Title : Barriers to improving the wellness of persons with severe mental illness: Implications for advancing their wellness
Abstract:
Objectives: Persons with severe mental illness living in community residential facilities may encounter barriers to advancing their wellness within these settings. Therefore, a study was conducted to identify the barriers and difficulties experienced by persons with mental illness in advancing healthy nutrition habits and involvement in physical activities during participation in a health promotion program, and to examine differences in their perceptions of these barriers as a result of program participation.
Design and Method: A process-oriented study was conducted using quantitative and qualitative methods to examine the barriers and difficulties experienced by 84 persons who participated in 6 health promotion programs and live in community residential facilities in Israel. The research instruments included a structured instrument measuring participants' perceptions of barriers to advancing wellness, interviews with participants, and documentation of barriers expressed during group sessions.
Results: The findings indicate that as this population tries to advance their wellness, they may face unique challenges. Among these are individual barriers, such as periods of relapse in their mental health and comorbid illnesses, which can create a pile-up of barriers that can expand the sense of disability beyond the mental illness. In addition, participants experienced systemic barriers, such as limited room for choice or control over the nutrition served in community residential facilities, and a lack of companionship for wellness-related activities, including physical activities. These systemic barriers reflect deficits in elements that could be essential to advancing their wellness, such as control and choice.
Conclusions: The findings indicate that any health promotion program should include not only the provision of knowledge about healthy nutrition but also approaches aimed at reducing individual and systemic barriers. Organizational change toward wellness could contribute to overcoming the individual and systemic barriers hindering the advancement of healthy nutritional habits, as well as to the enhancement of recovery-promoting processes.
