Physical activity and mental health: a randomised controlled trial examining martial arts training as a psychosocial intervention in schools
The mental health of adolescents in Australia is frequently described as being in crisis. Adolescents report numerous barriers impeding their access to mental health care including poor mental health literacy, fear of being stigmatised, a preference for self-management and the accessibility of treatment (Lawrence et al., 2015). The large treatment gap regarding adolescent mental health is very concerning, especially in view of significant Australian Government funding (Australian Government National Mental Health Commission, 2016). Given the importance of early intervention to minimise the effects of mental illness across the lifespan (Australian Government Department of Health, 2011), it is critical to establish accessible and empirically based treatments that engage adolescent populations. The idea that physical activity and martial arts training promotes mental health is not new. However, research examining both topics requires greater rigour (Faulkner & Taylor, 2005; Vertonghen & Theeboom, 2010). Consequently, the efficacy of these approaches to address mental health is often questioned. This study aimed to investigate how using physical activity to deliver a psychosocial intervention can improve adolescent mental health, specifically using martial arts training as a unique physical activity that may develop psychological strengths. As school systems provide natural and accessible ways to deliver mental health interventions to adolescents (Werner-Seidler et al., 2017) with the potential to reduce existing barriers to treatment (Sanchez et al., 2018), this study was delivered to Year 7 and 8 students in secondary schools in New South Wales, Australia. The study entailed a 10-week martial arts-based intervention that also incorporated a psychoeducational component. The intervention was assessed using standardised psychometric instruments under randomised-controlled trial conditions. The primary intervention outcomes were resilience and self-efficacy. Univariate and repeated measures analysis of variance showed that the intervention improved participants’ resilience and self-efficacy. Both outcomes improved following the intervention, however univariate analysis indicated the strongest outcome was measured for resilience, while repeated measures analysis found the strongest outcome was observed for self-efficacy. Regression analysis showed that most demographic factors did not affect the study’s outcome variables, the exception being socio-educational status which accounted for 10% to 14% of the observed variance for resilience outcomes and 7% to 10% of the observed variance for self-efficacy outcomes. Participants reported strong post-program intentions to continue martial arts training which suggested the intervention successfully engaged participants and had sufficient fidelity. The study provided additional evidence that physical activity, in this case through martial arts training, improves the mental health outcomes associated with psychological strengths. The intervention has the potential to fill a mental health treatment gap through delivery as a school-based strategy and engaging youth with a psychosocial intervention using physical activity. Given the importance of early intervention and the high frequency of youth not accessing mental health support, this research demonstrates a novel method for engaging adolescents and an efficacious approach for improving mental health outcomes.