Fusing Fitness With Mental Health Treatment in Supportive Housing and Related Settings

The New Social Worker magazine published a piece I wrote last summer shortly after earning my MSW in their Summer 2017 issue [Available for Download here].

Here is an excerpt: 

Four Attributes of an Effective Program

During the past year, I have identified four core attributes of the programs that effectively foster an atmosphere of health within the community and that enable individuals to attain their physical health, mental health, and recovery goals.

First, the programs provide preventive, holistic healthcare by addressing chronic health problems proactively—a key to improving quality of life and reducing emergency room visits.

Second, the programs fuse fitness with mental health in a setting that contrasts the traditional seated, face-to-face counseling experience. The transference experience is quite different when a client and worker chat while pedaling stationary bicycles next to one another. Individuals often seem more comfortable talking while exercising and frequently share information with me that they have not yet talked about with their social workers or case managers. For example, a client recently disclosed to me how his family dynamics influence his substance use while he rested between sets of 10 push-ups. I am able to discuss such experiences with clients and encourage them to share these issues with their social workers.

Third, clinical evidence indicates that exercise serves as an effective tool in the substance abuse intervention toolkit by affecting the brain’s reward system and serving as a positive, non-drug reinforcer (Smith & Lynch, 2012). In a practical sense, exercise provides a structured alternative to substance use during the period in which one prepares for and engages in it.

Fourth, exercise programs build community among staff and tenants and promote egalitarianism in the client-worker relationship. Typical barriers disintegrate when a case manager and client try to complete one last squat or shoulder press together.

2017 National Health Care for the Homeless Coalition Conference

In June, my supervisor and I will discuss our work integrating fitness and health counseling services at supportive housing and affordable housing sites at the NHCHC Conference and Policy Symposium in Washington, D.C. We have titled our presentation Move Toward Wellness: Integrating access to exercise in programs serving individuals impacted by homelessness.

People who have experienced homelessness die, on average, 15-20 years earlier than the general population. Individuals with severe mental illness–a significant proportion of the homeless population– die, on average, 25 years earlier than the general population. In order to most effectively implement preventive health programs for low-income individuals and people who have experienced or currently experience homelessness, we need to bring the programs to them - the places they live and frequent. 

In social work, we often say we need to "meet people where they're at." Usually, it's metaphorical. For example, if a woman uses heroin, we need to consider the physical, mental and social factors that influence her getting high and support her without expecting her to immediately cease abusing drugs. We also can't expect individuals from diverse backgrounds and complex experiences to conform to our standards of behavior and ways of thinking. 

But in the case of preventive health strategies, like fitness programs and health counseling, we need to literally meet people where they're at by doing the work in their buildings' community rooms, lobbies, patios or dining rooms. 

The presentation will share experiences and ideas for implementing such programs at sites with significant resources (like NYC's HIV/Aids Services Administration-funded supportive housing sites, which tend to receive more funding than most other supportive housing facilities) as well as the typical mixed-use supportive/affordable housing site that tends to operate with sparse funding and few frills. 

Come check us out if you plan to attend the conference in late-June.