Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
To examine the value added through the addition of an Exercise Physiologist (EP) to an Acute Inpatient Mental Health Service (MHAIS) and recommendations for statewide service planning.
Dates: January 2024 - December 2025
Implementation sites: Mental Health Acute Inpatient Service, West Moreton Hospital and Health Service
Partnerships: MHAIS consumers
This project was presented as a Poster at CEQ Showcase 2026 (PDF 570KB).
Aim
To conduct a comprehensive two-year evaluation of the pioneering implementation of an Exercise Physiology service in an Acute Inpatient Mental Health service and provide recommendations for statewide workforce development and service large scale adaptation.
Outcomes
- Queensland’s first permanently funded fulltime Exercise Physiologist in an acute inpatient mental health service.
- 794 referrals were received and delivered 2544 occasions of service which included a mixture of individual and group-based service delivery.
- 416% increase in exercise and physical activity service provision compared to two years prior.
- MHAIS consumers experience high prevalence of multimorbidity with 57.5% and 77.5% having a physical health and Psychiatric comorbidity respectively.
- Combine average self-reported pre and post session mental wellbeing rating (/10) was 6.4
- 8.2 respectively with individual Exercise Physiology service delivery indicating greater benefits of 5.9-8.9.
- Feedback from MHAIS consumers and staff indicate EP services are high value and essential.
Background
Acute Inpatient Mental Health services (AIMHSs) deliver vital assessment and therapeutic services for consumers experiencing an acute deterioration in their mental state. The opening of the Mental Health Acute Inpatient Service (MHAIS) in late 2023 incorporated many innovations to significantly improve consumer access to evidence based and person-centred therapeutic services. This included pioneering the integration of an Accredited Exercise Physiologist (AEP) within an AIMHS mental health multi-disciplinary team. Whilst this represented a first for Queensland, the integration of AEPs into AIMHS in other states have been demonstrated to be feasible and efficacious (Furzer et al. 2021; Wright K et al. 2024). AEPs are university-qualified allied health professionals that provide evidence-based exercise, physical activity and behavioural interventions for people experiencing complex physical and mental health conditions (Lederman et al. 2016). Exercise and physical activity interventions have been demonstrated to significantly improve mental health outcomes in transdiagnostic AIMHS consumers (Martland et al. 2023) and across mental health service settings (Lederman et al. 2017). For common AIMHS psychiatric presentations such as psychotic disorders like schizophrenia (Suetani et al. 2026), depressive disorders (Clegg et al. 2026), substance use disorders (Wang et al. 2025) and traumatic stress disorders (Rosenbaum et al. 2015) exercise and physical activity interventions have demonstrated to be effective in improving mental and physical health outcomes.
Research widely reports that implementing exercise and physical activity interventions in AIMHSs can be challenging due to barriers such as physical health conditions, low self-efficacy and the lack of knowledgeable, confident and appropriately trained staff to facilitate these interventions for consumers (McKenna et al. 2024). AEPs are experts in implementing exercise and physical activity interventions and reducing barriers to support consumers to engage in exercise and physical activities that can be highly supportive of their mental health recovery journey. Supporting increased engagement in physical activities for AIMHS consumers is critical as increased physical activity is not only associated with reduced risk of suicide ideation (Vancampfort et al. 2018) but also reduced risk of future use of AIMHS (Korge & Nunan. 2018).
The physical health of people living with serious mental illness (SMI) positively has increasingly become a key focus for mental health services. Physical health conditions are attributable to ~80% of early mortality (Lawrence et al. 2013) and the significant 15-25 year life
expectancy gap that people living with SMI experience (Calder et al. 2022). To address this, global advocacy and research bodies call for the integration of physical health trained health professions (Firth et al. 2019) such as AEPs into mental health services to implement evidence-based physical health and lifestyle interventions that are effective and tailored to mental health service consumers (Teasdale et al. 2025). With increased recognition of AEPs in mental health services, 2025 saw the inclusion of two AEPs into the West Moreton Allied Health in Mental Health New Graduate Program (NGP). MHAIS has started facilitating Exercise Physiology (EP) student placements and will host a First Nations EP Cadet into MHAIS in 2026.
Methods
The primary aim of EP service was to provide individual and group-based clinical Exercise Physiology and supportive therapeutic interventions that assist in a consumers mental health recovery and manage physical health conditions that might be negatively impacting their mental health. The secondary service aim was to facilitate safe and low-barrier access to the gym for consumers to engage in supervised exercise that fosters consumer’s self-efficacy towards ongoing physical activity engagement during their admission and after their discharge. The AEPs managed and developed the procedures that ensured safe consumer access to the onsite gym space which includes cardiorespiratory, resistance, assessment, and mobility support equipment. The gym space also utilises a multi-media system, dimmable lighting, and an aroma demister to assist with adapting the gym environment to suit the sensory needs of consumers. To further support increased gym-access for consumers, the AEPs developed operational procedures and staff training to support non-AEP staff to supervise scope-appropriate physical activities in the gym space.
