Perspectives on implementing HIIT interventions for service users in inpatient mental health settings: A qualitative study investigating patient, carer and staff attitudes

Background: High intensity interval training (HIIT) may have beneficial effects among people living with severe mental illness (SMI), however there remains an absence of information on attitudes of key stakeholders (e.g. family carers, healthcare professionals) towards offering HIIT interventions in psychiatric inpatient settings. This study sought to qualitatively investigate, in inpatients with SMI, carer and staff groups, perspectives on implementing HIIT interventions for patient groups in inpatient settings. Methods: Seven focus groups and one individual interview were conducted. These included three focus groups held with inpatients with SMI (n=13), two held with carers (n=15), and two held with healthcare professionals working in inpatient settings (n=11). An additional individual interview was conducted with one patient participant. Results: Two key themes emerged from the data, across all participants, that reflected the ‘Positivity’ in the application of HIIT interventions in psychiatric inpatient settings with beliefs that it would help patients feel more relaxed, build their fitness, and provide a break from the monotony of ward environments. The second theme related to ‘Implementation concerns’, that reflected subthemes about i) patient motivation, ii) patient safety and iii) practical logistical factors, including having access to the right sports clothing and staff availability. Limitations: Investigations were limited to one mental health service provider and participants might already be those with an interest in exercise-based interventions. Conclusions: HIIT interventions for SMI inpatients were perceived positively by key stakeholders. However, individual and organisational barriers to successful implementation are identified and should be addressed in advance.