Exercise is medicine for mental health in military veterans: a qualitative commentary

Abstract

Different approaches to treatment for mental health problems in military veterans continue to attract research attention. In addition to the NICE-approved treatments for post-traumatic stress disorder such as trauma-focused cognitive behavioural therapy and eye-movement desensitisation and reprocessing, a number of novel and innovative approaches have recently been developed. One such approach is encapsulated under the emerging paradigm of ‘exercise as/is medicine’. Following recent calls to strengthen the evidence base for new and emerging mental health treatments for veterans, this paper presents a commentary on current evidence in support of ‘exercise as medicine’ derived from qualitative research studies. It is concluded that qualitative research has made a significant contribution to the emerging evidence base for exercise-based interventions. This evidence base can be used to inform current debates about quality assurance in the area of veterans’ mental health-care and to underpin quality provision for service users. Qualitative research also has a significant future contribution to make towards improving the evaluation of novel treatment approaches, generating more impactful research and increasing the applicability of research findings in ‘exercise as/is medicine’. The paper closes with some critical reflections on the role of exercise-based interventions as a means of helping veterans improve their mental health.

Keywords:

• Exercise
• medicine
• veterans
• mental health
• PTSD
• qualitative research

Notes

1. We use the term ‘veterans’ (as per popular understandings of the term) to refer to former service personnel, whilst also recognising that many currently serving military personnel utilise exercise as a means of dealing with mental health concerns. (For a technical discussion of the term ‘veteran’ and its different meanings and limitations, see Burdett et al. 2012 and Dandeker et al. 2006.)

2. Whilst important in its own right, this research will not be reviewed within this paper which focuses on exercise as a form of treatment for mental health problems such as PTSD.

3. The contact armed forces website (http://www.contactarmedforces.org.uk/) also endorses these principles through a network of charities, academic institutions, Ministry of Defence and National Health Service.

4. https://www.cobseo.org.uk/about-us/.

5. Given the focus of this article, our commentary is focused on evaluation of exercise-based approaches, but it is worth noting that our comments apply equally well to evaluations of other novel interventions or approaches.

6. It is worth noting that qualitative research might be useful for countering a focus on pathology, for example by capturing the full range of emotions and benefits that may arise from taking part in exercise.

7. For further critique on the instrumental rationale of ‘exercise as medicine’, see Neville (2013).