Lifestyle interventions targeting physical activity, nutrition, sleep and smoking are key to mental health care, not optional extras, according to the report by a team of 30 authors from 19 countries.
The Commission report, Implementing Lifestyle Interventions in Mental Health Care, outlines a roadmap to improve care worldwide – from bringing in exercise and nutrition specialists to shifting workforce attitudes to prioritise a holistic approach.
It builds on a 2019 Commission report on protecting physical health in people with mental illness – who die 13 to 15 years earlier than the general population, largely due to preventable conditions like cardiovascular disease and diabetes.
Researchers reviewed 89 recent lifestyle interventions, targeting physical activity, nutrition, smoking cessation and sleep, to determine the most effective approaches, resulting in eight recommendations and 19 priorities for action. These were reviewed by people with lived experience and a Global South Advisory Group of 14 experts from lower income and conflict-affected countries to ensure they could be adapted across diverse settings.
Increased funding, upskilling of mental health staff and enabling access to a broader range of allied health professionals will be key to better incorporating lifestyle interventions into care.
The report was led by Dr Scott Teasdale at the USNW, Sydney. Institutions from the UK involved in the report include the University of Manchester, Sheffield Hallam University, King’s College London, the University of Southampton, the University of York, Anglia Ruskin University and the University of Glasgow.
Professor Joseph Firth is Chair of the Lancet Psychiatry Commission for Public Health and is a Research Fellow at the University of Manchester. Prof Firth said: “The heightened risk of physical diseases which accompanies severe mental illness have become some of the most life-threatening elements of such conditions yet unfortunately remain overlooked and under-treated.
“Our latest report moves from advocacy to action, using lifestyle interventions to address this serious issue: presenting both the evidence from clinical studies, alongside clear directions and best-practice examples for applying this evidence in real-world mental health care."
Dr Katarzyna Machaczek is a Research Fellow based in Sheffield Hallam University’s Advanced Wellbeing Research Centre. Dr Machaczek said: “Lifestyle interventions should form an integral component of mental health care. We recommend that providers tailor the implementation and delivery of interventions to their specific context, resources and population.
“We also emphasise the value of tailoring delivery to individual circumstances, while also considering broader social and environmental factors. Such an approach can improve acceptability and encourage sustained participation in lifestyle changes that support better physical and mental health.”
While delivery methods must be tailored to local contexts, many core principles are universal. This includes creating psychologically safe environments and ensuring support staff have the empathy and skills to provide trauma-informed, culturally sensitive care.
The report is one of two published by The Lancet Psychiatry Physical Health Commission today (Wednesday 13 August).
Read the full report Implementing lifestyle interventions in mental health care: third report of the Lancet Psychiatry Physical Health Commission.
