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    Mental Wellness

    Abstract
    The Institute of Medicine has described the prevalence of physical inactivity and the associated disease risks as “pandemic.” Additionally, over 46% of children and youth will suffer from mental health diseases and less than 1 in 5 will receive mental health treatment but physical activity can effectively reduce depression, anxiety, and some schizophrenia symptoms. Physical activity is “one of the most important things an individual can do for their health” according to the Centers for Disease Control but less than half of children and youth meet the guidelines for physical activity. Children and youth need supportive interventions to address their physical and emotional needs. Utilizing evidence-based strategies, Mentally Fit provides a unique program that addresses youth’s capacity to tolerate and manage emotions and build social skills all while they are engaging in physical activities and learning physical education. Mentally Fit uses state standards of measurement and results in increased physical activity, improved mood, body-image, and socialization skills.
    Mentally Fit Program
    Mentally Fit provides quality physical education, whereby students have an opportunity to learn meaningful content with appropriate instruction and assessments, is an evidence-based recommended strategy for increasing physical activity.6
    Mentally Fit meets the criteria for using evidence-based strategies by providing meaningful content through quality physical education and appropriate instruction with physical activities led by educated, trained professionals. Mentally Fit is led by Mr. Ron Johnson who has worked in professional sports, residential settings, and with children and youth struggling with mental health and behavioral disorders. Skilled adaptation to meet the needs of children and youth with challenges sets Mentally Fit apart from its’ competition. Mentally Fit is designed to build on social and emotion regulation skills while engaging children and youth in fun, fitness building activities. We provide the skills and knowledge that all children and youth need to maintain a healthy lifestyle.
    Mentally Fit believes that all children and youth deserve equal opportunities for physical mental well-being. As such, we accommodate children and youth with special health-care needs and/or disabilities and can tailor services to alternative educational settings.
    The goals of the Mentally Fit program include helping children and youth:
    • Increase physical fitness
    • Increase the mind-body connection
    • Increase social knowledge, interactions, connections, and support
    • Increase positive coping to replace maladaptive behaviors
    • Increase leadership and assertiveness
    Mentally Fit provides an environment that fosters physical exertion, teamwork, character-building, positive communication, and the attitude and skills needed for effective social interactions.
    The Mentally Fit program starts by collecting baseline data for each child and youth to assess their current fitness level. Mentally
    Fit works with clients to develop appropriate goals, providing experience in setting measurable and achievable goals. Goal-setting is a learned skill that has significant impact on performance.29 All clients receive individualized plans with activities tailored to make improvements from the initial assessment. The Mentally Fit program typically takes 3-6 weeks and includes a breadth of activities to improve fitness as well as social and emotional goals.

