Barriers and facilitators to increasing physical activity in medium secure mental health settings: An exploration of staff perceptions

The benefits of physical activity for people with severe mental illness (SMI) is widely recognised but for those in medium secure settings there are additional environmental barriers to being active that have not been fully explored. The aim of this study was to explore the perceived barriers and facilitators from the perspective of staff within the medium secure setting. Semi-structured focus groups were conducted with qualified and unqualified staff (n=24) across two UK medium secure NHS settings. Michie’s COM-B framework was used to inform the topic guide and the analysis of the data. The opportunities to be active in medium secure settings depend not only on access to facilities but also staff availability and willingness to support such activities. When an individualised approach is taken, and staff are skilled and motivated to support such activities then it is possible for people with SMI in medium secure settings to be physically active. People with SMI in secure settings have reduced autonomy to increase their own physical activities but it was suggested that with the appropriate opportunities and the motivation of staff their capability to be active could be enhanced. • Increasing physical activity for individuals with SMI in secure settings is recognised as important • There are complex issues surrounding capability and motivation of medium secure service users to be physically active • Opportunities to be active require access to facilities and staff motivation and confidence to support these opportunities.