“We would urge organisations to give their staff mental health awareness training and, when dealing with people who have mental health issues, to just be human and real, and not scared of people showing their feelings. They don’t have to be experts to make a difference, but need to be aware that people with mental health issues may initially need more support, such as being greeted at the door and shown around the first time.

There are some barriers to this group taking part in exercise. One is cost, as some find their mental health makes it difficult to work. Another can be finding the motivation to exercise.

It’s important to remember everyone will need a different approach: group exercise is a good way of connecting with people, but for people living with conditions such as social anxiety, this might be off-putting. MIND encourages outdoor exercise such as walking, running and outdoor group exercise, as research shows exercise in nature offers benefits for mental wellbeing. We run organised cycle groups, Bike Minded, as well as an outdoor physical exercise programme, Ecominds.

Local MIND branches welcome approaches from operators about running partnership programmes, as well as any publicity about the benefits of exercise for mental wellbeing.”

“I don’t think the fitness sector is sufficiently equipped to deal with people who turn to exercise to help with mental health issues. There isn’t a broad enough understanding of the subject and instructors don’t have the necessary skills, especially soft skills.

Maturity and experience is needed to work with people suffering with mental health issues, and all instructors should have some mental awareness training as a minimum. Ideally, each club would have a specialist who is Level 4 qualified in mental health. This is essential if the club is going to be dealing with people who have more acute issues.

With one in four people suffering from mental health issues, this is a large audience – but they are hard to market to, firstly because of the stigma and secondly because someone suffering from depression is very hard to engage with. The best route is therefore via GP referral or mental health charities. On a broader level, operators could start marketing the benefits of exercise for mental health, getting away from the weight loss aspect and moving towards the wellbeing perspective.

Rather than leading to mental breakdown, depression can often lead to a spiritual breakthrough, so practices like yoga and tai chi often appeal to those with mental health issues.”

“Mental health problems are very common, so all health club operators will already be catering for people with these issues. However, it can increase staff confidence to offer some basic training and education in this area.

When engaging with customers, talk about the holistic benefits of exercise and how it can lift the mood and keep you steady. Don’t present exercise as a standalone treatment for depression, but as a useful tool for managing mood and energy.

If you want to run specifically targeted programmes, develop partnerships with local mental health services. As well as directing clients to you, they can offer vital support, education and mentoring. Be clear that you are offering exercise, not therapy. People may well want to talk about their problems, but there should be no pressure to do this. Confidentiality is very important: be respectful and don’t gossip afterwards. It’s important to make sessions fun and low pressure. And connect with the individual, treating them as you would anyone else.

We organise progressive running programmes for women with mental health problems (see p56). Feedback shows people are initially wary about who else will be on the course and are relieved to find it’s just normal people, like them.”

“When working with this demographic, the exercise is the easy part. It’s the soft skills that are all-important: empathy and active listening. This is where more staff training is needed. The Wright Foundation offers a Level 4 Mental Health course for those wanting to specialise in this area.

An umbrella scheme won’t work – it needs to be patient-centred. Support and flexibility are the two main things we focus on in a programme I run in Wales. We offer a whole range of activities, because different people like different things.

Most mental health exercise schemes are around 15 weeks, but ours is 45 weeks. This means that, even if people relapse – which always happens – there’s time to get them back. We usually find that, by week 25, people are able to operate in the mainstream, but we’re there if they need us. As we’re trying to avoid stigma, we don’t label the programme.

Our clients are all referred by GPs or psychologists. The first thing we do is get them into a positive pattern. If I can just get them to a centre twice a week in the first month, I’m happy. Once they’ve formed the pattern, the exercise becomes more important. There are no real rules – it’s all about individuals’ needs: give them what they need for as long as they need it.”