors (listed in order of authorship):
Susan Hutchinson
Dalhousie University

Debbie Bauld
Recreation Nova Scotia

Brittany Naugler
Recreation Nova Scotia

Product Description and Application Narrative Submitted by Corresponding Author

What general topics does your product address?

Public Health


What specific topics does your product address?

Community-based clinical care , Mental health, Physical activity/exercise, Prevention, Rehabilitation, Social determinants of health


Does your product focus on a specific population(s)?

Disabled, Homeless


What methodological approaches were used in the development of your product, or are discussed in your product?

Community-academic partnership


What resource type(s) best describe(s) your product?

Lecture/presentation


Application Narrative

1. Please provide a 1600 character abstract describing your product, its intended use and the audiences for which it would be appropriate.*

The 'Recreation for Mental Health 101' is an educational presentation that was developed as a part of a Recreation for Mental Health project in Nova Scotia (for a full explanation of the project, see question 7). The key goals of the broader project are to increase collaboration between the mental health and recreation sectors and to advocate for and increase awareness about the use of recreation for individuals with mental illness and mental health problems. Therefore, the presentation describes the relationship between mental health and recreational activities, in that social, creative, and physical recreation activities can be used to maintain mental health or return to good mental health. The presentation’s overall aim is to raise awareness about the benefits of recreation for people living with mental illness and to provide key definitions in order to facilitate conversations between the mental health and recreation sectors. This is an introductory presentation that targets mental health and recreation practitioners and decision makers who are collaborating to provide recreation opportunities for individuals with mental illness and mental health problems. Within the presentation, mental health, mental illness, recovery, resilience, stigma, social determinants of health, and recreation are defined. The benefits of recreation for individuals with mental illness and mental health problems are detailed and barriers to participation are outlined. Anti-stigma resources are provided.


2. What are the goals of the product?

There are several goals of this product. The initial goals were to: 1) to educate stakeholders in Nova Scotia about the Recreation for Mental Health project (for a full explanation of the project, see question 7), 2) to give stakeholders of this project a common understanding of mental health and mental illness, as well as emphasize the importance of appropriate use of language in the creation of safe, supportive and inclusive recreation environments, 3) to detail the benefits and barriers to community recreation participation for individuals with mental illness and mental health problems, and 4) to build awareness of how recreation participation can benefit mental health. Although the presentation has been used in the context of the Recreation for Mental Health project in Nova Scotia, we see the presentation being useful in a broader context. For example, CAMH (Centre for Addiction and Mental Health) posts a series of 101 presentations (e.g. Anxiety 101, Bipolar 101) on the resources tab of their website. We see this presentation complimenting the fleet of 101 presentations currently being offered as well as being applicable in national and international contexts.


3. Who are the intended audiences or expected users of the product?

The intended users of the product at this time are stakeholders of the Recreation for Mental health project. The post doctoral fellow associated with the project, Dr. Lara Fenton, presents this education tool at the beginning of every workshop and conference that we host. We are hoping that after the peer review process the presentation can be posted online so that others can present it or use it as an informative tool. It will eventually become a part of a toolkit that the project management team is producing that aims to support the creation of postive recreation environments for individuals with mental illness. Our long term goal is that this product can be used as a educational tool outside the scope of the current project. As we emphasize both recovery and resilience in the presentation, we see it being particularly useful in education contexts, as universities and colleges are beginning to address student mental health.


4. Please provide any special instructions for successful use of the product, if necessary. If your product has been previously published, please provide the appropriate citation below.

This product has not been published before. This product is also heavily influenced by the geographical context in which it was produced. To be more useful in broader contexts, please delete slide 2 and slide 4. For slide 23, please add local mental health resources.


5. Please describe how your product or the project that resulted in the product builds on a relevant field, discipline or prior work. You may cite the literature and provide a bibliography in the next question if appropriate.

Much of the previous research that outlines the benefits of recreation for individuals with mental illness solely focuses on the physical and physiological benefits of physical activity and exercise (1-4). However, although benefits accrue from physical activity, defining recreation as exercise is overly simplistic. In addition to physical recreation there exists a significant body of scientific literature describing the capacity for social and creative recreation to positively impact recovery (i.e., a nonlinear journey to wellness) and social inclusion (i.e., community integration) in persons living with mental illness. Recently, this work has been synthesized (5, 6). This presentation aims to demonstrate that recreation is more than just physical exercise and includes social and creative recreation. The benefits of social, creative, and physical recreation activities for individuals with mental illness are outlined within the presentation and include reduced symptoms of mental illness (7, 8, 9), facilitating social connections and support (10), sense of belonging (8), and social inclusion (11).


6. Please provide a bibliography for work cited above or in other parts of this application. Provide full references, in the order sited in the text (i.e. according to number order). .