The AEPs offered a mixture of individual and group-based EP services. Individual EP services were adapted to the needs of each consumer and intervention planning was guided by completing comprehensive and person-centred EP assessments. Individual EP interventions
included, clinical exercise prescription, exercise supervision, physical health and behaviour change interventions, behavioural activation, psychoeducation and mindfulness-based interventions. Four primary group-based EP services were developed and facilitated
including a relaxing mindful movement, seated exercise, mixed aerobic and resistance exercise and a high-intensity anaerobic sexercise group intervention. Whilst most groups were delivered in the MHAIS gym space, groups were adapted by the AEPS to be delivered
on the ward (including the high-dependency unit) with minimal equipment requirements to increase accessibility and consumer engagement.
Where clinically indicated, physical health and physical functioning measures were tracked to assess intervention effectiveness.
AEPs also assessed the mental wellbeing of consumers before and after EP interventions to guide mindful reflection on the emotional and psychological benefits of exercise and physical activity participation. EP service referrals were received from Psychiatry and Medical, Nursing, Allied Health, Lived Experience staff and consumers were encouraged to refer themselves. Consumers from all MHAIS wards and the Hospital in the home (HiTH) team were able to be referred to the EP service. Referrals were triaged in relation to urgency and clinical complexity to determine recommendations for service options for and prioritisation of each referral. Information regarding the consumers pharmacology, physical and mental health history was examined to assess potential exercise-related and behavioural risk factors to guide assessment and intervention planning. Consumer service engagement was tracked based off the number of engagements with the AEPs and the total duration of service provision provided to consumers was captured from the Consumer integrated Mental Health and Addictions (CIMHA) portal. The review included the comprehensive examination and analysis of the MHAIS EP services referral demographics, service provision data, therapeutic outcomes, MHAIS staff feedback and consumer feedback collected from January 2024 to December 2025. Analysis informed recommendations in relation to acute mental healthcare workforce development and service planning.
Discussion
MHAIS has demonstrated statewide leadership and innovation through the integration of an AEP into the MHAIS model of care which has expanded consumer access to evidence-based and recovery-orientated therapeutic services. The MHAIS EP service has demonstrated to be in high demand and valued by consumers and MHAIS staff. Feedback supports that AEPs provide assessments and interventions that are adaptable to meet the dynamic needs of MHAIS consumers and have meaningfully impacted the recovery journeys of MHAIS consumers since its implementation. In comparison to existing literature evaluating EP services in AIMHSs (Furzer et al. 2021; Wright K et al. 2024), the MHAIS EP service has received significantly more referrals and been able to deliver significantly more occasions of service. This strongly suggests that the MHAIS EP service provides services that are accessible, versatile and meaningful to MHAIS consumers. In line with research indicating that exercise interventions are safe for people living with SMI (Martland et al. 2023), there have been zero serious adverse medical or behavioural escalation events during exercise sessions facilitated by AEPs and staff that have been appropriately orientated by an AEP. AEP supervision, oversight and appropriate risk screening procedures have been critical to achieving this outcome whilst also maintaining service
accessibility. Staff and consumer involvement in the development of EP services were vital to increase service accessibility for consumers and ensure EP services worked seamlessly within MHAISs daily operations. Investment in a dedicated environment for exercise such as the MHAIS gym has been vital to increase engagement and ability to facilitate a wide variety of exercise and physical activity interventions for consumers.
Care should be placed not just into exercise equipment acquisition but also the ability to adjust the sensory experience (light, sound, smell) of a gym environment to meet the diverse and dynamic sensory needs of AIMHS consumers. The AEPs also facilitated regular exercise and physical activity services on the wards with minimal equipment requirements which increased service accessibility, reduced logistical barriers and helped navigate consumer hesitancy regarding participation if they didn’t feel comfortable within a gym environment. The MHAIS EP service has demonstrated that AEPs should be integrated as a core service provider into existing and service planning for new AIMHSs as they provide safe, effective and highly valuable therapeutic services for AIMHS consumers. The MHAIS EP model of service is replicable for other AIMHSs with the integration of an AEP into the Cairns Adult Acute Mental Health Inpatient Service in January 2025 being successfully modelled off the MHAIS EP model of service. AEP integration into other Queensland AIMHSs has since expanded into Wide Bay HHS, Darling Downs HHS and the three AIMHSs in Metro South HHS. AEPs offer a unique opportunity for AIMHS to demonstrate innovation and expand workforce capability and service delivery for consumers. Inclusion of AEPs into Allied Health New graduate programs, facilitation of EP student placements and utilisation of HP1 EP cadetships are critical to support the growing role of AEPs within AIMHSs.
References
References are available on request.
Key contact
Matthew Wall
Senior Exercise Physiologist
Mental Health Acute Inpatient Service
West Moreton Hospital and Health Service