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exercise for change
Transcript of exercise for change
A innovative cost saving initiative.
A convenient service capable of nationwide expansion. In Conclusion Are you AWARE? 300,000 people in Ireland have depression (Aware)
A survey of GPs found that 25% of their caseload had ‘psychological or mental health issues’, most commonly anxiety, (49%), and depression (24%)
(SWAHB, 2004) What can exercise do
for mental health? Cost benefits to the HSE Funding “A vision for change” government mental health policy has allocated €35 million towards mental health services What's already in place? Ross Allen, Melissa Boland, Caitriona Cronin, Danielle Moran, Sarah Moore, Emma O' Loughlin What is depression? Mental health problems characterised by:
Absence of a positive affect
Loss of interest and enjoyment in ordinary things
Persistent low mood
Emotional, cognitive, physical and behavioural symptoms.
(NICE 2009) Our Service A 12 week exercise programmme
3 circuit-based classes per week
3 primary care centres;
Irishtown, Thomas Street and Harold's cross
One part time physiotherapist Why a Physio? Expertise Knowledge Member of the MDT Why this approach? Modern healthcare demands a preventative approach
60% of hospital bed days are accounted for by people with a chronic illness.
The rising rate of chronic disease is a crucial but frequently ignored contributor to rising medical expenditures (Thorpe et al. 2004)
NHS ''Up and Running'' programme Why Primary Care? 90% of mental health problems are dealt with in primary care. (Vision for Change, 2006)
"Easier and faster access to services" -WHO (2001)
Majority of people access mental health services via a GP referral – Gatekeepers to Primary Care Evaluation of
our service Activity levels
IPAQ Feedback Attendance HADS Score Direct expenditure: “It is estimated that the care of people with chronic illness consumes between 70-80% of all health care spending" Decreased medication use Co-morbidities What do we need to get started? Savings Feedback References National Institute for Health and Clinical Excellence (2009) Depression: the treatment and management of depression in adults. CG90. London: National Institute for Health and Clinical Excellence.
Rimer J et a. (2012) Exercise for depression. Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD004366. DOI: 10.1002/14651858.CD004366.pub5.
“A Vision for Change.” 2006
Mental Health plan for Europe (2005)
The Health Service Executive Chronic Illness Framework (2008)
“How To Look After Your Mental Health Using Exercise.” The Mental Health Foundation (2009).
Labour Research Department (2004) Exercise On Prescription: A Report For The Chartered Society Of Physiotherapy.
“Mental Health in Ireland: Awareness and Attitudes” HSE (2007).
“Physical Exercise and Clinically Depressed Patients: A Systematic Review and Meta-Analysis” Heitor Silveira, Helena Moraes, Natacha Oliveira, Evandro Silva Freire Coutinho, Jerson Laks, Andrea Deslandes (2013). Singleton, N., Bumpstead, R., O’Brien, M., Lee, A. and Meltzer, H. (2001) Psychiatric morbidity among adults living in private households, 2000. Ofﬁce for National Statistics.
Singleton, N., Bumpstead, R., O’Brien, M., Lee, A. and Meltzer, H. (2001) Psychiatric morbidity among adults living in private households, 2000. Ofﬁce for National Statistics.
Copty, M. (2004) Mental Health in Primary Care. South West Area Health Board and Irish College of General Practitioners
Goldberg, D.P. (1991) Filters to care – a model. In Jenkins, R., and Grifﬁths, S (eds.) Indicators for mental health in the population.
McCormick, A, Fleming, D. and Charlton, J. (1995) Morbidity statistics from general practice. Fourth national study 1991-1992.
“Physical exercise intervention in depressive disorders:Meta-analysis and systematic review “T. Josefsson, M. Lindwall, T. Archer. (2012).
Thorpe, K., Curtis, S. Florence, C., Joski, P. (2004). “Which Medical Conditions Account for the Rise in Health Care Spending? The Fifteen Most Costly Medical Conditions Accounted for Half of the Overall Growth in Health Care Spending between 1987 and 2000,” Health Affairs.
World Health Organisation (2001) The World Health Report 2001. Mental Health: New Understanding, New Hope. 24,245 Reduction in the 7,350,000 Drugs Payment Scheme yearly expenditure Reduction in GP visit costs Reduction in gross €3Billion expenditure on mental health ''A great, feasible
and viable idea''
--Physiotherapy manager, PCCC Dublin West ''Of the hundreds and thousands of patients we see, the majority of them present with a PMHx of depression''--Physiotherapy manager, PCCC Dublin West "The Vision for Change Policy still has funding and physiotherapy needs to become involved. Exercise is our expertise and is the most under utilised antidepressant there is." -- Waterford Regional Hospital Physiotherapy Manager