Patient preferences for the integration of exercise for depression into mental health care

Background: Exercise is an evidence-based treatment for depression, yet it is rarely integrated into mental health care in the United States. Purpose: The purpose of this study was to examine patient experiences with and preferences for integrating exercise into mental health care. Methods: Participants were 457 US adults with depression who reported current or past receipt of mental health care and completed an online survey assessing experienced and preferred levels of exercise integration using parallel three-level ordinal scales. Related samples Wilcoxon signed-rank tests compared experienced versus preferred levels of exercise integration. Multivariable ordinal logistic regression examined predictors of preferred exercise integration. Results: 22.5% preferred no discussion of exercise in the context of mental health care, 56.5% preferred general education and encouragement around exercise in mental health care, and 21.0% preferred structured exercise goal setting in mental health care. Participants preferred significantly greater exercise integration than they had experienced (Z = 6.8, P < .001). In multivariable analyses, prior experience with exercise being integrated into mental health care and greater belief in exercise’s antidepressant effects were associated with higher preferred integration, whereas current antidepressant use and physical health conditions limiting exercise were associated with lower preferred integration. Preference for integration of exercise into mental health care was unrelated to depression severity or physical activity level. Conclusion: US adults with depression prefer greater integration of exercise into mental health care than they currently receive, but most prefer limited integration. These findings highlight the importance of flexible, patient-centered approaches to exercise integration into mental health care.