The paper, delivered in collaboration with King’s College London and published in JAMA Psychiatry, brings together global evidence to show that structured physical activity significantly improves both mental and physical health outcomes in people with schizophrenia, major depressive disorder, and bipolar disorder.
Adults with severe mental illness die 10 to 20 years earlier than the general population, largely due to preventable cardiometabolic diseases such as heart disease and diabetes.
The review highlights low physical activity and prolonged sedentary behaviour as major contributors to this mortality gap.
People with schizophrenia spend nearly 10 hours per day sedentary, and fewer than 20% meet recommended activity guidelines. Individuals with depression or bipolar disorder are 30–50% less likely to achieve recommended activity levels compared with the general population.
Dr Florence Kinnafick, Reader in Physical Activity and Mental Health, and Loughborough University’s project lead, explained: “This is an important call to action for translating the existing and convincing evidence into practice.
“People with severe mental illness experience some of the greatest physical health inequalities, largely due to lifestyle factors such as low physical activity and high levels of sedentary behaviour. Embedding physical activity into routine psychiatric care is the logical and necessary next step.”
Dr Brendon Stubbs, lead author from King’s College London, said: "The evidence is clear, physical activity is a safe, effective and scalable therapy for people with severe mental illness. We would not accept psychiatric treatment that did not offer medication or psychotherapy. It is time to apply the same standard to physical activity as a part of treatment for mental illness."
Researchers reviewed more than 12,000 participants who had been clinically diagnosed with mental health illness with key findings showing that structured exercise produces:
- Moderate-to-large reductions in depressive symptoms
- Improvements in psychotic symptoms, including negative symptoms
- Enhanced cognitive functioning
- Better quality of life
- Significant cardiometabolic benefits
In some cases, exercising in people diagnosed with depression was comparable to antidepressant medications.
The authors recommend aiming for at least 150 minutes per week of moderate activity, including two strength-training sessions. Physical activity could also be personalised to include walking, cycling, yoga, and Pilates.
The review also highlights reducing mentally passive sedentary behaviours, such as watching television, and replacing these activities with light movement or cognitive engagement challenges such as puzzles and quizzes.
The study was completed alongside colleagues from Kings College London, Medical University of Vienna, Deakin University, University of Queensland, University of New South Wales, Federal University of Santa Maria, Federal University of Rio de Janeiro, Universidad Autónoma de Chile, and the University of Manchester.