Dr. Guy Faulkner is a professor of kinesiology at UBC who has long been fascinated by the link between physical activity and mental health. He is the founding editor of the academic journal Mental Health and Physical Activity, and often presents his findings to conferences worldwide. Recently he was a keynote speaker at our International Physical Literacy Conference in Winnipeg. For this newsletter he chatted with storyteller Will Johnson about the nuances of his work, and the main takeaways for those aspiring to an active, healthy lifestyle.
#1. On some level, we all understand that being able to move our bodies is beneficial to our mental health, but we've long lacked the scientific backing to make these claims. From the sounds of what I've learned about physical literacy, the relationship is way more profound and nuanced than we understand. Now that you've been studying this closely for years, what are you main takeaways when it comes to examining mental health outcomes from active living?
Over the last 10 years I think there has been an explosion of interest in the relationship between physical activity and mental health. There is even now an academic journal dedicated to this topic. The result of this developing research is that we have a convincing evidence base that supports the existence of a relationship between physical activity and a number of dimensions of mental health. This relationship may be critical. Mental health outcomes are important in their own right but they may also be critical in motivating people to stay physically active. Without regular participation, mental and physical benefits will not accumulate.
Of course that relationship is complex: what do we even mean by physical activity? What do we mean by mental health? In terms of physical activity we may be interested in the type of activity – playing a game of badminton, say, or going for a jog. What about the intensity of activity or where you are doing it? Are we talking about the effects of a short bout of brisk walking or looking at the long-term effects of exercising twice a week for 10 weeks? So we can consider many dimensions of physical activity. Similarly, when we think of mental health we might be interested in how physical activity prevents poor mental health, how it promotes brain health, in how it could be used as a treatment for a mental health condition or even just how it may induce happiness in us all.
Different doses of physical activity might be needed for different outcomes. Another important aspect is the mechanistic pathways through which we think physical activity promotes mental health. Is physical activity a distraction? Does it change how we feel about ourselves physically, which impacts our self-esteem? Or are there neurobiological mechanisms – does physical activity change brain plasticity for example?
The literature certainly indicates that a number of different doses of physical activity are effective in various populations for a wide range of mental health indicators. Therefore, the actual dosage of physical activity (frequency, intensity, and duration) required to produce beneficial results is not clear. However, the most effective dose of physical activity is likely the one that individuals enjoy and find pleasant. Several mechanisms have been proposed to underlie the changes in mental health. However, the exact mechanism for specific mental health benefits is still not clear. The critical challenge remains in helping people get active and stay active. Interventions need to be developed that are acceptable to people across the lifespan. Little is known about how much and what type of support is needed, and by whom, to facilitate changes in physical activity of sufficient amount to improve mental health. Instead of targeting activities that only account for 2% of our day (e.g., moderate-to-vigorous physical activity), we may also need to consider the contributions of light-intensity physical activity that can potentially displace high levels of sedentary time and may be beneficial for mental health.
Answering these questions should be the primary focus of future research in advancing the field of physical activity and mental health.
#2. Do you have any compelling examples of a mental health outcome someone experienced related to physical literacy?
One of my favourite studies I conducted was an evaluation of a football (soccer) team in England that was developed for young men with schizophrenia (Carter-Morris & Faulkner, 2003). The onset of mental health problems such as schizophrenia may lead to some individuals dropping out of, or not being able to access leisure opportunities in the community. I was interested in the role that sport could play in helping individuals reengage with community services, and return to an enjoyable yet also personally salient aspect of one’s former identity, before being ill. And what is of interest to many young men in England? Football!
A component of physical literacy is social participation and it was very evident that being involved in the football project had a positive effect on the lives of participants by promoting a sense of normalisation and offering safe opportunities for social interaction where one’s diagnosis was superfluous. I’ll never forget speaking to one participant who described to me how that when he’s on the pitch playing he’s a footballer and not a ‘schizophrenic’ and all that label implies. That’s really stuck with me. And it also highlights how the process of being physically active is important, it’s more than just being physically active.
Carter-Morris, P. & Faulkner, G. (2003). A football project for service users: the role of football in reducing social exclusion. Journal of Mental Health Promotion, 2, 24-30.
#3. How has your understanding of this issue evolved over the years? Is there anything you used to believe that has since been proved wrong?
Given the complexity of the relationship between physical activity and mental health I think I’ve moved more to thinking about how it is the process of being physically active that is critical. Issues of energy expenditure for example are secondary to the context in which physical activity is happening. So changing our language from there being ‘a positive association between physical activity and mental health’ to the more provisional ‘there can be a positive association under conducive circumstances’. For me this is where physical literacy can come in nicely – in contexts where physical literacy is being supported – conditions that promote enjoyment, mastery, social interactions for example– then we more reliably see mental health benefits. This is not to deny that there may be neurobiological mechanisms operating for some people in certain circumstances – but evidence doesn’t suggest such mechanisms need to be operating for people to report mental health benefits. So I would now say that there are ‘positive associations between physical activity and mental health under conducive circumstances that are supporting the development of physical literacy’
By extension: physical literacy promotion is mental health promotion!
#4. What is the most incendiary, surprising research discovery you've experienced during your career?
I certainly wish I had some incendiary discoveries in my career! Maybe they are still to come. I don’t necessarily think the results are surprising but I have done some work highlighting that youth sport participation is not always associated with positive health outcomes. A recent study examined team sport participation prevalence and longitudinal associations with health-related behaviours among Canadian adolescent girls (Lau et al., 2019). Girls who participated in sport were more likely to be more frequent cannabis users and binge drinkers compared to girls who did not participate in sport at all. Of course it’s not sport itself that leads to these health behaviours but the social context and the norms associated with team sports in particular. We do want to keep more girls in sport but we also need to consider how to prevent harmful substance use.
Lau, E., Riazi, N., Qian, W., Leatherdale, S., & Faulkner, G. (2019). Protective or risky? The longitudinal association of team sports participation and health-related behaviours in Canadian adolescent girls. Canadian Journal of Public Health, doi: 10.17269/s41997-019-00221-4. [Epub ahead of print]
#5. Can you share some stories about your own mental health, and its relationship to physical literacy? Have you ever had an ah-ha moment that led you to better health? What have some of your roadblocks been?
Mental health concerns us all and like most people I have had my ups and downs usually in response to life events. When things are going well I’m more active and I do struggle to maintain activity when things are not. So it does provide a reality check – despite what we know to be all the benefits of physical activity we still need to provide support and supportive environments for people to initiate and maintain participation in physical activity in ways that build competence, motivation and enjoyment.