Experiences of physical activity for adolescents in secure psychiatric care: Staff and patient perspectives

This study presents a novel contribution to understanding physical activity provision in secure psychiatric care. This is the first study to directly explore adolescent experiences, and triangulate these perspectives with two staff groups, a multidisciplinary team and physical health practitioners. This study included semi-structured with nine physical health practitioners, thirteen members of a multidisciplinary team (MDT), and five adolescent patients. Through an inductive reflexive thematic analysis, we constructed three overarching themes i) institutional barriers to PA, ii) the rehabilitative benefits of PA and iii) the need for collaborative working. Many of the barriers to PA were a function of the secure environment, which was associated with restrictions on movement, perpetuated by limited staff availability to escort to PA sessions. However, there was a widespread agreement that PA was multi-beneficial for patient's rehabilitation, incorporating mood improvement, increased engagement and increase in pro-social behaviours. For PA promotion and physical health support to become embedded within the service provision, collaboration and support is needed from a wider network of staff members. This suggests that future intervention work should target change at an institutional level, which involves targeting organisational policy. Such work could support staff to promote PA and motivate adolescent patients to engage in PA, whilst also supporting patient physical health within their job role.