1. McDevitt J, Snyder M, Miller A, Wilbur J. Perceptions of barriers and benefits to physical activity participation among outpatients in psychiatric rehabilitation. . Journal of Nursing Scholarship. 2006;38(1):50-5.
2. Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current opinion in psychiatry. 2005;18(2):189.
3. Street G, James R, Cutt H. The relationship between organised physical recreation and mental health. Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals. 2007;18(3):236.
4. Sylvia LG, Friedman ES, Kocsis JH, Bernstein EE, Brody BD, Kinrys G, et al. Association of exercise with quality of life and mood symptoms in a comparative effectiveness study of bipolar disorder. Journal of Affective Disorders. 2013;151(2):722-7. doi: 10.1016/j.jad.2013.07.031.
5. Fenton L, Gallant K, Hutchinson S, White C, Hamilton-Hinch B. Recreation for Mental Health Recovery. Leisure Loisir. In press.
6. Fenton L, White C, Gallant K, Hutchinson S, Gilbert R, Hamilton-Hinch B, et al. The Benefits of Recreation for the Recovery and Social Inclusion of Individuals with Mental Illness: An Integrative Review. Leisure Sciences. Submitted.
7. Dingle GA, Brander C, Ballantyne J, Baker FA. ‘To be heard’: The social and mental health benefits of choir singing for disadvantaged adults. Psychology of Music. 2013;41(4):405-21. doi: 10.1177/0305735611430081. PubMed PMID: 2013-23986-001. First Author & Affiliation: Dingle, Genevieve A.
8. Iwasaki Y, Coyle C, Shank JW, Messina E, Porter H, Salzer M, et al. Role of leisure in recovery from mental illness. American Journal of Psychiatric Rehabilitation. 2014;17(2):147-65.
9. Iwasaki Y, Coyle CP, Shank JW. Leisure as a context for active living, recovery, health and life quality for persons with mental illness in a global context. Health Promotion International. 2010;25(4):483-94.
10. Hebblethwaite S, Pedlar A. Community integration for older adults with mental health issues: Implications for therapeutic recreation. Therapeutic Recreation Journal. 2005;39(4):264-76. PubMed PMID: 2006-03476-002. First Author & Affiliation: Hebblethwaite, Shannon.
11. Donnelly P, Coakley JJ. The role of recreation in promoting social inclusion (Perspectives on social inclusion working paper series). Toronto: Laidlaw Foundation; 2002.


7. Please describe the project or body of work from which the submitted product developed. Describe the ways that community and academic/institutional expertise contributed to the project. Pay particular attention to demonstrating the quality or rigor of the work:

  • For research-related work, describe (if relevant) study aims, design, sample, measurement instruments, and analysis and interpretation. Discuss how you verified the accuracy of your data.
  • For education-related work, describe (if relevant) any needs assessment conducted, learning objectives, educational strategies incorporated, and evaluation of learning.
  • For other types of work, discuss how the project was developed and reasons for the methodological choices made.

Led by Dr. Susan Hutchinson of Dalhousie University, the ‘Recreation for Mental Health’ project was initiated in 2011 with the goal of promoting collaboration between the mental health and recreation sectors in Nova Scotia and to address the challenges associated with community recreation participation commonly experienced by people with mental health challenges. The project is a collaborative partnership between Dalhousie University, Canadian Mental Health Association (Nova Scotia Division), and Recreation Nova Scotia. The idea for the 'Recreation for Mental Health 101' presentation was based on the experience of the project management team (Dr. Susan Hutchinson, Dr. Lara Fenton, and representatives from Recreation Nova Scotia (Debbie Bauld) and Canadian Mental Health Association, Nova Scotia Division (Sue Marchand and Pamela Magee ) as they facilitated conversations in workshops through Nova Scotia's six geographic locations. The purpose of these workshops was to support collaboration between recreation and mental health. However, without an educational presentation at the beginning of the workshop, conversations were unstructured and stakeholders used different language, emphasized physical or cognitive disabilities, or associated recreation solely with exercise. We received informal feedback from stakeholders in the recreation sector that they did not truly understand mental health and mental illness. In conjunction, stakeholders in mental health were unsure of community recreation resources. The content of the presentation was developed based on a grey literature review (e.g., the Canadian Mental Health strategy). It also summarized an integrative review written by the research team affiliated with the project on the benefits and barriers to social, creative, and physical recreation environments for individuals with mental illness and mental health problems. An integrative review is a systematic integration of data across diverse methodologies. The benefits of recreation for mental illness detailed on slide 14 are based on this publication.


8. Please describe the process of developing the product, including the ways that community and academic/institutional expertise were integrated in the development of this product.

