ORIGINAL PAPER Focus on Exercise: Client and Clinician Perspectives on Exercise in Individuals with Serious Mental Illness Julia Browne 1 • Paul Mihas 2 • David L. Penn 1,3 Received: 16 January 2015 / Accepted: 20 May 2015 / Published online: 26 May 2015 Ó Springer Science+Business Media New York 2015 Abstract The health benefits of exercise are well estab- lished, yet individuals with serious mental illness (SMI) have a shorter life expectancy due in large part to physical health complications associated with poor diet and lack of exercise. There is a paucity of research examining exercise in this population with the majority of studies having ex- amined interventions with limited feasibility and sustain- ability. Before developing an intervention, a thorough exploration of client and clinician perspectives on exercise and its associated barriers is warranted. Twelve clients and fourteen clinicians participated in focus groups aimed at examining exercise, barriers, incentives, and attitudes about walking groups. Results indicated that clients and clinicians identified walking as the primary form of exer- cise, yet barriers impeded consistent participation. Distinct themes arose between groups; however, both clients and clinicians reported interest in a combination group/pe- dometer based walking program for individuals with SMI. Future research should consider examining walking pro- grams for this population. Keywords Serious mental illness Á Exercise Á Health Á Walking Á Focus groups Introduction The impact of exercise on physical health and psychological well being are well established. Exercise reduces the risk of obesity, sedentary lifestyle, and the development of chronic illnesses such as high blood pressure, diabetes, and heart disease (Bassuk and Manson 2005; Richardson et al. 2005). Moreover, exercise enhances cognition and self-efficacy, and reduces symptoms of anxiety and depression (Brosse et al. 2002; Lawlor and Hopker 2001; McAuley et al. 2013; Smith et al. 2010; Utschig et al. 2013). Despite these known benefits, over 60 million U.S. adults are overweight and approximately 30 % of the U.S. adult population does not engage in regular physical activity (Brosse et al. 2002). Thus, there is a critical discrepancy between the known value of exercise and the current levels of physical activity in the population. Although this discrepancy has been exten- sively examined in the general population, there has been far less attention given to populations that would benefit most from increasing physical activity, like those with serious mental illnesses. Individuals with serious mental illness (SMI) often die prematurely from preventable causes such as poor diet, lack of exercise, and high rates of substance use and smoking (Connolly and Kelly 2005). They are also more likely to be sedentary than the general population. Seden- tary lifestyle combined with weight gain from antipsy- chotic medication may contribute to higher rates of obesity and subsequent development of type II diabetes in this population (Connolly and Kelly 2005). Based on imminent health issues and unhealthy lifestyle choices observed in individuals with SMI, the potential benefits of increased physical exercise are substantial. The few studies examining the effects of exercise on physical and mental health in individuals with SMI have & Julia Browne jbrowne@unc.edu 1 Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 2 Odum Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 3 Australian Catholic University, Melbourne, VIC, Australia 123 Community Ment Health J (2016) 52:387–394 DOI 10.1007/s10597-015-9896-y