    Skills Chart
    The table below summarizes the goal areas, tools (program components), and long-term outcomes of the Mentally Fit program.
    Mentally Fit Physical Education Program
    Specific Goal AreasMentally Fit ToolsLong-term Outcomes
    Increase physical areas of weakness
    • Fitness Testing
    • Goal-setting
    • Tailored physical activities
    • Improved fitness
    • Improved mood
    • Improved body image
    Increase mind-body connection
    • Identify body triggers
    • Offer physical experiences
    • such as deep-breathing
    • Increased self-awareness
    • Increased concentration
    Increase social knowledge, interactions, connections, support
    • Rules and structure
    • Team sports
    • Corrective social experiences
    • Guided support in positive interactions
    • Reduced loneliness
    • Increased positive interactions
    Increase positive coping to replace maladaptive behaviors
    • Identify triggers
    • Physical coping such as walking away, deep breathing
    Reduced aggressive behaviors
    Increase leadership and assertiveness
    • Team captain
    • Responsibility for others
    • Encourage positive interactions
    • Improved mood
    • Improved self-esteem
    Fitness activities may include, but are not limited to:
    • Football
    • Basketball
    • Soccer
    • Volleyball
    • Jumping rope
    • Resistance bands
    • Body Squats
    • Burpies
    • Push-ups
    Nutritional education is also offered to build on the knowledge and skills that children and youth need to maintain healthy eating lifestyles. This is especially beneficial with the availability of soda, vending machines, and lower availability of high quality foods in lower income neighborhoods
    Mentally Fit Assessment
    Assessing clients with appropriate tools is an evidence-based strategy that we integrate into our practice. We use the state standard of fitness assessment, the California Physical Fitness Test (PFT). The PFT assesses the following five key areas of fitness:
    • Cardio respiratory endurance
    • Muscular strength
    • Muscular endurance
    • Body composition
    • Flexibility
    Clients are also assessed for their gain in knowledge in areas such as the standards of fitness for their own age, height, and weight. The testing outcomes are used to inform clients of their own areas of physical weaknesses as well as areas in which they excel.  Clients’ successes are documented in a manner that is easily understood by clients and can be included in medical charts when appropriate
    Solution
    According to the Centers for Disease Control, physical activity is one of the most important things an individual can do for their health.14 The benefits of physical activity to protect against cardiovascular disease as well as other diseases including cancer and depressive disorders are well documented.8,15,16 Additionally, physical activity is correlated to improved mental health and mood6,17,18,19 improving depression, anxiety, and in some cases schizophrenia.15,20 Most importantly, physical activity has efficacy as a treatment of depression.21
    Physical activity also addresses the social-emotional challenges faced by children and adolescents. Studies have found that adolescents participating in sports had higher self-esteem,22,23 more positive physical self-impressions24 and better body image.25 Additionally, there is evidence for lower rates of loneliness for those who engage in team sports.23,26Studies have even shown that children who are prone to shyness can have benefits from participation in physical activity and/or sports.27,28
    Physical education and activity clearly help maintain and improve physical health but are overlooked interventions for mental health.15,20 When you feel good about yourself physically it translates to a stronger mental state of mind. Physical fitness is not limited to an outward appearance but is determined by the measurable components of fitness. Children and youth can build on their body image and self-esteem through physical fitness rather than the social pressures of outward appearance.
    Summation
    The rates of obesity and mental health disorders in children and youth are alarming and physical activity is identified as a viable solution to these pandemic problems. Mentally Fit addresses these concerns using evidence-based strategies for increasing and measuring physical activity and builds skills in fitness and emotional coping. The benefits of engaging in the Mentally Fit program are numerous ranging from improved fitness and increased positive coping strategies to reduced aggression and depressed mood. We hope that you take advantage of what Mentally Fit has to offer for the children and youth you serve.


    Appendix
    1.U.S. Department of Health and Human Services. (2012). Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics Reports, 61(6).

    2.Ogden, C.L., Carroll, M.D., Kit, B.K., & Flegal, K.M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association, 311(8), 806-814.


    3.National Center for Health Statistics. (2012). Health, United States, 2011: With Special Features on Socioeconomic Status and Health. Hyattsville, MD; U.S. Department of Health and Human Services.


    4.Daniels, S.R., Arnett, D.K., Eckel, R.H., Gidding, S.S., Hayman, L.L., Kumanyika, S., Robinson, T.N., Scott, B.J., St Jeor, S., & Williams, C.L. (2005). AHA Scientific Statement: Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation, 111:1999–2012.


    5.http://www.cdc.gov/obesity/childhood/


    6.Committee on Physical Activity and Physical Education in the School Environment, Institute of Medicine of the National Academies (2013). Educating the student body: Taking physical activity and physical education to school. The National Academies Press, www.nap.edu


    7.Merikangas, K.R., He, J., Burstein, M., Swanson, S.A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolsescent Supplement (NCS-A). Journal of American Child Adolescent Psychiatry, 49(10), 980-989.


    8.U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics (2014). National Health and Nutrition Examination Survey, 2012: National Youth Fitness Survey Plan, Operations, and Analysis. Vital and Health Statistics Reports, Series 2, No. 163.


    9.U.S. Public Health Service, Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda. Washington, DC: Department of Health and Human Services, 2000.