The product was developed by the post doctoral fellow associated with the Recreation for Mental Health project, Dr. Lara Fenton, in consultation with the project management team, the advisory committee and one regional group in Nova Scotia. First, Dr. Fenton developed a draft of the presentation and met with each person on the project management team to garner feedback including Dr. Susan Hutchinson (Dalhousie University), Sue Marchand (Canadian Mental Health Association, Nova Scotia Division), Brittany Naugler (Project Coordinator), and Debbi Bald (Recreation Nova Scotia). Then, the product was presented to the 16 person advisory committee meeting which includes First Voice (i.e., individuals with experience of mental illness) and one regional working group from the Valley region to gather more feedback. Since that time, the product has been presented at a regional workshop and a symposium and we have gathered some informal feedback on the Recreation for Mental Health 101 presentation from our evaluations (see some of these comments below in question 9). Additionally, staff at Canadian Mental Health Association, Nova Scotia Division have given critical feedback by editing the document for messaging. This presentation is a 'live' document and is responsive to the feedback of the stakeholders that the project serves.


9. Please discuss the significance and impact of your product. In your response, discuss ways your product has added to existing knowledge and benefited the community; ways others may have utilized your product; and any relevant evaluation data about impact, if available. If the impact of the product is not yet known, discuss its potential significance.

Prior to the implementation of the Rec4MH101 presentation we were finding that stakeholders in facilitated conversations at regional workshops were not on the same page with their definitions and understanding of recreation and mental health. For example, in discussions people would talk about cognitive impairments and mobility challenges rather than mental health and mental illness. Or, they would confine recreation to physical activity and exercise. With the implementation of the Rec4MH101 presentation we have received informal feedback at regional workshops in Nova Scotia’s six geographical regions, and the annual provincial symposium. For example: “I now know how to better support others who support those with mental health issues”, “mental health first aid is going to be offered at my work place”, “I now know the importance of recreation in mental health & wellbeing, and I am more informed about mental health and recreation and made contacts that will be helpful in my work. We also have practical evidence that collaborations are happening and informal evidence that conversations are more focused. For example, a mental health nurse in the Valley region of Nova Scotia has collaborated with a local recreation director. They worked together to apply for a ‘Move More’ grant, which they won. They then hosted a 6 week recreation program at the local recreation facility for young adults with mental illness.


10. Please describe why you chose the presentation format you did.

The presentation format works well for conference style workshops and symposia where we are hosting between 50 and 150 people. We have chosen a slide presentation as the mode to disseminate this information because it fits well with the interactive nature of our symposia and workshops. The slide presentation can be easily and continually adapted to meet the needs of the growing project as well as other contexts.


11. Please reflect on the strengths and limitations of your product. In what ways did community and academic/institutional collaborators provide feedback and how was such feedback used? Include relevant evaluation data about strengths and limitations if available.

The strengths of this product include that it is a basic introduction to key terms that are relevant to practitioners who may not be familiar with mental health terminology or recreation opportunities. The presentation also synthesizes relevant literature in an accessible manner. As each slide has been carefully written, the product can be presented by others in approximately 25 min. As well, it can be posted on the project's website and read through as a stand-alone product. Limitations of the presentation is that it has not been rigorously evaluated. However, the project management team has applied for a grant to address this deficiency. We are aiming to develop a toolkit for mental health and recreation workers that will include this presentation. As a part of the toolkit development, all the knowledge products included will undergo rigorous evaluation procedures from knowledge users.


12. Please describe ways that the project resulting in the product involved collaboration that embodied principles of mutual respect, shared work and shared credit. If different, describe ways that the product itself involved collaboration that embodied principles of mutual respect, shared work and shared credit. Have all collaborators on the product been notified of and approved submission of the product to CES4Health.info? If not, why not? Please indicate whether the project resulting in the product was approved by an Institutional Review Board (IRB) and/or community-based review mechanism, if applicable, and provide the name(s) of the IRB/mechanism.

Shared decision making power in the Recreation for Mental Health project is facilitated through project management team meetings of which Dalhousie University, Canadian Mental Health Association, and Recreation Nova Scotia are a part. Within these meetings, the scope of the project and symposia and workshop planning are undertaken. As well, all partners participate in resource sharing. For example, the postdoctoral fellow will write grants for the non profit organization in order to support the project. One non profit partner donated some of the hours of a summer student to the project. Additionally, the nonprofit partners will use their networks to enhance stakeholder attendance and engagement. It has taken over a year to discover the assets that each partner brings to the table and how to best utilize this knowledge, resources, and power to collaborate for the betterment of mental health, and we are continuing to learn how to do this well.
This product is aiming to promote stigma reduction and education around the benefits of recreation for recovery and resilience. The product has been developed based on presentations to stakeholders who have given informal feedback. Intentional and formal feedback and editing was contributed by the project partners at Canadian Mental Health Association, Recreation Nova Scotia, and Dalhousie University. These partners have been notified of, and approve, the submission. All of the formal contributions are noted in form of authorship. No IRB approval was sought for this particular product, although we have received ethics approval for many of the workshops in order to write about process of facilitating multi sector collaboration.