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Tijdschrift voor Psychiatrie 62 (2020) 11, 981 - 989

Review article

The art of endurance: implementation of lifestyle interventions in mental healthcare

J. Deenik, A. Looijmans, F.R. Kruisdijk, F. Jörg

background An increasing number of studies in people with mental illness have demonstrated the efficacy of lifestyle interventions for both mental and physical health. However, implementing and sustaining such interventions in routine mental healthcare is challenging.
aim To describe implementation barriers and facilitators of various lifestyle interventions in routine mental healthcare.
method In this paper we summarise the results of three recent doctoral theses and provide recommendations for routine mental healthcare.
results Enabling factors and barriers for successful implementation appeared to be universal across various settings and patient populations. Mental healthcare professionals and patients appreciated and supported the lifestyle interventions. A lack of priority, recognition and support on the organisational level were reported as barriers in all the studies. Addressing various lifestyle behaviours simultaneously (e.g. physical activity and diet), personalised to the patients’ abilities and preferences, and setting measurable and attainable goals, were important for success. Moreover, involving qualified professionals (e.g. exercise professionals and dietitians with expertise in mental healthcare) and ensuring cooperation between patients and healthcare professionals and disciplines within and outside mental healthcare appeared crucial.
conclusion Successful implementation of lifestyle interventions in mental healthcare requires changes in culture and behaviour, a long-term strategy and endurance.

keywords depression, implementation, lifestyle interventions, physical activity, severe mental illness