    10.National Strategy for Suicide Prevention: Goals and Objectives for Action. Rockville, 3MD: U.S. Dept. of Health and Human Services, Public Health Service, 2001.


    11.NGA Center for Best Practices, Youth Suicide Prevention: Strengthening State Policies and School-Based Strategies.


    12.U.S. Department of Education, Twenty-third annual report to Congress on the implementation of the Individuals with Disabilities Education Act, Washington, D.C., 2001.


    13.Teplin, L. (2002). Archives of General Psychiatry, Vol. 59.


    14.http://cdc.gov/physicalactivity/everyone/health/index/html


    15.Walsh, R. (2011). Lifestyle and Mental Health. American Psychologist, 66(7), 579-592.


    16.Lee, I-Min, Hseieh, Chung-cheung, & Paffenbarger Jr., Ralph S. (1995). Exercise Intensity and Longevity in Men, The Harvard Alumni Health Study. Journal of the American Medicine Association, 273(15), 1179-1184.


    17.Dunn, A.L., Trivedi, M.H., Kampert, J.B., et. al. (2005). Exercise treatment for depression: efficacy and dose response. America Journal of Preventative Medicine, 28(1), 1-8.


    18.Wiles, Nicola J., Haase, Anne M., Lawlor, Debbie A. Ness, Andy, & Lewis, Glyn. (2012). Physical activity and depression in adolescents: cross-sectional findings from the ALSPAC cohort, Social Psychiatry and Psychiatric Epidemiology, 47(7), 1023-1033.


    19.Motl, R.W., Birnbaum, A.S., Kubik, M.Y., & Dishman, R.K.. (2004). Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosomatic Medicine, 66, 336-342.


    20.Callaghan, P. (2004). Exercise: a neglected intervention in mental health care? Journal of Psychiatric and Mental Health Nursing, 11(4), 472-483.


    21.Stathopoulous G., Powers, M.B., Berry, A.C., et al. (2006). Exercise interventions for mental health: a quantitative and qualitative review. Clinical Psychology Science and Practice, 13(2), 179–193.


    22.Bowker, A. (2006). The Relationship Between Sports Participation and Self-Esteem During Early Adolescence. Canadian Journal of Behavioural Science-Revue Canadienne Des Sciences Du Comportement, 38 (3), 214-229.


    23.Haugen, T., Safvenbom, R., & Ommundsen, Y. (2013). Sport Participation and Loneliness in Adolescents: The Mediating Role of Perceived Social Competence. Current Psychology, 32, 203-216.


    24.Dishman, R.K., Hales, D.P., Pfeiffer, K.A., Felton, G., Saunders, R., Ward, D.S., Dowda, M., & Pate, R.R. (2006). Physical self-concept and self-esteem mediate cross-sectional relations of physical activity and sport participation with depression symptoms among adolescent girls. Health Psychology, 25(3), 396-407.


    25.Campbell, A., & Hausenblas, Heather A. (2009). Effects of Exercise Interventions on Body Image: A Meta-analysis. Journal of Health Psychology, 14(6), 780-793.


    26.Page, R.M., Frey, J., Talbert, R., & Falk, C. (1992). Children’s feelings of loneliness and social dissatisfaction-relationship to measures of physical-fitness and activity, Journal of Teaching in Physical Education, 11(3), 211-219.


    27.Findlay, Leanne C., & Coplan, Robert J. (2008). Come out and Play: Shyness in Childhood and the Benefits of Organized Sports Participation, Canadian Journal of Behavioural Science-Revue Canadienne Des Sciences du Comportement, 40 (3), 153-161.


    28.Miller, S.R., & Coll, E. (2007). From social withdrawal to social confidence: Evidence for possible pathways. Current Psychology, 26(2), 86-101.


    29.Burton, D., Weinberg, R. Yukelson, D. &Weigand, D. (1998). The goal effectiveness paradox in sport: Examining the goal practices of collegiate athletes. The Sport Psychologist, 12, 404-418
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